1. REQUEST MEDICAL EVACUATION STP 21-24 SMCT 081-831-0101 SSG NEVIS, PRIMARY INSTRUCTOR 100TH TCSPBde

2. REQUEST MEDICAL EVACUATION
LESSON OUTLINE
REQUEST MEDICAL EVACUATION
STP SMCT
SSG NEVIS, 100TH TCSPBde
I. INSTRUCTIONAL INTENT:
THIS PERIOD OF TRAINING IS DESIGNED TO PREPARE UNITS ON PROPER FORMAT FOR REQUESTING A MEDICAL EVACUATION REQUEST USING NINE LINE FORMAT.
TRAINING OBJECTIVE:
AS A RESULT OF THIS INSTRUCTION THE SOLDIER WILL KNOW THE FORMAT FOR A NINE LINE MEDICAL EVACUATION REQUEST AND PROPER RADIO TRANSMISSION.
ACTION: REQUEST MEDICAL EVACUATION, STP SMCT
CONDITION: GIVEN AN ORDER TO REQUEST MEDICAL EVACUATION OF A PATIENT, PATIENT PICKUP SITE, OPERATIONAL COMMUNICATION EQUIPMENT, MEDICAL EVAC FORMAT, A STANDARD MAP, A GRID SCALE, AND UNIT SOI.
STANDARD: TRANSMIT MEDEVAC REQUEST AND PROVIDE ALL NECESSARY INFORMATION AS REQUESTED.
REFERENCES: STP SMCT
FM FM , pgs 7-1 to 7-3 & 7-7 to 7-9
UNIT SOI GTA
SAFETY AND ENVIRONMENT: BRIEFING GIVEN TO SOLDIERS AT START OF CLASS.
TASK
MAR05 SSG NEVIS- Instructor

3. Request Medical Evacuation CTT 081-831-0101(SL 2)
PRIMARY MISSION
MOVE CASUALTIES TO AN AREA WHERE THEY CAN RECEIVE PROPER MEDICAL CARE
NINE LINE MEDEVAC REQUEST FORM
GTA
Distribution: US ARMY TRAINING SUPPORT CENTERS (TSCs) HEADQUARTERS, DEPARTMENT OF THE ARMY, ATTN: ATIC-ITST-T, GTA Program, Fort Eustis, VA
CARRY MEDEVAC REQUEST FORM AT ALL TIMES.
TASK
MAR05 SSG NEVIS- Instructor

4. Request Medical Evacuation CTT 081-831-0101(SL 2)
AS A MEMBER OF A UNIT YOU MAY, AT ANY TIME, BE REQUIRED TO RADIO IN A MEDEVAC REQUEST TO SAVE LIFE OR LIMB OF A FELLOW SOLDIER
TASK
MAR05 SSG NEVIS- Instructor

5. Request Medical Evacuation CTT 081-831-0101(SL 2)
ACCIDENTS CAN, DO & WILL HAPPEN TO YOU OR ONE OF YOUR FELLOW SOLDIERS
THIS IS WHY YOU NEED TO KNOW HOW TO USE PROPER FORMAT / TRANSMISSION OF A NINE LINE MEDEVAC REQUEST
DURING THIS PERIOD OF INSTRUCTION WE DISCUSS THE FORMAT / TRANSMISSION OF A MEDEVAC REQUEST AND DO A PRACTICAL EXERCISE
LINE 1-5 MUST BE TRANSMITTED DURING INITIAL CONTACT WITH THE EVACUATION UNIT, WITHIN 25 SECONDS
TASK
MAR05 SSG NEVIS- Instructor

6. MEDIVAC REQUEST FORM GTA 08-01-004
LINE
ITEM
EVACUATION REQUEST MESSAGE 1
Location of Pickup Site. 2
Radio Frequ., Call Sign, & Suffix. 3
No. of Patients by Precedence. 4
Special Equipment Required. 5
Number of Patients by Type. 6
Security of Pickup Site (Wartime).
Number and Type of Wound, Injury, or Illness (Peacetime). 7
Method of Marking Pickup Site. 8
Patient Nationality and Status. 9
NBC Contamination (Wartime).
Terrain Description (Peacetime).
TASK
MAR05 SSG NEVIS- Instructor

7. LINE ITEM EXPLANATION 1. Location of Pickup Site.
Encrypt grid coordinates. .When using DRYAD Numeral Cipher, the same SET line will be used to encrypt grid zone letters and coordinates. To preclude misunderstanding, a statement is made that grid zone letters are included in the message (unless unit SOP specifies use at all times)
2. Radio Frequency, Call Sign, Suffix.
Encrypt the frequency of the radio at the pickup site, not a relay frequency. The call sign (and suffix if used) of person to be contacted at the pickup site may be transmitted in the clear.
3. No. of Patients by Precedence
Report only applicable info & encrypt brevity codes. A=Urgent, B=Urgent Surg, C=Priority, D=Routine, E= Convenience. (If 2 or more categories reported in same request, insert the word “break” btwn. Each category).
4. Spec Equipment
Encrypt applicable brevity codes. A = None, B = Hoist, C = Extraction equipment, C = Ventilator
5. No. of Patients by Type.
Report only applicable information and encrypt brevity code. If requesting MEDEVAC for both types, insert the word “break” between the litter entry and ambulatory entry: L + # of Pnt-Litter; A = # of Pnt-Ambul (sitting).
6. Security Pickup Site (Wartime).
6. Number and Type of Wound, Injury, Illness (Peacetime).
N = No enemy troops in area, P = Possibly enemy troops in area (approach with caution), E = Enemy troops in area (approach with caution), X= Enemy troops in area (armed escort required).
Specific information regarding patient wounds by type (gunshot or shrapnel). Report serious bleeding, along with patient blood type, if known.
7. Method of Marking Pickup Site.
Encrypt the brevity codes. A = Panels, B = Pyrotechnic signal, C = Smoke Signal, D = None, E = Other.
8. Patient Nationality & Status.
Number of patients in each category need not be transmitted. Encrypt only applicable brevity codes. A = US military, B = US Civilian, C = Non-US mil, D = Non-US civilian, E = EPW.
9. NBC Contamination (Wartime).
9. Terrain Description (Peacetime)
Include this line only when applicable. Encrypt the applicable brevity codes. N = Nuclear, B = Biological, C = Chemical.
Include details of terrain features in and around proposed landing site. If possible, describe the relationship of site to a prominent terrain feature (lake, mountain, tower).

8. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 1: 8 Digit Grid Coordinate of the Pickup Site.
- Encrypt grid coordinates. To preclude misunderstanding, a statement is made that grid zone letters are included in the message (unless Unit SOP specifies its use at all times).
- Where/ How Obtained: FROM MAP
- Who Normally Provides: UNIT LEADER(s)
TASK
MAR05 SSG NEVIS- Instructor

9. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 2: Radio Frequency, Call Sign and Suffix of the Requesting Unit.
- Encrypt the frequency of the radio at the pickup site.
- The call sign (and suffix if used) of the person to be contacted at the pickup site may be transmitted in the clear.
- Where/ How Obtained: FROM SOI
- Who Normally Provides: R T O
TASK
MAR05 SSG NEVIS- Instructor

10. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 3: Number of Patients by Precedence
- PRIORITY: A = URGENT
Patients should be evacuated within a maximum of 2 HOURS in order to save life, limb or eyesight
- PRIORITY: B = URGENT SURGICAL
Patient should be evacuated within a maximum of 2 HOURS and must receive far forward surgical intervention to save life and stabilize for permanent evacuation
- PRIORITY: C = PRIORITY
Patients should be evacuated within 4 HOURS to prevent their medical condition from deteriorating to such a degree that he or she will become an Urgent procedure.
TASK
MAR05 SSG NEVIS- Instructor

11. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 3: Number of Patients by Precedence (Continued)
- PRIORITY: D = ROUTINE
Patients whose medical condition is not expected to deteriorate and the patient should be evacuated within 24 HOURS.
- PRIORITY: E = CONVENIENCE
Is assigned to patients for whom evacuation by medical vehicle is a matter of medical convenience rather than necessity.
If 2 or more categories are reported in the same request, insert the word “break” between each category.
- Where/ How Obtained: FROM EVALUATION of PATIENT(s)
- Who Normally Provides: MEDIC, CLS or MOST SR PERSON PRESENT
TASK
MAR05 SSG NEVIS- Instructor

12. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 4: Special Equipment
- A = None
- B = Hoist
- C = Extraction Equipment
- D = Ventilator
- Where/ How Obtained: FROM EVALUATION of PATIENT/SITUATION
- Who Normally Provides: MEDIC, CLS or MOST SR PERSON PRESENT
TASK
MAR05 SSG NEVIS- Instructor

13. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 5: Number of Patients by TYPE
- Report only applicable information and encrypt brevity code. If requesting MEDEVAC for both types, insert the word “break” between the litter entry and ambulatory entry:
- L + # of Patients = Litter
- A + # of Patients = Ambulatory
- L = Litter
- A = Ambulatory
- Where/ How Obtained: FROM EVALUATION of PATIENT(s)
- Who Normally Provides: MEDIC, CLS or MOST SR PERSON PRESENT
TASK
MAR05 SSG NEVIS- Instructor

14. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 6: Situation Wartime/Peacetime
Wartime Situation:
- N = No enemy in the area
- P = Possible enemy in the area (approach with caution)
- E = Enemy troops in the area (approach with caution)
- X = Enemy troops in the area (armed escort required)
- Where/ How Obtained: FROM EVALUATION of SITUATION
- Who Normally Provides: UNIT LEADER
TASK
MAR05 SSG NEVIS- Instructor

15. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 6: Situation Wartime/Peacetime (Continued)
Peacetime Situation:
- Specific Information regarding patient wounds by type (gunshot or shrapnel).
- Report serious bleeding, along with patients blood type, if known.
- Where/ How Obtained: FROM EVALUATION of PATIENT(s)
- Who Normally Provides: MEDIC, CLS or MOST SR PERSON PRESENT
TASK
MAR05 SSG NEVIS- Instructor

16. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 7: Method of Marking site
- A = Panel (VS 17)
NOTE: Never denote which side is up, as MEDEVAC approaches, deploy panel and MEDEVAC advises you what color panel they see- you merely confirm, this applies to all visuals: flares, smoke, etc.
- B = Pyrotechnical Signal
Flare (color)
- C = Smoke Signal
- D = None
- E = Other
I.E., Strobe
- Where/ How Obtained: BASED ON SITUATION & AVAILIBILITY OF MATERIALS
- Who Normally Provides: MEDIC, CLS or MOST SR PERSON PRESENT
TASK
MAR05 SSG NEVIS- Instructor

17. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 8: Patient Nationality and Status
- Number of Patients in each category need not be transmitted
A = U.S. Military
B = U.S. Civilian
C = Non U.S. Military
D = Non U.S. Civilian
E = EPW
- Where/ How Obtained: FROM EVALUATION of PATIENT(s)
- Who Normally Provides: MEDIC, CLS or MOST SR PERSON PRESENT
TASK
MAR05 SSG NEVIS- Instructor

18. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 9: NBC Contamination -Wartime / Terrain - Peacetime
- WARTIME: NBC Contamination
N = Nuclear
B = Biological
C = Chemical
- Where/ How Obtained: FROM EVALUATION of SITUATION
- Who Normally Provides: MEDIC, CLS or MOST SR PERSON PRESENT
TASK
MAR05 SSG NEVIS- Instructor

19. NINE LINE MEDEVAC REQUEST FORMAT
LINE # 9: NBC Contamination -Wartime / Terrain – Peacetime (Continued)
- PEACETIME: Terrain Description
Description of the terrain in and around the pickup site to aid the pilot in locating your position.
If possible, describe the relationship of site to a prominent terrain feature (lake, mountain, tower).
- Where/ How Obtained: FROM TERRAIN EVALUATION/SURVEY
- Who Normally Provides: UNIT LEADER/PERSONNEL PRESENT
TASK
MAR05 SSG NEVIS- Instructor

20. NINE LINE MEDEVAC REQUEST FORMAT
RESPONSIBILTY OF THE REQUESTING UNIT
Light and Mark the Pickup Site
Tactical Support and Security
Patient Preparation and Consolidation
Assignment of Litter Teams to Load the Aircraft
Brief Pilot of Enemy Situation
Mark Friendly Positions when Armed Escort is required
Have an English Speaking Representative for Non U.S. Personnel (if possible)
Guide Aircraft (GTA / Signal Man)
TASK
MAR05 SSG NEVIS- Instructor

21. NINE LINE MEDEVAC REQUEST FORMAT
Mission of AIR MEDEVAC
Move Casualties to an area where they can receive proper Medical Care
Move Medical Personnel and Equipment
Crash Rescue
Advantages of AIR MEDEVAC
SPEED
FLEXIBILITY
En-Route Treatment
Disadvantages of AIR MEDEVAC
Weather & Limited Visibility
Enemy Situation
Limited Availability/Priority of Aircraft
TASK
MAR05 SSG NEVIS- Instructor

22. MEDIVAC REQUEST FORM GTA 08-01-004
LINE
ITEM
EVACUATION REQUEST MESSAGE 1
Location of Pickup Site. 2
Radio Frequ., Call Sign, & Suffix. 3
No. of Patients by Precedence. 4
Special Equipment Required. 5
Number of Patients by Type. 6
Security of Pickup Site (Wartime).
Number and Type of Wound, Injury, or Illness (Peacetime). 7
Method of Marking Pickup Site. 8
Patient Nationality and Status. 9
NBC Contamination (Wartime).
Terrain Description (Peacetime).
TASK
MAR05 SSG NEVIS- Instructor

23. LINE ITEM EXPLANATION 1. Location of Pickup Site.
Encrypt grid coordinates. .When using DRYAD Numeral Cipher, the same SET line will be used to encrypt grid zone letters and coordinates. To preclude misunderstanding, a statement is made that grid zone letters are included in the message (unless unit SOP specifies use at all times)
2. Radio Frequency, Call Sign, Suffix.
Encrypt the frequency of the radio at the pickup site, not a relay frequency. The call sign (and suffix if used) of person to be contacted at the pickup site may be transmitted in the clear.
3. No. of Patients by Precedence
Report only applicable info & encrypt brevity codes. A=Urgent, B=Urgent Surg, C=Priority, D=Routine, E= Convenience. (If 2 or more categories reported in same request, insert the word “break” btwn. Each category).
4. Spec Equipment
Encrypt applicable brevity codes. A = None, B = Hoist, C = Extraction equipment, C = Ventilator
5. No. of Patients by Type.
Report only applicable information and encrypt brevity code. If requesting MEDEVAC for both types, insert the word “break” between the litter entry and ambulatory entry: L + # of Pnt-Litter; A = # of Pnt-Ambul (sitting).
6. Security Pickup Site (Wartime).
6. Number and Type of Wound, Injury, Illness (Peacetime).
N = No enemy troops in area, P = Possibly enemy troops in area (approach with caution), E = Enemy troops in area (approach with caution), X = Enemy troops in area (armed escort required).
Specific information regarding patient wounds by type (gunshot or shrapnel). Report serious bleeding, along with patient blood type, if known.
7. Method of Marking Pickup Site.
Encrypt the brevity codes. A = Panels, B = Pyrotechnic signal, C = Smoke Signal, D = None, E = Other.
8. Patient Nationality & Status.
Number of patients in each category need not be transmitted. Encrypt only applicable brevity codes. A = US military, B = US Civilian, C = Non-US mil, D = Non-US civilian, E = EPW.
9. NBC Contamination (Wartime).
9. Terrain Description (Peacetime)
Include this line only when applicable. Encrypt the applicable brevity codes. N = Nuclear, B = Biological, C = Chemical.
Include details of terrain features in and around proposed landing site. If possible, describe the relationship of site to a prominent terrain feature (lake, mountain, tower).

24. MAR05 SSG NEVIS- Instructor
MEDEVAC PROCEDURES
Practical Exercise #1
Your Squad has encountered a Minefield while patrolling Route 1A. While conducting self-extracting procedures from a minefield the point man sets off a mine. He has the following injuries: He is missing his right forearm from the elbow down, and is in shock from loss of blood. The combat lifesaver has performed immediate first aid and the casualty is ready for evacuation. During the self-extraction the U.S. civilian on your squad starts to have a heart attack.
The squad has moved out of the minefield. The squad leader informs you that the pickup site will be at PK The site will be marked by a VS-17 panel. Your Call Sign is A Team and the MEDEVAC unit is DUSTOFF. The pickup site is in a large open field.
TASK
MAR05 SSG NEVIS- Instructor

25. MAR05 SSG NEVIS- Instructor
MEDEVAC PROCEDURES
Practical Exercise #1
DUSTOFF
A TEAM **proper radio procedures must be followed**
LINE 1: PK (pah-pah kee-lo, wun fife six fo-wer fo-wer fife eit sev-un)
LINE 2: A Team
LINE 3: 1 A BREAK, 1 B
LINE 4: 1 D
LINE 5: 1 L BREAK, 1 A
LINE 6: 1 missing right forearm and 1 Heart Attack
LINE 7: A
LINE 8: 1 A BREAK, 1 B
LINE 9: Large Open Field
OVER
TASK
MAR05 SSG NEVIS- Instructor

26. MAR05 SSG NEVIS- Instructor
MEDEVAC PROCEDURES
Practical Exercise #2
Your Squad has encountered a Minefield while patrolling Route 1A. While conducting self-extracting procedures from a minefield the point man sets off a mine. He has the following injuries: He is missing his right leg from the knee down. The combat lifesaver has performed immediate first aid and the casualty is ready for evacuation. During the self-extraction the U.S. civilian on your squad breaks his left leg.
The squad has moved out of the minefield. The squad leader informs you that the pickup site will be at PK The site will be marked by green smoke. Your Call Sign is B Team and the MEDEVAC unit is LIFESAVER. The pickup site is on a hill top.
TASK
MAR05 SSG NEVIS- Instructor

27. MAR05 SSG NEVIS- Instructor
MEDEVAC PROCEDURES
Practical Exercise #2
LIFESAVER
B TEAM **proper radio procedures must be followed**
LINE 1: Letters included, PK (pah-pah kee-lo, too fife fo-wer six fife fo-wer fife eit sev-un)
LINE 2: B Team
LINE 3: 1 A BREAK, 1 C
LINE 4: A
LINE 5: 1 L BREAK, 1 A
LINE 6: 1 missing right Leg and 1 Right Broken Leg
LINE 7: C
LINE 8: 1 A BREAK, 1 B
LINE 9: Hill Top
OVER
TASK
MAR05 SSG NEVIS- Instructor