EVACUATION: PARALLELS TO
CIVILIAN SYSTEMS
Save lives
Reduce permanent morbidity and deficits
Return fighting force to battlefront
Evacuate casualties for definitive care
STANDARD TRIAGE
Provide orderly care to those who need most
urgently
Save most number of lives
Coded system:
Green: minor injuries
Yellow: major injuries, acceptable for delayed
care
Red: major injuries, require immediate
treatment
Black: expectant
MILITARY CARE FOR
BATTLEFIELD CASUALTIES
Depend upon battlefield conditions
Urban vs rural mountainous terrain
Small arms fire vs. explosive
devices
Geography of battlefield
Dedicated resources available on
site
Health care system primary mission
is treatment of casualties
CARE OF BATTLEFIELD
CASUALTIES
Stratified to provide immediate
access to basic care
Stabilization in the battle field
Progressive levels of evacuation to
advanced care in rear
Evacuation to homeland for
definitive care & recovery
DIFFERENTIATED LEVELS OF
CARE
Echelon I: Buddy-aid,
corpsman/medic, First-Aid Station
Echelon II: FST / FRSS field support
hospital with surgical capacity
Echelon III: fixed base advanced
care hospital
Echelon IV: complex advanced
stabilization and care
Echelon V: definitive CONUS hospital
ECHELON I
Buddy-aid: every soldier carries
tourniquet, QuikClot pack
Medic/Corpsman first aid pack
with I.V.'s RL, bandages, needles
First Aid Station: if available, GMO
/ ER physician
CASUALTY EVACUATION
Casualty evacuation via ground
ambulance CASEVAC
Difficult terrain
Remote location
Medical evacuation MEDEVAC
Air rescue by Blackhawk/Seahawk
or Chinook helicopter
ECHELON II
Forward
surgical
capability
Mobile combat
support
hospital
Basic surgical
capacity to
save lives
ECHELON III
Fixed brick/mortar hospital with
ICU capacity, advanced radiology,
neurosurgical & orthopedic
capability
AEROMEDICAL EVACUATION
Critical care transport in air
Transcontinental evacuation
Transport of mass casualties
Provision of sophisticated ICU care while
en route
ECHELON IV
Landstuhl Regional Medical Center,
Germany
Intermediate advanced surgical
care for stabilization
Intensive care unit provisions
ECHELON V
Definitive care for battle injuries
Recuperation in CONUS
Walter Reed MC, Bethesda NMC,
Brooke AMC
CIVILIAN MASS CASUALTIES
Acute isolated event
Extensive destruction
Large number of ill, injured, or dead
Health facilities overwhelmed by ill or injured
Resources damaged or limited
Natural and Geologic
Weather and Atmospheric
Biologic and Infectious
Terrorist Acts
Man-made Accidents
Catastrophes
CIVILIAN HOSPITAL PREPAREDNESS