Commander BATSUB has asked for the attached to be circulated so that you are all aware of the protocols in respect to FAME Aide.
A Forward Aero Medical Evacuation (FAME) service is provided by the British Army Training Support Unit Belize (BATSUB). It is operated from Price Barracks, Ladyville, by 25 Flight Army Air Corps, with a medical team from BATSUB1. Its primary role is to evacuate British soldiers who are injured or become unwell during jungle training in Belize. The Team also provides limited FAME cover for the whole of Belize when no other means of transporting the patient is available. The Team will respond routinely unless the service has been stood down, or cannot respond because of the weather, technical or other problems.
FAME requests are to be made by the senior clinician treating the patient directly to the Senior Medical Officer (SMO) BATSUB. Individuals remote from medical facilities may contact SMO BATSUB directly. The decision to provide FAME will be made by SMO BATSUB on clinical grounds – no other individual may authorize FAME. Relevant Belizean clinicians already have the BATSUB SMO’s contact details.
In the event of the SMO deciding that the patient is not suitable for FAME, no contact is to be made to any other individual to request FAME, including the Belize Defence Force, 25 Flight, Commander BATSUB or the British High Commission. If the patient’s condition deteriorates, the senior clinician treating the patient may contact SMO BATSUB again to review the initial request FAME.
FAME may be no quicker than transferring the patient by road because of the time taken to get the aircraft into the air (one hour at night, 30 minutes during the day), the time taken to fly to the patient, and the flight to the destination. FAME will only deploy when the Belize Emergency Response Team (BERT) is unable to transport the patient. During the day BERT can arrange for patients to be transferred by the Wings of Hope aero medical service. Patients are to make best use of the scheduled water ferries and flights from the various Cayes to access definitive care whenever possible. The BATSUB aircraft is not to be viewed as a ‘free ride’ and as such, requests for FAME may well be denied.
FAME is not appropriate if the patient’s clinical condition is unlikely to deteriorate during a longer road transfer, or if investigations or definitive treatment will not take place any sooner if the patient is transferred by FAME. Noise, vibration, the confined space in the aircraft and low light levels make the assessment of a patient’s condition difficult during flight, and severely limit the treatment that can be provided. Road transport may therefore be the best option.
FAME is not a substitute for adequate medical insurance. SMO BATSUB’s responsibility for the patient ends once the patient reaches the destination medical facility or ambulance crew. SMO BATSUB does not arrange admission or any ongoing treatment at the destination or thereafter.
The aircraft may be diverted in-flight to collect injured exercising troops, who will always take priority.
The following patients are unsuitable for FAME:
-Violent or uncooperative or severely intoxicated patients and those afraid of flying.
-Handcuffed patients (for safety reasons in the event of an accident).
-Patients with certain chest injuries; ventilated patients; fitting patients and patients with cardiac dysrhythmia (heart rhythm problems).
-Patients unlikely to survive the flight.
-Patients with a skull fracture (because of air expansion).
-Decompression injuries – to be discussed with the SMO prior to any flight.