A critically-ill combat casualty should be transported by an Advanced Critical Care Evacuation Team (ACCET) if certain conditions are present.

Indications for ACCET transport: one or more of the following findings


Pulmonary disease:

(1) PaO2 to FIO2 ratio < 100

(2) inhalation injury

(3) acute pulmonary embolism with cardiac arrest or persistent hypoxemia

(4) bronchopleural fistula, pneumonectomy or other anatomic derangement



(1) FIO2 > 0.7 on lung protective ventilation

(2) pH < 7.25 on lung protective ventilation

(3) PEEP > 15 cm water AND plateau pressure (PPLAT) > 30 cm water

(4) severe brain injury AND PaCO2 > 40 mm Hg on a transport ventilator

(5) use of advanced ventilator modes (APRV, other)


Organ failure:

(1) cardiogenic shock refractory to maximal medical therapy

(2) multi-organ failure (MOF)

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