HUMAN RESOURCES SUPPORT

7-77. Human resources supports all functions affecting the Soldier’s status, readiness, and welfare. It includes casualty operations, which comprises production, dissemination, coordination, validation and synchronization of information regarding each casualty. Human resources teams are responsible for casualty reporting, casualty notification, casualty assistance, line-of-duty determination, disposition of remains, and disposition of personal effects, military burial honors, and casualty mail coordination.

7-78. Casualty operations include production, dissemination, coordination, validation and synchronization of information regarding each casualty. This information includes casualty reporting, casualty notification, casualty assistance, line-of-duty determination, disposition of remains, and disposition of personal effects, military burial honors, and casualty mail coordination.

Casualty Operations

7-79. Unit SOPs and OPORDs must address first aid procedures and casualty evacuation in detail to include aid for chemical casualties with particular emphasis on lifesaving tasks. They should cover the duties and responsibilities of essential personnel, the evacuation of CBRN contaminated casualties (on routes separate from noncontaminated casualties), and priority for manning essential weapons and positions. They should specify preferred and alternate methods of evacuation and make provisions for retrieving and safeguarding the weapons, ammunition, and equipment of casualties. Slightly wounded personnel are treated at the appropriate role of care and returned to duty as soon as possible. Platoon medics evaluate sick Soldiers and either treat or evacuate them as necessary. Medical and casualty evacuations should be rehearsed like other critical part of an operation.

7-80. Specific procedures should be followed when providing aid, evacuation, and reporting of combat casualties.

Casualty Care

7-81. When combat begins and casualties occur, the platoon first must provide aid to those WIA. Casualty care is provided by combat medics who are assisted by nonmedical personnel performing first aid procedures to alleviate potential life-threatening situations and ensure maximum survivability on the battlefield. This support is most commonly provided by enlisted personnel and includes first aid (self-aid/buddy aid), enhanced first aid (by the CLS), and EMT (platoon medic). Casualties are cared for at the point of injury or under nearby cover and concealment.

7-82. The tactical situation will determine how quickly fellow Soldiers can provide aid for wounded Soldiers. Understandably, fewer casualties occur if Soldiers focus on destroying or neutralizing the enemy causing the casualties. This is a critical situation discussed and rehearsed by the squads and platoons prior to executing a mission.

7-83. During the fight, casualties should remain under cover. As soon as the situation allows, squad leaders arrange for casualty evacuation to the platoon CCP. The platoon normally sets up the CCP in a covered and concealed location to the rear of the platoon position. At the CCP, the platoon medic conducts triage on all casualties, takes steps to stabilize their conditions, and starts the process of moving them to the rear for advanced treatment.

7-84. Before the platoon evacuates casualties to the CCP or beyond, leaders should remove all essential operational items and equipment from each person. Removal should include an automated network control device, GPS maps, position-locating devices, and laser pointers. Every unit should establish an SOP for handling the weapons and ammunition of its WIA.

Movement

7-85. Timely movement of casualties from the battlefield is important not only for safety and care for the wounded, but also for troop morale. Squad leaders are responsible for casualty evacuation from the battlefield to the platoon CCP. At the CCP, the senior medic assists the platoon sergeant and first sergeant in arranging evacuation by ground or air ambulance or by nonstandard means. Leaders must minimize the number of Soldiers required to evacuate casualties.

7-86. Casualties with minor wounds can walk or even assist with carrying the more seriously wounded. Soldiers can make field-expedient litters by cutting small trees and putting the poles through the sleeves of zippered Army combat uniform blouses or ponchos. A travois, or skid, may be used for casualty evacuation. This is a type of litter on which wounded can be strapped; it can be pulled by one person. It can be fabricated locally from durable, plastic rolls on which tie-down straps are fastened. In rough terrain (or on patrols), casualties may be evacuated all the way to the BAS by litter teams. From there they can be carried with the unit until transportation can reach them, or left at a position and picked up later.

7-87. From the platoon area, casualties normally are evacuated to the company CCP and back to the BAS. The company first sergeant, with the assistance of the platoon sergeant, normally is responsible for movement of the casualties from the platoon CCP to the company CCP. The unit SOP should address this activity, including the marking of casualties during limited visibility operations. Small, standard, or infared chemical lights work well for this purpose. Once the casualties are collected, evaluated, and treated, they are sent to company CCP. Once they arrive, the above process is repeated while awaiting their evacuation back to the BAS.

7-88. When the company is widely dispersed, the casualties may be evacuated directly from the platoon CCP by vehicle or helicopter. Helicopter evacuation may be restricted due to the enemy air defense artillery or small arms/rocket-propelled grenade (RPG) threat. In some cases, casualties must be moved to the company CCP or battalion combat trains before helicopter evacuation. When there are not enough battalion organic ambulances to move the wounded, unit leaders may direct supply vehicles to “backhaul” casualties to the BAS after supplies are delivered. Normally, urgent casualties will move by ambulance. Less seriously hurt Soldiers are moved by other means. If no ambulance is available, the most critical casualties must get to the BAS as quickly as possible. In some cases, the platoon sergeant may direct platoon litter teams to carry casualties to the rear.

7-89. The senior military person present determines whether to request medical or casualty evacuations and assigns precedence. These decisions are based on the advice of the senior medical person at the scene, the patient’s condition, and tactical situation. Casualties will be picked up as soon as possible, consistent with available resources and pending missions. Following are priority categories of precedence and criteria used in their assignment:

• Priority I-Urgent— assigned to emergency cases being evacuated as soon as possible and within a maximum of one hour in order to save life, limb, or eyesight; to prevent complications of serious illness; or to avoid permanent disability.
• Priority IA-Urgent-Surgical— assigned to patients who must receive far forward surgical intervention to save their lives and stabilize them for further evacuation.
• Priority II-Priority— assigned to sick and wounded personnel requiring prompt medical care. The precedence is used when special treatment is not available locally; the individual will suffer unnecessary pain or disability (becoming URGENT precedence) if not evacuated within four hours.
• Priority III-Routine— assigned to sick and wounded personnel requiring evacuation but whose condition is not expected to deteriorate significantly. The sick and wounded in this category should be evacuated within 24 hours.
• Priority IV-Convenience— assigned to patients for whom evacuation by medical vehicle is a matter of medical convenience rather than necessity.

Medical Evacuation

7-90. Medical evacuation is the term used to refer to movement of casualties by air or ground utilizing medical vehicles or aircraft. Medical evacuation operations normally involve the initial movement of wounded or injured Soldiers to the nearest medical treatment facility. Medical evacuation includes the provision of en route medical care, whereas casualty evacuations might not provide medical care during movement. (Refer to ATP 4-02.5 and ATP 4-02.2 for more information.) (See table 7-1a and table 7-1b on the 9-line request for medical evacuation procedures.

7-91. When possible, medical platoon ambulances provide evacuation and en route care from the Soldier’s point of injury or the platoon’s or company’s CCP to the BAS. The ambulance team supporting the company works in coordination with the senior combat medic supporting the platoons. In mass casualty situations, nonmedical vehicles may be used to assist in casualty evacuation as directed by the Infantry company commander or leader. However, plans for use of nonmedical vehicles to perform casualty evacuations should be included in the unit SOP.

Watch the video below to see an example of a medical evacuation

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Casualty Evacuation

7-92. Casualty evacuation is a term used to refer to the movement of casualties aboard nonmedical vehicles or aircraft.

WARNING.
Casualties transported in this manner may not receive proper en route medical care or be transported to the appropriate medical treatment facility to address the patient’s medical condition. If the casualty’s medical condition deteriorates during transport, or the casualty is not transported to the appropriate medical treatment facility, an adverse impact on his prognosis and long-term disability or death may result.

7-93. If dedicated medical evacuation platforms (ground and air) are available, casualties should be evacuated on these conveyances to ensure they receive proper en route medical care.

7-94. Since casualty evacuation operations can reduce combat power and degrade the efficiency of the Army health system (AHS), units should only use casualty evacuation to move Soldiers with less severe injuries when medical evacuation assets are overwhelmed. Planners should ensure casualty evacuations operations are addressed in the operation plan (OPLAN)/OPORD as a separate operation, as these operations require preplanning, coordination, synchronization, and rehearsals. The casualty evacuation plan should ensure casualties with severe or life threatening injuries are prioritized for evacuation and are evacuated on dedicated medical evacuation platforms.

7-95. When possible, nonmedical vehicles/aircraft transporting casualties should be augmented with a combat medic or CLS. (On nonmedical aircraft, sufficient space may not be available to permit a caregiver to accompany the casualties.) Refer to ATP 4-25.13 for additional information on casualty evacuation. The type of en route monitoring and medical care/first aid provided is limited by the following factors─

• Skill level of the individual providing care. (The combat medic is military occupational specialty [MOS]-qualified [MOS 68W] to provide EMT; the CLS is trained to provide enhanced first aid). The combat medic can provide emergency medical intervention, whereas the CLS only can monitor the casualty and ensure the basic lifesaving first-aid tasks are accomplished.
• Medical equipment available.
• Number of casualties being transported.
• Accessibility of casualties— if nonstandard evacuation vehicle is loaded with the maximum number of casualties, the combat medic or CLS may not be able to attend to the casualties while the vehicle is moving. If the condition of a casualty deteriorates and emergency measures are required, the vehicle will have to be stopped to permit care to be given.

Unit Reporting

7-96. As casualties occur, the nearest observer informs the platoon sergeant who then informs the first sergeant via the most expedient method available; for example, free text within Mission Command Systems, radio voice. The first sergeant submits a personnel status report to the Infantry battalion S-1 section. This report documents duty status changes on all casualties. Casualties are taken to CCP for classification of injury type (routine, urgent, return to duty), evacuation, and integration into the medical treatment system.

7-97. A casualty report is filled out when a casualty occurs, or as soon as the tactical situation permits. This usually is done by the Soldier’s squad leader and turned in to the platoon sergeant, who forwards it to the first sergeant. A brief description of how the casualty occurred (including the place, time, and activity being performed) and who or what inflicted the wound is included. If the squad leader does not have personal knowledge of how the casualty occurred, he gets this information from Soldiers who have the knowledge.

7-98. DA Form 1156, Casualty Feeder Card (see figure 7-5a and figure 7-5b), are used to report those Soldiers who have been killed and recovered, and those who have been wounded. This form also is used to report KIA Soldiers who are missing, captured, or not recovered. The Soldier with the most knowledge of the incident should complete the witness statement. This information is used to inform the Soldier’s next of kin and to provide a statistical base for analysis of friendly or enemy tactics. Once the casualty’s medical condition has stabilized, the company commander may write a letter to the Soldier’s next of kin. During lulls in the battle, the platoon forwards casualty information to the company headquarters. The first sergeant ensures a completed DA Form 1156 is forwarded to the Infantry battalion S-1, who then enters the data into the defense casualty information processing system.

Killed in Action

7-99. The platoon leader designates a location of the collection of KIAs. All personal effects remain with the body. However, squad leaders remove and safeguard equipment and issue items. They keep these until they can turn the equipment and issue items over to the platoon sergeant. The platoon sergeant turns over the KIA to the first sergeant. As a rule, the platoon should not transport KIA remains on the same vehicle as wounded Soldiers. KIAs normally are transported to the rear on empty resupply trucks, but this depends on unit SOP.

7-100. Commanders and first sergeants must establish procedures to ensure the Soldier’s next of kin are notified properly and according to procedure. The potential for unofficial communications exist with KIA and casualty operations. The use of cell phones and computers in proximity to the area of operation enables many Soldiers to contact their home station regarding the casualty. Such communication is unofficial and unacceptable. The next of kin for Soldiers WIA or KIA should not receive notification through unofficial means. There usually is a communication blackout until the next of kin is notified. No Internet or phone calls home are permitted.

Medical/Personnel Accounting

7-101. When a Soldier becomes a casualty, the platoon combat medic or senior combat medic records the medical treatment the Soldier receives on the Soldier’s DD Form 1380. The BAS and brigade support medical company read the Soldier’s DD Form 1380 when they treat the Soldier. The Infantry battalion S-1 should electronically receive a notification message to update the Soldier’s patient tracking status. In turn, this message should be forwarded to the company. In this manner, a casualty’s location can be determined and Soldiers properly accounted for by the company.