Collaboration in practice--assessment of an RAF CCAST.

Aeromedical evacuation of critically ill patients by the Royal Air Force is undertaken in a complex healthcare environment--one which demands effective teamwork to achieve the best possible outcome for the patient. A military team cannot rely purely on rank structure to guarantee a disciplined and efficient working unit. Furthermore, personnel must acknowledge the many potential hindrances of a Critical Care Air Support Team (CCAST) working environment that can affect optimal performance. These include: fatigue as a result of extended hours of duty; effects of altitude; isolation; and entering war zones, all of which may negatively affect motivation, stress and communication. This article reviews and discusses adaptation strategies utilised by a CCAST to overcome these obstacles. The importance of role equality within a team and the subsequent feeling of value this promotes, effective communication and positive "can do" attitudes contribute to making the team work.