OMFTS casualty-care concept.

shore-based care, ship-based care, and evacuation capabilities. If shore-based medical capabilities are minimal, evacuation, en route care, and sea based capabilities must compensate. If evacuation times are long, shore-based capabilities must be sufficient to stabilize the patient before movement.2

The long distances implicit in the OMFTS vision of combat operations mean that tactical aeromedical evacuation from the battlefield to ship-based care could take 1 to 2 hours. Thus, the keys to casualty survival will be effective first aid and lifesaving emergency surgery on the battlefield.

First-Responder Care

Hemorrhage and inability to breathe require immediate attention at the site of injury. Other Marines (buddy care) and corpsmen offer the first opportunity to apply lifesaving procedures. Better training and medical equipment are needed to provide those first responders with the skills and tools they need to be effective.

Injuries to the extremities are the most common wartime wounds. A study of Vietnam War casualties found that management of such wounds and associated bleeding was inadequate. Corpsmen were not trained to handle life-threatening injuries, and they lacked such simple field equipment as effective tourniquets.


Experience from the Vietnam War underscores the value of early trauma care. In that war, 78 percent of those killed in action died within 5 minutes, 16 percent in 5 to 30 minutes, and 6 percent in 1/2 to 2 hours. Eight to 10 percent of combat casualties required lifesaving surgery.

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