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AAMedP-1.1

AAMedP-1.1 aeromedical evacuation

Military and civilian-contracted aeromedical crews, aircrew and national authorities who compose, train, equip and clear aeromedical evacuation missions between NATO nations

AAMedP-1.1 is NATO's standard for the terminology, patient categorisation, aircrew composition, equipment and training used to move ill or injured patients safely between NATO nations' aeromedical evacuation services.

Edition
B
Published
2020-07

What it is

What AAMedP-1.1 covers

AAMedP-1.1 is NATO's Allied Aeromedical Publication on aeromedical evacuation: the movement of ill or injured patients under medical supervision by air transport, as an integral part of their treatment. Its own aim is to standardise the terminology, procedures, training and equipment involved, so that a patient of one NATO nation can be moved safely and on time by another nation's aeromedical services. Edition B, Version 1 was promulgated in July 2020.

This is a document for those who compose, equip and run an aeromedical evacuation mission, not for a general equipment manufacturer or software supplier. It names no certification scheme and sets no contract clause for a supplier outside the narrow case where a nation contracts civilian aircraft or crew to help deliver a mission.

Categorisation and clinical selection: named, not reproduced here

Chapter 2 covers fitness for air travel and clinical selection criteria: judgements a qualified medical officer makes case by case, weighing the benefit of moving a patient against the risk of the flight. Chapter 3 then sets out priority, dependency and classification codes that tell movements staff how urgently a patient needs to move, how much in-flight medical support they need, and what space and supervision they need in the cabin. This page names that these categories and criteria exist, because they shape crew composition and aircraft choice, but it does not reproduce the clinical thresholds or category definitions themselves: they are a medical judgement, not a compliance criterion. Chapter 3 also requires each patient to be tagged with a medical record "in accordance with" STANAG 2132/AMedP-8.1, and manifests of patients on tactical or strategic missions to be prepared "in accordance with" STANAG 7213/ATP-3.3.4.1.

Aircrew, equipment and training

Chapter 4 sets how an aeromedical crew is composed and trained: crew size and skill mix scale with the number of patients carried and their dependency level, and the highest-dependency patients require crew members with intensive-care training. Crews plan equipment for the unexpected (delays, diversions, in-flight emergencies), brief patients on safety belts, harnesses, smoking rules and emergency conduct, and train and rehearse the evacuation drills each aircraft type demands.

Chapter 5 carries most of the testable, non-clinical requirements. Aeromedical aircraft stretchers and their supports must meet dimensions set "as detailed in" STANAG 2040/AMedP-2.1, restrain a patient against in-flight accelerations, and give crew enough working space around each patient; the aircraft itself must provide adequate lighting, power outlets and oxygen. All electro-medical equipment used in aeromedical evacuation "shall be tested for electromagnetic compatibility and is to be cleared by the relevant national authority for the aircraft on which it is to be used," with recommended, non-mandatory minimum specifications (alarms, displays, power supply, environmental tolerance, interface) at Annex A. Before each mission, stretcher fittings and all aeromedical equipment are checked for serviceability, patients and equipment are loaded per existing safety instructions, and communication and oxygen equipment are checked immediately before take-off. The aircraft interior and equipment need disinfection after carrying an infectious patient, and disinsection may also be required. Ground equipment, loading ramps, cooling and heating apparatus, is expected where the aircraft and climate demand it. Property exchange runs "in accordance with" STANAG 2128/AMedP-1.12, and the flight plan or a signal to the Aeromedical Evacuation Control Centre must carry a minimum set of information, including that the aircraft is on an aeromedical mission, the total number of patients, and the highest medical priority aboard, without this page reproducing what that priority scale means.

Chapter 6 lists the lecture and demonstration curriculum an aeromedical crew works through: the history and organisation of aeromedical evacuation, aircraft types and configurations, documentation practice, aviation physiology, survival and ditching drills, in-flight emergency procedures, further supervised flying experience, and recurring instruction on safety, crew resource management and aircrew restrictions such as duty time, alcohol and medication.

Contaminated and highly infectious casualties

Chapter 7 requires a risk assessment before a chemically contaminated or potentially highly infectious casualty is moved by air, weighing the risk to other occupants and to the receiving population against the medical benefit of moving the patient, and considering protective measures and reporting. Annexes B and C, which it points to, give a clinician the clinical signs and epidemiological detail for judging whether high-level containment transport is warranted. This page names that those annexes exist rather than reproducing their content, which is a clinical judgement made by a qualified clinician, not a compliance criterion a reader applies themselves.

Civilian and mixed assets in mass casualty scenarios

Chapter 8 treats strategic aeromedical evacuation capacity as each nation's own responsibility, and describes five ways civil aircraft and crew can augment a military capability, from a fully civil aircraft and crew to a fully military one with a mixed medical team. Where civil assets are contracted, the document sets out what the contract has to address: that the contracted capability meets this publication's requirements, that legal and medico-legal responsibility is established and that "the contractor must be able to verify the quality and level of training of medical crews," standard operating procedures, points of embarkation and disembarkation, expected patient numbers, documentation per STANAG 2132/AMedP-8.1, and briefing routines.

How it binds

AAMedP-1.1 sits under STANAG 3204, the NATO agreement recording nations' commitment to use it; that is the cover which gives the publication its force. The document's own front matter records that France, the Netherlands and Norway lodged specific reservations against named paragraphs at the time of promulgation, which is how a NATO Allied Publication like this one is adopted with national exceptions rather than word for word. Where a nation instead contracts civilian assets to help deliver a mission, its requirements are carried into that contract rather than applying by default.

How you are evaluated

AAMedP-1.1 describes no organisational certification scheme: no accredited certification body, notified body or self-declaration mechanism appears anywhere in it. What it describes is national-authority clearance of specific electro-medical equipment before it is used aboard an aircraft, an aviation equipment clearance rather than certification of the organisation that owns or operates it. Where a nation contracts civilian assets, the contracting authority itself is the assessor: the contract names the requirements to be met, and the contractor has to be able to demonstrate that the crews it supplies meet the required quality and training level, evaluated against that specific contract rather than an external scheme.

Standards it references

  • [STANAG 3204](/standards/stanag-3204) - the NATO agreement recording nations' commitment to use this publication; the cover that gives AAMedP-1.1 its force.
  • [AJP-2](/standards#q=AJP-2) - named in a footnote as the NATO process through which some of this document's own definitions were being updated at the time of drafting; background rather than a requirement this document imposes.
  • [STANAG 2087](/standards/stanag-2087) and [AAMedP-1.5](/standards#q=AAMedP-1.5) - Forward Aeromedical Evacuation. Referenced for the principles governing evacuation in forward areas, including priority of movement and medical escorts.
  • [STANAG 2132](/standards/stanag-2132) and [AMedP-8.1](/standards/amedp-8-1) - Documentation Relative to Initial Medical Treatment and Evacuation. Invoked directly for patient tagging and contracted civil-asset documentation.
  • [STANAG 7213](/standards#q=STANAG%207213) and [ATP-3.3.4.1](/standards#q=ATP-3.3.4.1) - Tactics, Techniques and Procedures for NATO Air Movements. Patient manifests are prepared "in accordance with" it.
  • [STANAG 2040](/standards#q=STANAG%202040) and [AMedP-2.1](/standards#q=AMedP-2.1) - Stretchers, Bearing Brackets and Attachment Supports. Stretcher and support dimensions are set "as detailed in" it.
  • [STANAG 2128](/standards/stanag-2128) and [AMedP-1.12](/standards/amedp-1-12) - Medical and Dental Supply Procedures. Property exchange runs "in accordance with" it.

Several of these, the documentation, manifest and stretcher-dimension references, are invoked with directive language such as "in accordance with" and "as detailed in," closer to a binding cross-reference than background reading; the AJP-2 and AAMedP-1.5 references read as background pointers instead.

How we help

AAMedP-1.1 is an operational and technical publication. The work it describes, composing and training an aeromedical crew, checking and clearing equipment, disinfecting an aircraft, briefing a patient, is carried out in the day-to-day handling of a mission, not in software, and ComplyTrain does not change that. What it helps with is the evidence trail around that handling: aircrew composition and training records for a given mission profile, the pre-flight equipment inspection checklist and its sign-off, the national-authority clearance record for electro-medical equipment carried aboard, and, where civil assets are contracted, the contract's compliance matrix and the crew-training evidence the document asks a contractor to be able to produce, held as controlled, versioned records rather than paper that goes missing after the mission.

What ComplyTrain does not do: it does not compose or fly an aeromedical crew, decide a patient's fitness to fly, clear equipment for use aboard an aircraft, or make any clinical judgement about a patient's condition or the containment a highly infectious casualty needs. Those stay the qualified medical officer's and the national authority's own responsibility. The standards explorer shows the other Allied Publications this document points to, and we are glad to talk through what a specific tasking or contract is actually asking an organisation to evidence.

Standards it references

Questions

Is AAMedP-1.1 mandatory?

It binds NATO nations through STANAG 3204, the agreement recording their commitment to use it, and nations can and do record reservations against specific paragraphs at promulgation. Where a nation contracts civilian assets to help deliver a mission, its requirements are carried into that contract rather than applying automatically.

Does AAMedP-1.1 set fitness-to-fly or clinical selection criteria?

It names that fitness for air travel and clinical selection are assessed, in Chapter 2, and that patients are categorised by priority, dependency and classification, in Chapter 3, but it leaves the actual clinical judgement to a qualified medical officer and does not reproduce thresholds or category definitions for a reader to apply.

Can an organisation be "AAMedP-1.1 certified"?

No. AAMedP-1.1 names no certification scheme for an organisation. What it describes is national-authority clearance of specific electro-medical equipment for use aboard an aircraft, which is an equipment clearance, not a certificate a company or unit holds.

What is the difference between AAMedP-1.1 and STANAG 3204?

STANAG 3204 is the NATO agreement recording nations' commitment to use AAMedP-1.1; it is the cover that gives the publication its force. AAMedP-1.1 is the publication itself, the document that sets out the terminology, categorisation, aircrew procedures, equipment and training for aeromedical evacuation.

Does AAMedP-1.1 apply to a company supplying medical equipment or software?

Not directly. AAMedP-1.1 addresses aeromedical crews, aircrew and the national authorities that clear equipment, not a general manufacturer or software supplier. The one place a commercial party is addressed directly is where civilian aircraft or crew are contracted to help deliver a mission, and there the requirements come from that specific contract.