ATV CASEVAC

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    • #92428
      JohnnyMac
      Participant

        I thought about the use of ATVs to facilitate CASEVAC on the battlefield, and found this purpose built towable trailer. It looks like it’s being used by a few search and rescue teams, and others. Seems like an interesting concept so I thought I’d share.

        http://eeresq.com/

      • #92429
        Civilianresponder
        Participant

          That’s cool.

        • #92430
          wheelsee
          Participant

            Looks cool but I don’t see much use for what we do…..notice the patient is backboarded (possible C-spine injury) with the rescuer at the head to maintain airway control…..backboards are great for fall injuries but aren’t required for penetrating trauma (the damage is already done)…..

          • #92431
            JohnnyMac
            Participant

              @wheelsee So then, just use a regular atv towable trailer and call it a day?

            • #92432
              wheelsee
              Participant

                @wheelsee So then, just use a regular atv towable trailer and call it a day?

                Depends. :yahoo:

                On terrain – having trailer usually requires more space to maneuver, read more open ground. Otherwise, just use a regular ATV/UTV and place the injured behind the driver in a seated position. If its a broken leg (read femur/thigh), what was it caused by?? Penetrating trauma?? TQ high and tight and yes, its gonna hurt like a MF. Maybe use a small jeep, like a Samurai?? We used to use ATV’s and place the backboard cross-wise on the back to be able to get to a LZ (landing zone).

                Again, what are the resources available?? From my limited exposure, the results of raids (injuries) are likely to have the same results as our brethren in the War for Southern Independence. The VAST majority, if not all, of our advances in trauma is due to technology. If we’re deprived of that, the results are gonna be ugly……..

              • #92433
                Abacus
                Participant

                  Didn’t we used to place litters on the front and back of Willie’s Jeeps back in the day?

                  The modern equivalent might be a side by side UTV. I have used razors and mules to great effect out west. You could probably rig a litter or backboard onto one if you needed to.

                  You might wind up having to carry folks until you can get them on a truck if the terrain is to tight for a side by side.

                • #92434
                  wheelsee
                  Participant

                    Didn’t we used to place litters on the front and back of Willie’s Jeeps back in the day?

                    The modern equivalent might be a side by side UTV. I have used razors and mules to great effect out west. You could probably rig a litter or backboard onto one if you needed to.

                    Yes.

                    More bang for the buck…… https://ww2db.com/image.php?image_id=4807

                    But this was what we saw on MASH https://www.flickr.com/photos/lee-ekstrom/6395312321/

                  • #92435
                    A_A_Ron2guns
                    Participant

                      Spine boards are great if you’re looking at spinal injury or have to do compressions because you have a firm surface to do that. They’re also good for transportation and if you have a less than compliant patient you can strap and cuff. They also disinfect easier than mesh.

                      The drawback is space. They tend to weigh less than a talon 2 foldable litter but are difficult to maneuver in regular vehicles.

                      The trick is to always remember we don’t work in a vacuum. METT-TC. Mission, enemy, time, terrain, troops, civil/chem considerations. Tailor your rescue gear to your needs.

                    • #92436
                      Max
                      Keymaster

                        Haven’t I been banging on about the need for UTV’s / trucks in support of operations? Ammo forward, causalities to the rear?

                        If you are sending out a patrol you need communications back to an operations room. At that operations room should be a vehicle mounted QRF, with medical evacuation and care capability.

                        Here is the problem with the ‘prepper’ side of things – they don’t think they have the numbers to do this, and therefore dismiss it in favor of some sort of sniper fantasy. Well, good operational practices do not change just because you have no mates.

                        If you find yourself in a tactical situation requiring patrolling etc, then you need to be in an organized force, however you decide to achieve that, either now or then.

                      • #92437
                        Abacus
                        Participant

                          When I was a lad in the Boy Scouts, the more advanced scouts in my troop had a suspected spinal injury on a remote excursion from our annual summer camp. I was too young to go, so I stayed at the base camp”. According to the hotwash I got to hear, the scouts, leaders, and camp staff got the casualty to a logging road by taping/strapping him to a hollow core door one of them found. Someone had left it laying around up on the ridge. From there they loaded him up into a truck and brought him to a rondevouz point with EMS. This was in terrain not unlike the VTC.

                          The next year, and every year since, they cached a back board and aid bag along the route using an ATV before each event.

                          When I later became a staff member at the camp, I was tasked with getting GPS coordinates for various known clearings near where the excusrion usually took place. They got marked on a map I the base camp aid station next to the phone to pass to care flight.

                        • #92438
                          JohnnyMac
                          Participant

                            Yeah, anytime we encounter casualties in training, it sucks bad. Like you say all the time, the hardest thing you have to do is evacuate a casualty under fire.

                            At the last HEAT 2, I was a casualty, and hopped up the ambush site hill with assistance, but at the top, my unwounded leg gave out- complete muscular fatigue (and I wasn’t even leaking blood!). At that point, our movement slowed to a snail’s pace as I had to be carried. We endex’d after a bit of two man carrying at the top. Obviously, you gotta do what you gotta do, but it’s been in the back of my mind ever since.

                          • #92439
                            A_A_Ron2guns
                            Participant

                              A HUGE part of casevac is preplanning. Much like everything else in combat. Preselected casualty collection points, evacuation routes, litter bearers, training, supplies etc. all of that has to be in place before the first casualty is taken. If it’s not you’ll have even more casualties and people that could have been saved will die and people that wouldn’t have been a casualty will become one.

                            • #92440
                              tango
                              Participant

                                Wouldn’t you want to stabilize any significant penetrating wound regardless? To prevent secondary damage due to fractures, floating fragments, etc? Especially a leg wound where you’re worried about large arteries?

                              • #92441
                                A_A_Ron2guns
                                Participant

                                  By stabilize do you mean immobilization? Ideally yes. You’ll want a “packaged” patient. That’s not always the case especially in a hot or warm zone. Just depends.

                                • #92442
                                  Abacus
                                  Participant

                                    As I was taught in the scouts, first aid rule #1 is don’t get hurt rendering aid. Rule 2 says if the casualty is somewhere that is unsafe and will injure them further, get them away from that situation. As a life guard that meant I had to get them off the bottom of the lake first. I can backboard them later on the surface.

                                    Moving into the military side, we are taught to slap a TQ on and drag his bleeding ass away from the firefight. Getting your causality shot more is not conducive to their long term survival, neither is taking a round or two yourself.

                                  • #92443
                                    wheelsee
                                    Participant

                                      UMass and Harved did a study in the early 90’s (I’m stretching my memory here). The comparison was the death rate as compared to medicine technology at various historical times.
                                      If early 1990s violence had 1970’s medicine to work with, the death rate would be 10x what it was in the early 1990s.
                                      If early 1990’s violence had 1930’s medicine to work with, the death rate would be 20x what it was in the early 90s.
                                      If early 1990s violence had 1880s medicine to work with, the death rate would have been 30x what it was in the 90s.

                                      Primary point – the death rate (per 1,000) due to violence was headed downward, not because we were any less violent. But rather because our technology had advanced. One of the primary reasons for this (IMHO) was the advance in communications (radio and cellular). We were actually getting to patients quicker because someone found them and notified 911 (versus the old days of someone finding a MVC, car wreck, then having to drive to a nearby house and call the operator)

                                      Re: penetrating trauma and backboards. The DOD and US Park Police did a joint project in the 90s for EMT-Tactical (SWAT). In that class, they discussed that there was NO record of any soldier having neurological deficits after he was moved that had not been there previously, dating back to WWI (one case was found in WWI but on review, there was no documented exam prior to moving, so couldn’t say when the deficits had taken place).

                                      At the end of the day, backboards DO make moving a patient easier but they are bulky and unwieldy (this is why you don’t see military carrying them on the battlefield). They also have dangers all of their own. Fall trauma is a whole nuther ballgame. Here is an interesting thread line on LSB (long spine boards) – https://emtlife.com/threads/back-boarding.11750/. The NEXUS criteria discussed is what we use in the ED. Whereas EVERYONE with trauma used to get a cross-table lateral X-ray on their neck, then it moved to CT scan of the C-spione, now only those who fallout of the NEXUS criteria (anything over 0, https://www.mdcalc.com/nexus-criteria-c-spine-imaging#evidence ) are considered for imaging (CT is now the standard in many places). (my apologies for getting into the weeds here….)

                                      Review MARCH……..

                                    • #92444
                                      wheelsee
                                      Participant

                                        Wouldn’t you want to stabilize any significant penetrating wound regardless? To prevent secondary damage due to fractures, floating fragments, etc? Especially a leg wound where you’re worried about large arteries?

                                        That’s what they make TQs for……not to prevent further damage but to prevent bleeding out…….. review MARCH

                                      • #92445
                                        Max
                                        Keymaster

                                          Yes, we don’t need to thrash around here. Actual TC3 protocols are published here somewhere, and I know I just put them in the Tactical Manual.

                                        • #92446
                                          Scott G
                                          Participant

                                            Back when I was an EMT I worked part time for an ambulance company providing support for a motocross track. We used 4-wheelers to move the EMTs around the course and had a mule which carried backboards and could be used for transport. Ambulatory would sit in the seats and we could get two back-boarded patients across the back. If necessary we could have strapped more to the roof, though we never practiced that or tried it.
                                            We would sometime just transport patients to their trailer, to our ambulance, to the main gate to meet a responding ambulance, or to a nearby LZ for the MD State Police helicopter to transport. Sometimes provider would ride in the seat with ambulatory or boarded patient (just face back and lean over the seat), sometimes provider would walk next to vehicle if patient needed more attention and the Mule would just move slow enough for provider to keep up.
                                            Most patients were trauma from motorcycle accidents. Occasionally we had non-trauma stuff like anaphylactic shock from a bee sting or severe dehydration.
                                            Point being, these types of vehicles have their place and definitely can be used. Best to plan ahead and train with the vehicles ahead of time so there is a plan and improvisation is not necessary.

                                          • #92447
                                            Roadkill
                                            Participant

                                              I’m flipping a house. As soon as it sells I’m buying a Rokon. I think you can get a single track trailer for them. I’ll just steal their idea and weld one up.

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