How to handle casualties in the field - for everyone

HOW TO HANDLE CASUALTIES IN THE FIELD - A GUIDE FOR EVERYONE FROM PLTHQ THROUGH SL TO RIFLEMEN

INTRODUCTION

Please note: Every situation is different. This is a basic guideline to follow when dealing with injuries in the field. Please use your common sense to judge a situation and communicate that up the chain of command to the best of your ability.
Credit: Rhea (base layout), johnb43 (edit), griffin68965 (advice), FloofyFloof (updates)

IMPORTANT

• This guide will be gradually updated with new knowledge.

DEFINITIONS

• "Pull Security”: Keeping your gun up, and looking outward away from triage. Constantly scanning the area for anything that may pose a threat to friendly forces.
• “Stable”: If the person can be left alone and not die, he is stable. Specifically, he is not bleeding and his medication will not kill him. (Consciousness is only secondary)
• “Unstable”: If the person can't be left alone due to uncontrolled bleeding or medication.
• “Category”: Category of patient’s injuries:
  • CAT1: The patient is at an immediate risk of death (heavy bleeding, cardiac arrest).
  • CAT2: The patient is combat ineffective (bleeding controlled or minimum, broken limbs, severe weapon sway).
  • CAT3: The patient is combat effective (small bruises, scrapes, pain, controlled bleeding).
    • If you are still combat effective and have a task at hand, avoid running to the medic immediately. Deal with your task first, then ask your team leader if you can move to the medic or wait for the medic to catch up to you.
  • CAT4: The patient is dead. KIA.

LEVEL 1

Situation: 40% or fewer squad members combat ineffective (CAT 2). Orders to move out. Area clear, no present threat. 

• Platoon HQ Procedure: No change. Continue on as planned.
• Squad Lead Procedure: Leave behind Medic, and injured personnel for treatment. Relay orders to treat, and rejoin the squad as soon as possible.
• Medic Procedure: Find a suitable triage location and PAK whoever possible (people in severe pain, because of weapon sway, and people with head and/or torso damage). Keep good communication with Squad Lead about treatment times, and when you move from triage location to squad location.
• Squad Member Procedure:
  • When in a triage location/situation the medic outranks the SL in regards to all things medical:
    • Injured: Report to triage, communicate injuries and whether stable (not bleeding) or unstable (actively bleeding) to the medic. Pull security, gun up and facing out away from the medic at all times. Once treated, stay with the medic until rejoined with the squad. Keep radio communication clear.
    • Uninjured: Follow all orders given by Squad Leader. Keep radio communication clear as the medical situation is being handled.

LEVEL 2

Situation: More than 40% squad members are combat ineffective (CAT 2). Orders to move out. Area clear, no present threat.

• Platoon HQ Procedure: Once given the information that a squad will be delayed for medical, determine whether the objective can wait or not. If not, you may need to reissue orders. Unless absolutely necessary do not order the platoon to hold.
• Squad Lead Procedure: Order all injured to a triage location. Injured to cover 360 security from triage while awaiting treatment. Uninjured members to hold security no less than 20 meters from triage location when possible, and no more than 100 meters. Relay to PLT HQ that you will be delayed due to medical for X mins (approximation comes from medic).
• Medic Procedure: Triage patients while determining the approximate treatment time of all patients (assume a longer time than need if unsure) and relay to Squad Lead. PAK whoever possible (people in severe pain, because of weapon sway, and people with head and/or torso damage). Relay to squad lead once all squad members are combat effective.
• Squad Member Procedure:
  • When in a triage location/situation the medic outranks the SL in regards to all things medical:
    • Injured: Report to triage, communicate injuries and whether stable (not bleeding) or unstable (actively bleeding) to the medic. Pull security, gun up and facing out away from the medic at all times. Once treated, stay with the medic until rejoined with the squad. Keep radio communication clear.
    • Uninjured: Follow all orders given by Squad Leader or Medic. Keep radio communication clear as the medical situation is being handled. Pull 360 security gun up and facing out away from the triage at all times. If the medic requires your assistance they will let you know.

LEVEL 3

Situation: 1 or more highly unstable patients or at risk of death (CAT1). Orders to move out. Area clear, no present threat.

• Platoon HQ Procedure: Once information is received that a squad is unable to move due to a medical emergency, you may need to reissue orders. If a second medic is necessary, send platoon medic first (if available) if not order the nearest squad to send their medic to the squad in need. Unless absolutely necessary do not order the platoon to hold.
• Squad Lead Procedure: Immediately relay to PLT HQ that your squad is unable to move due to a medical emergency, and to standby for further information. Once you have a number of wounded, categories of injured, and an approximate time for your squad to be combat effective again relay to Plt HQ. ["PLT HQ this is Bravo We have 5 Injured, 3 CAT1s, 2 CAT2s. We are unable to move at this time. Medic is up and stable. Combat Effective in approximately 15 mins"]  Assist Medic in gathering injured into a secure triage location. Order Uninjured squad members to assist medic, or pull security. During triage ensure squad members are performing their roles and not staring at the medic.
• Medic Procedure: Begin stabilizing all CAT1 personnel. Order uninjured or stable squad members to stabilize any other CAT1 patients and drag or carry them to your triage location. For each patient, stitch torso and head first, then after having done that to all CAT 1 patients move on to their limbs. Order CAT2 patients to stabilize themselves and to take medical supplies from your pack if needed. Start giving IVs before moving on to CAT2 patients. Get CAT2 or CAT3 patients combat effective if you are expecting more contact. PAK whoever possible (people who were CAT1 and people in severe pain, because of weapon sway, and people with head and/or torso damage).
• Squad Member Procedure:
  • When in a triage location/situation the medic outranks the SL in regards to all things medical:
    • Injured: Report to triage, communicate injuries and whether stable (not bleeding) or unstable (actively bleeding) to the medic. If bleeding attempt to stabilize yourself. If you need to resupply on medical to do so, take them from your medic’s bag but inform them if you do so. Pull security, gun up and facing out away from the medic at all times. Once treated move away from the triage and follow guidelines for uninjured squad members. 
    • Uninjured: Follow all orders given by Squad Leader or Medic. Keep radio communication clear as the medical situation is being handled. Pull security gun up and facing out away from the triage at all times. If the medic requires your assistance they will let you know.