Methods for evacuating the wounded from the battlefield: tactics and methods

The immediate removal of the wounded from the fire is a critical stage that determines the survival of the fighter and the effectiveness of further medical care. The promptness of the rescuer’s actions directly affects the amount of blood loss and the likelihood of the victim developing a state of shock in the first minutes after injury. The choice of a specific transfer method depends on many factors, including the nature of the injury, the physical condition of the evacuee, and the terrain.

Modern first aid tactics known as TCCC (Tactical Combat Casualty Care), dictates strict safety rules during evacuation activities. The first priority is always to suppress the threat from the enemy, since a second wounded person on the battlefield will only aggravate the situation and reduce the overall chances of saving the group. Only after temporary safety has been ensured or enemy fire has been suppressed, the physical movement of the wounded person to shelter begins.

In a real combat encounter, the time spent delivering a casualty to a zone of relative safety is often measured in seconds. An incorrectly chosen method of transportation can lead to additional injuries, displacement of foreign bodies, or increased bleeding from damaged vessels. Therefore, knowledge of action algorithms and mastery of emergency movement skills is a mandatory requirement for any military personnel or law enforcement officer.

Safety principles and assessment of the situation before evacuation

Before any manipulation with a wounded person begins, a quick but thorough assessment of the tactical situation is necessary. Tactical pause allows you to understand where the source of danger is and choose the optimal escape route to the nearest shelter. Ignoring this step often results in the rescuer and the casualty being caught in the crossfire, negating all previous stabilization efforts.

All other manipulations, including checking breathing or applying bandages, are carried out only after leaving the zone of direct fire contact. The movement should be carried out as low as possible to the ground, using natural folds of the relief and funnels from breaks.

⚠️ Warning: Never try to drag a wounded person in an open area without first providing smoke cover or suppressing enemy fire. An exposed rescuer figure is an excellent target and puts the entire group at risk.

When assessing a route, it is necessary to take into account not only the direction of fire, but also the presence of minefields or tripwires. Driving along tracks or ruts left by vehicles that have already been traveled can be deadly. The rescuer must visually monitor the path of movement of the wounded person to avoid additional injuries from barbed wire, broken glass or sharp objects.

Emergency dragging of a wounded person to a safe area

When there is no time for preparation, and the life of the wounded hangs in the balance, emergency drag methods are used. These methods do not require special equipment and allow one fighter to quickly move a comrade several meters into cover. The basic principle here is to use the inertial force and weight of the rescuer's own body to reduce the load on the spine.

The most common method is to drag clothing or items of equipment by the collar. The rescuer grabs the wounded man's clothing from behind, as close to the head as possible, and backing away, drags him along. It is important that the wounded person’s head does not fall back and does not hit uneven ground, so the position of the neck is controlled by the rescuer’s elbows or forearms.

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When dragging by the clothes, try to grab the collar as high as possible, close to the wounded man’s shoulders, so that his body does not drag along the ground, but rises slightly.

If the wounded person is unconscious and his weight is high, an effective method is to drag him by a belt or a weight-bearing vest. The rescuer stands astride the wounded man facing his head, grabs the belt or straps with both hands and, leaning on his knees, drags the wounded man between his legs. This method allows you to develop significant force and quickly cover short distances.

🏃‍♂️ Dragging by the collar allows you to quickly drag the wounded person 5-10 meters towards the shelter.
🛡️ Using a belt or unloading straps reduces the risk of the rescuer’s hands slipping from blood-wet clothing.
🧱 When crawling, the rescuer’s body serves as an additional shield for the wounded from bullets and shrapnel.

Transporting a wounded person in your arms and in your arms

When the situation and physical condition of the wounded allows, manual transportation methods are used. They require more physical training from the rescuer, but allow you to quickly cover the distance to armored vehicles or a first-aid post. One of the basic methods is transportation by hand “in weight” or in a semi-suspended state.

The fireman's drag variation method is used if the wounded person is conscious or his weight allows his body to be lifted. The rescuer grabs the wounded man from behind under the arms, grabbing his forearms or wrists, and pulls him backwards. This method is convenient for dragging into narrow hatches or openings, but it creates a load on the shoulder joints of the wounded, which is unacceptable in case of arm fractures.

If the wounded person can cooperate, the arm support method is used. The rescuer comes up from the side, grabs the wounded man by the waist, and with his free hand grabs his arm thrown over the neck. The movement is carried out synchronously, leaning on the wounded person’s healthy leg. If both legs are injured, this method is ineffective and requires a transition to stretcher evacuation or dragging.

Use of standard means of evacuation: stretchers and slings

For planned evacuation or movement over long distances, standard means are used, such as soft stretchers, evacuation slings and frame structures. Evacuation slings (rescue straps) allow you to quickly secure a wounded person and drag him without fear for the integrity of the spine, since the body is fixed at several points.

Frame stretchers provide rigid fixation and protection of the wounded from uneven terrain. They are indispensable when transporting fighters with fractures of the spine or pelvis. However, their use requires time to deploy and usually requires the participation of two or more people. In combat conditions, the use of heavy frame stretchers is justified only in the “cold zone”.

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⚠️ Attention: When using soft stretchers or slings for dragging, be sure to check the reliability of the knots and fastenings every 10-15 meters of the path.

Evacuation with improvised means and improvisation

In a real combat situation, standard equipment may be unavailable, damaged or expended. In such cases, rescuers are forced to resort to improvisation using available materials. A classic example is a stretcher made from two poles (machine guns, skis) and clothes (jackets, raincoats).

The design of an improvised stretcher

Pass two strong poles (2-2.5 meters long) through the sleeves of two closed jackets or raincoats. Fasten buttons or zippers all the way. Make sure the fabric is taut and will support the person's weight. This method allows you to create a bed that is strong enough to transport the wounded in a prone position.

You can also use blankets, tarpaulins, or even pieces of barbed wire (with caution) twisted into bundles to carry the wounded. If poles are not available, you can use the “four hands” method, where two rescuers make a seat out of their hands.

🌲 To make poles, use durable poles, skis or even long pieces of reinforcement.
🧥 Jackets and pea coats are turned with the sleeves inside so that the seams do not put pressure on the wounded person.
⛓️ When using ropes or belts to tie a structure, make at least three knots for security.

Features of evacuation for various types of injuries

The choice of evacuation method is directly dictated by the nature of the injury. When the abdomen is wounded, the wounded person is transported only lying on his back with his legs bent in order to relax the abdominal muscles and reduce pain. Any tension in the press can lead to prolapse of internal organs through the wound channel.

With a chest wound, especially a penetrating one, it is critical not to apply pressure to the chest. Lying on the injured side often makes breathing easier, as the healthy lung expands better. If stretcher transport is used, it is recommended that the head end be slightly elevated unless there are signs of shock and low pressure.

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The main rule: the position of the wounded person during transport should minimize pain and prevent aggravation of the injury, even if this slows down movement.

Limb fractures require mandatory immobilization before evacuation. If a wounded person with an unfixed hip fracture is dragged, the sharp edge of the bone can damage blood vessels and nerves, turning a closed fracture into an open one with catastrophic blood loss. In such cases, splinting becomes a priority, even if it is carried out under limited time conditions.

Psychological support and condition control on the road

Evacuation from the battlefield is a tremendous stress not only for the wounded, but also for the rescuer. The wounded person may experience panic, aggression, or fall into a stupor. The task of the evacuator is to constantly maintain verbal contact, reassure the wounded and give simple, understandable commands. The phrase “We’ll get you out, hold on” can prolong the life of a wounded person in a state of shock.

During the movement, it is necessary to constantly monitor the condition of the wounded: the color of the skin, the presence of a pulse in the carotid artery, the level of consciousness. If the wounded person begins to turn pale, break out in a cold sweat and lose consciousness, these are signs of increasing hemorrhagic shock. In this case, the evacuation speed should be maximum, and the rescuer’s actions should be decisive.

☑️ Checklist before starting an evacuation

Control of external bleeding (tourniquet/pressure): Patency of the airway: Fixation of the cervical spine (if suspected): Brief instructions to the wounded on the plan of action

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The physical fatigue of the rescuer also plays a role. During prolonged evacuation by hand or by dragging, the strength may run out, which will lead to the fall of the wounded person. It is necessary to rationally distribute forces, attract other fighters to replace them, or use technical means. Remember that living rescuers are more important than dead heroes, and the risk should always be justified.

Frequently asked questions (FAQ)

Is it possible to drag a wounded person by the legs if there are no other options?

Dragging by the legs is only possible in emergency cases, when the threat to life from fire is higher than the risk of head injury. In this case, the wounded person’s head must be supported with a hand or a backpack/cash box placed under it so that it does not hit the ground. This method is dangerous if a spinal injury is suspected.

What to do if the wounded person weighs more than 100 kg, and there is only one rescuer?

You cannot carry such a wounded man in your arms alone. It is necessary to use drag methods (by collar, belt, slings) or improvised drags (on a raincoat, door, shield). Physical force is less effective here than using inertia and sliding.

Is it necessary to remove the body armor from a wounded person before evacuating?

In the “hot zone” the body armor is not removed - it can save you from re-injury when moving. Removal of armor plates and unloading is carried out only in a safe place for detailed examination and resuscitation measures, if necessary for access to the wound or breathing.

How to transport a wounded person with suspected spinal fracture?

Only on a rigid base (spinal board, shield) in a supine position. The movement should be carried out using the “platform” method (three to four people) to prevent bending and twisting of the spinal column. Any twisting can lead to paralysis.