Evacuation Planning Considerations

Medical Regulating

1. Military Treatment Facility (MTF)

- DECON/Treatment Coordination. Ensure MTF is prepared to receive dirty casualties and determine the most appropriate location for DECON.
- Treatment Capabilities (Toxicology, Critical Care, Trauma Surgery). Determine whether the MTF has the services necessary to care for and sustain the CBRN casualty on site and/or establish telemedicine support.
- Capacity. The CBRN casualty is far more resource intensive than a typical trauma or critically ill casualty. Assess the MTF’s capacity and capability to treat CBRN casualties and identify potential alternate locations.

2. Evaluation. Integrate the medical regulating system into CBRN exercise scenarios.

Landing Zone/Casualty Exchange Points

1. Route coordination. Consider alternate routes, primary routes may be jammed or unavailable.

2. Environmental Considerations

- Wind
- Terrain / Slope
- Drainage
- Water sources

Evacuation Platforms

1. Clean and Dirty. It is necessary to plan for both clean and dirty platforms for evacuation.
2. Refuel. When planning evacuations, consider the time it takes for refueling in a MASCAL situation, as well as the distance from the objective to the DECON site and MTF. Also factor in any platform decontamination that may be necessary prior to arrival at the refueling site.
3. Aircraft / Vehicle DECON (Spot, Wash Down, Detailed). Based on the available assets, determine the time it will take to conduct each type of decontamination.
4. Preparation time (hasty vs. deliberate). Factor the time it takes to prepare the platform for a hasty or deliberate CBRN mission.
5. Evaluation. Integrate evacuation and handoff training into CBRN training exercises.

Protective Measures (allow for time required to install when planning)

1. Barrier (disposable; plan for additional on-hand quantities)

- Preventive maintenance checks need to occur on a regular basis.
- Consider time required for deliberate vs. hasty set-up.
- 6mm tarp and chemical or 100-mph tape for improvised

2. PPE (Pilots / Drivers / Crew)

Casualty Care

Class VIII (medical supplies) and critical care support equipment:

1. Antidote and countermeasure resupply and additional stock (information on the CDC’s Strategic National Stockpile can be found at https://www.cdc.gov/phpr/stockpile

2. Airway support / ventilation - anticipate need for advanced airway management and ventilators

3. Casualty Monitoring

- Electronic vital signs monitoring
- ETCO2
- Hypothermia. Special emphasis must be placed on maintaining body temperature, as cut-out procedures will create greater exposure to environmental factors.