Medical Evacuation
Line 6 of 9-line: (peacetime)
# and type of wound, injury or illness describes wounds by type (gunshot or shrapnel) serious bleeding blood type if known
Triage:
Delayed, intermediate, minimal, expectant
Staffing of Relay, Loading, and Ambulance Control Points
Important points may be manned to supervise the blanket, litter, and patient movement items (PMI) exchange and to ensure that messages and medical supplies to be forwarded are expedited.
Treat and Stabilize
Maintain or improve the patient's medical condition during transport and provide en route care as required. This task is performed by medical evacuation crewmembers and providers when necessary.
Evacuation Platoon: MCAS
Medical Company (Area Support): The ambulance platoon performs ground MEDEVAC and en route patient care for supported units, primarily in support of units at EAB. Four ambulance squads (or eight ambulance teams)
efficient/efficiency
Minimizes mortality by rapidly and efficiently moving the sick, injured, and wounded to and between MTFs Ensures continuum of care between roles of care Serves as a force multiplier as it clears the battlefield Builds the morale of Soldiers Provides critical en route medical care Provides economy of force Provides connectivity of the AHS as appropriate to the Military Health System
what is the transportation flow for ground evacuation?
POI/CCP to supporting BAS( role I MTF) with follow-on evacuation to an AXP to BSMC or MCAS
Emergency movement of medical personnel, equipment, and supplies
Provide a rapid response for the emergency movement of scarce medical resources throughout an operational environment.
When detainees are evacuated through medical channels, medical personnel:
Report this action through medical channels to detainee operations medical director and the next higher headquarters. Request disposition instructions from the MEDBDE (SPT) patient movement branch.
Air ambulances may fly as far forward as possible on the battlefield (T/F)
True
what are examples of patient movement items that must be present ?
ventilators, patient monitors, pulse oximeters
Where are the ambulance teams from ambulance platoons normally collocated?
with the BMSC/MCAS treatment platoon for mutual support
Ambulance Team Duties
• Maintain contact with supported elements. • Find and collect the wounded. • Administer tactical combat casualty care (TCCC). • Initiate or complete the Department of Defense (DD) Form 1380 (Tactical Combat Casualty Care Card). • Evacuate patients to the BAS. • Direct or guide ambulatory patients to the BAS. • Resupply company/platoon medics. • Serve as messengers in medical channels. •Perform route reconnaissance from Role 1 MTF to Role 2 MTF or the higher role of medical care.
Line 3 of 9-line:
# of patients by precedence A-Urgent B-Urgent Surgical C-Priority D- Routine E- Convenience If 2 or more categories are reported then there must be a "BREAK" between each category
Casualty Collection Point
A location that may or may not be staffed, where casualties are assembled for evacuation to a medical treatment facility.
what priority of patients receive priority for air ambulance?
URGENT and URGENT-SURG patients
Can a patient skip roles?
Yes, sometimes its necessary to go straight to role III
Area support
a method of logistics, medical support, and personnel services in which support relationships are determined by the location of the units requiring support.
what policy does medical evacuation follow?
theater evacuation policy and is an integral part of medical regulating.
evacuation of military working dogs
-Injured or ill military working dogs may be evacuated on any transportation means available. The using unit is responsible for the evacuation of the animal. -Handler must be present -brought to veterinary
function of Maneuver BN Medical Platoon ambulance squad:
-Provide ground ambulance evacuation support from supported infantry/armored companies or from POI back to a CCP or to the Role 1 MTF/BAS. -They also provide area support to other elements (which do not have organic MEDEVAC resources) operating in their AO. -Organized into ambulance teams.
Planning factors to consider when planning MEDEVAC support to ARSOF includes:
-small unit and austere AHS capability - Remote operational areas and long evacuation routes - Medical evacuation, medical regulating and patient tracking requires an understanding of sensitivity of ARSOF missions. During evacuation, they must account for any sensitive items and documents that the ARSOF patient possesses.
medical evacuation of detainees:
-treated and evacuated with MPs -physically segregated from US and multinational patients -guards are NOT the responsibility of MEDEVAC units, they are provided by BCT
Ambulance Exchange Point
A location where a patient is transferred from one ambulance to another en route to a medical treatment facility.
Ambulance Shuttle System
A system consisting of one or more ambulance loading points, relay points, and when necessary, ambulance control points, all echeloned forward from the principal group of ambulances, the company location, or basic relay points as tactically required.
Line 9 of 9-line: (wartime)
CBRN contamination C- chemical B- burn R- radiological N- nuclear
What should the medical planner consider during the MEDEVAC plan development?
CCP AXP ambulance shuttle system staff of relay, loading, and ambulance control points
what is the only factor used to determine medical precedence?
Casualties requiring evacuation are prioritized to ensure the most seriously injured or ill receive timely medical intervention consistent with their medical condition
Ambulance team:
Consists of two ambulances, each ambulance has three medical personnel (an emergency care sergeant or health care specialist and two ambulance/aide drivers). The primary function of the ambulance team is to collect and treat the sick, injured, and wounded Soldiers on the battlefield and to provide MEDEVAC support from the POI, CCP, or AXP to the supporting MTF.
The MEDBDE (SPT) patient movement branch is responsible for:
Coordinating the transportation means. Identifying the MTF to which the detainees will be taken. Coordinating, in conjunction with the MTF commander, with the Detainee Reporting System to account for detainees within medical channels.
Who provides direct support air ambulance for BMSC role 2?
FSMP from supporting GSAB medical company (air ambulances)
Who coordinates and positions air ambulance assets?
GSAB/CAB with medical brigade
Priority I—URGENT
Is assigned to emergency cases that should be evacuated as soon as possible and within a maximum of one hour in order to save life, limb, or eyesight and to prevent complications of serious illness and to avoid permanent disability. (1 hour)
Priority IV—CONVENIENCE
Is assigned to patients for whom evacuation by medical vehicle is a matter of medical convenience rather than necessity.
Priority IA—URGENT-SURG
Is assigned to patients that should be evacuated as soon as possible and within a maximum of one hour who must receive far forward surgical intervention to save life, limb, or eyesight and stabilize for further evacuation. (1 hour)
Priority III—ROUTINE
Is assigned to sick and wounded personnel requiring evacuation but whose condition is not expected to deteriorate significantly. The sick and wounded in this category should be evacuated within 24 hours.
Priority II—PRIORITY
Is assigned to sick and wounded personnel requiring prompt medical care. This precedence is used when the individual should be evacuated within four hours or if his medical condition could deteriorate to such a degree that he will become an URGENT precedence, or whose requirements for special treatment are not available locally, or who will suffer unnecessary pain or disability. (4 hours)
Line 1 of 9-line:
Location of pickup (grid coordinates with grid zone letters)
Evacuation platoon (BMSC):
Medical Company (Brigade Support): Evacuation platoons provide ground ambulance evacuation support from the supported BCT or from the POI to the supporting MTF. Five evacuation teams (or ten ambulances) Three teams in the evacuation squad (forward) Two teams in the evacuation squad (area)
Army Special Operations Forces (ARSOF) have organic MEDEVAC system?
No, they depend on conventional theatre MEDEVAC system for support
Line 5 of 9-line:
Number of patients by types L + # = litter patients A + #= ambulatory patients if both patients are present then "BREAK" between reporting
Line 8 of 9-line:
Patient nationality and status A- US military B- US citizen C- Non-US military D- Non-US citizen E- enemy POW
What is the order in which a MEDEVAC request is submitted?
Point of injury (POI), through intermediaries, higher HQ, who then transmit request to nearest MEDEVAC unit
1) Acquire and locate
Provide a rapid response to acquire wounded, injured, and ill personnel. Clear the battlefield of casualties and facilitate and enhance the tactical commander's freedom of movement and maneuver. This task is performed by the medical evacuation crew of the evacuation platform.
Intratheater Medical Evacuation
Provide rapid evacuation utilizing dedicated assets to the most appropriate role of care. Provide a capability to cross-level patients within the theater hospitals and to transport patients being evacuated out of theater to staging facility prior to departure. This task is performed by the evacuation platforms in the medical company (ground ambulance) and medical company (air ambulance).
Medical Company (Ground Ambulance)
Provides MEDEVAC within the theater of operations Normally assigned or attached to the MMB or a MEDBDE (SPT) for mission command Employed in EAB to provide area support Tactically located where it can best control its assets and execute its patient evacuation mission
Medical Company (Air Ambulance) (15 HH-60)
Provides aeromedical evacuation support within the brigade and corps Organic to the GSAB for mission command Employed as needed in the theater, corps, division, or EAB Tactically located where it can best control its assets and execute its patient evacuation mission
Line 2 of 9-line:
Radio frequency, call sign, and suffix. Frequency of radio for pick up site. Call sign and suffix of the person to be contacted at pick up site
Line 6 of 9-line: (wartime)
Security at pickup site N- no enemy troops P- possible enemy troops in area E- enemy troops in area ( proceed with caution) X- enemy troops in area (need armed escort)
Line 4 of 9-line:
Special equipment required A- None B- Hoist C- Extraction equipment D- Ventilator
Requirements for patient acquisition SOP?
Vehicle assignment for the organic medical personnel • Vehicles designated to be used for casualty transport and/or casualty evacuation • Procedures for requesting MEDEVAC support (during routine operations or during mass casualty situations) •Role of the first sergeant, platoon sergeants, and combat lifesavers in MEDEVAC
what does the 9-line MEDEVAC provide?
a standardized message format that helps expedite the medical evacuation process. The same format is used for both air and ground MEDEVAC requests. These are secure messages to provide operational security.
property exchange
all medical equipment remains with patient and army elements exchange property with transferring element
Line 9 of 9-line: (peacetime)
details of terrain features in and around pick up site
What do GSAB air ambulances provide for the BSMC commander?
flexibility/agility in emergency movement of treatment teams/medical equipment blood/blood products class VIII
Line 7 of 9-line:
method of marking pickup site A-panels B- pyrotechnic signal C- smoke signal D- None E- Other
Casualty evacuation (CASEVAC)
movement of casualties aboard nonmedical vehicles or aircraft without en route medical care.
what is a unit with an organic MEDEVAC's primary responsibility?
patient acquisition
MEDEVAC mission considerations:
patient acquisitions ambulance route selection ambulance team duties Area MEDEVAC support Ground ambulances Air ambulances
Medical evacuation (MEDEVAC)
performed by dedicated, medically equipped, and standardized MEDEVAC platforms designed especially for the MEDEVAC mission to provide en route care by trained medical professionals who provide the timely, efficient movement and en route care of the wounded, injured, or ill persons from the battlefield or other locations to MTFs.
Direct support
requiring a force to support another specific force and authorizing it to answer directly to the supported force's request for assistance.
who makes the decision to request a MEDEVAC and determines medical precedence?
senior medical personnel or highest ranking officer on the scene
Medical evacuation definition
timely and effective movement of the wounded, injured, or ill to and between medical treatment facilities on dedicated and properly marked medical platforms with en route care provided by medical personnel.
what do EAB units without organic MEDEVAC resources do?
use evacuation support on an area basis
Ambulance Route Selection
• Tactical mission • Coordinating evacuation plans and operations with the unit movement officer • Security of routes and security escort • Availability of routes • Physical characteristics of roads and cross-country routes (to include natural obstacles) • Requirements to traverse roads in urban areas and potential obstructions from rubble and debris • Traffic density • Time and distance factors • Proximity of possible routes to areas that may be subject to enemy fire • Lines of patient drift • Cover, concealment, and available defilade for moving and stationary vehicles • Obstacle plans •Fire support plan (to ensure MEDEVAC assets are not dispatched onto routes and at the times affected by the fire support mission)