AF Form 3838: DNR Certification for Aeromedical Evacuation – Aeromedical evacuation (AE) missions move patients safely and efficiently by air, often in critical or high-risk situations. In certain cases, patients with advanced directives or terminal conditions require a formal Do Not Resuscitate (DNR) order specific to the flight environment. The U.S. Air Force uses AF Form 3838 for this purpose.
This article explains what AF Form 3838 is, when it is required, how to complete it, and why it matters in the Air Force aeromedical evacuation system. It serves as a practical resource for flight surgeons, aeromedical evacuation crews, medical personnel, and patients involved in AE missions.
What Is AF Form 3838?
AF Form 3838, titled Do Not Resuscitate (DNR) Certification for Aeromedical Evacuation, is an official U.S. Air Force form that documents a patient’s DNR status specifically for air transport. It ensures that aeromedical evacuation crew members (AECMs) respect the patient’s wishes regarding resuscitation efforts during flight when standard CPR or advanced life support would otherwise be attempted.
Unlike a general civilian or hospital DNR order, this form is tailored to the unique operational environment of military aeromedical evacuation, where resources, altitude effects, and mission constraints differ from ground-based care.
Purpose of AF Form 3838
The primary purpose is to provide clear, documented certification that a patient should not receive resuscitative measures (such as CPR, defibrillation, or intubation for cardiac/respiratory arrest) while in transit via aeromedical evacuation. This protects patient autonomy, reduces ethical and legal risks for the crew, and aligns care with the patient’s end-of-life wishes or clinical prognosis.
It is referenced in key guidance such as DAFI 48-107 Volume 3 (En Route Care Documentation) and related aeromedical publications. The form is mentioned alongside patient movement records and in-flight death protocols.
When Is AF Form 3838 Required?
AF Form 3838 is completed when a patient has an existing valid DNR order (or equivalent advance directive) and is being transported via the Air Force AE system. Key scenarios include:
- Patients with terminal illnesses or poor prognosis where resuscitation would not align with goals of care.
- Cases identified during pre-flight medical screening or patient movement requirements (PMR) review.
- Situations where a flight surgeon or attending physician determines that DNR status must be explicitly documented for the flight environment.
It is not a general DNR order — it applies specifically to the aeromedical evacuation leg of care. Personnel should also reference broader DoD and Air Force policies on patient movement and end-of-life care.
Note: Only authorized medical providers (typically flight surgeons or credentialed physicians) should initiate or certify this form.
How to Complete AF Form 3838
While the exact block-by-block layout is detailed in the official PDF, the form generally requires:
- Patient Identification: Full name, rank/grade (if applicable), DoD ID number or SSN, date of birth, and unit/organization.
- Medical Provider Certification: Physician or flight surgeon statement confirming the existence of a DNR order, the clinical rationale, and that the order is current and valid.
- DNR Details: Scope of the DNR (e.g., no CPR, no advanced cardiac life support) and any specific limitations or exceptions applicable to the flight.
- Signatures: Signature of the certifying physician/flight surgeon, date, and any required witness or AE command review signatures.
- Additional Notes: Any supporting documentation references (e.g., advance directive, hospital DNR order) and validity period if applicable.
Download the Official AF Form 3838 PDF here:
https://static.e-publishing.af.mil/production/1/af_sg/form/af3838/af3838.pdf
Always use the most current version available on the official Air Force e-Publishing site. Forms should be completed legibly, preferably electronically when possible, and attached to the patient’s aeromedical evacuation records (such as the AF Form 3899 series or electronic health record documentation).
Integration with Aeromedical Evacuation Processes
AF Form 3838 integrates into the broader AE workflow:
- It is noted during patient classification and PMR (Patient Movement Request) processing.
- Aeromedical evacuation crews receive the form as part of pre-flight documentation.
- In the event of in-flight clinical deterioration or death, the DNR certification guides care and post-incident reporting (e.g., via DD Form 2852 for patient movement events).
Proper documentation supports compliance with DAFI 48-107 series instructions on en route care and helps maintain high standards of patient safety and dignity during transport.
Key Considerations for USAF Personnel
- Legal and Ethical Aspects: Respecting DNR wishes is both a patient right and a professional obligation. Misapplication can lead to unnecessary interventions or liability.
- Training: Aeromedical evacuation crew members and medical personnel receive training on DNR protocols as part of qualification programs.
- Coordination: Communicate early with the flight surgeon, AE squadron, and receiving facility.
- Updates: DNR status can change; ensure the form reflects the most current physician order before flight.
Military members, retirees, and authorized civilians transported under the AE system should discuss advance care planning with their providers well before potential movement.
Where to Find More Information?
- Official source: Air Force e-Publishing (search for AF Form 3838).
- Governing instructions: DAFI 48-107V1 and V3 (En Route Care and Aeromedical Evacuation Medical Operations).
- Related forms: AF Form 3899 series (Aeromedical Evacuation Patient Record), patient movement documentation.
For the latest policies, always consult the current Department of the Air Force Instructions (DAFIs) and your local medical treatment facility or AE unit guidance, as procedures may be updated.
Important: This article is for informational purposes only and does not replace official Air Force policy, medical advice, or legal counsel. Contact your flight surgeon, aeromedical evacuation squadron, or legal office for case-specific guidance.
Download AF Form 3838: Official PDF Link
Keywords: AF Form 3838, DNR Aeromedical Evacuation, Air Force DNR form, Do Not Resuscitate AE, USAF aeromedical evacuation documentation, flight surgeon DNR certification.