It is helpful to evacuation chain personnel when casts are labeled. Such inscriptions should include the date and type of injury, the date of surgery and cast application, and a simple sketch of the bone injury. Patients should be turned during travel as ordered by the referring surgeon. Instructions for specific care enroute both at the staging area and aloft should be provided to the medical evacuation teams. Every attempt should be made to maintain urinary output above 1,500 ml per day.
Equipment is normally available aboard the aircraft to continue such treatment.
Convulsions, high fever, and respiratory distress can be expected to develop if this principle is not followed. The casualty is most likely to be hypovolemic or hypervolemic during the, first 3-4 days post injury. Homeostatic mechanisms have usually restored the circulating volume to normal after this period. Oxygenation problems at ground level will be increased at higher altitudes. If transfer must be accomplished, proper supplies for transfusions should accompany the patient with orders for the use of blood enroute.