Evacuate Casualties

Conditions: You are a soldier deployed to a unit in a forward area. There are casualties that must be evacuated to receive medical aid. The casualties have had self-aid or buddy-aid applied. A military vehicle (ground vehicle or rotary-wing aircraft) is available. You may have a litter and straps (or materials to improvise them) to secure the casualty and other soldiers available to assist in the evacuation.

Standards: Transported the casualties to medical aid or a pickup site using an appropriate carry or, if other soldiers are available, by litter. The litter was loaded onto a military vehicle (ground vehicle or rotary-wing aircraft) without dropping or causing further injury to the casualty.

Performance Steps

1. Request medical evacuation. (See Task 081-831-0101.)

   a. Make contact.

   b. Determine whether casualties must be moved or will be picked up at current location.  If they must be moved, continue with step 2.  If they will not be moved, continue to monitor communications and go to step 5.

2. Transport a casualty using the one and two man carries. (See STP 21-1-SMCT, Task 081-831-1046.)

Note. Perform these procedures when medical and combat lifesaver personnel are not available. As soon as medical personnel are available, assist them, as necessary, in treating and evacuating the casualties.

3. Move a casualty, if necessary, using a four-man litter squad.

Note. If military vehicles and litter materials are not available, continue with step 4.

Note. Four-man litter squad bearers should be designated with a number from 1 to 4. The litter bearer designated as #1 is the leader of the squad.

   a. Prepare the litter.

       (1)  Open a standard litter.

       (2)  Lock the spreader bars at each end of the litter with your foot.

   b. Prepare the casualty.

       (1)  Place the casualty onto the litter using the modified two-man arms carry or the modified two-man fore-and-aft carry.

       (2)  Secure the casualty to the litter with litter straps.

   c. Lift the litter.

       (1)  Position one squad member at each litter handle with the litter squad leader at the casualty's right shoulder.

Note. The leader should be at the right shoulder to monitor the casualty's condition.

       (2)  On the preparatory command, "PREPARE TO LIFT,” the four bearers kneel beside and grasp the litter handles.

       (3)  On the command, "LIFT,” all bearers rise together.

       (4)  On the command, "FOUR MAN CARRY, MOVE,” all bearers walk forward in unison.

           (a)   If the casualty does not have a fractured leg, carry the casualty feet first on level ground and head first when going up hill.

           (b)   If the casualty has a fractured leg, carry the casualty head first, except when going up hill.

   (5)  To change direction of movement, such as from feet first to head first, begin in a litter-post carry position.  The front and back bearers release the litter and the middle bearers rotate the litter and themselves.

4. Load casualties onto a military vehicle.

   a. Ground ambulance.

Note. Ground ambulances have medical specialists to take care of the casualties during evacuation. Follow any special instructions for loading, securing, or unloading casualties.

       (1)  Make sure each litter casualty is secured to his or her litter.  (Use litter straps when available.)

       (2)  Load the most serious casualty last.

       (3)  Load the casualty head first (head in the direction of travel) rather than feet first.

       (4)  Make sure each litter is secured to the vehicle.

   b. Air ambulance.

Note. Air ambulances have medical specialists to take care of the casualties during evacuation. Follow any special instructions for loading, securing, or unloading casualties.

       (1)  Remain 50 yards from the helicopter until the litter squad is signaled to approach the aircraft.

       (2)  Approach the aircraft in full view of the aircraft crew, maintaining visual confirmation that the crew is aware of the approach of the litter party.  Ensure that the aircrew can continue to visually distinguish friendly from enemy personnel at all times.  Maintain a low silhouette when approaching the aircraft.

       (3)  Approach UH-60/UH-1 aircraft from the sides.  Do not approach from the front or rear.  If you must move to the opposite side of the aircraft, approach from the side to the skin of the aircraft.  Then, hug the skin of the aircraft, and move around the front of the aircraft to the other side.

       (4)  Load the most seriously injured casualty last.

       (5)  Load the casualty who will occupy the upper birth first, then load the next litter casualty immediately under the first casualty.

Note. This is done to keep the casualty from accidentally falling on another casualty if his litter is dropped before it is secured.

       (6)  When casualties are placed lengthwise, position them with their heads toward the direction of travel.

       (7)  Make sure each litter casualty is secured to his or her litter.

       (8)  Make sure each litter is secured to the aircraft.

   c. Ground military vehicles.

Note. Nonmedical military vehicles may be used to evacuate casualties when no medical evacuation vehicles are available. If medical personnel are present, follow their instructions for loading, securing, and unloading casualties.

       (1)  When loading casualties into the vehicle, load the most seriously injured casualty last.

       (2)  When a casualty is placed lengthwise, load the casualty with his or her head pointing forward, toward the direction of travel.

       (3)  Ensure each litter casualty is secured to the litter.  (Use litter straps, if available.)

       (4)  Secure each litter to the vehicle as it is loaded into place.  Make sure each litter is secured.

       (5)  Watch the casualties closely for life-threatening conditions and provide first aid, as necessary.