AF Form 3899D: Patient Movement Hemodynamic Flowsheet

AF Form 3899D: Patient Movement Hemodynamic Flowsheet – The AF Form 3899D, officially titled Patient Movement Hemodynamic/Respiratory Flowsheet, is a specialized medical documentation tool used in the U.S. Air Force Aeromedical Evacuation (AE) system. It enables En Route Care (ERC) teams—including non-licensed clinicians, licensed clinicians, and privileged providers—to accurately record critical patient data during air transport.

This form focuses on patients requiring invasive hemodynamic monitoring or mechanical ventilation, ensuring continuity of care from originating facility through staging and in-flight phases. It supports safe patient movement for ill or injured service members, beneficiaries, and others in the AE system.

Purpose of AF Form 3899D in Aeromedical Evacuation

Aeromedical evacuation involves unique physiological stresses (altitude changes, vibration, G-forces, and limited space). The AF Form 3899D helps teams track vital signs (VS), hemodynamic parameters, intracranial monitor readings, and ventilator settings in real time.

Key guidance comes from DAFI 48-107V3, En Route Care Documentation (17 December 2020). It states that the form documents vital signs, hemodynamic values, intracranial pressures, and ventilator data for patients with invasive monitoring or ventilators in the AF AE System. Any or all fields may be used as needed.

When this form serves as the primary source for vital signs, annotating “See AF Form 3899D for VS” on the main patient record (such as AF Form 3899) is recommended.

The form is part of the broader AF Form 3899-series used when electronic health record (EHR) systems are unavailable or impractical during transport. Completed forms become part of the patient’s permanent medical record and must comply with Privacy Act and HIPAA requirements.

Download the official AF Form 3899D PDF here: https://static.e-publishing.af.mil/production/1/af_sg/form/af3899d/af3899d.pdf

Who Uses AF Form 3899D?

  • En Route Care (ERC) non-licensed clinicians
  • Licensed clinicians (e.g., nurses)
  • Privileged providers (physicians, flight surgeons)

It pairs with other forms in the series, such as:

  • AF Form 3899 (Patient Movement Record)
  • AF Form 3899C (Patient Movement Physical Assessment)
  • AF Form 3899L (for En Route Critical Care teams like CCATT)
  • AF Form 3899E (Intake/Output)
  • AF Form 3899N (Pain Adjunct Flow Sheet)

Key Sections and What to Document on AF Form 3899D

The flowsheet (front and back) features a time-based grid for frequent recordings, typical during critical care transport. Common data elements include:

Vital Signs & Basic Parameters:

  • Temperature (T)
  • Oxygen saturation (SpO₂)
  • Respiratory rate (RR)
  • Heart rate (HR)
  • Blood pressure (BP) / Mean Arterial Pressure (MAP)

Hemodynamic & Advanced Monitoring:

  • Intracranial pressure (ICP) / Cerebral Perfusion Pressure (CPP)
  • Central Venous Pressure (CVP)
  • Bladder pressure (if applicable)
  • Arterial line readings
  • Pulmonary artery catheter data (when used)

Respiratory / Ventilator Settings:

  • Ventilator mode (e.g., AC, SIMV, PC)
  • Fraction of inspired oxygen (FiO₂)
  • Tidal volume (TV)
  • Respiratory rate (set and actual)
  • Positive End-Expiratory Pressure (PEEP)
  • Endotracheal tube (ETT) size and location (nasal, oral, trach)
  • Peak inspiratory pressure or other airway pressures
  • End-tidal CO₂ (EtCO₂) or arterial blood gas (ABG) values (pH, PaO₂, PaCO₂, base excess, etc.)

Additional Lab/Fluid Values (as relevant):

  • Sodium (Na) / Potassium (K)
  • Hemoglobin (Hgb) / Hematocrit (Hct)
  • Ionized calcium (iCa) / HCO₃

The layout supports serial entries (e.g., every 15–60 minutes or per protocol) with columns for time, readings, and provider notes or interventions. Not every field needs completion—use only what applies to the patient’s condition.

Pro Tip: Always ensure entries are legible, timed, initialed/signed, and include any changes in patient status or equipment adjustments. This supports handoffs, quality improvement reviews, and legal/medical record requirements.

How AF Form 3899D Fits into the Patient Movement Process?

  1. Patient Preparation & Validation — The validating flight surgeon reviews stability for flight using the main AF Form 3899 and supporting documentation.
  2. En Route Documentation — During ground transport, staging, and flight, ERC teams use the 3899D (plus other series forms) to record trends.
  3. Critical Care Augmentation — For higher-acuity patients, Critical Care Air Transport Teams (CCATT) may use AF Form 3899L as the primary record, with 3899D as a supplemental flowsheet.
  4. Handoff & Archiving — At the receiving facility, documentation transfers with the patient. Paper forms are scanned into the permanent record.

Proper use reduces risks associated with altitude (e.g., gas expansion, hypoxia) and supports rapid response to deterioration.

Importance of Accurate Documentation in AE

Accurate flowsheet entries directly impact patient safety and mission success. Trends in hemodynamic instability or ventilator changes can prompt interventions like adjusting oxygen, fluids, or consulting the ERCC physician.

All documentation must follow DAFI 48-107V3 and related instructions (e.g., DAFI 48-107V1 for broader AE operations). Incomplete or unclear records can delay movement or complicate post-mission reviews.

For equipment issues during transport, use AF Form 4449 (En Route Care Equipment Malfunction Report).

Best Practices for Completing AF Form 3899D

  • Start with patient identifiers (name, SSN/DOD ID, date of birth) linked to the main 3899 record.
  • Record baseline values pre-flight and continue at appropriate intervals.
  • Note any interventions, medication effects, or environmental factors (e.g., cabin altitude).
  • Use military time and ensure all entries are attributable.
  • When EHR is available, prioritize it; otherwise, the 3899-series serves as the official record.
  • Store and transmit forms securely per DoD privacy policies.

Related Resources (Official U.S. Air Force):

  • DAFI 48-107V3: En Route Care Documentation → e-Publishing.af.mil
  • Air Force e-Publishing Forms Index
  • USTRANSCOM Patient Movement guidance (TRAC2ES system)

Conclusion

The AF Form 3899D Patient Movement Hemodynamic/Respiratory Flowsheet is an essential tool for maintaining high standards of care during aeromedical evacuation. By providing a structured way to track complex physiological data, it helps USAF medical teams deliver safe, effective en route care under challenging conditions.

Whether you are a flight nurse, CCATT member, or validating flight surgeon, mastering this form ensures better patient outcomes and compliance with Air Force standards.

Download AF Form 3899D PDF: Official Link

For the latest guidance, always consult current Department of the Air Force Instructions on e-Publishing and your local aeromedical evacuation squadron or medical treatment facility.

This article is for informational purposes and references publicly available U.S. government sources as of 2026. Always verify the most current form version and instructions through official Air Force channels.