Aeromedical Evacuation From a Level 2 Field Hospital in UNMISS: Operational Characteristics and In-Flight Medical Interventions, 2023-2025

INTRODUCTION: Aeromedical evacuation (AE) is a critical capability of military medical support systems, allowing patients to be transferred rapidly from forward medical facilities to higher levels of care while maintaining medical supervision during transport. Despite its importance, published information describing AE activities from Level 2 field hospitals operating in United Nations peacekeeping missions remains limited. MATERIALS AND METHODS: A retrospective descriptive study was performed to examine AE missions conducted from the Vietnamese Level 2 Field Hospital deployed in Bentiu, South Sudan within the United Nations Mission, between July 2023 and December 2025. Data were extracted from mission documentation, including MEDEVAC logs and flight reports. Collected variables included patient demographics, mission characteristics, and medical interventions performed during transport. Associations between operational factors and the performance of in-flight interventions were evaluated using Fisher's exact test and the Mann-Whitney U test. RESULTS: Thirty AE missions were analyzed. The average patient age was 41.8 ± 8.8 years, and 25 (83.3%) were male. Medical conditions accounted for 16 (53.3%) of evacuations, followed by trauma, 8 (26.7%). Median flight time was 75 minutes (IQR 70-112.5). In-flight medical interventions were performed in 22 (73.3%) of missions, most commonly continuous physiologic monitoring, 16 (53.3%), intravenous medication administration, 14 (46.7%), and oxygen therapy, 12 (40.0%). Special flights and missions with ≥2 accompanying medical personnel were significantly associated with in-flight interventions (P = .01 and P = .032). No in-flight mortality occurred. CONCLUSIONS: Aeromedical evacuation from a Level 2 field hospital was operationally feasible and clinically safe. The frequent need for in-flight interventions highlights the importance of appropriate patient stabilization, escort team composition, and mission planning in deployed operational environments.