Page 131 - JSOM Fall 2021

FIGURE 4 Line formation. casualty over your shoulder. At the same time, slip your
arm from his waist, pass the arm between the casual-
ty’s legs, and grasp behind the casualty’s knee. Move the
hand grasping the casualty’s wrist to the hand at the ca-
sualty’s knee. Grasp the casualty’s wrist with the hand at
the casualty’s knee, freeing your other hand. Place your
free hand on your knee and slowly rise to a standing
position. Use the hand on your knee to help you rise
without straining your back. Adjust the casualty’s body
so his weight is distributed comfortably. Move forward,
carrying the casualty (Figure 8).
• SEAL Team 3 carry: Rescuers place casualty’s arms over
rescuer’s neck with outside hand grasping casualty’s
wrist. Rescuers use inside hands to secure casualty by
belt, pants, or body armor. Simultaneously raise casu-
alty. Step forward with casualty’s feet dragging behind.
Begin carry (Figure 8).
• Hawes carry: Rescuer reaches over casualty’s arm and
FIGURE 5 File formation.
grasps casualty‘s opposite arm just above elbow. Begin
carry (Figure 8).
• Crawling extraction (neck drag): Tie the casualty’s
hands together with material that will not cut his wrists,
such as the casualty’s field dressing or a cravat. Do not
tie the materials tight enough to interfere with blood cir-
culation. If the casualty is conscious, have him interlock
his fingers. Face the casualty’s head and straddle his hips
FIGURE 6 Diamond formation. on your knees. Loop the casualty’s arms around your
neck. Crawl forward on your hands and knees, dragging
the casualty beneath you.
FIGURE 8 Red Zone extraction methods.

FIGURE 7 VEE formation.

After the extraction, a quick evaluation and treatment of the
• One- or two-person drag using lines: Attach drag line to most vital compromised areas should be performed using the
casualty’s harness or other gear, as appropriate. Extend short MARCH (MAR) protocol (Table 3). (See the detailed
drag line to a drag length of 1 to 2 meters. The rescuer at- MARCH-P protocol and techniques, below, in Table 4.)
taches the other side of the line to his person or equipment,
as needed; then, initiate drag using the legs, not the back. TABLE 3 The MAR Protocol
• Rescue assault tether (RAT) strap extraction: Attach the Massive hemorrhage: spot and treat deadly bleeding
fast-release side of the strap to the rescue belt and on M injuries. Application of tourniquet, compressive bands,
the other side prepare a loop; attach the strap to the or hemostatic agent depends on each case.
casualty by using the loop around the legs; initiate drag Airway: Evaluation of airway obstruction or risk of
using the legs, not the back (Figure 8). A airway obstruction, and use of the nasopharyngeal or
oropharyngeal airway if necessary.
• Fireman’s carry: Raise the casualty to a standing po-
sition. Grasp the casualty’s wrist and lift his arm over Respiration: Assessment of respiratory compromise;
detection of tension pneumothorax requires application
his head while continuing to support the casualty with R of chest decompression. In case of open chest injury,
your other arm. Bend at the waist and kneel, pulling the apply the chest seal.

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