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Military emergency medicine
From WikEM
Contents
US Military Emergency Medicine Care Levels
| Echelons of Care | Military Hierarchy | Personnel/Facility | Type of Care | Navy/Marine Corps Hierarchy | Army Hierarchy | Rough Civilian Equivalents |
| I | Unit | Self/Buddy Aid | First aid | Self/Buddy Aid | Self/Buddy Aid | Community first aid |
| Combat Lifesaver | First aid, beginning of emergency treatment | Combat Lifesaver (CLS) | Combat Lifesaver | First responders (police, fire) | ||
| Combat medic | Emergency medical treatment | Hospital Corpsman (HM) | Combat Medic (68W) | EMT-basic | ||
| Battalion aid station | Advanced trauma and medical management | Battalion Aid Station (BAS); Ship’s complement medical staff | Treatment squad, BAS, SOF medic (18D) | Paramedic | ||
| II | Division | Medical company (clearing station) | Initial resuscitation | Medical Battalion; Casualty Receiving & Treatment Ships (CRTS);Shock Trauma Platoon (STP); Ship’s complement medical staff | Medical battalions/companies, Casualty Evacuation (CASEVAC/Dustoff) | Level IV trauma center |
| Field surgical support group | Initial resuscitation | Forward Resuscitative Surgery System (FRSS) | Forward Surgical Team (FST), Special Operations Resuscitation Team (SORT), Joint Medical Augmentation Unit (JMAU); future - Forward Resuscitation and Surgical Team (FRST) | Level III trauma center | ||
| III | Corps | Combat support hospital, fleet hospitals | Resuscitative surgery and medical care | Fleet hospital; Hospital ships | Field hospital levels - Combat Support Hospital (CSH); Historical - Evacuation Hospital (EVAC) and Mobile Army Surgical Hospital (MASH) | Level II trauma center |
| IV | Echelons above corps | Combat support hospital, host nation hospitals, hospital ships | Definitive care | Overseas medical treatment facilities | General hospital, Communications Zone Hospital (COMMZ) | Level I trauma center |
| V | Out of theater (continental US) | Fixed medical facilities | Restorative and rehabilitative care | CONUS military/civilian hospitals | CONUS military/civilian hospitals or OCONUS military hospitals | Tertiary and quaternary hospitals |
Echelon I
- Self-Aid/Buddy Aid
- Combat Lifesaver (CLS)
- Advanced first aid training provided to Marines
- Hospital Corpsman (HM)
- HMs can be forward deployed with Marine platoons and companies to provide EMS basic and paramedic level of care
- Battalion Aid Station (BAS)
- Staffed with corpsmen, Independent Duty Corpsman (IDC), and Battalio Surgeon
- Ship’s Complement Medical Staff
- Varies in staff depending on size of ship
Echelon II
- Ship’s Complement Medical Staff
- Varies in staff depending on size of ship
- Medical Battalion
- Provides surgical care for the MEF
- Provides stabilizing surgical procedures
- Capable of holding patients up to 72 hours
- Casualty Receiving & Treatment Ships (CRTS)
- Part of an Expeditionary Strike Group (ESG)
- Provides additional medical capabilities for receiving a mass casualty of up to 50 casualties
- Shock Trauma Platoon (STP)
- Small forward unit with one physician supporting the MEF specializing in patient stabilization and CASEVAC
- No surgical capability
- Forward Resuscitation Surgical Suite (FRSS)
- This surgical suite is pushed as far forward to be close to the combat area to allow surgical treatment of casualties within the “golden hour” after injury
- Staffed with 8 to 10 personnel (two surgeons, one critical care nurse, one anesthesiologist, and four to six corpsmen)
- Enough space for one operating room and one pre- and post-operative care room
- Equipped with cutting-edge surgical gear and takes less than one hour to set up or break down
Echelon III
- Fleet Hospitals
- Deployable ground asset but located away from enemy threat providing up to 500 hospital beds, 80 ICU beds, and 6 OR’s
- Hospital Ships
- USNS Mercy and USNS Comfort
- Deployable medical assets providing up to 1,000 beds, 100 ICU beds, and 12 OR’s
Echelon IV
- Overseas Medical Treatment Facilities
- Offers surgical capability found in echelon III, along with further definitive therapy for those patients in the recovery phase
Echelon V
- CONUS Military/Civilan Hospitals
- Provide full convalescent, restorative, and rehabilitative care to all patients returned to the Continental United States (CONUS).
