TASK FORCE III DESERT SHIELD/STORM

File: aaacf_12.txt
Page: 12
Total Pages: 273
prescription and baseline laboratory data. Occasionally a call to home base was
 required to clarify some question, but this presented no problems.
	Many individuals were deployed on prescription medications for which 
refills were unavailable on either the ATC or ATH TA. Women's health issues 
were poorly addressed in planning deployment supply packages. Birth control 
pills should be added to the ATC Table of Allowances (TA).
	There was no system to return patients to their bases after referral care. 
The Navy ships Mercy and Comfort provided excellent specialty services, but the 
ships' movements were not predictable and once the vessel was out of port, it was 
impossible to return a patient to his unit. Army helicopters were unable to pick 
up patients from the hospital ships. Although Wing interest persisted, it was 
impossible to keep track of a patient once he left a base for care. There was a low 
level of confidence in the aeromedical evacuation system, and some patients were 
sent home by regular airlift in lieu of aerevac when deemed safe to do so. Joint 
Service cooperation was variable. Cases were related in which Air Force ATH's 
refused care to Army patients. Doctor to doctor cooperation was more effective 
than system to system.
	There was almost universal need for better access to dental care. Deployed 
SME's disagreed on whether the majority of the demand was a result of poor pre-
deployment enforcement of dental standards or due to acute problems. The
dentists reported their workload consisted of large numbers of acute problems but
also that the demand for care of preexisting problems was high among ARC
personnel. Dental services were also provided to Allies.
	SME's felt they had no background to deal with dental problems.
	Squadrons deployed to Desert Shield with much higher numbers of 
individuals than predicted by exercise experience and planned for in the ATC 
Concept of Operations. Deployed bases continued to grow throughout Desert 
Shield far beyond original estimates. ATC's designed to support 300 people for 30 
days were supporting up to 1200 alone. Routine sick call medications were rapidly 
depleted. Only 4 of 17 flying wings had ATM's in place by the end of August. For 
supporting bases such as Moron, Cairo West, and Diego Garcia, the ever-
expanding role was not matched by reevaluation of medical needs. Most SME's
felt the four-man ATC manpower UTC would be adequate to support 800 deployed 
personnel at the visit rate seen during Desert Shield. Supplies should be 
increased to match that number.
	There was one case of pain-only decompression sickness reported. An A-10 
had rapid decompression at 25,000 feet. Symptoms resolved at ground 
and hyperbaric therapy was not required.
	One AWACS mission was terminated early for an in-flight attack of renal 
colic with subsequent lithotripsy of a stone.

C O M M A N D  A N D  C O N T R O L

	Response of line commanders to SME input was variable and probably 
depended heavily on the degree of rapport and credibility established before 
deployment.
	Command and control of SME s was frequently misunderstood by the 
medical command structure. Of the 18 individuals who commanded a TAC ATH, 
only 7 were experienced flight surgeons. Several SME's were required to perform 
MOD duties at the ATH. In other cases, this request was refused by squadron or 
wing commanders. Other initiatives attempted to locate ATC operations within 
the ATH impairing aircrew accessibility to their flight surgeon. Conflicts also