Mass casualty care in an expeditionary environment: developing local knowledge and expertise in context.

To discover new experience-based clinical and care delivery knowledge learned in the Iraq and Afghanistan combat zones, 107 Air Force, Army, and Navy nurses were interviewed. Eight areas of experiential knowledge were identified in the new care delivery system that featured rapid transport, early trauma and surgical care, and expeditious aeromedical evacuation: (1) organizing for mass casualties, (2) uncertainty about incoming casualties, (3) developing systems to track patients, (4) resource utilization, (5) ripple effects of a mass casualty event, (6) enlarging the scope of nursing practice, (7) operating medical facilities under attack, and (8) nurse emotions related to mass casualties.