AF Form 3899N: Patient Movement Pain Adjunct Flow Sheet

AF Form 3899N: Patient Movement Pain Adjunct Flow Sheet – The AF Form 3899N, officially titled Aeromedical Evacuation Patient Movement Pain Management Record (also known as the Patient Movement Pain Adjunct Flow Sheet), is a critical documentation tool used by U.S. Air Force flight nurses, aeromedical evacuation technicians, and registered nurses during patient transport.

This specialized flow sheet ensures safe, continuous monitoring of pain management interventions for patients undergoing aeromedical evacuation (AE) or other patient movement scenarios, particularly when advanced analgesic techniques like IV patient-controlled analgesia (PCA), epidurals, or peripheral nerve blocks (PNB) are in use.

What Is AF Form 3899N Used For?

In the high-stress, resource-limited environment of aeromedical evacuation, effective pain control directly impacts patient comfort, physiological stability, and overall outcomes. The AF Form 3899N serves as a dedicated record to document:

  • Objective and subjective patient data related to pain adjunct therapies.
  • Vital signs, pain scores, sedation levels, and neurological status.
  • Infusion pump settings, verifications, and checks for safety.
  • Adverse reactions and any changes requiring intervention.

It is referenced in Department of the Air Force Instruction (DAFI) 48-107 Volume 3, En Route Care Documentation, as the standard form for tracking pain management adjuncts during patient movement.

Key uses include:

  • Monitoring patients receiving IV PCA, epidural infusions, or continuous peripheral nerve blocks (CPNB).
  • Ensuring dual registered nurse (RN) verification of medication orders and pump settings.
  • Facilitating clear handoffs between care teams.
  • Supporting compliance with AE standards for documentation when electronic health records (EHR) are supplemented or unavailable.

The form integrates with the broader AF Form 3899 series used in the Aeromedical Evacuation system and TRAC2ES (TRANSCOM Regulating and Command & Control Evacuation System).

Who Uses AF Form 3899N?

Primary users are:

  • Flight Nurses (FN)
  • Aeromedical Evacuation Technicians (AET)
  • Registered Nurses (RN) providing en route care

Documentation typically includes initials (e.g., FN or 2 RN initials like SS/RD) for accountability. The form becomes part of the patient’s permanent medical record.

Key Sections of the AF Form 3899N

The form features structured tables and checklists designed for quick, repeated assessments during transport:

  1. Patient Identification
    Includes Name, Case/Cite #, Status, Service, DOD ID #, and Allergies.
  2. Route of Pain Management (Check all that apply)
    • IV PCA
    • Epidural
    • Nerve Block (PNB)
  3. Dermatome Level (DL)
    Left and Right sides, with anatomical references (e.g., C3 Neck, T4 Nipples, T10 Navel, L1 Groin, L4 Knee). Essential for epidurals and nerve blocks.
  4. Pain Assessment
    • 0-10 scale or Wong-Baker Faces Scale.
    • Behavioral Pain Rating (e.g., Calm & Cooperative, Agitated).
    • Instruction: Notify C2 for unrelieved pain.
  5. Sedation Level (MAAS – Motor Activity Assessment Scale)
    Scored from 0 (Unresponsive) to 6 (Calm & Cooperative) to prevent oversedation.
  6. Adverse Reactions
    Common codes: OS (Oversedation), NV (Nausea/Vomiting), UR (Urinary Retention), SOB (Shortness of Breath), Ø (None), or ADSE (Other). Changes must be documented on the 3899 or EHR.
  7. Motor Function (MF) and Sensory Function (SF)
    Rated + (Normal) or – (Decreased). Required for Epidurals and Nerve Blocks.
  8. Vital Signs Flow Sheet
    Multi-column table for repeated entries of:

    • Date/Time
    • RR (Respiratory Rate), Pulse, BP, O2 Sat, O2/LPM
    • MAAS, DL, MF, SF, Temperature, Pain Score
    • Adverse Reactions
    • Tubing/Dressing checks (√ Q 4 HRS)
    • Pump settings: Basal Rate, Bolus (ml), Lock Out, Cumulative
    • FN Initials
  9. Order Verification
    Medication (e.g., Ropivacaine 0.2%, Morphine, Hydromorphone, Other), Basal Rate, Bolus, Lockout Interval, VTBI (Volume to Be Infused). Requires 2 RN verification and breakthrough pain orders.
  10. Pump Verification
    Pump locked?, Tubing/MED line, Bag labeled, Fluid remaining, Insertion site, Wastage, etc. Also requires dual RN initials.

Special Notes on the Form:

  • Dressings checked every 4 hours.
  • CPNB requires q 2 hour assessments.
  • Pumps must be checked in the locked position.
  • All significant changes documented on the form or in the EHR.

How to Complete AF Form 3899N Properly

  • Start with patient identifiers and allergies.
  • Select the applicable pain management route(s).
  • Perform baseline assessments of pain, sedation, motor/sensory function, and dermatome levels.
  • Verify orders and pump settings with two RN signatures before departure.
  • Conduct and record assessments at regular intervals throughout the transport.
  • Document any adverse reactions or changes immediately and notify the appropriate command/control (C2) element if pain is unrelieved.
  • Ensure pump verifications (locked, tubing intact, labels correct) are completed and initialed.

Proper use supports patient safety, legal accountability, and continuity of care across staging facilities, aircraft, and receiving medical treatment facilities (MTFs).

Why Accurate Documentation on AF Form 3899N Matters

In aeromedical evacuation, altitude changes, vibration, and limited resources can affect infusion pumps and patient physiology. Consistent use of the 3899N helps:

  • Prevent medication errors through dual verification.
  • Detect early signs of complications like local anesthetic systemic toxicity (LAST), oversedation, or respiratory depression.
  • Maintain high standards of en route care as outlined in DAFI 48-107 series instructions.

This form works alongside other AE documentation tools, such as AF Form 3899 (Patient Movement Record) and AF Form 3899I (Patient Movement Medication Record).

Download the Official AF Form 3899N

The current official version is available as a fillable PDF directly from the U.S. Air Force e-Publishing site:

→ Download AF Form 3899N PDF here: https://static.e-publishing.af.mil/production/1/af_sg/form/af3899n/af3899n.pdf

Always use the latest version from e-Publishing.af.mil for official missions. Blank AF Form 3899-series forms are also referenced in DAFI 48-107V3.

Additional Resources for AE Personnel

  • DAFI 48-107 Volume 1 & 3: En Route Care and Aeromedical Evacuation documentation standards.
  • Training materials for Aeromedical Evacuation Crew Members (AECMs).
  • AMC/SGK resources for examples and best practices.

Note: This article is for informational purposes and to assist U.S. military medical personnel and contractors supporting AE operations. Always refer to the most current Department of the Air Force instructions and your local guidance for clinical practice.

Keywords: AF Form 3899N, Patient Movement Pain Adjunct Flow Sheet, aeromedical evacuation pain management, AF 3899N, flight nurse documentation, IV PCA monitoring, epidural flow sheet, Air Force AE forms.

For questions about completing the form or AE pain management protocols, consult your unit’s Aeromedical Evacuation Squadron or the latest DAFI 48-107 publications.