Casualty evacuation is the rapid removal of severely injured personnel from the battlefield. It is reserved for patients who cannot wait for a medical evacuation after a site is secured, because they might die of their injuries while waiting for attention. People from within their units with medical training can supervise their preparation and removal to a safer location so they can start receiving treatment. Battlefield medicine often focuses on rapidly evaluating and transferring people to get them to the most appropriate facilities as quickly as possible.
When forces engage with the enemy and people are injured, a corpsman or person with similar training can evaluate anyone with injuries. This evaluation determines whether the issue is mild enough for someone to continue, or severe enough to require evacuation. Medical evacuations use dedicated equipment and vehicles to transport people, but may have to wait for forces to secure the site so it is safe for medical personnel. By contrast, a casualty evacuation allows personnel to be immediately removed.
The patient is transferred to a litter and stabilized with available supplies, which may include pressure bandages to compress injuries, along with pain management medications. Stretcher-bearers can move the casualty to meet a helicopter or vehicle for evacuation. Because this equipment is not dedicated for medical uses, it may be armed and can engage with the enemy, in contrast with ambulances and other medical equipment. It is also permissible to attack a casualty evacuation in progress under international law, because it is not strictly medical.
Proper training for members of a team who may participate in casualty evacuation can include instruction on how to use first aid supplies and handle a litter. They also need to be familiarized with quickly moving patients, stopping bleeding, and identifying serious injuries that may need immediate attention. Under the direction of a medical officer, people can provide medical support in the field to help a patient survive long enough to make it to treatment.
Those with injuries so severe that they need immediate casualty evacuation can be brought directly into operating rooms at a battlefield surgical center. Surgeons may focus on stabilizing the patient with basic measures and packaging for transport to an advanced surgical center. Within hours of severe injuries, patients can be in advanced medical facilities where they receive high level care and rehabilitation services. Advances in battlefield medicine have significantly improved survivability after severe injuries by getting people to facilities offering a high standard of care with extreme rapidity.
