Perform Tactical Casualty Movement and Request MEDEVAC

First Aid 5

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Tactical Casualty Movement

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Tactical Casualty Movement (cont.)

TCCC has improved the medical management of casualties in combat through new principles, practices, and technology.

What has not improved is the movement of casualties to cover so that treatment can begin.

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Importance of Rescue

Medical vs. Rescue

In many instances we cannot treat until an extraction is performed.

Statistically very dangerous.

Targeting Rescuers

Ratio of rescuers to victims?

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1) While under fire and without a weapon,

Gunnery Sgt. Ryan P. Shane runs to Sgt.

Lonnie Wells, a downed Marine to pull him

to safety during combat operations as part

of Operation Al Fajr in Fallujah on Nov. 9.

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2) Gunnery Sgt. Ryan P. Shane attempts

to pull a fatally-wounded Marine to safety

while under fire. Seconds later Shane

was also wounded by enemy fire.

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3) Gunnery Sgt. Ryan P. Shane (center)

and another member of the 1st Battalion,

8th Marine Regiment, attempt to pull a

fatally-wounded Marine to safety.

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4) Gunnery Sgt. Ryan P. Shane, foreground at

left, and another member of the 1st Battalion,

8th Marine Regiment, attempt to move a

fatally-wounded Marine to safety. Seconds

later Shane was also wounded by enemy fire.

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5) Gunnery Sgt. Ryan P. Shane, left, is hit by

enemy fire as he and another member of the

1st Battalion, 8th Marine Regiment try to pull

fatally wounded Marine to safety.

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6) The unidentified Marine runs for cover

after Gunnery Sgt. Ryan P. Shane, on

ground at left, was hit by insurgent

sniper fire.

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10

7) Gunnery Sgt. Ryan P. Shane, left, lies

wounded after being hit by enemy fire

while trying to pull a fatally wounded

Marine, right, to safety.

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11

Introduction

Casualty movement on the battlefield is often a

complex, problem-solving process

Occurs in all terrains and combat environments

Must be appropriate for the tactical situation

Tactical Casualty Movement (TCM) includes:

- Individual Movement Techniques (IMT)

- Drags

- Manual carries

- Litter carries

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Tactical Casualty Movement (cont.)

visinsita, or innate force of matter is a power of resisting, by which every body, as much as it lies, endeavors to preserve in its present state, whether it be of rest, or of moving

PhilosophiaeNaturalisPrincipia Mathematica

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Tactical Casualty Movement (cont.)

What matters when moving a casualty?FORCE must be exerted (rescuer) to move a specific matter or object (casualty) at rest.

This matter wants to stay at rest, unless acted upon by an outside force.

The initial force applied to matter will be greater to begin movement than continuing it in motion.

Motionis generally described in terms of velocity, acceleration, displacement, and time.

Once the object is in motion it gains a property referred to as momentum(which relates to the objects mass and velocity).

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Every object in a state of uniform motion tends to

remain in that state of motion unless an external

force is applied to it.

The relationship between an object's mass m, its

acceleration a, and the applied force F is F = ma.

Acceleration and force are vectors (as indicated by

their symbols being displayed in slant bold font); in this

law the direction of the force vector is the same as

the direction of the acceleration vector.

For every action there is an equal and opposite

reaction.

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Tactical Casualty Movement (cont.)During High Threat Extraction the basic forces

Imposing our force on matter at rest.

Decreasing the Coefficient of Friction (contact points) of the specific matter.

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Tactical Casualty Movement (cont.)

The tactical leader (squad leader, Platoon Sergeant, or Platoon Leader) on the ground must direct or be aware TCM is occurring

Integrates TCM into overall tactical situation

Tactical Leader can provide support to protect rescuer and casualty

Covering fire/Suppressive fire

Obscurants (smoke)

Vehicle Cover

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Individual Movement TechniquesCasualties should move on their own when medically and tactically appropriateIncludes:

Low CrawlHigh CrawlRushesWalking

Allows tactical leaders to keep non or minimally injured Soldiers engaged in the fightRescuers maintain weapon readinessAllows medics and combat life-savers to focus attention on more seriously-injured casualties

Insert pics of IMT

RUSH

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Drag TechniquesIdeal for short distances during tactical engagements

AdvantagesCasualty maintains low profile

1-handed methods allow rescuer to maintain close-quarter firing ability with free hand

Heavy casualties that cannot be carried may be dragged

DisadvantagesOnly for short distances

Still requires significant strength to drag a fully-loaded casualty

Rescuer maintains a high profile

Where do you grab?

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One-Person Drag

Crouching decreases profile.

Free hand to engage targets.

Single rescuer requires more strength & work resulting in rescuer fatigue and difficulty moving casualty.

Crouch

Weapon Ready

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Rescuers have a high profile, but may crouch to decrease profile.

Both have a free hand to engage targets.

Using 2 rescuers requires less strength & work resulting in less rescuer fatigue.

Two-Person Drag

Crouch

Weapons Ready24

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Drag Accessories

Dragon Harness

Dragon Handle

Rat Strap

(Rescue Assault Tether)

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Dragon Harness

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Manufactured ( i.e. Dragon Harness, Dragon Handle, or Rat Strap).

Field expedient with rope and snap-link.

Provides mechanical advantage over dragging by hand.

Used with single or multiple rescuers.

Drag Straps and Lines

Dragon Handle

Rat Strap

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Drags

Handle system

Fast hook up

Exponentially increases speed of rescue

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Drag Litters

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Drag Litters (cont.)

Soft Litter IndividualCarry Kit (SLICK)

Blackhawk Fast Attack Litter

Canadian tactical and operations medical solutionslitter

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Manual CarriesCarries lift a casualty off the ground without a litter

Requires much strength and rescuers fatigue quickly

Casualties with armor, helmets and full pouches may weigh over 300 lbs

Single carries inappropriate for most tactical casualty movements due to casualty weight and high profile

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Not appropriate for most tactical casualty movements due to casualty weight and high profile

High center of gravity (CG) increases the chance of falling over

May work with lighter casualties and stronger rescuers

May allow free hand for weapon readiness

CASUALTY: light without

armor

Weapon Hand Available

RESCUER:larger,

stronger

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Hawes CarryMore appropriate for tactical situations

Casualty must be conscious and have use of one arm

Casualty arm holds onto chest of rescuer

Hops along with legs if possible

Lower CG

Rescuer has free hand for weapon use

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Hawes Carry (cont.)

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Hawes Carry (cont.)

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Hawes Carry (cont.)

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Two-Man Supporting Carry Conscious or unconscious casualty

No rescuer use of weapons with unconscious casualty

Less rescuer fatigue due to shared load

Neck flexion may close airway; consider NPA if unconscious

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Litters

SKEDLitter

TalonLitter

Long Spine Board

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http://www.narescue.com/NAR-Spine-Board--P63C0.aspx

Evacuation

Being able to evacuate a casualty in a quick and efficient manner can result in saving his life.

You may need to move the casualty to a casualty collection point or other location where the casualty can receive needed medical care.

and difficult to move easily.

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Evacuation (cont.)

Sometimes, the casualty can walk, but at other times he must be carried on a litter. If a standard medical litter is not available and a SKED, or Talon litter is available, use it to transport the casualty.

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Evacuation (cont.)

The SKED litter is a compact and lightweight transport system used to evacuate a casualty over land.

It can also be used to rescue a casualty in water.

A SKED litter can also be hoisted to a helicopter.

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SKEDLitter

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SKEDDirectionsRemove the SKED litter from its pack and place it on the ground.Unfasten the retainer strap.Step on the foot end of the SKED litter and unroll the SKEDcompletely.Bend the SKED litter in half and back roll. Repeat with the opposite end of the litter so that the SKED litter should lays flat.SKED is equipped with handholds and straps for the casualty, and dragline.

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Place and Secure a Casualty to a SKEDLitter

Place the casualty onto the litter.

Secure the casualty to the litter so he/she will not fall off.

Transport the casualty (carry or drag).

dragline end.

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TalonLitter

The Talon litter is a compact quad folding litter that when extended becomes a full size nation litter.

easier that a conventional litter.

It also comes with a carrying case that allow an individual Soldier to carry it on his back like

a rucksack.

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TalonLitter (cont.)

This litter is also a component of the Warrior Aid and Litter Kit.

The increased weight of a Soldier in full gear makes carrying him for any distance a problem.

Utilizing a litter makes transporting this individual much easier.

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TalonLitter (cont.)

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TalonDirections

Open the litter following the basic instructions.

This is best done with two individuals one on each side of the litter.

Load the casualty on the litter as you would a conventional litter.

Secure the casualty with the straps that are attached to the litter.

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TalonDirections (cont.)

Step 1. Release the buckles

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TalonDirections (cont.)Step 2. Place Litter on the ground and completely extend with fabric side up.

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