1 Reason JSOMTC, SWMG(A) Slide 4 Agenda Define and differentiate - - PDF document

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Slide 1 JSOMTC, SWMG(A)

CASEVAC and Casualty Documentation PFN: SOMEML08

Hours: 1.0 Instructor:

Slide 2

JSOMTC, SWMG(A)

Terminal Learning Objective

 Action: Communicate knowledge of

CASEVAC and casualty documentation

 Condition: Given a lecture in a classroom

environment

 Standard: Received a minimum score of

75% on the written exam IAW course standards

Slide 3

JSOMTC, SWMG(A)

References

 AR 40‐66 Medical Record Administration

and Health Care Documentation

 FM 8‐10‐6 Medical Evacuation in a Theatre

• f Operations, Tactics, Techniques and

Procedures

 FM 4‐02.2 Medical Evacuation  STP 8‐68W13‐SM‐TG Soldiers Manual and

Trainer’s Guide

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JSOMTC, SWMG(A)

Reason

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JSOMTC, SWMG(A)

Agenda

 Define and differentiate between CASEVAC,

MEDEVAC, and TACEVAC

 Describe the procedures for requesting casualty

evacuation

 Describe the process of documenting casualty

information

 Define the 4 roles of military care

Slide 6 JSOMTC, SWMG(A)

Define and differentiate between CASEVAC, MEDEVAC, and TACEVAC

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JSOMTC, SWMG(A)

MEDEVAC

• Clearly marked

medical platform

• Medical personnel

and supplies

• nboard
• Configured to

receive patients

• Not allowed to be

armed or render lethal aid under the Geneva convention

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JSOMTC, SWMG(A)

CASEVAC and TACEVAC



CASEVAC ‐‐Casualty Evacuation



The Unregulated (by the Geneva Convention) movement of casualties.



Does not have to be on a strictly medical platform (gun truck, LMTV, MRAP, armed aircraft, etc)



Is not marked as a medical platform, and can there fore render lethal aid



TACEVAC—Tactical Evacuation



Blanket Category that includes booth CASEVAC and MEDEVAC



The current language used by the TCCC committee



Denotes any and all transport that evacuates a PT in a tactical situation.



Intended as a blanket term allaying confusion on what is “MEDEVAC” vs. “TACEVAC”

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JSOMTC, SWMG(A)

Decision to MEDEVAC/CASEVAC

 Made by the Senior Military Person Present  Decision based on mission requirements,

tactical situation and the advice and input

• f the senior medical provider

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JSOMTC, SWMG(A)

Describe the procedures for requesting casualty evacuation

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JSOMTC, SWMG(A)

Basic 9‐Line Format

 Line 1: Location  Line 2: Radio Freq/Call

Sign

 Line 3: Number of

Patients by Precedence

 Line 4: Special Equipment  Line 5: Number of

Patients by Type

 Line 6 (Wartime): Security  Line 6 (Peacetime) Type of

Injury

 Line 7: Method of

Marking

 Line 8: Patient Nationality

and Status

 Line 9 (Wartime): NBC  Line 9 (Peacetime):

Terrain description

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JSOMTC, SWMG(A)

Line 1 ‐ 2

 (LINE 1) Location of Pickup Site

• Grid zone designator, map sheet number, and

six digit grid

• Codename

 (LINE 2) Radio Frequency and Call Sign

• Frequency/Call sign for the unit on the ground

with the casualty

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JSOMTC, SWMG(A)

Line 3

 (LINE 3) Number of Patients by Precedence

• A = Urgent: 2 Hours to save life, limb or

eyesight

• B = Urgent Surgical: Forward surgical

intervention required to save life or permit survival along evacuation chain

• C = Priority: 4 Hours
• D = Routine: 24 Hours
• E = Convenience:

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JSOMTC, SWMG(A)

Line 4

 (LINE 4) Special Equipment Required

• Ventilator
• Extraction devices (Jungle Penetrator, other

hoisting equipment, etc.)

• Use applicable Brevity Codes
• A ‐ None
• B ‐ Hoist
• C ‐ Extraction equipment
• D ‐ Ventilator

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JSOMTC, SWMG(A)

Line 5

 (LINE 5) # of Patients by Type

• Ambulatory versus litter
• Critical for sending correct number and type of

EXFIL platforms with proper configuration

• Utilize applicable Brevity Codes
• L ‐ Litter patient
• A ‐ Ambulatory patient

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JSOMTC, SWMG(A)

Line 6

 (LINE 6) Wartime: Security of Pickup Site

• Encrypt applicable Brevity Codes
• N ‐ No enemy troops in area
• P ‐ Caution: Enemy contact unlikely
• E ‐ Caution: Enemy contact possible
• X ‐ Danger: Active enemy in area

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JSOMTC, SWMG(A)

Line 6

 (LINE 6) Peacetime: Wound, Injury or Illness

• Spins up the appropriate personnel and

equipment

• Smart guys might bring something you forgot

to request

• Provide specific wound(s) information
• Blunt or penetrating, GSW, shrapnel, MVA
• Patient’s blood type if known

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JSOMTC, SWMG(A)

Line 7

 (LINE 7) Method of Marking Pickup Site

• Day: Panels, smoke (You pop, He identifies

color, You confirm)

• Night: Pyrotechnics, chemlights, strobe etc.
• Whatever you use, make sure you perform a

functions check and secure it to the PZ if necessary

• Utilize applicable Brevity Codes
• A ‐ Panels, B ‐ Pyro, C ‐ Smoke, D ‐ None, E ‐ Other

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JSOMTC, SWMG(A)

Line 8

 (LINE 8) Patient Nationality and Status

• Friendly INDIG Versus Enemy INDIG
• Utilize applicable Brevity Codes
• A‐ US military
• B‐ US civilian
• C‐ Non US military
• D‐ Non US civilian
• E‐ EPW

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JSOMTC, SWMG(A)

Line 9

 (LINE 9) Wartime: NBC Contamination

• Utilize applicable Brevity Codes
• N ‐ Nuclear
• B ‐ Biological
• C ‐ Chemical

 (LINE 9) Peacetime: Terrain Description

• Trees, wires, slope of terrain
• Can use major terrain feature for PZ ID

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JSOMTC, SWMG(A)

MIST Report

 Given with 9 line request  Provides additional information on

patient’s condition

M – Mechanism of injury and time of injury I – Injury or illness S – Symptoms and vital signs T – Treatment given

Slide 23

JSOMTC, SWMG(A)

Describe the process of documenting casualty information

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JSOMTC, SWMG(A)

Facts

 30,000 Wounded in Action in OEF/OIF  Less than 10% have any form of pre‐

hospital documentation

 In only 1% of cases is the information

sufficient

 “Home grown” formats were used in many

cases of successful documentation

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JSOMTC, SWMG(A)

Why Document?

 Transfer critical patient information to the

next provider

 Legal record of care/potential disability

benefits post service

 Gather data to enhance training and

equipment for the pre‐hospital provider

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JSOMTC, SWMG(A)

DD Form 1380 Field Medical Card (FMC)

Slide 27

JSOMTC, SWMG(A)

Tactical Combat Casualty Care (TCCC) Card DA Form 7656

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JSOMTC, SWMG(A)

TCCC Card ‐ 2014 Version

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JSOMTC, SWMG(A)

Scenario

While on a vehicle patrol, the second vehicle in your movement hits an IED while moving at 25

• mph. It is 0200. The driver is killed and Joe your

commo man is thrown 20 feet from the vehicle. He has no allergies. He has a lower left leg amputation, shrapnel to right posterior shoulder and neck, and his airway is compromised. You cric him on the scene. At 0205 you treat the amputation with a tourniquet and stump

• dressing. You give him 500 ml Hextend IV.

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JSOMTC, SWMG(A)

Scenario Continued

 You administer 50 mg Ketamine IN at 0230  You administered 1 gm Ertapenem IV at

0230

 Vitals were taken at 0210 and 0232, patient

was responsive to pain on both occasions. Pulse was 120 and strong on both readings. Respirations were 18 S/R, and Pt had palpable radial pulses on 2nd reading after Hextend administration.

 Patient was evacuated at 0235.

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JSOMTC, SWMG(A)

Verbal Handoff

 What on this card should be included in a

verbal handoff to evacuation personnel?

 How would you conduct a handoff if you

didn’t have time for written documentation?

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Slide 34

JSOMTC, SWMG(A)

Define the 4 roles of military care

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JSOMTC, SWMG(A)

Multi Tiered System

 "Roles" 1 through 4  Covers point of injury through definitive

care, and every step in between

 No tier will be skipped unless strictly for

reasons of medical expediency

 Same system utilized throughout DOD, but

with different actual unit structures

Slide 36

JSOMTC, SWMG(A)

Role 1: 1st Responder throughBn Aid Station

 1st echelon of Care  Medic/Corpsman, 18D/SOCM,

PA

 No definitive surgical capability  Extremely limited Patient hold

capability

 Conventional: Typically a Bn

Aid station

 SOF: medical capabilities at

team level are essentially Role 1 care INTENT: Stabilize as permitted by

• rganic capabilities

and evacuate rapidly.

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JSOMTC, SWMG(A)

Role 2: Furthest Forward Primary Care

 PA/medics  Brigade level asset (Army)

means different things to different services

 May include X‐ray, dental,

preventive med, laboratory.

 Has blood products, capable of

advanced trauma management

 Limited patient hold.

INTENT: Provide primary care to assigned forward deployed unit, stabilize combat casualties within

• rganic

capabilities.

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JSOMTC, SWMG(A)

Role 2: Cont.

 NATO doctrine includes damage control surgery

as a role 2 capability, US doctrine does not.

 HOWEVER

• US Navy has surgical capability (shipboard

platform) organic to role 2, USMC has integrated capability.

• US Air Force has both a surgical role 2 and

stand alone surgical capability

• US Army compartmentalizes between the

medical company (non‐surgical role 2) and the stand alone Forward Surgical Team.

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JSOMTC, SWMG(A)

Forward Surgical Team

 Stand along surgical

capability

 Mobile team, requires

support: power, water, etc.

 Slightly different structures

for different services, same essential objective

 Ideally housed in a role 2

facility, upgrading the role 2 for a true surgical capability INTENT: Deploy damage control surgery capability as far forward as possible.

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JSOMTC, SWMG(A)

Role 3: Short Term Definitive Care

 Surgery capable definitive

care facility with large patient hold capacity.

 Gets a solid patient

disposition, then sends patient back to unit for light duty etc. or CONUS for advanced follow on care.

 Typical patient dwell time 1

week or less.

INTENT: Definitive (surgical) treatment followed by either RTD or further evacuation.

Slide 41

JSOMTC, SWMG(A)

Role 4: CONUS or Allied Country Care

 Role 4 medical care is found in

CONUS‐based hospitals and

• ther safe havens. Mobilization

requires expansion of military hospital capacities and the inclusion of the Department of Veterans Affairs and civilian hospital beds in the National Disaster Medical System to meet the increased demands created by the evacuation of patients from the area of

• perations. ‐‐Emergency War

Surgery Handbook INTENT: Provides full spectrum medical services in the environment of first‐world care.

Slide 42

JSOMTC, SWMG(A)

SOF vs. Conventional Forces

SOF

 Supported as Mission

• dictates. May be supported

by conventional forces, may build a completely different network.

 Call goes to HQ element

(sometimes), and is routed as mission dictates

 Support structure changes

radically with mission and

• location. You might have to

build your own support.

Conventional

 Has doctrinally set support

structures that fit within the

• rganization's doctrinal

role.

 Patient doctrinally goes to

role 1 and progresses up the chain

 TO&Es are always there

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JSOMTC, SWMG(A)

Questions?

Slide 44

JSOMTC, SWMG(A)

Agenda

 Define and differentiate between CASEVAC,

MEDEVAC, and TACEVAC

 Describe the procedures for requesting casualty

evacuation

 Describe the process of documenting casualty

information

 Define the 4 roles of military care

Slide 45

JSOMTC, SWMG(A)

Reason

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Slide 46

JSOMTC, SWMG(A)

References

 AR 40‐66 Medical Record Administration

and Health Care Documentation

 FM 8‐10‐6 Medical Evacuation in a Theatre

• f Operations, Tactics, Techniques and

Procedures

 FM 4‐02.2 Medical Evacuation  STP 8‐68W13‐SM‐TG Soldiers Manual and

Trainer’s Guide

Slide 47

JSOMTC, SWMG(A)

Terminal Learning Objective

 Action: Communicate knowledge of

CASEVAC and casualty documentation

 Condition: Given a lecture in a classroom

environment

 Standard: Received a minimum score of

75% on the written exam IAW course standards

Slide 48 JSOMTC, SWMG(A)

CASEVAC and Casualty Documentation PFN: SOMEML08

Hours: 1.0 Instructor: