Every commander should have a medical evacuation plan before undertaking an operation. This plan should have contingencies included so as not to rely on a single asset.
a. When rescuing a casualty (victim) threatened by hostile action, environmental hazard, or any other immediate hazard, the rescuer should not take action without first determining the extent of the hazard and his ability to handle the situation. THE RESCUER MUST NOT BECOME A CASUALTY.
b. The rescue team leader must evaluate the situation and analyze the factors involved. This evaluation can be divided into three major steps:
• Evaluate the circumstances of the rescue.
c. The task must be identified. In planning a rescue, the rescuer tries to obtain the following information:
• Who, what, where, when, why, and how the situation happened.
• Number of casualties by precedence (urgent, priority, routine, tactical immediate),
• number of casualties by type (litter or ambulatory), and the nature of their injuries.
• Terrain features and location of the casualties.
• Tactical situation.
• If adequate assistance is available to aid in security, rescue, treatment, and evacuation.
• If treatment can be provided at the scene; if the victims require movement to a safer location.
• Equipment required for the rescue operation.
d. Circumstances of the rescue are as follows:
(1) After identifying the task, relate it to the circumstances of the situation.
• Are additional personnel, security, medical, or special rescue equipment needed?
• Are there circumstances, such as aircraft accidents (mass casualties), that may require specialized skills?
• What is the weather condition?
• Is the terrain hazardous?
• How much time is available?
(2) The time element may cause a rescuer to compromise planning stages or treatment (beyond first aid). Make a realistic estimate of time available as quickly as possible to determine the action time remaining. The key elements are the casualty's condition and environment.
(3) Mass casualties are to be expected on the modern battlefield. All problems or complexities of rescue are now multiplied by the number of casualties. Time becomes the critical element.
(4) Considerations for the main rescue group for a planned rescue are as follows:
(a) Carry all needed equipment, hot food and drinks, stove, sleeping bags, tents, bivouac sacks, warm clothes, ropes, and stretchers.
(b) Prepare the evacuation route (ground transport to hospital, walking trails, fixed lines, lowering lines, anchor points, and rescue belay points). If the victim is airlifted out, attach a paper with the medical actions that were performed on the ground (for example, blood pressure, pulse rate, drugs started, and so on).
(c) When performing all rescues, the rescuers are always tied in for safety. With all rescue techniques, remember to think things through logically for safety and to prevent the rescuer from accidentally untying himself or the fallen climber.
(d) Constantly inform the casualty (if they are conscious) as to what you are doing and what he must do.
e. The rescue plan should proceed as follows:
(1) In estimating time available, the casualties' ability to endure is of primary importance. Age and physical condition may vary. Time available is a balance of the endurance time of the casualty, the situation, and the personnel and equipment available.
(2) Consider altitude and visibility. Maximum use of secure, reliable trails or roads is essential.
(3) Ensure that blankets and rain gear are available. Even a mild rain can complicate a normally simple rescue. In high altitudes, extreme cold, or gusting winds, available time is drastically reduced.
(4) High altitudes and gusting winds reduce the ability of fixed-wing or rotary-wing aircraft to assist in operations. Rotary-wing aircraft may be available to remove casualties from cliffs or inaccessible sites, and to quickly transport casualties to a medical treatment facility. Relying on aircraft or specialized equipment is a poor substitute for careful planning.
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