a. Objective. To measure the candidate's ability to evacuate casualties using manual carries, medical devices, tactical vehicles, and aircraft in a battlefield scenario.

b. Requirements. The candidate is required to complete eight of the nine performance tasks listed below and pass six of the eight. The test board chairperson will determine if paragraph 3-14c(4) or 3-14c(5) is tested. The tasks are tested in a simulated battlefield scenario with the required equipment.

(1) The host unit will not establish a combat lane with all evacuation tasks on it. Two or more tactical vehicles are not permitted on the same combat lane.

(2) The host unit will train the candidates on the 4-person carry position and the commands to lift, move, load, and lower the litter.

(3) Candidates will serve as the number 1 litter bearer when loading casualties onto a tactical vehicle or aircraft. He or she does not have to be in the number 1 position but may position the litter bearers to best utilize the litter squad’s strengths. All commands and directions will be given by the candidate to the litter bearers.

(4) Candidates will not be used as a casualty at any time during test week.

(5) Candidates will not be used as part of the litter bearer squad to load a tactical vehicle or aircraft except when they are being tested.

(6) Casualties will weigh between 140 and 180 pounds (63.56 and 81.72 kilograms). Mannequins or sandbags will not be used.

c. Tasks. The following tasks are tested using reaction-style testing.

(1) Establish a helicopter landing point (Figure 3-33).

(2) Load casualties onto a UH-60 helicopter (Figure 3-34).

(3) Load casualties onto ground evacuation platform (M996, M997, or M113)

(Figure 3-35).

(4) Load casualties onto nonstandard vehicle (5-ton M-1085, M-1093, or 2 1/2-ton M-1081) (Figure 3-36).

(5) Load casualties onto nonstandard vehicle (2 1/2-ton, 6x6 or 5-ton, 6x6, cargo truck) (Figure 3-37).

(6) Load casualties onto nonstandard vehicle (1 1/4-ton, 4x4, M998) (Figure 3-38).

(7) Prepare to transport a casualty with a suspected spinal injury (Figure 3-39).

(8) Transport a casualty using the fireman’s carry (Figure 3-40).

(9) Transport a casualty using the cradle drop drag (Figure 3-41).

d. Equipment. Host unit will provide all equipment and supplies for evacuation tasks at the tested sites.

e. Changes. Changes are NOT authorized without an exception to policy approval.

CONDITIONS: Given strobe lights, flashlights or vehicle lights, marker panels, and an area to be prepared for the landing site.

STANDARDS: The site is large enough for a helicopter to land and take off. All obstacles that cannot be removed are marked or identified and the touchdown point on the landing site is identified.

1. Select the landing site. (State the four factors and considerations for each to the evaluator.)

a. The size of the landing site.

(1) A helicopter requires a relatively level landing area 30 meters in diameter. This does not mean that a loaded helicopter can land and take off from an area of that size.  Most helicopters cannot go straight up or down when fully loaded; therefore, a larger landing site and better approach and departure routes are required.

(2) When obstacles are in the approach or departure routes, a 10 to 1 ratio must be used to lay out the landing site (Figure 3-33a). For example, during the approach and departure, if the helicopter must fly over trees that are 15 meters high, the landing site must be at least 150 meters long (10x15 = 150 meters).

Figure 3-33a. Obstacles in the Approach or Departure Route.

b. The ground slope of the landing site. When selecting the landing site, the ground slope must be no more than 15 degrees. Helicopters cannot safely land on a slope of more than 15 degrees.

(1) When the ground slope is under 7 degrees, the helicopter should land upslope.

(2) When the ground slope is 7 to 15 degrees, the helicopter must land sideslope.

c. Surface conditions.

(1) The ground must be firm enough that the helicopter does not bog down during loading or unloading. If firm ground cannot be found, the pilot must be told. He may hover at the landing site during the loading or unloading.

(2) Rotor wash on dusty, sandy, or snow-covered surfaces may cause loss of visual contact with the ground; therefore, these areas should be avoided.

(3) Loose debris that can be kicked up by the rotor wash must be removed from the landing site. Loose debris can cause damage to the blades or engines.

d. Obstacles.

(1) Landing sites should be free of tall trees, telephone lines, power lines or poles, and similar obstructions on the approach or departure ends of the landing site.

(2) Obstructions that cannot be removed (such as large rocks, stumps, or holes) must be marked clearly within the landing site.

2. Remove all obstacles and debris at the landing site and mark obstructions that cannot be removed. Ensure that the marker is properly secured to the obstacle or ground.

3. Mark the landing site and identify the touchdown point.

NOTE: For EFMB testing purposes, only step 3b will be performed with strobe lights during daylight hours.

a. When and how the landing site should be marked is based on the mission, capabilities, and situation of the unit concerned. Normally, the only mark or signals required are smoke (colored) and a signalman. VS-17 marker panels may be used to mark the landing site, but MUST NOT be used any closer than 50 feet to the touchdown point. In addition to identifying the landing site, smoke gives the pilot information on the wind direction and speed.

b. An inverted "Y," composed of four lights, marks the landing site and touchdown point at night (Figure 3-33b). Strobe lights, flashlights, or vehicle lights may also be used to mark the landing site. The marking system used will be fully explained to the pilot when contact is made.

NOTE: The candidate will state to the evaluator the marking system used and identify the touchdown point once he or she completes marking the landing site.

Figure 3-33b. Night Landing Site.

FM 7-8

FM 21-60

FM 3-21.38

STP 8-91W15-SM-TG, Task No. 071-334-4002

Figure 3-33. Establish a Helicopter Landing Point.

CONDITIONS: Given a UH-60 helicopter, three treated casualties, and three litters with straps. You and three noncandidate soldiers will form a litter squad, with you serving as the number 1 person to load the casualties. The flight crew has configured the aircraft to receive the casualties.

STANDARDS: Prioritize, load, and secure three casualties onto a UH-60 helicopter within 20 minutes, in the proper sequence, without causing further injury to the casualties.

1. Survey the casualties to determine loading sequence.

NOTE: Time starts when the candidate starts surveying the casualties or starts the steps to secure the casualties onto the litters.

a. Position litter casualties in the helicopter according to the nature of their injuries or condition.

b. Load the most seriously injured casualties last on the bottom pans of the litter support unit. However, if in-flight emergency medical care may be required, such as cardiopulmonary resuscitation, load the casualty onto either of the top pans to facilitate access.

c. Load casualties receiving IV fluids or oxygen on any litter pan, depending on their injuries or condition (if applicable).

d. Load casualties in traction splints last on a bottom pan (if applicable).

2. Under the supervision of the flight personnel, serve as the number 1 position and with the assistance of the noncandidate soldiers—

a. Secure the three casualties onto the litters.

b. Move the litter to the aircraft.

NOTE: The UH-60 can be loaded on both sides. Load the casualty so that upon rotating the litter support, his or her head will be forward in the cabin.

WARNING: DO NOT APPROACH THE AIRCRAFT UNTIL THE FLIGHT CREW DIRECTS YOU TO DO SO.

c. Load litters onto litter pans.

(1) If loading from one side of the aircraft with the carousel turned, the sequence is upper right, upper left, lower right, and then lower left.

(2) If loading from both sides of the aircraft simultaneously, the sequence is upper then lower.

(3) Direct the litter squad to move into the semioverhead carry, lifting the litter just high enough for the litter stirrups of one end to slide onto the litter pan.

(4) Direct the litter squad to slide the litter forward until the litter stirrups of both ends are secured on the pan. The candidate raises the pan back to its upright position and secures it and the litter.

NOTE: The litter team may assist the candidate in securing the pan and the litter but it is still the candidate’s responsibility to ensure that the pan and litter are secured properly.

WARNING: THE LITTER SQUAD DEPARTS ONLY WHEN DIRECTED TO DO SO BY THE FLIGHT CREW.

3. Load the remaining casualties IAW steps 2b and 2c.

NOTE: Time ends when the litter squad departs the aircraft after loading and securing the last litter.

FM 8-10-6

Figure 3-34. Load Casualties Onto a UH-60 Helicopter.

CONDITIONS: Given an unconfigured ground evacuation platform, three treated casualties, and two litters with straps. You and three noncandidate soldiers will form a litter squad, with you serving as the number 1 person to load the casualties.

STANDARDS: Configure the vehicle properly. Prioritize, load, and secure three casualties (two litter and one ambulatory) within 15 minutes, in the proper sequence, without causing further injury to the casualties.

1. Survey the casualties to determine loading sequence.

NOTE: Time starts when the candidate starts surveying the casualties, starts the steps to secure the casualties onto the litters, or starts the steps to configure the vehicle.

a. Casualties are normally loaded head first. They are less likely to experience

motion sickness or nausea with the head in the direction of travel. When en route, if care is required for an injury on one side, it may be necessary to load feet first to access the casualty from the aisle.

b. Casualties with wounds of the chest or abdomen or those receiving IV fluids are loaded in lower berths to provide gravity flow.

c. Casualties wearing bulky splints should be placed on lower berths.

2. Secure the two litter casualties onto the litters.

NOTE: The candidate may direct the noncandidates to secure the casualties while he or she configures and prepares the vehicle. However, it is still the candidate’s responsibility to ensure that the casualties are properly secured to the litters.

3. Configure and prepare the vehicle properly to receive the casualties (two litter and 1 ambulatory). Remove any debris and trash.

4. Serve as the number 1 person and, with the assistance of the noncandidate soldiers, move the litters to the vehicle.

5. Load the casualties, in the proper sequence, onto the vehicle.

a. M996.

(1) Load the litter head first in the right berth and then left.

(2) Instruct the ambulatory casualty to sit in the aisle or tailgate seat.

b. M997 and M113.

(1) Load the litter head first in the upper right berth and then lower right.

(2) Instruct the ambulatory casualty to sit on the left side of the vehicle.

6. Secure the casualties for transport.

NOTE: The noncandidate soldiers may assist the candidate by securing the litters onto the litter racks. However, it is still the candidate’s responsibility to ensure that the litters are properly secured.

7. Fold and stow the litter rail extension (if applicable).

8. Close the door and secure the latch.

NOTE: Time ends when the door is secured.

FM 8-10-6, Chapter 10

Figure 3-35. Load Casualties Onto Ground Evacuation Platform (M996, M997, or M113).

CONDITIONS: Given an unconfigured, nonstandard vehicle (without bow and canvas), five treated casualties, and five litters with straps and cravats. You and three noncandidate soldiers will form a litter squad, with you serving as the number 1 person to load the casualties.

STANDARDS: Configure the vehicle properly. Prioritize, load, and secure five casualties within 20 minutes, in the proper sequence, without causing further injury to the casualties.

1. Survey the casualties to determine loading sequence.

NOTE: Time starts when the candidate starts surveying the casualties, starts the steps to secure the casualties onto the litters, or starts the steps to configure the vehicle.

2. Secure the five casualties onto the litters.

NOTE: The candidate may direct the noncandidates to secure the casualties while he or she configures and prepares the vehicle. However, it is still the candidate’s responsibility to ensure that the casualties are properly secured to the litters.

3. Serve as the number 1 person and, with the assistance of the noncandidate soldiers, move the litters to the vehicle.

4. Configure and load an M-1085 (Figure 3-36a).

Figure 3-36a. M-1085 Configuration.

a. Lower the seats and secure the vertical support brackets in place. Remove any debris and trash.

b. Place four litters (litter numbers 1 through 4) crosswise on the seats, forward, next to the cab. Secure the litters individually to the seats with cravats using nonslip knots.

NOTES: 1. Casualties may be loaded either head to head or head to toe. 2. The noncandidate soldiers may assist the candidate by securing the litters to the vehicle.  However, it is still the candidate’s responsibility to ensure that the litters are properly secured.

c. Place one litter (litter number 5) lengthwise on the floor, forward toward the cab, feet first, ensuring that the patients' head is exposed from under the upper litters. Secure the litter to the vertical seat supports with cravats using nonslip knots.

5. Configure and load an M-1093 (Figure 3-36b).

a. Lower the seats and secure the vertical support bracket into place. Remove any debris and trash.

CONDITIONS: Given an unconfigured, nonstandard vehicle (without bow and canvas), five treated casualties, and five litters with straps and cravats. You and three

noncandidate soldiers will form a litter squad, with you serving as the number 1 person to load the casualties.

STANDARDS: Configure the vehicle properly. Prioritize, load, and secure five casualties within 20 minutes, in the proper sequence, without causing further injury to the casualties.

1. Survey the casualties to determine loading sequence.

NOTE: Time starts when the candidate starts surveying the casualties, starts the steps to secure the casualties onto the litters, or starts the steps to configure the vehicle.

2. Secure the five casualties onto the litters.

NOTE: The candidate may direct the noncandidates to secure the casualties while he or she configures and prepares the vehicle. However, it is still the candidate’s responsibility to ensure that the casualties are properly secured to the litters.

3. Serve as the number 1 person and, with the assistance of the noncandidate soldiers, move the litters to the vehicle.

4. Configure and load an M-1085 (Figure 3-36a).

Figure 3-36a. M-1085 Configuration.

a. Lower the seats and secure the vertical support brackets in place. Remove any debris and trash.

b. Place four litters (litter numbers 1 through 4) crosswise on the seats, forward, next  to the cab. Secure the litters individually to the seats with cravats using nonslip knots.

NOTES: 1. Casualties may be loaded either head to head or head to toe. 2. The noncandidate soldiers may assist the candidate by securing the litters to the vehicle.  However, it is still the candidate’s responsibility to ensure that the litters are properly secured.

c. Place one litter (litter number 5) lengthwise on the floor, forward toward the cab, feet first, ensuring that the patients' head is exposed from under the upper litters.

Secure the litter to the vertical seat supports with cravats using nonslip knots.

5. Configure and load an M-1093 (Figure 3-36b).

a. Lower the seats and secure the vertical support bracket into place. Remove any debris and trash.

b. Place three litters (litter numbers 1 through 3) crosswise on the seats, forward, next to the cab. Secure the litters individually to the seats with cravats using nonslip knots.

NOTES: 1. Casualties may be loaded either head to head or head to toe. 2. The noncandidate soldiers may assist the candidate by securing the litters to the vehicle.  However, it is still the candidate’s responsibility to ensure that the litters are properly secured.

c. Place two litters (litter numbers 4 and 5) lengthwise on the floor, forward toward the cab, feet first. Secure the litters together and to the vertical seat support with cravats using nonslip knots.

Figure 3-36b. M-1093 Configuration.

6. Configure and load an M-1081 (Figure 3-36c).

a. Lower the seats and secure the vertical support bracket into place. Remove any debris and trash.

b. Place three litters (litter numbers 1 through 3) crosswise on the seats, forward, next to the cab. Secure the litters individually to the seats with cravats using nonslip knots.

NOTES: 1. Casualties may be loaded either head to head or head to toe. 2. The noncandidate soldiers may assist the candidate by securing the litters to the vehicle.  However, it is still the candidate’s responsibility to ensure that the litters are properly secured.

c. Place two litters (litter numbers 4 and 5) lengthwise on the floor, forward toward the cab, feet first. Secure the litters together and to the vertical seat support with cravats using nonslip knots.

Figure 3-36c. M-1081 Configuration.

7. Raise and secure the tailgate.

NOTE: Time ends when the tailgate is secured.

FM 8-10-6

STP 8-91W15-SM-TG, Task No. 081-833-0173

Figure 3-36. Load Casualties Onto Nonstandard Vehicle

(5-Ton M-1085, M-1093, or 2 1/2-Ton M-1081).

CONDITIONS: Given an unconfigured, nonstandard vehicle (without bow and canvas), five treated casualties, and five litters with straps and cravats. You and three noncandidate soldiers will form a litter squad, with you serving as the number 1 person

to load the casualties.

STANDARDS: Configure the vehicle properly. Prioritize, load, and secure five casualties within 20 minutes, in the proper sequence, without causing further injury to the casualties.

1. Survey the casualties to determine loading sequence.

NOTE: Time starts when the candidate starts surveying the casualties, starts the steps to secure the casualties onto the litters, or starts the steps to configure the vehicle.

2. Secure the five casualties onto the litters.

NOTE: The candidate may direct the noncandidates to secure the casualties while he or she configures and prepares the vehicle. However, it is still the candidate’s responsibility to ensure that the casualties are properly secured to the litters.

3. Serve as the number 1 person and, with the assistance of the noncandidate soldiers, move the litters to the vehicle.

4. Configure and load the vehicle.

a. Lower the seats. Remove any debris and trash.

b. Place three litters crosswise on the seats, as far forward as possible, and two litters lengthwise, in the bed of the truck, as far forward as possible.

NOTES: 1. Casualties may be loaded either head to head or head to toe. 2. The noncandidate soldiers may assist the candidate by securing the litters to the vehicle.  However, it is still the candidate’s responsibility to ensure that the litters are properly secured.

c. Secure the first three litters individually to the seats and secure the other two litters on the floor together and to the seat with cravats using nonslip knots.

5. Raise and secure the tailgate.

NOTE: Time ends when the tailgate is secured.

FM 8-10-6

STP 8-91W15-SM-TG, Task No. 081-833-0172

Figure 3-37. Load Casualties Onto Nonstandard Vehicle

(2 1/2-Ton, 6x6 or 5-Ton, 6x6, Cargo Truck).

CONDITIONS: Given a configured, nonstandard vehicle (without the cargo bow and canvas), three treated casualties, and three litters with straps and cravats. You and three noncandidate soldiers will form a litter squad, with you serving as the number 1 person to load the casualties.

STANDARDS: Prioritize, load, and secure three casualties within 15 minutes, in the proper sequence, without causing further injury to the casualties.

1. Survey the casualties to determine loading sequence.

NOTE: Time starts when the candidate starts surveying the casualties, starts the steps to secure the casualties onto the litters, or starts the steps to configure the vehicle.

2. Secure the three casualties onto the litters.

NOTE: The candidate may direct the noncandidates to secure the casualties while he or she configures and prepares the vehicle. However, it is still the candidate’s responsibility to ensure that the casualties are properly secured to the litters.

3. Serve as the number 1 person and, with the assistance of the noncandidate soldiers, move the litters to the vehicle.

4. Load an M998 (Figure 3-38a).

Figure 3-38a. 3-Casualty Configuration.

a. Remove any debris and trash.

b. Place two litters side-by-side across the back of the truck with the litter handles resting on the sides of the truck.

NOTES: 1. Casualties may be loaded either head to head or head to toe. 2. The noncandidate soldiers may assist the candidate by securing the litters to the vehicle.

However, it is still the candidate’s responsibility to ensure that the litters are properly secured.

c. Secure the litters to the vehicle with cravats using nonslip knots.

d. Place one litter lengthwise, head first, in the bed of the truck. Secure it in place.

e. Leave the tailgate open. The two tailgate chain hooks will support it.

NOTE: Time ends when the last litter is secured.

FM 8-10-6

STP 8-91W15-SM-TG, Task No. 081-833-0171

Figure 3-38. Load and Unload Casualties Onto Nonstandard Vehicles (1 1/4-Ton, 4x4, M998).

CONDITIONS: Given a casualty with a suspected spinal injury, three noncandidate soldiers for assistance, and necessary materials and equipment.

STANDARDS: Complete all the necessary steps to immobilize and prepare a casualty with a suspected spinal injury for transport within 10 minutes, without causing further injury to the casualty.

1. Place the casualty on a long spine board.

a. Place the spine board next to, and parallel with, the casualty.

b. Candidate will immobilize the casualty's head and neck using manual stabilization.

(1) Place his or her hands on both sides of the casualty's skull, with the palms over the ears.

(2) Support the jaw (mandible) with the fingers.

(3) Maintain manual stabilization until the casualty has been placed and secured on the spine board.

c. Candidate will instruct an assistant to apply a cervical collar.

d. Candidate will brief the three assistants on their duties and instruct them to kneel on the same side of the casualty, with the spine board on the opposite side of the casualty.

(1) First assistant. Place the near hand on the shoulder and the far hand on the waist.

(2) Second assistant. Place the near hand on the hip and the far hand on the thigh.

(3) Third assistant. Place the near hand on the knee and the far hand on the ankle.

e. On the candidate’s command, and in unison, the assistants roll the casualty slightly toward them. Turn the casualty's head slightly, keeping it in a straight line with the spine.

f. Instruct the assistants to reach across the casualty with one hand, grasp the spine board at its closest edge, and slide it against the casualty. Instruct the number two assistant to reach across the board to the far edge and hold it in place to prevent board movement.

g. Instruct the assistants to slowly roll the casualty back onto the board. Keep the head and spine in a straight line.

h. Instruct the second assistant to place the casualty's wrists together at the waist and tie them together loosely.

NOTE: If the cervical collar or improvised collar does not fit flush with the spine board, place a roll in the hollow space between the neck and board. The roll should only be large enough to fill the gap, not to exert pressure on the neck.

2. Secure the casualty to the long spine board.

a. Secure the casualty with straps across the chest, hips, thighs, and lower legs.

NOTE: Include the arms if the straps are long enough. If the spine board is not provided with straps and fasteners, use cravats or other long strips of cloth.

b. Secure the casualty's head and head supports to the board with straps or cravats.

WARNING: DO NOT RELEASE MANUAL STABILIZATION UNTIL THE CRAVATS OR HEAD STRAPS ARE FIRMLY IN PLACE.

(1) Apply head supports.

(2) Use two rolled towels, blankets, sandbags, or similar material.

(3) Place one close to each side of the head.

(4) Using a cravat-like material across the forehead, make the supports and head one unit by tying to the board (Figure 3-39a).

3. Secure the casualty to a litter.

Figure 3-39a. Casualty on a Long Spine Board.

STP 8-91W15-SM-TG, Task No. 081-833-0092

BTLS FOR PARAMEDICS

EMERGENCY CARE

Figure 3-39. Prepare to Transport a Casualty With a Suspected Spinal Injury.

CONDITIONS: Given an unconscious casualty without a spinal injury. You must manually transport the casualty without assistance.

STANDARDS: Transport the casualty 25 meters using the fireman’s carry without dropping or causing further injury to the casualty.

1. Roll the casualty onto his or her abdomen. (The casualty will by lying on his or her back.)

a. Kneel at the casualty’s uninjured side.

b. Place the casualty’s arms above his or her head.

c. Cross the ankle that is farther from you over the one that is closer to you.

d. Place one of your hands on the casualty’s shoulder that is farther from you; place your other hand in the area of the casualty’s hip or thigh that is farther from you.

e. Roll the casualty gently toward you onto his or her abdomen.

2. After rolling the casualty onto his or her abdomen, straddle him or her.

3. Extend your hands under the casualty’s chest and lock them together.

4. Lift the casualty to his or her knees as you move backward.

5. Continue to move backward, thus straightening the casualty’s legs and locking his or her knees.

6. Walk forward, bringing the casualty to a standing position. Tilt the casualty backward slightly to prevent his or her knees from buckling.

7. As you maintain constant support of the casualty with one arm, free your other arm, quickly grasp the casualty’s wrist, and raise his or her arm high. Instantly pass your head under the casualty’s raised arm, releasing it as you pass under it.

8. Move swiftly to face the casualty and secure your arms around his or her waist.  Immediately place one foot between the casualty’s feet and spread them apart (approximately 6 to 8 inches).

9. Grasp the casualty’s wrist and raise his or her arm high over your head.

10. Bend down and pull the casualty’s arm over and down on your shoulder, bringing his or her body across your shoulders. At the same time, pass your arm between the casualty’s legs.

11. Grasp the casualty’s wrist with one hand, and place your other hand on your knee or weapon for support.

12. Rise with the casualty positioned correctly (Figure 3-40a).

13. Carry the casualty 25 meters without stopping and without causing further injury to the casualty.

Figure 3-40a. Fireman’s Carry.

FM 4-25.11

FM 8-10-6

Figure 3-40. Transport a Casualty Using the Fireman’s Carry.

CONDITIONS: Given an unconscious casualty without a spinal injury. You must manually transport the casualty without assistance.

STANDARDS: Transport the casualty 25 meters using the cradle drop drag without dropping or causing further injury to the casualty.

1. Kneel at casualty’s head with him or her lying on his or her back.

2. Slide your hands, palms up, under the casualty’s shoulders and get a firm hold under his or her armpits.

3. Rise partially, supporting the casualty’s head with your forearms, chest, or abdomen.

4. Rise and expediently drag the casualty backward with him or her in a semisitting position (Figure 3-41a) for 25 meters without causing further injury.

Figure 3-41a. Cradle Drop Drag.

FM 4-25.11

FM 8-10-6

Figure 3-41. Transport a Casualty Using the Cradle Drop Drag.