LANE 6 Litter/Manual Carries and EVAC
INITIATE A FIELD MEDICAL CARD
081-831-0033
Conditions: You have treated a casualty for injury or illness and must record the treatment given. You
are not in a CBRN environment. You will need DD Form 1380 (Field Medical Card [FMC]) and a pen or
pencil.
Standards: Complete, as a minimum, blocks 1, 3, 4, 7, 9, and 11. Complete blocks 2, 5, 6, 8, 10, 12, 13,
14, 15, 16, and 17 as appropriate. Complete other blocks as time permits.
Performance Steps
CAUTION: All body fluids should be considered potentially infectious. Always observe body substance
isolation (BSI) precautions by wearing gloves and eye protection as a minimal standard of protection.
1. Remove the protective sheet from the carbon copy.
NOTE: The FMCs are issued as a pad of 20 cards, each containing an original card, a carbon protective
sheet, and a duplicate sheet.
2. Complete the minimum required blocks.
a. Block 1. Enter the casualty's name, rank, and complete social security number (SSN). If the
casualty is a foreign military person (including prisoners of war), enter their military service
number. Enter the casualty's military occupational specialty (MOS) or area of concentration for
specialty code. Enter the casualty's religion and sex.
b. Block 3. Use the figures in the block to show the location of the injury or injuries. Check the
appropriate box(es) to describe the casualty's injury or injuries.
NOTES: 1. Use only authorized abbreviations. Except for those listed below, however, abbreviations
may not be used for diagnostic terminology.
Abr W--Abraded wound.
Cont W--Contused wound.
FC--Fracture (compound) open.
FCC--Fracture (compound) open comminuted.
FS--Fracture (simple) closed.
LW--Lacerated wound.
MW--Multiple wounds.
Pen W--Penetrating wound.
Perf W--Perforating wound.
SL--Slight.
SV--Severe.
2. When more space is needed, attach another DD Form 1380 to the original. Label the second card in
the upper right corner "DD Form 1380 #2." It will show the casualty's name, grade, and SSN.
c. Block 4. Check the appropriate box.
d. Block 7. Block 7. Check the yes or no box. Write the dose administered and the date and
time that it was administered.
e. Block 9. Write the information requested. If you need additional space, use Block 14.
f. Block 11. Initial the far right side of the block.
3. Complete the other blocks as time permits. Most blocks are self-explanatory. The following
specifics are noted:
a. Block 2. Enter the casualty's unit of assignment and the country of whose armed forces they
are a member. Check the armed service of the casualty, that is, A/T = Army, AF/A = Air Force,
N/M = Navy, and MC/M Marine.
b. Block 5. Write in the casualty's pulse rate and the time the pulse was measured.
c. Block 6. Check the yes or no box. If a tourniquet is applied, you should write in the time and
date it was applied.
d. Block 8. Write in the time, date, and type of IV solution given. If you need additional space,
use Block 9.
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Performance Steps
e. Block 10. Check the appropriate box. Write the date and time of disposition.
f. Block 12. Write the time and date of the casualty's arrival. Record the casualty's blood
pressure, pulse, and respirations in the space provided.
g. Block 13. Document the appropriate comments by the date and time of observation.
h. Block 14. Document the provider's orders by date and time. Record the dose of tetanus
administered and the time it was administered. Record the type and dose of antibiotic
administered and the time it was administered.
i. Block 15. The signature of the provider or medical officer is written in this block.
j. Block 16. Check the appropriate box and enter the date and time.
k. Block 17. This block will be completed by the United Ministry Team. Check the appropriate
box of the service provided. The signature of the chaplain providing the service is written in
this block.
NOTE: As the FMC is the first, and sometimes only, record of treatment of combat casualties, accuracy
and thoroughness of information provided is of the utmost importance.
4. Attach the completed FMC to the casualty's uniform by twisting the wire after threading it through the
top buttonhole of the uniform. Keep the FMC in plain view.
NOTE: Do not attach the FMC to the casualty's body armor or LCE/LCV as this equipment will be
separated from the casualty once they arrive at the medical treatment facility (MTF).
Evaluation Preparation:
Setup: For training and evaluation construct a combat casualty scenario. Have another soldier act as a
casualty and have them respond to the soldier's questions with personal data according to the scenario
provided. Ensure the soldier acting as the casualty has read the scenario thoroughly.
Brief soldier: Tell the soldier to complete the FMC by asking appropriate questions of the casualty. Tell
the casualty to respond to the soldier's questions with necessary information according to the scenario
provided. To test step 2, you may either have the soldier complete the minimum required blocks, or you
may require the completion of all blocks. After step 2, ask the soldier what must be done with each copy
of the FMC.
Performance Measures GO NO-GO
1. Removed the protective sheet from the carbon copy. —— ——
2. As a minimum, completed blocks 1, 3, 4, 7, 9, and 11. —— ——
3. Made proper distribution of the FMC copies. —— ——
4. Attached the FMC to the top buttonhole of the casualty's uniform. —— ——
Evaluation Guidance: Score each soldier according to the performance measures. Unless otherwise
stated in the task summary, the soldier must pass all performance measures to be scored GO. If the
soldier fails any steps, show what was done wrong and how to do it correctly.
TRIAGE CASUALTIES ON A CONVENTIONAL BATTLEFIELD
081-833-0080
Conditions: You are operating on the battlefield and have encountered several casualties with
conventional injuries. You are not in a CBRN environment.
Standards: Complete all the steps necessary to establish priorities for medical treatment and the
evacuation of casualties.
Performance Steps
CAUTION: All body fluids should be considered potentially infectious. Always observe body substance
isolation (BSI) precautions by wearing gloves and eye protection as a minimal standard of protection.
1. Assess the situation.
a. Sort the casualties and allocate treatment based on the resources available.
(1) Assess and classify the casualties for the most efficient use of available medical
personnel and supplies.
(2) Give available treatment first to the casualties who have the best chance of survival.
(3) A primary goal is to locate, and return to duty, troops with minor wounds; however, at no
time should abandonment of a single casualty be considered.
(4) Triage establishes the order of treatment, not whether treatment is given. It is usually the
responsibility of the senior medical person present.
b. Determine the tactical and environmental situation.
(1) Whether casualties must be transported to a more secure area for treatment.
(2) The number and location of the injured and the severity of the injuries.
(3) Available assistance (self-aid, buddy-aid, combat lifesaver, and medical personnel).
(4) Evacuation support capabilities and requirements.
NOTE: Nuclear weapons exposure will not be used as a criteria for sorting. Field experience with these
injuries does not exist.
2. Assess the casualties and establish priorities for treatment.
a. Immediate--casualties whose conditions demand immediate treatment to save life, limb or
eyesight. This category has the highest priority.
(1) Airway obstruction.
(2) Respiratory and cardiorespiratory distress from otherwise treatable injuries (for example,
electrical shock, drowning or chemical exposure).
NOTE: A casualty with cardiorespiratory distress may not be classified "Immediate" on the battlefield.
This casualty may be classified "Expectant", contingent upon such things as the situation, number of
casualties, and available support.
(3) Massive external bleeding.
(4) Shock.
(5) Burns on the face, neck, hands, feet, or perineum and genitalia.
NOTE: After all life- or limb-threatening conditions have been successfully treated, give no further
treatment to the casualty until all other "Immediate" casualties have been treated. Salvage of life always
takes priority over salvage of limb.
b. Delayed--casualties who have less risk of loss of life or limb if treatment is delayed.
(1) Open wounds of the chest without respiratory distress.
(2) Open or penetrating abdominal injuries without shock.
(3) Severe eye injuries without hope of saving eyesight.
(4) Other open wounds.
(5) Fractures.
(6) Second and third degree burns (not involving the face, hands, feet, genitalia, and
perineum) covering 20% or more of the total body surface area (TBSA).
c. Minimal--"walking wounded", can be treated by self-aid or buddy-aid.
(1) Minor lacerations and contusions.
(2) Sprains and strains.
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Performance Steps
(3) Minor combat stress problems.
(4) First or second degree burns (not involving the face, hands, feet, genitalia, and perineum)
covering under 20% of the TBSA.
NOTE: Minimal casualties may assist the soldier medic by providing buddy-aid or by monitoring other
casualties.
d. Expectant--casualties who are so critically injured that only complicated and prolonged
treatment can improve life expectancy. This category is to be used only if resources are
limited. If in doubt as to the severity of the injury, place the casualty in one of the other
categories.
(1) Massive head injuries with signs of impending death.
(2) Burns, mostly third degree, covering more than 85% of the TBSA.
NOTE: Provide ongoing supportive care if the time and condition permits; keep separate from other
triage categorized casualties. (See Common Core task 101-515-0002.)
3. Record all treatment given on the Field Medical Card (FMC).
4. Establish MEDEVAC priorities by precedence category.
a. Urgent. Evacuation is required as soon as possible, but within 2 hours, to save life, limb or
eyesight. Generally, casualties whose conditions cannot be controlled and have the greatest
opportunity for survival are placed in this category.
(1) Cardiorespiratory distress.
(2) Shock not responding to IV fluid therapy.
(3) Prolonged unconsciousness.
(4) Head injuries with signs of increasing intracranial pressure.
(5) Burns covering 20% to 85% of the TBSA.
b. Urgent Surgical. Evacuation is required for casualties who must receive far forward surgical
intervention to save life and stabilize for further evacuation.
(1) Decreased circulation in the extremities.
(2) Open chest and/or abdominal wounds with decreased blood pressure.
(3) Penetrating wounds.
(4) Uncontrollable hemorrhage or open fractures with severe hemorrhage.
(5) Severe facial injuries.
c. Priority. Evacuation is required within 4 hours or the casualty's condition could get worse and
become an "Urgent" or "Urgent Surgical" category condition. Generally, this category applies
to any casualty whose condition is not stabilized or who is at risk of trauma-related
complications.
(1) Closed-chest injuries, such as rib fractures without a flail segment or other injuries that
interfere with respiration.
(2) Brief periods of unconsciousness.
(3) Soft tissue injuries and open or closed fractures.
(4) Abdominal injuries with no decreased blood pressure.
(5) Eye injuries that do not threaten eyesight.
(6) Spinal injuries.
(7) Burns on the hands, face, feet, genitalia, or perineum, even if under 20% of the TBSA.
d. Routine. Evacuation is required within 24 hours for further care. Immediate evacuation is not
critical. Generally, casualties who can be controlled without jeopardizing their condition or who
can be managed by the evacuating facility for up to 24 hours.
(1) Burns covering 20% to 80% of the TBSA if the casualty is receiving and responding to IV
fluid therapy.
(2) Simple fractures.
(3) Open wounds including chest injuries without respiratory distress.
(4) Behavioral emergencies and combat stress casualties.
(5) Terminal cases.
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Performance Steps
e. Convenience. Evacuation by medical vehicle is a matter of convenience rather than necessity.
(1) Minor open wounds.
(2) Sprains and strains.
(3) Minor burns under 20% of TBSA.
5. Prepare a medical evacuation request. (See STP 21-24-SMCT, task 081-831-0101.)
a. Pickup location--provided by the unit leader.
b. Radio frequency, call sign, and suffix--provided by the radio/telephone operator (RTO).
c. Number of patients by precedence category.
d. Special equipment required--none, hoist, extraction equipment, ventilator.
e. Number of patients by type--litter, ambulatory.
f. Security of the pickup site.
g. Method of marking the pickup site--provided by the unit leader.
h. Patients' nationality and status.
i. CBRN contamination, if any.
NOTE: As a minimum, the first five items must be provided in the exact sequence listed.
Evaluation Preparation:
Setup: For training and evaluation construct a scenario that involves multiple combat casualties.
Moulaged soldiers may be used as casualties. Brief each soldier as to their wounds and what their
actions should be when assessed. Tell the casualties not to assist the soldier in any way; unless they are
designated as "minimal" casualties and instructed to provide buddy-aid.
Brief the soldier: Tell the soldier to assess the situation and the casualties, establish priority of treatment,
establish MEDEVAC priorities, and prepare the evacuation request.
Performance Measures GO NO-GO
1. Assessed the situation. —— ——
2. Assessed the casualties. —— ——
3. Established the order of treatment; initiated treatment in the correct sequence. —— ——
4. Recorded the treatment given on the FMC. —— ——
5. Assigned the MEDEVAC priorities. —— ——
6. Prepared the evacuation request. —— ——
Evaluation Guidance: Score each soldier according to the performance measures. Unless otherwise
stated in the task summary, the soldier must pass all performance measures to be scored GO. If the
soldier fails any steps, show what was done wrong and how to do it correctly.
COORDINATE CASUALTY TREATMENT AND EVACUATION
081-833-0227
Conditions: You are deployed to a unit in a forward area. There are casualties that must be treated and
evacuated to receive medical aid. A military vehicle (ground vehicle or rotary-wing aircraft) may be
available. You may have a litter and straps (or materials to improvise them) to secure the casualty and
other soldiers available to assist in treatment and evacuation. You are not in a CBRN environment.
Standards: Ensure that medical and/or self-aid/buddy aid is provided to the casualties, as appropriate.
Ensure that the casualties are transported to medical aid or to a pickup site using an appropriate carry or,
if other soldiers are available, by litter. Ensure that the litters are properly loaded onto a military vehicle
(ground vehicle or rotary-wing aircraft) without dropping or causing further injury to the casualties.
Performance Steps
1. Evaluate the casualties according to the tactical situation. (See task 081-833-0080.)
NOTE: Tactical combat casualty care (TC-3) can be divided into three phases.
* Care under fire--you are under hostile fire and are very limited as to the care you can provide.
* Tactical field care--you and the casualty are relatively safe and no longer under effective hostile fire,
and you are free to provide casualty care to the best of your ability.
* Combat casualty evacuation care--care is rendered during casualty evacuation (CASEVAC).
2. Coordinate treatment of the casualties according to the tactical situation and available resources.
3. Request medical evacuation (MEDEVAC). (See task 081-831-0101.)
a. Make contact.
b. Determine whether casualties must be moved or will be picked up at the current location. If
they must be moved, continue with step 4. If they will not be moved, continue to monitor
communications and go to step 6.
4. Move a casualty, if necessary, using a four-man litter squad.
NOTE: If military vehicles and litter materials are not available, continue with step 5.
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.
(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 the litter and
grasp the 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.
* Head first when going up hill.
(b) If the casualty has a fractured leg, carry the casualty-* Head first on level ground.
* Feet first when going up hill.
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Performance Steps
(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.
5. Coordinate transportation of casualties using appropriate carries, if necessary. (See STP 21-1SMCT, task 081-831-1046.)
6. Coordinate loading of casualties onto a military vehicle.
a. Ground ambulance.
NOTE: Ground ambulances have medical personnel to take care of the casualties during evacuation.
Follow any special instructions for loading, securing, or unloading casualties.
(1) Secure each litter casualty to his/her litter.
(2) Load the most serious casualty last.
(3) Load the casualty head first (head in the direction of travel) rather than feet first.
(4) Secure each litter to the vehicle.
b. Air ambulance.
NOTE: Air ambulances have medical personnel 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/her litter is
dropped before it is secured.
(6) When casualties are placed lengthwise, position them with their heads toward the
direction of travel.
(7) Secure each litter casualty to his/her litter.
(8) Secure each litter to the aircraft.
c. Ground military vehicles.
NOTE: Nonmedical military vehicles may be used to evacuate casualties when no medical evacuation
vehicles are available.
NOTE: FM 8-10-6 contains suggested loading plans for many common nonmedical vehicles. You should
become familiar with the plans for vehicles assigned to your unit.
(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/her head pointing
forward, toward the direction of travel.
(3) Secure each litter casualty to his/her litter.
(4) Secure each litter to the vehicle as it is loaded into place.
(5) Watch the casualties closely for life-threatening conditions and provide treatment, as
necessary, during CASEVAC.
NOTE: CASEVAC refers to the movement of casualties aboard nonmedical vehicles or aircraft. Care is
rendered while the casualty is awaiting pickup or is being transported. A soldier accompanying an
unconscious casualty should monitor the casualty's airway, breathing, and bleeding.
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Evaluation Preparation:
Setup: Evaluate this task during a training exercise involving a MEDEVAC aircraft or vehicle, or simulate
it by creating a scenario, and provide the equipment needed for the evaluation.
Brief Soldiers: Tell the soldier the scenario to include the end result desired.
Performance Measures GO NO-GO
1. Evaluated the casualties according to the tactical situation. —— ——
2. Coordinated treatment of the casualties according to the tactical situation and
available resources.
—— ——
3. Requested medical evacuation. —— ——
4. Moved a casualty using a four-man litter squad, if necessary. —— ——
a. Prepared the litter.
b. Prepared the casualty.
c. Lifted the litter.
5. Coordinated transportation of casualties using appropriate carries, if necessary. —— ——
6. Coordinated loading of casualties onto a military vehicle. —— ——
Evaluation Guidance: Score each soldier according to the performance measures. Unless otherwise
stated in the task summary, the soldier must pass all performance measures to be scored GO. If the
soldier fails any steps, show them what was done wrong and how to do it correctly.