Page 132 - JSOM Fall 2021

nearest the litter. The leader of the litter team positions
himself at the handle nearest the casualty’s right shoul-
der and directs the other bearers. This position allows
the leader to monitor the casualty during the evacua-
tion. Upon command of the leader, the four litter bear-
ers lift the litter in unison and move the casualty to the
aid station or collection point (Figure 10).
• Two-operators chair carry: The two-hand seat carry can
be used to move a conscious or unconscious casualty for
a short distance. Position the casualty on his back. Bear-
ers position themselves on opposite sides of the casual-
Request for Transport to the Orange Zone ty’s hips and knees. Each bearer passes one arm under
Because each zone has different objectives, for communica- the casualty’s back and the other arm under the casu-
tion, we modified the MEDEVAC code to MEDEVAC PMSCS alty’s thigh. Bearers grasp each other’s wrists securely.
specified to each zone (Figure 9). Both bearers rise in unison, lifting the casualty. Bearers
move forward, carrying the casualty (Figure 10).
FIGURE 9 Adapted MEDEVAC for PMSCS. • SEAL Team 3 carry: as reviewed previously (Figure 10).
FIGURE 10 Orange Zone extraction method

Orange Zone
As mentioned, the main objectives in the Orange Zone are to
triage patients as quickly as possible and to treat potentially
life-threatening injuries immediately before transport to the
Green Zone.
The Orange Team’s objective is to extract the casualty from
The Orange Teams are formed the same way as the Red Teams the Red Zone for removal to the Orange Zone, where a full
are, of six members: one guard, one leader, and four support evaluation using the MARCH protocol (see Table 4 for the
members. Their equipment, however, differs from that of the MARCH-P protocol) is carried out, as well as triage using the
Red Team. It includes a CAT, hemostatic dressings, bandages, START system (Figure 11), to categorize the patient. Depend-
a cricothyroidotomy set, oropharyngeal and nasopharyngeal ing on the result of these evaluations, the patient will be dis-
airways, chest decompression needles, a tactical stretcher, alu- charged or transported to the Green Zone.
minum-magnesium hydroxide solution for CS gas injuries, tri-
age cards, and foil hypothermia blankets. FIGURE 11 The START (Simple Triage and Rapid Treatment) System.

Extraction techniques are also different for the Orange Team,
which needs to travel from the Red Zone to the Orange Zone.
The usual methods are as follows:
• Human litter: Two litter bearers position themselves on
the same side of the casualty and kneel on one knee.
Operator 1 slips his arms under the casualty’s back and
waist; Operator 2 slips his hands under the casualty’s
hips and knees. Both operators lift in unison upon com-
mand from the leader and move forward, carrying the
casualty high on their chests (Figure 10).
• Tactical stretch: Position the casualty on his back with
his arms at his sides. Place the litter near and parallel to
the casualty. If there are four litter bearers, each bearer
positions himself at one of the handles so that the ca-
sualty will be carried feet first and kneels on the knee

130 | JSOM Volume 21, Edition 3 / Fall 2021