This session on Complex Medical Evacuation (medevac) coordination with Dr. Sarah Spelsberg will provide a real-world, systems-based approach to managing critically ill and injured patients in remote and resource-limited environments. Drawing on her extensive experience in search and rescue, expedition medicine, and high-stakes evacuations in the Aleutian Islands and Bering Sea, Dr. Spelsberg will explore the logistics, communication strategies, and decision-making frameworks required to execute safe and efficient evacuations across challenging terrain and austere conditions. Participants will gain insight into coordinating multi-agency responses, including ground teams, aviation assets such as Coast Guard C-130s and helicopters, and receiving medical facilities. The lecture will highlight key considerations such as risk assessment, environmental constraints, patient packaging, and transport prioritization, while emphasizing adaptability and leadership in dynamic, high-pressure scenarios. This talk is ideal for learners interested in wilderness, expedition, and disaster medicine, offering practical strategies that bridge prehospital care, emergency medicine, and global health systems.