Preserving Our Past, Capitalizing on the Present, Embracing the Future

Nursing on the Army Burn Team

— by COL (Ret.) C. J. Moore, AN

Since 1951, Army nurses have served on the Army Burn Team, transporting critically burned combat casualties to the military’s only Burn Center at the US Army Institute of Surgical Research, in San Antonio, Texas.

The military doctrine created during the Vietnam War governs the current air evacuation system. This flight and care strategy is a series of staged intercontinental transfers. Experienced burn teams, who fly patients to the continental US, have decreased patient mortality to nearly zero.

This highly successful policy was tweaked in 2003, during second gulf conflict, when medical planners revised how to move burn patients. The policy now assigns the Air Force Critical Care Air Transport Team (CCATT) to carry burn casualties from the theater of war to Landstuhl Regional Medical Center in Germany. The Army Burn Team then flies the casualties in a C-17 for a 12½-hour nonstop flight to San Antonio. This remarkable, well-orchestrated evacuation process often allows for patients to be transferred from Iraq or Afghanistan to Germany and on to CONUS within 96 hours following wounding.1

The team members are full-time burn critical care specialists who also have air evacuation training. The group consists of a general surgeon, a critical care nurse, a licensed vocational nurse, a respiratory therapist, and a senior NCO who serves as an operations and logistics officer for the transatlantic flight. These healthcare workers must be ready to deploy within two hours of notification, 24/7/365.

MAJ Elizabeth Mann explained, “We have about four teams available with the capability to deploy within a matter of hours. We generally fly commercial to Germany and bring oxygen on board, air compressors for our special ventilators, mini IV pumps, suction machines, transport monitors, medical supplies, burn dressings and electrical power for all the equipment.”2

MAJ Elizabeth Mann in a simulation training mission on a C-17While in the air, burn nurses act as liaison between medical and operational aircrews and support personnel in order to promote patient comfort and to expedite the mission. They evaluate individual patient's in-flight needs and provide continuing nursing care from originating to destination facility. Optimal burn management requires meticulous observation for multisystem organ failure and adequate hydration. Burn nurses are wound care experts who dress wounds generally once or as needed during the flight. Moreover, “many patients require pressure monitoring while others may need intracranial drains and monitors.”3 Once the aircraft has landed, the patients are off-loaded and quickly placed in an ambulance that speeds them to the Burn Center.

Burn nurses are like all military nurses who answer the call to care for “our heroes” – those wonderful defenders of our country. They demonstrate the capability and importance of nurses’ care during time of war. Because of their compassion and dedication, many burn patients will live. They also create incredible foundation for future of the profession of nursing.
1 Evan Renz, et al., “Global War on Terrorism: Assessment, Treatment, And Evacuation Of Burn Trauma Casualties.” U.S. Army Medical Department Journal (April 1, 2005),,+treatment,+and+
evacuation+of...-a0147669348 (Accessed August 23, 2013).
2 Amy McGuire, “Critical Care Nursing in the Air,” Advance Healthcare Advance for Nurses (December 8, 2008)
3 Ibid.