Operational Medicine Medical Education and Training

Evacuation in the Field

CORRESPONDENCE COURSE

U.S. ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL

SUBCOURSE MD0001 EDITION 200

EVACUATION IN THE FIELD

Other subcourses in the Health Care Specialist series provide instruction on treating various wounds and injuries. Many times, the last step given in the treatment instructions is to evacuate the casualty to a medical treatment facility.

This subcourse describes procedures for evacuating casualties to a medical treatment facility or to a point where they can be picked up by an evacuation vehicle and transported to a medical treatment facility.

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Length: 190 Pages

Estimated Hours to Complete: 12

Format: PDF file

Size: 4.9 MB

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Anyone may take this course. However, to receive credit hours, you must be officially enrolled and complete an examination furnished by the Nonresident Instruction Branch at Fort Sam Houston, Texas. Enrollment is normally limited to Department of Defense personnel. Others may apply for enrollment, but acceptance is not guaranteed.
 

Evacuation in the Field

Distance Learning Course
190 Pages
Est. 12 Hours
4.9 MB pdf file

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TABLE OF CONTENTS

 

INTRODUCTION

 

1 TRIAGE AND EVACUATION FLOW

Section I. Triage Procedures

Section II. Evacuation Flow 

Exercises

2 MANUAL CARRIES

Section I. General

Section II. One-Man Carries 

Section III. Two-Man Carries

Exercises

3 LITTERS AND LITTER CARRIES

Section I. Litters

Section II. Dressing a Litter

Section III. Placing a Casualty on a Litter

Section IV. Litter Carries

Exercise

4 GROUND EVACUATION VEHICLES

Section I. Ground Ambulances 

Section II. Nonmedical Military Vehicles

Exercises

5 AEROMEDICAL EVACUATION

Section I. Air Ambulances

Section II. High Performance Hoist Operations

Section III. Aeromedical Evacuation Request

Section IV. Preparing a Landing Site

Exercises

6 REMOVING CASUALTIES FROM TACTICAL VEHICLES

Exercises

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LESSON 1

TRIAGE AND EVACUATION FLOW

Section I. TRIAGE PROCEDURES

1-1. INTEGRATED BATTLEFIELD

Modern weapons are far more deadly and accurate than those used in past conflicts. The AirLand Battle doctrine, which is the Army's basic operational concept, involves preparing for an integrated battlefield in which conventional air and land weapons, nuclear weapons, biological weapons, chemical weapons, and directed energy (laser) weapons may be used. Military commanders will rely upon medical resources to treat, evacuate, and (when possible) return soldiers to duty. In the initial phases of battle, the soldiers who are evacuated, treated, and returned to duty may provide the tactical commander with his only source of trained combat replacements.

1-2. TRIAGE

Triage means sorting. Triage is used to determine the sequence in which casualties are to be treated in order to maximize the number of survivors and to return to duty those soldiers with minor wounds. Triage is also used to determine the sequence in which casualties are to be evacuated. Triage is a continuous process that is performed at each medical treatment facility (MTF) through which the casualties pass. The goal of successful triage is to do the most good for the most people. Triage is usually performed by the most senior medical person available.

1-3. TRIAGE FOR TREATMENT (NONCHEMICAL ENVIRONMENT)

When a medic (or any other person) has more than one casualty, he must decide which casualty to treat first. Some injuries require immediate treatment if the casualty is to live while others can go for a fairly long time without treatment before the casualty's condition deteriorates significantly. When chemical agents are not being used, casualties are triaged as being immediate, delayed, minimal, or expectant and are treated in that order. Triage assures that treatment is directed first toward casualties who have the best chance to survive based upon available medical personnel and supplies. Triage determines the order of treatment, not whether or not treatment is given.

a. Immediate. A casualty in the immediate category requires immediate care if he is to survive. Once a casualty in the immediate category has been treated and the life-threatening or limb-threatening condition controlled (airway obstruction expelled, tourniquet applied, and so forth), the treatment of the casualty's other non-immediate injuries are delayed until the life/limb-threatening conditions of other casualties have been treated. Procedures used are short duration and use only essential medical resources. Examples of casualties in this category include casualties with:

(1) An obstruction of the airway or respiratory distress.

NOTE: A casualty with cardiopulmonary failure in a battlefield situation is categorized

as expectant.

(2) Bilateral femur fractures.

(3) Massive external bleeding.

(4) Shock.

(5) Second and/or third degree burns of the face, neck, hands, feet, perineum, and/or genitalia, but with less than 85 percent of the body's surface burned.

NOTE: A casualty with second or third degree burns of the face or neck will usually be in shock and have respiratory distress.

(6) Penetrating chest injuries.

b. Delayed. A casualty in the delayed category has less risk of death or loss of limb if treatment is delayed than a casualty in the immediate category. Examples of casualties in this category include casualties with:

(1) Extensive soft tissue wounds requiring debridement.

(2) Maxillofacial wounds without airway compromise.

(3) Vascular injuries with adequate distal circulation.

(4) An a vascular limb (damaged blood vessels in the limb resulting in the arm or leg having a poor blood supply or no blood supply).

(5) Second and/or third degree burns on 20 to 85 percent of the casualty's body surface, but not including the face, neck, hands, feet, perineum, or genitalia.

(6) Other open wounds, including an open head wound.

(7) Fractures requiring operative manipulation, debridement, and fixation.

c. Minimal. Casualties in the minimal category generally do not require evacuation to a MTF. These casualties can usually be treated with self-aid (casualty treats himself) or buddy-aid (casualty treated by a nonmedical soldier, such as a combat lifesaver). Treatment by the medic, if needed, can usually be performed quickly. Some of these casualties can be returned to duty. Others can be used by the medic to assist in providing care, defending the immediate area, or evacuating casualties. Examples of casualties in this category include casualties with:

(1) Soft tissue wounds without profuse bleeding (minor lacerations and contusions).

(2) Upper extremity fractures, fingers, dislocations, and sprains.

(3) Second and/or third degree burns under 20 percent of the casualty's body surface and not involving the face, neck, hands, feet, perineum, or genitalia.

(4) Combat stress (battle fatigue).

d. Expectant. Casualties in the expectant category have life-threatening conditions that are beyond the capability of the medic to treat and only complicated and prolonged treatment offers any hope of improving life expectancy. This category is used only if resources are limited. Examples of casualties in this category include casualties with:

(1) Massive head injuries with signs of impending death (unresponsive with penetrating head wounds).

(2) Burns, mostly third degree, covering more than 85 percent of the body's surface area.

(3) Mutilating wounds involving multiple structures.

(4) Agonal respirations (ineffective gasping breaths).

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