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During the latter half of 1990 the Royal Air Force established a medical evacuation chain in support of the British First Armoured Division during Operation Granby (known as Operation Desert Storm in the USA). Medical contingency plans, formulated prior to embarkation from the UK, foresaw the need for five aeromedical staging facilities sub-deployed throughout the east of the Arabian Peninsula. The early days of the deployment found personnel busy with the construction of tented and hardened facilities and with the establishment of local operating procedures. Many problems were initially encountered, especially with supply, communications and in co-ordinating with collaborating coalition and host nation units. Nevertheless, progress was rapid and non-combatant operations were started within days of arrival. As the ground offensive became more imminent, training took on a sense of urgency. Advanced first aid techniques were taught to all non-medical staff, whereas doctors, nurses and paramedical personnel were taught ACLS and ATLS skills. All studied field hygiene, the hazards of nuclear, chemical and biological warfare, casualty handling, battle psychology and the intricacies of loading and unloading various types of aircraft. By the start of the ground phase of the war the British evacuation chain was fully operational and capable of treating and transferring hundreds of casualties per day. In the event, only about 850 patients were transported down the evacuation chain during the conflict, and less than 10% of these were battle casualties. This paper presents an overview of the British aeromedical evacuation system and discusses, in more detail, the establishment and operation of the busiest aeromedical staging facility at Al Jubail in the Eastern Province of Saudi Arabia.