CASEVAC and Casualty Documentation PFN: SOMEML08 Hours: 1.0 Instructor: JSOMTC, SWMG(A) Slide 1 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 JSOMTC, SWMG(A) Slide 2 References AR 40‐66 Medical Record Administration and Health Care Documentation FM 8‐10‐6 Medical Evacuation in a Theatre of Operations, Tactics, Techniques and Procedures FM 4‐02.2 Medical Evacuation STP 8‐68W13‐SM‐TG Soldiers Manual and Trainer’s Guide JSOMTC, SWMG(A) Slide 3 1
Reason JSOMTC, SWMG(A) Slide 4 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 JSOMTC, SWMG(A) Slide 5 Define and differentiate between CASEVAC, MEDEVAC, and TACEVAC JSOMTC, SWMG(A) Slide 6 2
MEDEVAC Clearly marked • medical platform Medical personnel • and supplies onboard Configured to • receive patients Not allowed to be • armed or render lethal aid under the Geneva convention JSOMTC, SWMG(A) Slide 7 CASEVAC and TACEVAC CASEVAC ‐‐Casualty Evacuation TACEVAC—Tactical Evacuation The Unregulated (by the Blanket Category that includes Geneva Convention) booth CASEVAC and MEDEVAC movement of casualties. The current language used by Does not have to be on a the TCCC committee strictly medical platform (gun Denotes any and all transport truck, LMTV, MRAP, armed that evacuates a PT in a tactical aircraft, etc) situation. Is not marked as a medical Intended as a blanket term allaying confusion on what is platform, and can there fore “MEDEVAC” vs. “TACEVAC” render lethal aid JSOMTC, SWMG(A) Slide 8 Decision to MEDEVAC/CASEVAC Made by the Senior Military Person Present Decision based on mission requirements, tactical situation and the advice and input of the senior medical provider JSOMTC, SWMG(A) Slide 9 3
Describe the procedures for requesting casualty evacuation JSOMTC, SWMG(A) Slide 10 Basic 9‐Line Format Line 1: Location Line 6 (Peacetime) Type of Line 2: Radio Freq/Call Injury Sign Line 7: Method of Line 3: Number of Marking Patients by Precedence Line 8: Patient Nationality Line 4: Special Equipment and Status Line 5: Number of Line 9 (Wartime): NBC Patients by Type Line 9 (Peacetime): Line 6 (Wartime): Security Terrain description JSOMTC, SWMG(A) Slide 11 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 JSOMTC, SWMG(A) Slide 12 4
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: JSOMTC, SWMG(A) Slide 13 JSOMTC, SWMG(A) Slide 14 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 JSOMTC, SWMG(A) Slide 15 5
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 JSOMTC, SWMG(A) Slide 16 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 JSOMTC, SWMG(A) Slide 17 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 JSOMTC, SWMG(A) Slide 18 6
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 JSOMTC, SWMG(A) Slide 19 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 JSOMTC, SWMG(A) Slide 20 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 JSOMTC, SWMG(A) Slide 21 7
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 JSOMTC, SWMG(A) Slide 22 Describe the process of documenting casualty information JSOMTC, SWMG(A) Slide 23 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 JSOMTC, SWMG(A) Slide 24 8
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 JSOMTC, SWMG(A) Slide 25 DD Form 1380 Field Medical Card (FMC) JSOMTC, SWMG(A) Slide 26 Tactical Combat Casualty Care (TCCC) Card DA Form 7656 JSOMTC, SWMG(A) Slide 27 9
TCCC Card ‐ 2014 Version JSOMTC, SWMG(A) Slide 28 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. JSOMTC, SWMG(A) Slide 29 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 2 nd reading after Hextend administration. Patient was evacuated at 0235. JSOMTC, SWMG(A) Slide 30 10
JSOMTC, SWMG(A) Slide 31 JSOMTC, SWMG(A) Slide 32 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? JSOMTC, SWMG(A) Slide 33 11
Define the 4 roles of military care JSOMTC, SWMG(A) Slide 34 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 JSOMTC, SWMG(A) Slide 35 1 st echelon of Care Role 1: 1 st Responder Medic/Corpsman, 18D/SOCM, throughBn Aid PA Station No definitive surgical capability Extremely limited Patient hold INTENT: Stabilize capability as permitted by Conventional: Typically a Bn organic capabilities Aid station and evacuate rapidly. SOF: medical capabilities at team level are essentially Role 1 care JSOMTC, SWMG(A) Slide 36 12
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