Infantry Drills

FM 3-21.8 – Chapter 6 – Section IV – Casualty Procedures

Section IV – Casualty Procedures

6-48.     Following are the procedures that should be followed in the treatment, evacuation, and reporting of combat casualties.

Initial care

6-49.     When combat begins and casualties occur, the platoon first must provide initial care to those wounded in action (WIA).

6-50.     Effective casualty evacuation provides a major increase in the morale of a unit. This is accomplished through the administration of first aid (self-aid/buddy aid), enhanced first aid (by the combat lifesaver), and emergency medical treatment (by the trauma specialist/platoon medic). Casualties are cared for at the point of injury or under nearby cover and concealment.

6-51.     During the fight, casualties should remain under cover where they received initial treatment. As soon as the situation allows, squad leaders arrange for casualty evacuation to the platoon CCP. The platoon normally sets up the CCP in a covered and concealed location to the rear of the platoon position. At the CCP, the platoon medic conducts triage on all casualties, takes steps to stabilize their conditions, and starts the process of moving them to the rear for advanced treatment. Before the platoon evacuates casualties to the CCP or beyond, leaders should remove all key operational items and equipment from each person. Removal should include automated network control devices (ANCD), GPS maps, position-locating devices, and laser pointers. Every unit should establish an SOP for handling the weapons and ammunition of its WIA.

6-52.     The tactical situation will determine how quickly fellow Soldiers can treat wounded Soldiers. Understandably, fewer casualties occur if Soldiers focus on destroying or neutralizing the enemy that caused the casualties. This is a critical situation that should be discussed and rehearsed by the squads and platoons prior to executing a mission.


6-53.     Timely movement of casualties from the battlefield is important not only for safety and care for the wounded, but also for troop morale.

6-54.     Squad leaders are responsible for casualty evacuation from the battlefield to the platoon CCP. At the CCP, the senior trauma specialist assists the platoon sergeant and 1SG in arranging evacuation by ground or air ambulance or by non-standard means. Leaders must minimize the number of Soldiers required to evacuate casualties. Casualties with minor wounds can walk or even assist with carrying the more seriously wounded. Soldiers can make field-expedient litters by cutting small trees and putting the poles through the sleeves of zippered Army combat uniform (ACU) blouses or ponchos. A travois, or skid, may be used for casualty evacuation. This is a type of litter on which wounded can be strapped; it can be pulled by one person. It can be locally fabricated from durable, rollable plastic on which tie-down straps are fastened. In rough terrain (or on patrols), casualties may be evacuated all the way to the BAS by litter teams. From there they can be carried with the unit until transportation can reach them, or left at a position and picked up later.

6-55.     From the platoon area, casualties are normally evacuated to the company CCP and then back to the BAS. The company 1SG, with the assistance of the platoon sergeant, is normally responsible for movement of the casualties from the platoon to the company CCP. The unit SOP should address this activity, including the marking of casualties during limited visibility operations. Small, standard, or infrared chemical lights work well for this purpose. Once the casualties are collected, evaluated, and treated, they are sent to company CCP. Once they arrive, the above process is repeated while awaiting their evacuation back to the BAS.

6-56.     When the company is widely dispersed, the casualties may be evacuated directly from the platoon CCP by vehicle or helicopter. Helicopter evacuation may be restricted due to the enemy air defense artillery (ADA) or small arms/RPG threat. In some cases, casualties must be moved to the company CCP or battalion combat trains before helicopter evacuation. When there are not enough battalion organic ambulances to move the wounded, unit leaders may direct supply vehicles to “backhaul” casualties to the BAS after supplies are delivered. Normally, urgent casualties will move by ambulance. Less seriously hurt Soldiers are moved through other means. If no ambulance is available, the most critical casualties must get to the BAS as quickly as possible. In some cases, the platoon sergeant may direct platoon litter teams to carry casualties to the rear.

6-57.     The senior military person present determines whether to request medical evacuation and assigns precedence. These decisions are based on the advice of the senior medical person at the scene, the patient’s condition, and the tactical situation. Casualties will be picked up as soon as possible, consistent with available resources and pending missions. Following are priority categories of precedence and the criteria used in their assignment.

Priority I-Urgent

6-58.     Assigned to emergency cases that should be evacuated as soon as possible and within a maximum of two hours in order to save life, limb, or eyesight; to prevent complications of serious illness; or to avoid permanent disability.

Priority IA-Urgent-Surg

6-59.     Assigned to patients who must receive far forward surgical intervention to save their lives and stabilize them for further evacuation.

Priority II-Priority

6-60.     Assigned to sick and wounded personnel requiring prompt medical care. The precedence is used when special treatment is not available locally and the individual will suffer unnecessary pain or disability (becoming URGENT precedence) if not evacuated within four hours.

Priority III-Routine

6-61.     Assigned to sick and wounded personnel requiring evacuation but whose condition is not expected to deteriorate significantly. The sick and wounded in this category should be evacuated within 24 hours.

Priority IV-Convenience

6-62.     Assigned to patients for whom evacuation by medical vehicle is a matter of medical convenience rather than necessity.


6-63.     Casualty evacuation (CASEVAC) is the term used to refer to the movement of casualties by air or ground on nonmedical vehicles or aircraft. CASEVAC operations normally involve the initial movement of wounded or injured Soldiers to the nearest medical treatment facility. Casualty evacuation operations may also be employed in support of mass casualty operations. Medical evacuation (MEDEVAC) includes the provision of en route medical care, whereas CASEVAC does not provide any medical care during movement. For definitive information on CASEVAC, see FM 8-10-6, Medical Evacuation in a Theater of Operations, Tactics, Techniques, and Procedures, FM 8-10-26, Employment of the Medical Company (Air Ambulance), and Table 6-1.

6-64.     When possible, medical platoon ambulances provide evacuation and en route care from the Soldier’s point of injury or the platoon’s or company’s CCP to the BAS. The ambulance team supporting the company works in coordination with the senior trauma specialist supporting the platoons. In mass casualty situations, non-medical vehicles may be used to assist in casualty evacuation as directed by the Infantry company commander. However, plans for the use of non-medical vehicles to perform casualty evacuation should be included in the unit SOP.


Table 6-1. Procedures to Request Medical Evacuation (MEDEVAC).




Where/How Obtained

Who Normally Provides


1/Location of pickup site by grid coordinates with grid zone letters

Encrypt the grid coordinates of the pickup site. When using the DRYAD Numeral Cipher, the same “SET” line will be used to encrypt the grid zone letters and the coordinates. To prevent misunderstanding, it is stated that grid zone letters are included in the message (unless SOP specifies its use at all times).

From map

Unit leader(s)

Required so evacuation vehicle knows where to pick up patient, and, unit coordinating the evacuation mission can plan the route for the evacuation vehicle (if evacuation vehicle must pick up from more than one location).


unit radio frequency, call signal, and suffix

Encrypt the frequency of the radio at the pickup site, not a relay frequency. The call sign (and suffix if used) of the person to be contacted at the pickup site may be transmitted in the clear.

From SOI


Required so evacuation vehicle can contact requesting unit while en route (or obtain additional information and change in situation or directions).

3/Number of patients by precedence.

Note the brevity codes used.

Report only applicable information and encrypt the brevity codes.






If two or more categories must be reported in the same request, insert the word BREAK between each category.


evaluation of patient(s)

Medic or senior person present

Required by unit controlling the evacuation vehicles to assist in prioritizing missions.

4/Special equipment required

Encrypt the applicable brevity codes.



C-Extraction equipment



evaluation of



Medic or senior person present

Required so equipment can be placed on board the evacuation vehicle prior to the start of the mission.

5/Number of patients

Report only applicable information and encrypt the brevity code. If requesting MEDEVAC for both types, insert the word BREAKbetween the litter entry and ambulatory entry. For


L + # of PNT-litter

A + # of PNT-ambulatory


evaluation of patient

Medic or senior person present

Required so appropriate number of evacuation vehicles may be dispatched to the pickup site. They should be configured to carry the patients requiring evacuation.

Table 6-1. Procedures to Request Medical Evacuation (MEDEVAC) (continued).




Where/How Obtained

Who Normally Provides


6/Security of pickup site (wartime)

N-No enemy troops in area

P-Possibly enemy troops in area (approach with


E-Enemy troops in area (approach with caution)

X-Enemy troops in area (armed escort required)


evaluation of situation

Unit leader

Required to assist the evacuation crew in assessing the situation and determining if assistance is required. More definitive guidance (such as specific location of enemy to assist an aircraft in planning its approach) can be furnished by the evacuation aircraft while it is en route.

7/Number and type of wound, injury, or illness (peacetime)

Specific information regarding patient wounds by type (gunshot or shrapnel). Report serious bleeding and patient blood type (if known).

From evaluation of patient

Medic or senior person present

Required to assist evacuation personnel in determining treatment and special equipment needed.

8/Method of marking pickup site

Encrypt the brevity codes.


B-Pyrotechnic signal

C-Smoke signal



Based on situation and availability of materials

Medic or senior person present

Required to assist the evacuation crew in identifying the specific location of the pick up. Note that the color of the panels or smoke should not be transmitted until the evacuation vehicle contacts the unit just prior to its arrival. For security, the crew should identify the color. The unit should verify it.

9/Patient nationality and status

The number of patients in each category does not need to be transmitted. Encrypt only the applicable brevity codes.

A-US military

B-US civilian

C-Non-US military

D-Non-US civilian


From evaluation of patient

Medic or senior person present

Required to assist in planning for destination facilities and need for guards. Unit requesting support should ensure that there is an English-speaking representative at the pickup site.

10/CBRN contamin-ation (wartime)

Include this line only when applicable. Encrypt the applicable brevity codes.




From situation

Medic or senior person present

Required to assist in planning for the mission. Determine which evacuation vehicle will accomplish the mission and when it will be accomplished.

11/Terrain description (peacetime)

Include details of terrain features in and around proposed landing site. If possible, describe relationship of site to prominent terrain feature (lake, mountain, and tower).

From area survey

Personnel at site

Required to allow evacuation personnel to assist route/avenue of approach into area. Of particular importance if hoist operation is required.

Unit SOPs

6-65.     Unit SOPs and OPORDs must address casualty treatment and evacuation in detail. They should cover the duties and responsibilities of key personnel, the evacuation of chemically contaminated casualties (on routes separate from noncontaminated casualties), and the priority for manning key weapons and positions. They should specify preferred and alternate methods of evacuation and make provisions for retrieving and safeguarding the weapons, ammunition, and equipment of casualties. Slightly wounded personnel are treated and returned to duty by the lowest echelon possible. Platoon medic evaluate sick Soldiers and either treat or evacuate them as necessary. Casualty evacuation should be rehearsed like any other critical part of an operation.

Casualty Report

6-66.     A casualty report is filled out when a casualty occurs, or as soon as the tactical situation permits. This is usually done by the Soldier’s squad leader and turned in to the platoon sergeant, who forwards it to the 1SG. A brief description of how the casualty occurred (including the place, time, and activity being performed) and who or what inflicted the wound is included. If the squad leader does not have personal knowledge of how the casualty occurred, he gets this information from any Soldier who does have the knowledge. Department of the Army (DA) Form 1156, Casualty Feeder Card (Figure 6-5A and B), is used to report those Soldiers who have been killed and recovered, and those who have been wounded. This form is also used to report KIA Soldiers who are missing, captured, or not recovered. The Soldier with the most knowledge of the incident should complete the witness statement. This information is used to inform the Soldier’s next of kin and to provide a statistical base for analysis of friendly or enemy tactics. Once the casualty’s medical condition has stabilized, the company commander may write a letter to the Soldier’s next of kin. During lulls in the battle, the platoon forwards casualty information to the company headquarters.

Figure 6-5A. DA Form 1156, casualty feeder card (report front).

Figure 6-5B. DA Form 1156, casualty feeder card (report back).


6-67.     The platoon leader designates a location for the collection of KIAs. All personal effects remain with the body. However, squad leaders remove and safeguard any equipment and issue items. He keeps these until he can turn the equipment and issue items over to the platoon sergeant. The platoon sergeant turns over the KIA to the 1SG. As a rule, the platoon should not transport KIA remains on the same vehicle as wounded Soldiers. KIAs are normally transported to the rear on empty resupply trucks, but this depends on unit SOP.

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