Page 263 - PJ MED OPS Handbook 8th Ed

9-Line MEDEVAC Request

Line – 1. Location

Line – 2. Call sign and frequency _________________________________________________
Line – 3. Number of patients by precedence
A – Urgent Number _______________ D – Routine Number _______________
B – Urgent Surgical Number _________ E – Convenience Number __________
C – Priority Number _______________
Line – 4. Special equipment required
A – None C – Extraction equipment
B – Hoist D – Ventilator
Line – Number of patients
L – Litter Number _________________ A – Ambulatory Number ___________
Line – 6. Security at pick-up site
N – No enemy E – Enemy in area
P – Possible enemy X – Enemy (armed escort required)
Line – 7. Method of marking pick-up site
A – Panels D – None
B – Pyro E – Other
C – Smoke
Line – 8. Patient nationality and status
A – US Military Number D – Non-US Civilian Number
B – US Civilian Number E – Enemy Prisoner of War Number
C – Non-US Military Number
Line – 9. NBC Contamination/Terrain Description
N—nuclear B—biological C—chemical
M—Mechanism of injury: _________________________________________________________
I—Injury sustained: ______________________________________________________________
S—Symptoms/signs: _____________________________________________________________
T—Treatment given: _____________________________________________________________

Chapter 23. Mnemonics, Conversion Charts and Cheat Sheets n 261