Medical Evacuation Vehicle
1. General description of operational capability.
a. Mission Area.
b. Operational and Organizational Concept.
(1) The integration of medical evacuation support into the IBCT, as an integrated part of the internetted combat forward formation, enhances the organic medic who rides with and accompanies the infantry soldier during dismounted operations. The Medical Evacuation Vehicle based evacuation assets are able to move forward covered by integrated overwatching fires which provide protection for the patient and medical team. This capability keeps the other platforms of the formation free to sustain the integrated support of the assault. The evacuation will include emergency care enroute enhanced by the medic and by a protected environment with adequate lighting and accessible medical equipment.
(2) The organic treatment capability of the infantry and RSTA battalions is augmented when conditions require reinforcement by Brigade Support Battalion medical assets, generally in HMMWV platforms with survivability enhanced through internetted situational awareness. Expanded care and further evacuation depends upon the enhanced diagnostic, patient holding, and reachback capability resident in the brigade support medical company (BSMC) linked to Army/Joint/Theater or sustaining base medical support. Evacuation support to combined arms combat formations is reinforced by HMMWV ambulances from the BSMC. These assets evacuate casualties from the combat formation area to the next level of care.
(3) The medical force package is, through the IBCT Surgeon, integrated into the brigade operational plans. It is organized to provide essential force health protection. This capability maximizes the soldier’s functional return and supports the Army’s commitment to the safety and survivability of the soldier.
(4) The Medical Evacuation Vehicle will be the primary ambulance platform.
3. Shortcomings of Existing Systems.
4. Capabilities Required.
a. System Performance.
(1) The Medical Evacuation Vehicle will be based on the ICV variant.
Rationale: The Medical Evacuation Vehicle is based on the ICV due to the close parallels of operational requirements between the two vehicles. The Medical Evacuation is an organic vehicle to the ICV maneuver formation and helps maximize commonality of the platform while simultaneously reducing the maintenance footprint and variety of logistics support.
(2) The Medical Evacuation Vehicle must provide the mounting capability to securely transport four (4) patients on standard NATO litters, or (6) ambulatory patients, in addition to an ambulance team of three (3). All litter mounting brackets and hardware will accommodate the standard NATO litter and be provided as part of each Medical Evacuation Vehicle.
Rationale: The dispersion of combat formations and the lack of initial air evacuation capability produce the need to maneuver with the combined arms combat formation and acquire the wounded soldier in a hostile environment. Once acquired, the soldier must be ground evacuated to the next echelon of care.
(3) The Medical Evacuation Vehicle must have an accessible attendant’s seat that will allow the attendant to change position and visually monitor all patients while the vehicle is in motion.
Rationale: It is necessary for medical personnel to be seated while the vehicle is in motion to prevent injury, however medical personnel must be able to monitor the patient’s condition while the vehicle is in motion.
(4) The Medical Evacuation Vehicle will provide accessible and adequate interior space for ambulance mission package and storage for the crew’s individual gear and clothing. The storage area must not interfere with air or rail loading requirements or the care of wounded. The interior storage/ working space requirement is projected to be 285 ft3.
Rationale: The interior work area must be free for hands-on airway management, hemorrhage control and patient monitoring. In order to accomplish these critical life saving tasks, the medical crew must be able to readily access the medical equipment sets while stationary or on the move.
(5) Must provide 28 inch lateral clearance/18 inch vertical clearance between NATO standard litters in the loaded configuration.
Rationale: Evacuation vehicles must provide adequate room between litters to allow on-board medical crew personnel sufficient room to provide enroute care.
(6) Must have intravenous bag holders that will support two 1000-milliliter bags at each litter or treatment station.
Rationale: A holder will prevent the IV bag from interfering in patient loading, unloading, and treatment procedures. In addition, the holder will stabilize the bag during transport and allow the medical attendant to more accurately observe the transfusion flow.
(7) Have the capability to safely mount and carry oxygen cylinders in an useable configuration.
Rationale: Oxygen is a routine and necessary part of the trauma treatment protocol and is essential in the early resuscitation and treatment of injured soldiers.
(8) Have the ability to host the Medical Communications for Combat Casualty Care (MC4) network consistent with the base ORD.
Rationale: The MC4 program provides the capability to digitally document CHS provided to the soldier which serves as the first input to the computerized patient record. The documentation of treatment not only enhances continuity of care from the point of injury through reachback to the sustaining base but also meets both executive and congressional requirements for complete healthcare documentation.
(9) Have a lighting system in the patient transport/ care area (T), and attachable shelter (O) which will provide full white and blackout interior illumination with protected, individual fixture switches, and a master on/off switch. The blackout system must incorporate an automatic shut off if there is an open hatch, door, or ramp. The light produced must be adequate to perform advanced trauma management and must be extendable into the external shelter system.
Rationale: Appropriate illumination is key in effective patient diagnosis and treatment and for enroute monitoring. It is a tactical necessity to require a blackout/adjustment feature of the illuminating system.
(10) Have Geneva Convention markings that can be removed or masked without altering any camouflage pattern.
Rationale: It is imperative that the Medical Evacuation have the ability to identify itself as a medical asset under all conditions and to all participants involved in a conflict. This will decrease the instances of fratricide and improve battlefield command and control. It is equally important that the markings have the capability to be easily masked/removed at the discretion of the IBCT Commander.
(11) Must provide easy access for ambulatory and litter patient loading and unloading using Army standard four-man carry/loading techniques.Have a hydraulically operated ramp to provide access to interior.
Rationale: Ease of access is imperative for the ability to quickly and safely load litter patients into the litter berths. This reduces risk of exposure to hostile activity or inclement weather.
5. Program Support.
6. Force Structure. Projected Army initial requirement is 100 ambulance configurations. This will equip five brigade-size units with 20 each.
8. Program Affordability.