CASUALTY EVACUATION OPERATIONS

1. CASUALTY EVACUATION OPERATIONS

2. PURPOSE The purpose of this briefing is to provide an overview of casualty evacuation procedures and to provide you the information necessary to set up a SOP for casualty evacuation procedures at your respective sites

3. TASK: Conduct cas-evac operations CONDITIONS: In a field environment, given an injured soldier, a radio, a combat lifesaver bag, and the desire to save their buddy’s life. STANDARDS: Soldiers must demonstrate a general knowledge of cas-evac operations, properly format and submit a med-evac request utilizing the “nine line” format.

4. REFERENCES • FM 8-10-4, Medical Platoon Leader’s Handbook (TTPs) • FM 7-20, The Infantry Battalion • CTC Trends, JRTC, Nov 97, No. 97-19 • CALL Newsletter, Jul 99, No. 99-6 • CMTC Trends Compendium Apr 98 • FM 21-11, First Aid for Soldiers

5. AGENDA • REDUCING COMBAT DEATHS • CHS LIFESAVING MEASURES • IMPORTANCE OF THE CLS • PLANNING CONSIDERATIONS • MEDICAL TREATMENT FACILITIES • TRANSPORTATION OF CASUALTIES • CATEGORIES OF PRECEDENCE • THE MEDEVAC REQUEST

6. REDUCING COMBAT DEATHS • Majority of combat deaths occur on • The battlefield before evacuation • Takes place • 80% of combat deaths occur within • First hour after initial injury • 50% of combat deaths are a result • of the soldier bleeding to death • Of these 50% of combat deaths, 40% • could have lived had the bleeding • been stopped

7. CHS LIFESAVING MEASURES • SELF-AID • BUDDY AID • COMBAT LIFESAVER • COMBAT MEDIC • TREATMENT SQUAD

8. WHAT IS A COMBAT LIFESAVER? • A MEMBER OF THE • SQUAD OR CREW • TRAINED, EVALUATED & • CERTIFIED IN MEDICAL SKILLS • EXPERTISE BEYOND BASIC • FIRST AID

9. COMBAT LIFESAVER’S ROLE • ADDITIONAL LIFESAVING EXPERTISE • AT THE SQUAD/CREW LEVEL • EXTENSION OF THE PLATOON MEDIC • USES SKILLS & EQUIPMENT CONSISTENT • WITH HIS SECONDARY MISSION • PRIMARY MOS IS FIRST RESPONSIBILITY

10. Basic Planning Considerations • Medical Evacuation • Medical Treatment Facilities

11. Planning Medical Evacuation • Medical evacuation requirements and units available are listed to include their locations, missions, and attachments. • Location of casualty collecting points and ambulance exchange points are placed on overlays. • Identify routes, means and schedules (if any) of evacuation and responsibilities. • Evacuation request procedures and channels.

12. Medical Treatment Facilities • Medical treatment facilities (aid stations, hospitals). • Locations and missions of appropriate medical treatment facilities.

13. EXECUTION: Casualty evacuation is a team effort. The primary duty of a combat lifesaver is the mission. Treatment of casualties is secondary. Appropriate ground and air evacuation techniques should be used based on METT-T and on patient categories of precedence (URGENT, PRIORITY, and ROUTINE). COMMUNICATIONS: Redundant communications are important to timely casualty evacuation. SAFETY: Leaders must retain common sense and attention to safety considerations despite their concern for casualties.

14. Transportation of Casualties • When the situation is urgent you may have to transport the casualty. For this reason, you must know how to transport him without increasing the seriousness of his condition. • Transporting a casualty by litter is safer and more comfortable for him than by manual means; it is also easier for you. • Manual transportation, however, may be the only feasible method because of the terrain or the combat situation.

15. Standard Evacuation Types UH-60A/Q Ambulance *An M113 series Armored Ambulance can carry 4 litters

16. UH-60Q Interior

17. Non-Standard Evacuation Types

18. Casualty Evacuation TTPs • USE SPECIALIZED • EQUIPMENT • POLELESS LITTER • SKED LITTER • DESIGNATE AND TRAIN • AID AND LITTER TMS

19. The rapidly employable lightweight litter, referred to as the SKEDS litter, is designed to be used as a rescue system in most types of terrain, including mountains, jungle, waterborne, and on snow or ice.

20. Manual CarriesOne-man carries Two-man carries

21. Manual Carries (One Man) • Fireman’s Carry • Support Carry • Arms Carry • Pistol-belt Carry and Drag • Neck Drag

22. TWO-MAN SUPPORT CARRY

23. TWO-MAN SUPPORT CARRY (cont)

24. Manual Carries (two man) • Two man support carry • Two man arms carry • Two man fore-and-aft carry • Two hand seat carry

25. CATEGORIES OF PRECEDENCE FOR EVACUATION URGENT-PATIENT WHO SHOULD BE EVACUATED AS SOON AS POSSIBLE AND WITHIN TWO HOURSTO SAVE LIFE, LIMB, OR EYESIGHT. PRIORITY-PATIENT WHO SHOULD BE MOVED WITHIN FOUR HOURS OR HIS/HER CONDITION WILL DETERIORATE TO SUCH A DEGREE THAT HE WILL BECOME URGENT. ROUTINE-PERSONNEL WHOSE CONDITION IS NOT EXPECTED TO WORSEN SIGNIFICANTLY AND WHO WILL REQUIRE EVACUATIONIN THE NEXT 24 HOURS.

26. MEDEVAC REQUEST FORMAT • LINEITEM/BREVITY CODES • 1 Location of pickup site • 2 Frequency/Call sign of pickup site • 3 Number of patients by precedence • A - URGENT • C - PRIORITY • D - ROUTINE • 4 Special equipment • A - NONE • B - HOIST • C - EXTRACTION EQUIPMENT • D - VENTILATOR • 5 Number of patients by type • L + # LITTER • A + # AMBULATORY • 6 Security of pickup site • N - NO ENEMY • P - POSSIBLE ENEMY • E - ENEMY IN AREA • X - ARMED ESCORT NEEDED • 7Method of marking pickup site • A - PANELS • B - PYROTECHNICS • C - SMOKE • D - NONE • E - OTHER • 8Patient nationality and status • A - US MILITARY • B - US CIVILIAN • C - NON US MILITARY • D - NON US CIVILIAN • E - EPW • 9NBC contamination • N - NUCLEAR • B - BIOLOGICAL • C – CHEMICAL

27. LINE 1 LOCATION OF THE PICKUP SITE

28. LINE 2 RADIO FREQUENCY/CALL SIGNAND SUFFIX SOI and ANCD

29. LINE 3 NUMBER OF PATIENTS BY PRECEDENCE BREVITY CODES: A- URGENT C -PRIORITY D -ROUTINE

30. LINE 4 SPECIAL EQUIPMENT REQUIRED BREVITY CODES: • A NONE • B HOIST • C EXTRACTION EQUIPMENT • D VENTILATOR

31. LINE 5 NUMBER OF PATIENTS BY TYPE BREVITY CODES: • L + #Patients Litter • A + #Patients Ambulatory

32. LINE 6 SECURITY OF PICKUP SITE (WARTIME) BREVITY CODES: • N NO ENEMY • P POSSIBLE ENEMY TROOPS IN AREA (APPROACH WITH CAUTION) • E ENEMY TROOPS IN AREA (APPROACH WITH CAUTION) • X ENEMY TROOPS IN AREA (ARMED ESCORT REQUIRED)

33. LINE 6 NUMBER AND TYPE OF WOUND, INJURY, OR ILLNESS (PEACETIME) GIVE SPECIFIC INFORMATION, GUNSHOT WOUND, BLEEDING AND BLOOD TYPE IF KNOWN

34. LINE 7METHOD OF MARKING PICKUP SITE BREVITY CODE: • A PANELS • B PYROTECHNIC SIGNAL • C SMOKE SIGNAL • D NONE • E OTHER

35. LINE 8PATIENT NATIONALITY AND STATUS ENCRYPT BREVITY CODE: • A US MILITARY • B US CIVILIAN • C NON-US MILITARY • D NON-US CIVILIAN • E EPW (Detainee)

36. LINE 9NBC CONTAMINATION(Wartime) ENCRYPT BREVITY CODE: • N NUCLEAR • B BIOLOGICAL • C CHEMICAL

37. LINE 9TERRAIN DESCRIPTION(PEACETIME) INCLUDE DETAILS OF TERRAIN FEATURES IN AND AROUND PROPOSED LANDING SITE

38. Example “Badger03 this is Badger76 MEDEVAC 9 line follows—over” “This is Badger03 send it –over” “line 1-- UV 8945 4452 “line 2-- 30300 in the red, badger76 “line 3-- 1C “line 4-- A “line 5-- 1A “line 6-- N “line 6-- 1, broken ankle compound fracture (peacetime) “line 7-- C “line 8--A “line 9-- NONE “line 9-- Open field no power lines.(peacetime) “Over” “This is Badger03 roger out”

39. SUMMARY • REDUCING COMBAT DEATHS • CHS LIFESAVING MEASURES • IMPORTANCE OF THE CLS • PLANNING CONSIDERATIONS • MEDICAL TREATMENT FACILITIES • TRANSPORTATION OF CASUALTIES • CATEGORIES OF PRECEDENCE • THE MEDEVAC REQUEST