Transport a Casualty
Conditions: You have evaluated and given first aid to a casualty. You need to move the casualty to get further medical aid. There may or may not be other soldiers to help. Necessary equipment and materials: two pistol belts or rifle slings or improvised material that will not cut or bind the casualty (cravat bandages or litter straps), poncho, shirts or jackets, and poles or tree limbs.
Standards: Transported the casualty using an appropriate carry without dropping or causing further injury to the casualty.
Performance Steps
1. Select an appropriate carry for the casualty.
WARNING: Do not use manual carries to move a casualty with a neck or spine injury, unless a life-threatening hazard is in the immediate area. Seek medical personnel for guidance on how to move and transport the casualty.
a. Fireman's carry. Use for an unconscious or severely injured casualty.
b. Support carry. Use for a casualty who is able to walk or hop on one leg.
c. Arms carry. Use for short distances only, for a casualty who is unable to walk.
d. Saddleback carry. Use for a conscious casualty only.
e. Pack-strap carry. Use for carrying a casualty moderate distances.
f. Pistol-belt carry. Use for long distances. This carry allows the hands of the casualty and bearer to be free.
g. Pistol-belt drag. Use in combat, generally for short distances.
h. Neck drag. Use in combat, generally for short distances.
CAUTION: Do not use the neck drag if the casualty has a broken arm or a suspected neck injury
i. Cradle-drop drag. Use to move a casualty who cannot walk when being moved up or down stairs.
j. Two-man support carry. Use for both conscious and unconscious casualties.
k. Two-man arms carry. Use for moderate distances and for placing a casualty on a litter.
Note. In extreme emergencies, the two-man arms carry is the safest for transporting a casualty with a back or neck injury. If possible, use two more bearers to keep the casualty's head and legs in alignment with his body.
l. Two-man fore-and-aft carry. Use for long distances and for placing a casualty on a litter.
m. Two-hand seat carry. Use for carrying a casualty short distances and for placing him on a litter.
n. Four-hand seat carry. Use for moderate distances for a casualty who is conscious and can stand but not walk. Can be used to place a casualty on a litter and is especially useful in transporting a casualty with a head or foot injury.
o. Use litters if materials are available, if the casualty must be moved a long distance, or if manual carries will cause further injury.
2. Perform the carry.
a. Fireman's carry.
(1) Kneel at the casualty's uninjured side.
(2) Place casualty's arms above the head.
(3) Cross the ankle on the injured side over the opposite ankle.
(4) Place one of your hands on the shoulder farther from you and your other hand on his hip or thigh.
(5) Roll the casualty toward you onto his abdomen.
(6) Straddle the casualty.
(7) Place your hands under the casualty's chest and lock them together.
(8) Lift the casualty to his knees as you move backward.
(9) Continue to move backward, thus straightening the casualty's legs and locking the knees.
(10) Walk forward, bringing the casualty to a standing position but tilted slightly backward to prevent the knees from buckling.
(11) Maintain constant support of the casualty with one arm. Free your other arm, quickly grasp his wrist, and raise the arm high.
(12) Instantly pass your head under the casualty's raised arm, releasing it as you pass under it.
(13) Move swiftly to face the casualty.
(14) Secure your arms around his waist.
(15) Immediately place your foot between his feet and spread them (approximately 6 to 8 inches apart).
(16) Again grasp the casualty's wrist and raise the arm high above your head.
(17) Bend down and pull the casualty's arm over and down your shoulder bringing his body across your shoulders. At the same time pass your arm between the legs.
(18) Grasp the casualty's wrist with one hand while placing your other hand on your knee for support.
(19) Rise with the casualty correctly positioned.
Note. Your other hand is free for use as needed.
b. Support carry.
(1) Raise the casualty to a standing position as in the fireman's carry.
(2) Grasp the casualty's wrist and draw his arm around your neck.
(3) Place your arm around his waist.
Note. The casualty is thus able to walk using you as a crutch.
c. Arms carry.
(1) Raise the casualty to a standing position as in the fireman's carry.
(2) Place one arm under the casualty's knees and your other arm around his back.
(3) Lift the casualty carrying him high to lessen fatigue.
d. Saddleback carry.
(1) Raise the casualty to a standing position as in the fireman's carry.
(2) Support the casualty by placing an arm around his waist.
(3) Move in front with your back to him.
(4) Have the casualty encircle your neck with his arms.
(5) As you stoop, raise the casualty upon your back.
(6) Clasp your hands together beneath his thighs if possible.
e. Pack-strap carry.
Note. In this carry the casualty's weight rests high on the bearer's back. To eliminate the possibility of injury to the casualty's arms, the bearer must hold the casualty's arms in a palms-down position.
(1) Raise the casualty to a standing position as in the fireman's carry.
(2) Supporting the casualty with your arms around him, grasp the wrist closer to you.
(3) Place the arm over your head and across your shoulder.
(4) Move in front of the casualty while supporting his weight against your back.
(5) Grasp the other wrist.
(6) Place this arm over your shoulder.
(7) Bending forward, hoist the casualty as high on your back as possible so all his weight is resting on your back.
f. Pistol-belt carry.
(1) Link two pistol belts (or three, if necessary) together to form a sling.
Note. If pistol belts are not available for use, other items, such as one rifle sling, two cravat bandages, two litter straps, or any suitable material that will not cut or bind the casualty may be used.
(2) Place the sling under the casualty's thighs and lower back so a loop extends from each side.
(3) Lie face up between the casualty's outstretched legs.
(4) Thrust your arms through the loops.
(5) Grasp the hand and trouser leg on the casualty's injured side.
(6) Roll toward the casualty's uninjured side onto your abdomen, bringing him onto your back.
(7) Adjust the sling as necessary.
(8) Rise to a kneeling position.
Note. The belt will hold the casualty in place.
(9) Placing one hand on your knee for support, rise to an upright position.
Note. The casualty is now supported on your shoulders.
(10) Carry the casualty with your hands free for use in rifle firing, climbing banks, or surmounting obstacles.
g. Pistol-belt drag.
(1) Extend two pistol belts (or three, if necessary) or similar objects to their full length and join them together to make one loop.
(2) Roll the casualty onto his back.
(3) Pass the loop over the casualty's head and position it across his chest and under the armpits.
(4) Cross the remaining portion of the loop forming a figure eight.
Note. Keep tension on the belts so they do not become unhooked.
(5) Lie on your side facing the casualty, resting on your elbow.
(6) Slip the loop over your arm and shoulder on which you are leaning.
(7) Turn away from the casualty onto your abdomen so you can drag the casualty as you crawl.
h. Neck drag.
WARNING: Do not use the neck drag if the casualty has a broken and/or fractured arm or a suspected neck injury. If the casualty is unconscious, protect his head from the ground.
(1) Tie the casualty's hands together at the wrists. (If conscious, the casualty may clasp his hands together around your neck.)
(2) Straddle the casualty in a kneeling face-to-face position.
(3) Loop the casualty's tied hands over and/or around your neck.
(4) Crawl forward, looking ahead, dragging the casualty with you.
i. Cradle drop drag.
(1) With the casualty lying on his back, kneel at the head.
(2) Slide your hands, palms up, under the casualty's shoulders.
(3) Get a firm hold under his armpits.
(4) Partially rise, supporting the casualty's head on one of your forearms.
Note. You may bring your elbows together and let the casualty's head rest on both of your forearms.
(5) With the casualty in a semi-sitting position, rise and drag the casualty backwards.
(6) Back down the steps (or up if appropriate), supporting the casualty's head and body and letting the hips and legs drop from step to step.
j. Two-man support carry.
(1) Two bearers help the casualty to his feet and support him with their arms around his waist.
(2) The bearers grasp the casualty's wrists and draw his arms around their necks.
k. Two-man arms carry.
Note. In extreme emergencies, when there is no time to obtain a board, this carry is the safest for transporting a casualty with a back and/or neck injury. Use two additional bearers to keep the head and legs in alignment with the body.
(1) Two bearers kneel at one side of the casualty and place their arms beneath the casualty's back (shoulders), waist, hips, and knees.
(2) The bearers lift the casualty as they rise to their knees. Keep the casualty's body level to prevent unnecessary movement and further injury.
(3) As the bearers rise to their feet, they turn the casualty toward their chests. To lessen fatigue, bearers should carry the casualty high and as close to their chests as possible.
l. Two-man fore-and-aft carry.
(1) Position the casualty on his back, if necessary.
(2) The taller of the bearers kneels at the casualty's head.
(3) The shorter bearer spreads the casualty's legs and kneels between the legs with his back to the casualty.
(4) The shorter bearer positions his hands behind the casualty's knees.
(5) The taller bearer kneels at the casualty's head, slides his hands under the casualty's arms and across the chest, and locks his (bearer's) hands together.
(6) The bearers rise together while lifting the casualty.
Note. The alternate method, with both bearers facing the casualty, is useful for placing the casualty on a litter.
m. Two-hand seat carry.
(1) Position the casualty on his back, if necessary.
(2) A bearer kneels on each side of the casualty at the hips.
(3) Each bearer passes his arms under the casualty's thighs and back, and grasps the other bearer's wrists.
(4) The bearers rise while lifting the casualty.
n. Four-hand seat carry.
(1) Each bearer grasps one of his own wrists and one of the other bearer's wrists to form a packsaddle.
(2) The bearers lower themselves sufficiently for the casualty to sit on the packsaddle.
(3) The casualty places his arms around the bearers' shoulders for support.
(4) The bearers rise to an upright position.
o. Improvised litter.
(1) Use the poncho and two poles or limbs.
(a) Open the poncho and lay the two poles lengthwise across the center forming three equal sections.
(b) Reach in and pull the hood up toward you and lay it flat on the poncho.
(c) Fold one section of the poncho over the first pole.
(d) Fold the remaining section of the poncho over the second pole to the first pole.
(2) Use shirts or jackets and two poles or limbs.
(a) Button two or three shirts or jackets and turn them inside out leaving the sleeves inside.
(b) Lay the shirts or jackets on the ground and pass the poles through the sleeves.
(3) Place the casualty on the litter by using any of the following carries:
(a) One-man arms carry.
(b) Two-man arms carry.
(c) Two-man fore-and-aft carry.
(d) Two-hand seat carry.
(e) Four-hand seat carry.
(4) Lift the litter.
(a) Raise the litter together.
(b) Keep the litter as level as possible.
Note. Use caution when transporting on a slope, incline, and/or hill.
