CASEVAC (casualty evacuation) is the movement of casualties aboard non-medical vehicles or aircraft, usually without medical care en route. MEDEVAC (medical evacuation) moves casualties on dedicated, properly marked medical platforms, with medical personnel providing care during the trip. CASEVAC is a lift of opportunity. MEDEVAC is a medical system.
Both terms describe how a casualty leaves the fight. Neither describes how the casualty gets from the point of injury to the pickup point, which is often the hardest move of all. This guide covers the difference, when each is used, how the 9-line MEDEVAC request works, and where that first move fits.
What is CASEVAC?
U.S. Army doctrine (FM 4-02) defines casualty evacuation as "the movement of casualties aboard nonmedical vehicles or aircraft without en route medical care."
In practice CASEVAC means using whatever can move: a tactical vehicle, a cargo helicopter, a boat or a pickup truck. The platform was built for another job. It may be armed, it carries no protected medical markings, and it usually has no medic aboard unless one rides along. Units choose CASEVAC when a casualty can't wait for a MEDEVAC platform, when the threat is too high for one, or when none is available.
What is MEDEVAC?
ATP 4-02.2 defines medical evacuation as "the timely and effective movement of the wounded, injured, or ill to and between medical treatment facilities on dedicated and properly marked medical platforms with en route care provided by medical personnel."
Three things set MEDEVAC apart: the platform is dedicated to medical use, it is marked as medical, and trained medical personnel treat the patient on the way. In the U.S. Army, air ambulance MEDEVAC units are known by the call sign "Dustoff." Marked medical platforms are protected under the Geneva Conventions, which is also why they are expected to operate as medical assets rather than combat assets.
CASEVAC vs MEDEVAC at a glance
| CASEVAC | MEDEVAC | |
|---|---|---|
| Platform | Any available vehicle or aircraft, not built for medical use | Dedicated medical ground or air ambulance |
| Care en route | Usually none, unless a medic rides along | Provided by medical personnel |
| Markings and protection | No medical markings, no special protection | Marked as medical, protected under the Geneva Conventions |
| Armed | May be armed | Operates as a medical asset |
| When it is used | No MEDEVAC available, threat too high, or time too short | The standard when it is available and the situation allows |
How the 9-line MEDEVAC request works
Units request MEDEVAC with a standard nine-line format so the aircrew knows where to go, what to bring and what to expect:
- Grid location of the pickup site
- Radio frequency and call sign
- Number of patients by precedence (how urgent)
- Special equipment needed, such as a hoist
- Number of patients by type: litter or ambulatory
- Security of the pickup site in wartime, or the number and type of wounds in peacetime
- Method of marking the pickup site
- Patient nationality and status
- CBRN contamination in wartime, or terrain description in peacetime
Line 5 is the one that decides space on the aircraft. A litter patient can't walk and has to be carried. Every litter patient on line 5 is also a casualty someone had to move to the pickup site in the first place.
Where the first move fits: point of injury to the CCP
Tactical Combat Casualty Care (TCCC) breaks care into three phases. Care Under Fire focuses on fire superiority and moving the casualty to cover. Tactical Field Care is the care given once the team has cover but is still in the tactical environment. Tactical Evacuation Care covers transport out, whether by CASEVAC or MEDEVAC.
CASEVAC and MEDEVAC both pick up from a point: a casualty collection point (CCP), a landing zone or a vehicle. Getting the casualty to that point happens before either one, often by one or two people, under threat, in terrain no vehicle can reach. Full litters are rarely there for that leg because they are too heavy to carry on every mission and get cached at the rally point or left on the vehicle.
That gap is the reason the Pocket Litter exists. At 2.5 lb it rides in a cargo pocket, deploys in under 10 seconds and lets one person drag a casualty to cover or to the CCP with the spine supported. From there, the full litter and the evacuation platform take over. How military teams use it.
Carry the first leg
A 2.5 lb litter that stays on the operator, so the casualty reaches the CCP with the spine supported.
Pocket Litter for military teams →Frequently asked questions
Is CASEVAC faster than MEDEVAC?
Often, because CASEVAC uses whatever platform is closest. The tradeoff is that the casualty usually gets no medical care during the trip. Units weigh speed against care based on the injury and the threat.
Is Dustoff CASEVAC or MEDEVAC?
Dustoff is the call sign tradition of U.S. Army air ambulance units, so it refers to MEDEVAC: dedicated, marked aircraft with medical crew.
What is a casualty collection point?
A casualty collection point (CCP) is a designated spot where casualties are gathered, treated and prepared for evacuation. It is usually the handoff between the people who moved the casualty and the evacuation platform.
What does litter mean on a 9-line?
On line 5 of the 9-line MEDEVAC request, a litter patient is one who cannot walk and must be carried on a litter (stretcher). An ambulatory patient can walk.
How do you move a casualty to the CCP without a litter?
With a drag or carry by hand, a poncho or improvised litter, or a pocket-sized litter like the Pocket Litter. Hand drags give the spine no support. A litter with stiffeners does.
Sources
- FM/ATP 3-21.8 glossary: casualty evacuation (FM 4-02) and medical evacuation (ATP 4-02.2) definitions
- 9-line MEDEVAC request card, Joint Base Langley-Eustis
- EMS Tactical Combat Casualty Care, StatPearls (NCBI Bookshelf)
General information, not medical advice. Get hands-on training from a qualified instructor before you need these skills.