Page 227 - 2022 Ranger Medic Handbook

Determine Medical Assets
On a given operation, the unit will be supported by its internal medical assets. External medical personnel, equipment, or
units may also be attached or used as needed. A thorough understanding of all medical assets available to the mission
is crucial. This includes the proper unit designations or names, number of personnel by specialty, treatment & evacuation
capabilities, logistical requirements, task organization, and command & control. It is important to ensure that all external
medical assets are well connected into the unit’s structure operationally, logistically, and administratively.
Evacuation Assets. There are two types of evacuation during tactical evacuation (TACEVAC) operations: casualty evacu-
ation (CASEVAC) and medical evacuation (MEDEVAC). CASEVAC implies the use of nonmedical platforms to evacuate
casualties. These mission platforms are ground vehicles, watercraft, or aircraft typically used by the unit for infiltration,
exfiltration, or resupply. These vehicles do not usually have organic medical personnel or equipment onboard unless
prepositioned in the operational plan. These assets are more suited for routine evacuation of nonemergent casualties, but
prestaged medical personnel and equipment can facilitate the treatment and transport of the more seriously wounded.
Medical planners should plan for the use of CASEVAC assets as much as possible, as these assets are often the most
readily available for rapid evacuation.
Furthermore, CASEVAC assets are usually armed and are thus better prepared to conduct evacuation while the fight with
the enemy is still ongoing. MEDEVAC refers to the use of dedicated medical platforms whose primary mission is the
evacuation of casualties. Most often conducted by aircraft, MEDEVAC can also be carried out using medically staffed and
equipped front line ambulances (FLAs, MRAP, Stryker). MEDEVAC platforms are usually assigned to a regulated region,
are not under the direct control of the tactical unit and must be requested through operational channels in the execution
sequence. Controllers in operations centers receive MEDEVAC requests and launch or divert MEDEVAC assets as required
on a prioritized basis.
Unit medical planners will determine the casualty evacuation assets that will likely be needed to support the unit’s mission
whether by air, ground, or water. Assets should be matched to the expected needs in pre-mission planning.
Med planners should also be knowledgeable of Strategic evacuation (STRATEVAC) from the joint operations area (JOA)
MTF to a home or allied nation MTF with higher capability of care (e.g., transfer to a Role 4) through the Theater Patient
Movement Requirements Center TPMRC (a component of USTRANSCOM). TPMRC assist patients who require transfer
to a military treatment facility. Coordination with TPMRC may be necessary IOT decompress casualties from the JOA MTF
for patient holding capacity.
DETERMINE MEDICAL ASSETS
■ Organic, attached, air, ground, theater, JTF, host nation, ISB, FSB, etc…
■ CASEVAC/MEDEVAC support
É How many and what type?
É Capabilities and limitations? SECTION 7
É Hoist and high angle extraction?
É Medical personnel and equipment on board? Level of training?
■ Determine nearest surgical capability
É Where are your casualties being evacuated to?
É What are the capabilities/limitations?
É What is their MASCAL or overload plan for their system?
■ Determine staging base area medical support
É Can they provide labs, x-rays, medications, preventive medicine, etc?
■ What are the gaps in care or requirements that exceed tier medical capabilities?
■ Are there conventional assets aligned to that combatant command that can meet those requirements?
■ Discuss request for force options with the S3/G3 cell to determine feasibility (e.g., mobilization and command/sup-
port relationship considerations).
Familiarization with Evacuation Assets. In premission planning, there are key questions that must be answered concern-
ing CASEVAC and MEDEVAC. How many and what type of platforms are available? What are the capabilities, limitations
and restrictions of the platforms? Are air evacuation assets capable of hoist or high-angle extractions? What medical
equipment is on board each platform? Who are the assigned medical personnel and to what levels are they trained?

2022 RANGER MEDIC HANDBOOK 213