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Patient Evacuation
Casualty movement is the collective term for the techniques used to move a casualty from the initial location (street, home, workplace, wilderness, battlefield) to the ambulance. In wilderness or combat conditions, it may first be necessary to stabilize the patient prior to moving them to avoid causing further injury. In such situations, evacuation may involve carrying the victim some distance on improvised stretchers, a travois, or other improvised carrying gear. Spinal immobilization is necessary if there is a likelihood of head or spinal injury. Once the patient is ready to be moved, the first step is the casualty lifting, to put him/her on a stretcher or litter (rescue basket). The final step is the patient transfer from the stretcher to the hospital bed. The use of wheeled stretchers, usually used in most developed emergency services, does not need much explanation, except that great care must be taken in order to avoid aggravating an unstable trauma. See also * CASEVAC ...
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Ambulance
An ambulance is a medically-equipped vehicle used to transport patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to medical emergencies by emergency medical services (EMS), and can rapidly transport paramedics and other first responders, carry equipment for administering emergency care, and transport patients to hospital or other definitive care. Most ambulances use a design based on vans or pickup trucks, though others take the form of motorcycles, buses, hearses, aircraft and boats. Ambulances are generally considered emergency vehicles authorized to be equipped with emergency lights and sirens. Generally, vehicles count as an ambulance if they can transport patients. However, it varies by jurisdiction as to whether a non-emergency patient transport vehicle (also called an ambulette) is counted as an ambulance. These vehicles are not usual ...
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Stabilization (medicine)
Stabilization is a process to help prevent a sick or injured person from having their medical condition deteriorate further so that they can be treated. Examples include while the person is waiting for medical treatment and in the intensive care unit. Stabilization is often performed by the first person to arrive on scene, EMTs, or nurses before or just after arrival in hospital. It includes controlling bleeding, arranging for proper evacuation, keeping patients warm with blankets, and calming them by providing personal attention and concern for their well-being. Stabilization is also often an important principal of care in an ICU. It is particularly important in trauma cases where spinal injury is suspected to immobilize the cervical spine, or back. Failure to do so can cause permanent paralysis or death. In the field, spinal stabilization involves moving the person's back as a single unit with as many as five rescuers assisting, then applying a cervical collar (which c ...
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Travois
A travois (; Canadian French, from French language, French ; also travoise or travoy) is an A-frame structure used to drag loads over land, most notably by the Plains Indians of North America. Construction and use The basic construction consists of a platform or netting mounted on two long poles, Lashing (ropework), lashed in the shape of an A-frame; the frame is dragged with the sharply pointed end forward. Sometimes the blunt end of the frame is stabilized by a third pole bound across the two poles. The travois is dragged by hand, sometimes fitted with a shoulder harness for more efficient dragging, or dragged by dogs or horses (after the 16th-century introduction of horses by the Spanish). A travois can either be loaded by piling goods atop the bare frame and tying them in place, or by first stretching cloth or leather over the frame to hold the load to be dragged. Although considered more primitive than wheel-based forms of transport, on the type of territory where the ...
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Casualty Lifting
Casualty lifting is the first step of casualty movement, an early aspect of emergency medical care. It is the procedure used to put the casualty (the patient) on a stretcher. Developed emergency services use lifting devices, such as scoop stretchers, that allow secured lifting with minimal personnel. Other methods (explained below) can be used when such devices are not available. Since only stabilised casualties are moved (except in unusual circumstances), the lifting is usually never performed in emergency; emergency movements are sometimes performed to respect the Golden Hour. This depends on the organisation of the medical services and on the specific circumstances. Maximum care must be taken to avoid to worsen an unstable trauma. The head-neck-chest axis must be kept straight to protect the spine, and the first responders must keep the patient's body stable (no movement of the feet) during the lift. The first responders have to carry a heavy load (probably more than 2 ...
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Stretcher
A stretcher, gurney, litter, or pram is an medical device, apparatus used for moving patients who require medical care. A basic type (cot or litter) must be carried by two or more people. A wheeled stretcher (known as a gurney, trolley, bed or cart) is often equipped with variable height frames, wheels, tracks, or skids. Stretchers are primarily used in Acute (medicine), acute out-of-hospital care situations by emergency medical services (EMS), military, and search and rescue personnel. In medical forensics, the right arm of a corpse is left hanging off the stretcher to let paramedics know it is a deceased person. They are also used to restrain prisoners during executions via lethal injection. History An early stretcher, likely made of wicker over a frame, appears in a manuscript from . Simple stretchers were common with militaries right through the middle of the 20th century. Gurney Generally spelled ''gurney'', but also ''guerney'' or ''girney''. The first usage of the t ...
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Litter (rescue Basket)
A litter is a stretcher designed to be used where there are physical obstacles that impair movement, including other hazards such as, in confined spaces, on slopes or uneven terrain, or in densely forested areas. Typically it is shaped to accommodate an adult in a supine position, face up position and it is used in search and rescue operations. The person is strapped into the basket, making safe evacuation possible. The person generally is further protected by a cervical collar and sometimes a long spine board, so as to immobilize the person and prevent further injury. A litter essentially is a stretcher with sides (or just a raised edge) and a removable head and/or torso cover. They are most notably remembered from Korean War, Korea and Vietnam War, Vietnam images of United States Air Force Pararescue airmen or more recent United States Coast Guard, Coast Guard video clips of Helicopter rescue basket, helicopters rescuing injured people from isolated areas. Some will also recall ...
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Patient Transfer
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care provider. Etymology The word patient originally meant 'one who suffers'. This English noun comes from the Latin word , the present participle of the deponent verb, , meaning , and akin to the Greek verb ( ) and its cognate noun (). This language has been construed as meaning that the role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging in shared decision-making about their care. Outpatients and inpatients An outpatient (or out-patient) is a patient who attends an outpatient clinic with no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance is still r ...
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CASEVAC
Casualty evacuation, also known as CASEVAC or by the callsign Dustoff or colloquially Dust Off, is a military term for the emergency patient evacuation of casualties from a combat zone. Casevac can be done by both ground and air. "DUSTOFF" is the callsign specific to U.S. Army Air Ambulance units. CASEVACs by air today are almost exclusively done by helicopter, a practice begun on a small scale toward the end of World War II; before that, STOL aircraft, such as the Fieseler Fi 156 or Piper J-3 were used. The primary difference between a CASEVAC and a medical evacuation (MEDEVAC) is that a MEDEVAC uses a standardized and dedicated vehicle providing en route care, while a CASEVAC uses non-standardized and non-dedicated vehicles that may or may not provide en route care. CASEVACs are commonly referred to as "a lift/flight of opportunity". If a corpsman/medic on the ground calls for a CASEVAC, the closest available unit with space could be called to assist, regardless of its ...
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MEDEVAC
Medical evacuation, often shortened to medevac or medivac, is the timely and efficient movement and en route care provided by medical personnel to patients requiring evacuation or transport using medically equipped air ambulances, helicopters and other means of emergency transport including ground ambulance and maritime transfers. Examples include civilian EMS vehicles, civilian aeromedical helicopter services, and military air ambulances. This term also covers the transfer of patients from the battlefield to a treatment facility or from one treatment facility to another by medical personnel, such as from a local hospital to another medical facility which has adequate medical equipment. In Asia, according to Aeromedical Global (M) Sdn Bhd, medical evacuations via air ambulance can be performed via a single or dual stretched setup. According to patients medical condition, Emergency Air Ambulances will be equipped with relevant equipment (ventilators, Portable O2 Concentrator e ...
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Critical Emergency Medicine
Critical emergency medicine (CREM) refers to the acute (medicine), acute medicine, medical care of patients who have medical emergency, medical emergencies that pose an immediate threat to life, irrespective of location. In particular, the term is used to describe the role of anaesthesiologists in providing such care. The term was introduced in 2010 in a position paper by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine, who defined it as "immediate life support and resuscitation of critically ill and injured patients in the pre-hospital emergency medicine, pre-hospital as well as hospital settings". It describes the roles and competencies of anaesthesiologists and intensive care medicine, intensive care physicians in caring for patients with life-threatening illness or injury who require resuscitation or support of their vital functions, particularly in Scandinavia and other parts of Europe. One reason the term was introduced was to distinguish these core ac ...
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Emergency Medical Services
Emergency medical services (EMS), also known as ambulance services, pre-hospital care or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other acronym, initialisms such as EMAS or EMARS. In most places, EMS can be summoned by members of the public (as well as medical facilities, other emergency services, businesses and authorities) via an emergency telephone number (such as 911 in the United States) which puts them in contact with a dispatching centre, which will then dispatch suitable resources for the call. Ambulances are the primary vehicles for delivering EMS, though Nontransporting EMS vehicle, squad cars, Motorcycle ambulance, motorcycles, Air medical services, aircraft, Water ambulance, boats, Firefighting apparatus, fire appara ...
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