CIANURO DE POTASIO

Medical evacuation encompasses both the evacuation of Soldiers from the point of injury or wounding to an MTF staffed and equipped to provide essential care in the AO and further evacuation from the AO to provide definitive, rehabilitative, and convalescent care in CONUS.

SECTION I — INTEGRATED MEDICAL EVACUATION SYSTEM

MEDICAL EVACUATION SYSTEM

8-1. Medical evacuation is the system which provides the vital linkage between the roles of care necessary to sustain the patient during transport. This is accomplished by providing en route medical care and emergency medical intervention, if required, which enhances the individual’s prognosis and reduces long-term disability.

8-2. Army medical evacuation is a multifaceted mission accomplished by a combination of dedicated ground and air evacuation platforms synchronized to provide direct support, general support, and area support within the AO. At the operational level, organic or direct support medical evacuation resources locate, acquire, treat, and evacuate Soldiers from the point of injury or wounding to an appropriate MTF.

Soldiers are then stabilized, prioritized, and prepared for further evacuation, if required, to an MTF capable of providing required essential care within the AO.

8-3. The mission of Army medical evacuation assets is the evacuation and provision of en route medical care to wounded. However, the essential and vital functions of medical evacuation resources encompass many additional missions and tasks that support the AHS. Medical evacuation resources/assets are used to transfer patients between MTFs within the AO and from MTFs to USAF mobile aeromedical staging facilities or aeromedical staging facilities; emergency movement of Class VIII, blood and blood products, medical personnel and equipment; and serve as messengers in medical channels.

8-4. The appropriate level of care must be maintained throughout the continuum of care. A patient who has received complex care such as damage control resuscitation or damage control surgery requires continuous maintenance of the critical care support that was initiated at the forward MTF. To avoid the risk that these patients will deteriorate during transport, the level of care should not be decremented during en route care. Based on the appropriate level of care, the medical personnel providing en route care may be paramedics, nurses, or other properly trained medical specialists. When possible, this en route care should be used as far forward as mission, enemy, terrain and weather, troops and support available, time available, and civil considerations allows.

T

E

P

8-5. The theater evacuation policy is established by the Secretary of Defense, with the advice of the Joint Chiefs of Staff, and upon the recommendation of the combatant commander. The policy establishes, in number of days, the maximum period of noneffectiveness (hospitalization and convalescence) that patients may be held within the AO for treatment. This policy does not mean that a patient is held in the AO for the entire period of noneffectiveness. A patient who is not expected to be ready to return to duty within the number of days established by the theater evacuation policy is treated, stabilized, and then evacuated out of the AO. This is done providing that the treating physician determines that such evacuation will not aggravate the patient’s disabilities or medical condition. For example, a theater evacuation policy of seven

days does not mean that a patient is held in the AO for seven days and then evacuated. Instead, it means that a patient is evacuated as soon as possible after the determination is made that he cannot be returned to duty within seven days following admission to a Role 3 MTF.

E

P

The following paragraph implements STANAG 2087 and 3204.

8-6. The initial decision for evacuation priorities is made by the treatment element or the senior nonmedical person at the scene. Soldiers are evacuated by the most expeditious means of evacuation based on their medical condition, assigned evacuation precedence, and availability of medical evacuation platforms. Patients may be evacuated from the point of injury or wounding to an MTF in closest proximity to the point of injury/wounding to ensure they are stabilized to withstand the rigors of evacuation over great distances. The evacuation precedences for the Army operations at Roles 1 through 3 are—

 Priority I, URGENT is assigned to emergency cases that should be evacuated as soon as possible and within a maximum of one hour to save life, limb, or eyesight and to prevent complications of serious illness and to avoid permanent disability.

 Priority IA, URGENT-SURG is assigned to patients who must receive far forward surgical intervention to save life and stabilize for further evacuation.

 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.

 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 IV, CONVENIENCE is assigned to patients for whom evacuation by medical vehicle is a matter of medical convenience rather than necessity.

Note. The NATO STANAG 3204 has deleted the category of Priority IV, CONVENIENCE.

However, this category is still included in the U.S. Army evacuation priorities as there is a requirement for it in an OE.

R

8-7. The Service component commander is responsible for medical evacuation at the operational level and is responsible for executing the medical evacuation of his forces. Strategic aeromedical evacuation is the responsibility of the U.S. Transportation Command.

8-8. Within Army support to other Services, Army resources may provide ship-to-shore medical evacuation on an area support basis. Medical evacuation from shore-to-ship for deployed USN and U.S.

Marine Corps forces could also be available within the Army’s support capabilities.

ORGANIZATIONS

8-9. There are two types of U.S. Army medical evacuation platforms—air (rotary-wing) and ground.

These platforms are dedicated and designed, equipped, and staffed to perform the medical evacuation mission.

G

A

8-10. Ground ambulances are organic to BCT maneuver battalion medical platoons and to both the brigade support medical company and the medical company (area support). In the maneuver battalion medical platoons, the actual vehicle platform (wheeled or tracked) varies with the type of parent unit. Both the brigade support medical company and the medical company (area support) have wheeled vehicles.

Maneuver Battalion Medical Platoon

8-11. The organic medical platoon ground ambulances provide medical evacuation support from the point of injury, company aid post, or casualty/patient collection point to the battalion aid station. In armor BCTs depending upon the mission, enemy, terrain and weather, troops and support available, time available, and civil considerations factors and the medical evacuation plan, the tracked ambulances may evacuate the patient to an ambulance exchange point and transfer the patient to a wheeled ambulance for further movement to an MTF. This enables the tracked ambulance to keep pace with the maneuvering force.

Brigade Support and/or Area Support Medical Company Evacuation Platoon

8-12. The medical company (brigade support) evacuation platoon provides medical evacuation support on an area basis to units within its assigned AO. Additionally, it provides direct support to evacuate patients from the supported battalion aid stations to the medical company Role 2 MTF.

8-13. The medical company (area support) provides supported EAB units with medical evacuation support on an area basis for those units that do not have organic medical evacuation resources.

Medical Company (Ground Ambulance)

8-14. The mission of the medical company (ground ambulance) is to provide ground evacuation within the theater. This unit provides direct support to BCTs and is employed in the EAB to provide area support. It is tactically located where it can best control its assets and execute its patient evacuation mission. This unit has a single-lift capability for evacuation of 96 litter patients or 192 ambulatory patients.

A

A

8-15. The medical company (air ambulance) (HH-60) is assigned to the general support aviation battalion, combat aviation brigade. This unit provides air medical evacuation for all categories of patients consistent with evacuation precedence and other operational considerations within the AO. It evacuates patients from point of injury or Roles 1 and 2 MTFs to theater hospitals established in EAB. This unit has a single-lift capability of 72 litter patients or 84 ambulatory patients, or some combination thereof.

PRIMARY TASKS

8-16. Table 8-1 discusses the primary tasks of the medical evacuation function.

Table 8-1. Primary tasks and purposes of the medical evacuation function

Primary Task Purpose

Acquire, locate, treat, stabilize, and evacuate

Clear the battlefield of casualties to facilitate and enhance the tactical commander’s freedom of movement. This task is performed by the medical crew of the evacuation platform.

En route medical care Maintain the patient’s medical condition during transport and provide emergency medical intervention when required. This task is performed by the medical evacuation crew.

Area support Provide medical evacuation for units without organic medical evacuation assets. This task is performed by medical evacuation platforms in Roles 1 and 2 and by medical evacuation platforms in the medical company (ground ambulance) and the medical company (air ambulance).

Table 8-1. Primary tasks and purposes of the medical evacuation function (continued)

Primary Task Purpose

Emergency movement of medical

personnel, supplies, and equipment Provide a rapid response for the emergency movement of scarce medical resources throughout the operational environment when required by the tactical situation.

Transfer of patients between medical treatment facilities and mobile aeromedical staging facilities

Provide a capability to cross-level patients within the theater hospitals and to transport patients being evacuated out of the theater to staging facility prior to flight departure.

Medical property transfer Provide a reciprocal procedure to exchange like medical property when patients are evacuated with equipment accompanying them.

Medical regulating support Provide support to medical regulating activities to ensure vital linkup between tactical evacuation support and the scheduling of patients for evacuation out of theater by strategic aeromedical evacuation resources.

8-17. For additional information on medical evacuation and medical regulating, refer to JP 4-02 and AR 40-3.