SOF combat casualty care applies to all special operations components and the full range of military operations involving the integration of special operations assets conducting special and irregular operations in a joint, combined, or multinational environment. SOF combat casualty care is the medical management provided to CAX in a tactical, combat environment. This medical management is often in contrast to CF, with its robust logistics tail, its focus on stabilizing the casualty, and the rapid rearward movement capability to advanced hospital trauma care.
There are many dynamic factors on the modern battlefield that may influence combat casualty care including the following:
• Enemy fire: This may prevent the immediate management of CAX at the point of injury (POI) or wounding and may place the combat lifesaver (CLS)/medical personnel at risk while providing care to CAX.
• Medical equipment limitations: CLS/medical personnel are generally limited to what they are carrying in their CLS kit or medical aid bag.
• A widely variable evacuation time: In the civilian community, evacuation is generally under 25 minutes; in a combat situation, it may be delayed for several hours.
• Tactical considerations: Tactical constraints that may take precedence over medical care and the timely evacuation of CAX.
• Casualty transportation: CASEVAC may or may not be available. Air superiority must be achieved before any air evacuation assets will be deployed. As stated previously, the tactical situation must dictate when or if CASEVAC can occur. Additionally, there are environmental factors that may prevent evacuation assets from reaching CAX.
Note: The ongoing and evolving process to standardize terminology is evident when using the terms medical evacuation (MEDEVAC) and casualty evacuation (CASEVAC) within the CF and joint SOF arena. The Army Medical Department (AMEDD) uses the term MEDEVAC when referring to the evacuation of CAX using dedicated, standardized medical evacuation platforms, with medical personnel providing en route care. CASEVAC, according to the AMEDD, is reserved for casualty evacuation by non-medical vehicles, watercraft, or aircraft, with or without en route medical attendance. In the SOF arena, evacuation of CAX will often be accomplished by other than dedicated U.S. Army aeromedical or special operations forces aircraft. U.S. Air Force (USAF) may also perform this extraction of the team and CAX. USAF reserves the term MEDEVAC for the aeromedical evacuation of stable patients from one medical treatment facility (MTF) to another.
SOF are advised to avoid the term MEDEVAC when discussing the initial management of combat CAX and use the term CASEVAC instead to eliminate any misunderstanding of the mission required. This publication will use the term CASEVAC throughout to denote the evacuation of CAX by ground vehicle, watercraft, or aircraft assets.
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