EVACUATION PLATFORMS
ARMY GROUND AMBULANCES
General
a. Ground ambulances are vehicles designed for or converted to carrying patients. They are dedicated assets to be used solely for the medical mission. They are organic to CHS units that evacuate sick, injured, and wounded soldiers by ground ambulance. These vehicles are equipped with an MES designed for use in these ambulances.
b. They are staffed with a driver/medic and an additional medic who are both qualified in basic EMT procedures. Track ambulances are staffed with three medical personnel (ambulance driver, track commander, and medic).
NOTE The third medic may not be present on the MTOE. This position may be staffed by US Army Reserve personnel.
This paragraph implements STANAG 2931.
c. The Geneva Conventions stipulate that ground ambulances be clearly marked with the distinctive emblem (red cross on a white background). To camouflage or not display this emblem will result in the loss of the protections afforded under these conventions. Guidance on the camouflage of medical units, vehicles, and aircraft on the ground is contained in STANAG 2931.
Ground Ambulances
Vehicles designed or modified as ambulances include field (wheel) ambulances, the bus ambulance, and the M113 (track) armored personnel carrier.
a. Military field ambulances, designed for use by field units, operate on paved and secondary roads, trails, and cross-country terrain. Field ambulances operating in the forward areas of the CZ must possess mobility and survivability comparable to the units being supported. Current field ambulance variations include the M1010, HMMWV (M996 and M997), and M113. These ambulances are normally used to evacuate patients from frontline units to BASs.
b. The bus ambulances are useful in transporting large numbers of patients within EAC.
c. The M113, when configured with a litter kit, an NBC kit, and an MES, is classified as a standard evacuation vehicle and is therefore included in this section on ground ambulances.
Ambulance Driver
The ambulance driver/medic is responsible for the ambulance at all times. He performs driver maintenance on the vehicle and is responsible for reporting major deficiencies to his section chief or supervisor. The ambulance driver/medic is an MOS-qualified medic; if required, he can perform emergency medical intervention and provide EMT. The driver's responsibilities include:
Providing maximum safety and welfare for the patients entrusted to his care. This includes ensuring that the patient is secured to the litter prior to loading.
Ensuring operational readiness and responsiveness. This is accomplished by maintaining and being able to use the authorized equipment aboard the ambulance. This equipment includes:
Litters.
Blankets.
Splints.
Medical expendables.
Oxygen canisters.
Flashlights.
Auxiliary fuel.
Decontamination equipment.
Special medical materials and equipment.
Ensuring he has the required information, tools, and equipment to navigate to the pick-up location. (This includes a map, tactical overlays, map coordinates, compass, and when available, position locator equipment.)
NOTE When traversing open terrain (such as in a desert) with few distinguishable landmarks, strip maps are ineffective.
Preparing the ambulance for loading and unloading.
Assisting the litter bearers in the loading and unloading of patients.
Performing property exchange when patients are loaded or unloaded.
Providing emergency transport of medical personnel, medical supplies, and blood and blood products.
Acting as a messenger in medical channels.
Medic
The medic acts as the assistant driver and his duties include:
Becoming familiar with the condition of each patient being evacuated and reviewing the information on the FMC.
Coordinating with the individual in charge for any special instructions in the care and treatment of the patients en route.
Providing EMT as required.
Making periodic checks of patients while en route.
Supervising and assisting in the proper loading and unloading of the ambulance.
Assisting the driver with land navigation and guiding the driver when backing or moving off roads, or when under blackout conditions.
Ambulance Loading and Unloading
In loading and unloading ambulances, litter patients are moved carefully. Details of the loading and unloading procedures vary slightly depending on the number of bearers, the presence or absence of a medic, and the type of vehicle used.
a. General Procedures.
Patients are normally loaded head first. The exception is if the nature of the patient's injuries make this inadvisable. They are less likely to experience motion sickness or nausea with the head in the direction of travel. They also experience less noise from the opening and closing of rear doors. Further, there is less danger of injury to the patients if a rear-end collision occurs.
When a patient requires en route care for an injury to one side of his body, it may be necessary to load him feet first to make the injured side readily accessible from the aisle. Patients with wounds of the chest or abdomen, or those receiving IV fluids are loaded in lower berths to provide gravity flow. For ease of loading and patient comfort, those patients wearing bulky splints should be placed on lower berths, if possible.
b. Instructional Procedures. For loading and unloading the ambulances, the litter bearers are numbered and formal commands are given so that each individual can learn his particular job and work as a team.
(1) Loading procedures. The sequence for loading four litter patients in the berths is upper right, lower right, upper left, and lower left. The most seriously injured are loaded last so they will be the first to be off-loaded. A three-man squad is required to load and unload the ambulance.
(2) Unloading procedures. The sequence for unloading the ambulance is the reverse of the loading procedures: lower left, upper left, lower right, and upper right. A three-man squad is needed to unload the ambulance.
Truck, Ambulances, 4x4, Utility, M996 and M997
The M996 and M997 ambulances are tactical vehicles designed for use over all types of roads, as well as cross-country terrain. It can also operate in all weather conditions (Figure 10-1). These ambulances are diesel-powered and equipped with four-wheel hydraulic service brakes. The ambulances can be heated and ventilated. Only the M997 can be air-conditioned. Supplemental electrical power to operate the life support equipment is also available. For operations in an NBC environment, the M996 and M997 ambulances are equipped with a gas-particulate filter unit (GPFU).
a. Patient Carrying Capacities. Refer to Table 10-1 for the various patient carrying capacities.
b. Two-Litter Configuration, M996. The sequence for loading patients in the berths is right first, then left. The most seriously injured patient is loaded last so that he is the first to be taken out of the ambulance. The sequence for unloading is the reverse of loading.
NOTE The numbers used in the explanation of the figures correspond to the parts/equipment represented in the graphic.
(1) Assembling litter rail extension (Figures 10-2 and 10-3).
(a) Turn latch (1) counterclockwise and open stowage compartment door (2).