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  • Combat Search & Rescue - Medevac Training


    Sarissa

    COMBAT SEARCH AND RESCUE

    THE ART OF THE MEDEVAC

     

    This Guide/Syllabus is a list of information and requirements needed to attain a Medevac tag. It will cover general information, Advised loadouts, battlefield practice, triage and radio communication.

     

    The role of a CSAR Medic

    A CSAR Medic is part of the Medevac team. Usually consisting of 2 Medics aboard a Helicopter (though sometimes it can be Motorised Medics) and CSAR Medics, when employed, are the only members of the Platoon who can completely treat Battlefield wounds. Whereas embedded Squad Medics are limited to only carrying basic medical supplies (bandages, tourniquets and medicine) the CSAR Medic will be responsible for carrying the Personal Aid and Surgical Kits. CSAR & the Medevac is the ability for the Platoon to continue to operate as an effective fighting unit.

     

    General Practices of CSAR Medics

    CSAR Medics, by their very nature, need to be fast. They will be inserted into a potentially hostile area and will encounter many cases of varying intensity of wound almost as soon as they hit the ground. Likely, the CSAR Medic will do very little actual fighting. Therefore, I have created a list of guidelines a CSAR Medic should abide by.

     

    1. Equipment - CSAR Medics need to be fast. That means they need to be lightweight. Choosing lighter Body Armour, lighter weapons and taking less magazines means that you maintain your speed without sacrificing your medical effectiveness. You will also be called into squads that are nearly dead, with little to no medical supplies left. That means that you are likely to run out. So you also have to pack smart. Make sure your bags are filled with medical supplies, but that you stay at a reasonable weight (25kg). Then, if necessary place multiple bags inside the Medevac Vehicle to allow you to quickly replenish your supplies.

      Note: it is advisable to carry your PAK and SK inside your Uniform or Vest. This allows you to leave a Bag of Medical Supplies with a Squad Medic who has run out.

       
    2. Triage - Triage is the most important part of being a CSAR Medic.You will routinely be surrounded by wounded personnel, all needing your medical attention. It is up to you in this case to quickly check the needs and importance of each case and heal them as required. Remember, you may have to stop PAKing someone multiple times to save another critical casualty, or even tourniquet several limbs so you can save someone from bleeding out.
       
    3. Be Clear - Radio Communication can be difficult at the best of times; but when you’re talking to your Medevac or to the squads as a whole, then things need to be clear. Monitor your radio net, listen to what the pilot tells you, relay the information to the rest of your team and make sure everyone knows the plan.
       
    4. Be Confident - CSAR can be a tricky thing. It can get a little stressful at times (We all know FK Arma can get a little stressful) and you will be subject to people crowding around you, talking over each other sometimes even cussing you out for not fixing them first. Remember: You are the Combat Search & Rescue Medic. It is up to you who needs healing first. If you need to tell them to shut the fuck up, then you do that. If you need to order someone to help, then you do that.

    Now, I’m going to look at these topics in more detail.

    Loadouts & Equipment

    As previously stated, CSAR Medics need to pack light and smart. I’ve created this loadout based upon what I believe makes sense for a CSAR Medic to carry in the field.


    Uniform 

    20171124102852_1.thumb.jpg.097f8bc76585d76392da927a9ad34ee9.jpg

    • Personal Aid Kit
    • Surgical Kit
    • Pistol Ammunition
    • Maglite

    Vest 

    20171124102856_1.thumb.jpg.5c380cf97d7982832bd81c02d1abda49.jpg

    • Primary Weapon Ammo
    • White Smoke Grenades (for providing cover while you head to save those trapped in the open)
    • Purple Smoke Grenades (Used to mark EMERGENCY locations)
    • Blue Smoke Grenades (Used as general Friendly POS markers)

    Backpack

    20171124102858_1.thumb.jpg.088ba7aacef134ff714dc316c4a2ae73.jpg

    This shows a limited supply bag, so you can load multiples of these into your chopper and grab new ones every time you need to resupply.

    • 45 Elastic Bandages
    • 10 QuikClot
    • 12 Packing
    • 8 Tourniquets
    • 5 Saline
    • 4 Bodybags

    Total Weight and Notes

    Due to the fact that you will not be doing a large amount of fighting, I recommend that you take SMGs over Rifles. Lighter & easier to manoeuvre, they make more sense for CSAR Medics to carry. In an effort to remain lightweight and fast, you should attempt to stay near 25kg, as pictured here.
     

    Communication

    CSAR Medics rely on communication to understand the threats and problems that may await them on the ground. While I have already outlined the Medevac comms procedures in another guide [link], I am going to go into more depth for the CSAR Medic here.

    Patient Precedence - Categories of Wounds:
    We use a simplified version of the US Army 9-Line Emergency Medical Communications guide when discussing Medevacs and Patients, I will talk about each Category here.

     

    • Category 1 -  Urgent : Urgent patients are defined as those who are in immediate risk of death or combat ineffective. In Arma terms, this means those who have open, unstable wounds or those who are unconscious and unable to move.

    For example, a Rifleman is lying on the ground unconscious. The Squad Medic has attempted to stabilise the patient by bandaging all wounds but has run out of bandages and left wounds open on the torso. This leaves the soldier in a critical state, as the soldier will bleed out without immediate medical care.

     

    • Category 2 - Priority : Priority patients are those in a combat zone who are currently unable to fight at peak efficiency. Be this due to blood loss, broken limbs or narcotic overdose. This does also include those who have been bandaged, but whose wounds are not sealed by a Surgical Kit.

    Example, after a firefight Bravo has two members of their team with wounds. One soldier has a broken arm and the other has a bandaged, yet open, chest wound. Due to the nature of the chest wound (in which re-opening can lead to uncontrolled bleed and rapid deterioration to CAT 1) both of this instances are classified as Priority.

     

    • Category 3 - Routine : Routine patients are calls sent in when a Squad Medic has run out of supplies or is overwhelmed by the sheer number of small cuts and abrasions the squad has suffered. These wounds are considered non-threatening, and CAT 3 is also used to call for resupply.

    Example, after a firefight Delta suffers minor wounds and one KIA. The KIA is their Squad Medic. Since his body, and therefore his supplies, are non-retrievable, the Squad Leader calls for a CAT 3 response at his position. The CSAR Medic would treat all personnel at the scene and leave behind a bag of medical supplies.

     

    • Category 4 - Convenience : Category 4 covers any and all calls that are non-essential. This includes such things as Body Collection, treating those who have had Morphine after Squad Medics run out of Epinephrine and retrieval of equipment*. While not technically necessary during a game of Arma, I always include CAT 4 as it is a good practice to follow and allows for the Medevac helicopter to remain busy while not on any calls.

    *I include retrieval of equipment as part of IRL CSAR teams is also sometimes destruction of sensitive equipment. While I do not consider that to be a job of the CSAR Medic, sometimes having an expanded CSAR Team is a fun way to change a mission. For reference, see the movie Black Hawk Down in which a CSAR Team is inserted into Cliff Wolcott’s crash site to treat wounded personnel, recover bodies and also recover or destroy sensitive radio equipment.

     

    Radio Procedures & Freqs

    The CSAR Medics should have two channels set on your Short Range. One set to 66 - The Emergency Channel, and the other set to your Team Frequency (for example 66.5).
    The Pilot/Driver of the Medevac Vehicle should have their Long Range on two Frequencies - 68/67 (For FAC or RTO respectively) and 66 (For Emergency Comms). Their Short Range should be set to the Team Frequency (e.g. 66.5)

    The Medevac Vehicle essentially acts as a ‘signal booster’ for the Medics on the ground. The CSAR Medics listen to calls in their immediate vicinity whereas the Medevac Vehicle will listen to Company-wide communications.

     

    Triage

    Triage is the single most vital part of the CSAR role. Triage dictates who has the most need of your time. As a CSAR Medic you will be in situations where 2 or 3 squads worth of people cluster around you and all demand attention. You can be in the middle of PAKing someone for the 3rd time, only to be interrupted again after an unstabilised patient is brought to you.

    This is the challenge.

    This is what makes it fun.

    This is what separates CSAR Medics from normal Medics - the ability to make snap decisions while under pressure.

    I will now outline which patients take priority in which situations in numerical order (highest priority first)

    1. Open Wounds -  Limbs (Apply Tourniquet)
    2. Open Wounds - Torso/Head (Stop the Bleed)
    3. Open Wound (NOT Bleeding) - Limbs (Stop Wound & Remove Tourniquet)
    4. Closing Wounds - (Stitching)
    5. Fixing Limbs - (PAK)
    6. Non-essential - (Resupply/Epi/Blood [when not counteracting a bleed])

     

    The Evaluation

    The Evaluation for the CSAR tag will be carried out by myself; and will scrutinize your actions in response to this guide. I do not intend to make the evaluations easy, and expect to have a much lower pass rate than the Medical Evaluations.

    To request and evaluation you must post in this thread. You need to already hold the Medic Tag. I will place you into a shortlist, the next time a CSAR mission comes up (and I am available) I will arrange an evaluation with one of the people on this list. [I will attempt at “First come first served” but as we all know, real life gets in the way]

    During the evaluation, you will operate as part of an independant CSAR team. I will shadow you as a Rifleman/guard. You will not receive any help or advice from me, and will receive no help from your counterpart. You will be expected to answer calls on your own. If I witness 3 instances which do not fall within my expectations, you will fail the Evaluation.

     

    I will grade you on:

    • Equipment
    • Weight/Speed
    • Brevity & Clarity of Communication
    • Triage
    • Confidence
    • Attitude

     

    Good luck!

     

    Edited by Sarissa




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