Unfortunately, in today’s military the chances of using a 9-line MEDEVAC format in combat is high and many operational personnel are not receiving the training required to properly call it in to medical personnel. If a MEDEVAC is improperly called in the patient may not receive medical care in a timely manner, possibly resulting in catastrophic consequences. All personnel, civilian or military should be trained to calmly and collectively call in a 9Line MEDEVAC under stress. Additionally, training should include stressful scenarios where personnel, from privates to senior officers, practice calling in MEDEVACS to training cadre.
When calling in a MEDEVAC there are several steps that the individual must take to ensure the 9 Line is properly called in and dispatched units are given the necessary information required to reach the patient’s location.
Step 1: Return fire/render the scene safe- Before attempting to call in a 9Line MEDEVAC the scene must be rendered safe. Personnel should not reduce the overall efficacy of the force’s firepower to call in a 9Line. If the unit under fire reduces the overall aggression and violence of action against the enemy force it could result in a greater loss of personnel. At all costs the firefight must be won before moving towards rendering aid to the wounded.
Step 2: Care under fire- Once fire superiority has been established medical personnel can begin care under fire. In this step medical personnel and medically trained operators can begin to tend to life threatening wounds while maintaining security.
Step 3: Determine number of patients by type- this is not only important information to have when calling in the 9line but it will also allow medical personnel to properly triage patients based on their medical condition and chances of living. In this step critically wounded personnel are identified and consolidated in the event there is limited space on incoming MEDEVAC platforms.
Step 4: Contact MEDEVAC channel- while rending the scene safe is important, getting the MEDEVAC out is also extremely important. MEDEVAC units will have varied response times but giving them notification of the situation as soon as possible will help reduce their time to station. If the operating element has a BFT this should be hit as soon as possible to let supporting units know of the emergency taking place. Again, operating personnel should practice radioing for help as part of their response to an attack.
Step 5: Using 9 Line MEDEVAC format to call in MEDEVAC- The first 5 lines are most important when calling in a MEDEVAC, the other 4 can be relayed when birds are in the air. Ensure you have a safe LZ for the landing party.
Important: no matter what the situation on the ground the radio operator should remain calm and collected at all costs. Personnel calling in a MEDEVAC while in a state of panic may relay incorrect information or speak in a manner that is incomprehensible over the radio. Remember, responding units will not come any faster if the RTO is calling the 9Line in an excitable manner.
To ensure the 9Line is called in properly the Operator should consider writing down the information to ensure all pertinent information is passed.
The 9line MEDEVAC format can vary based on the operational element. Some elements use the U.S. military 9line MEDEVAC while others use NATO 9Line or internally generated 9Lines with special information required for supporting units. All leadership and medical personnel should get with local MEDEVAC elements to ensure they have proper radio frequencies and 9Line formats readily available. In addition every person on the ground should have a 9Line MEDEVAC on his or her persons at all times. This can be a card placed in an IFAK, on a radio or kept in a pocket. We recommend using the RE Factor Tactical 9Line MEDEVAC reference guide which can be adhered to the back of a radio, buttstock of a weapon or inside of a vehicle.
General 9 Line MEDEVAC:
Line 1: Location of pickup site- this is given in an MGRS 6-8 digit grid.
Line 2: Frequency and call-sign at pickup site- this is the frequency and call-sign that you will be talking to the incoming MEDEVAC aircraft on. In most cases this is a predetermined, non-encrypted channel that is set-aside for MEDEVAC. If possible write this on all 9Line cards prior to mission.
Line 3: Number of patients by precedence-
A- Urgent (surgical)- i.e. requires in-flight surgeon to perform surgery while en route to hospital.
B- Urgent (non-surgical)- i.e. patient has arterial bleed that can be stabilized until arrive to hospital
C- Priority- i.e. injuries that are not immediately life threatening but could become life threatening eventually
D- Routine- i.e. patient requires regular medical care but unit cannot transport them by their own means.
E- Convenience- i.e. non life-threatening care provided to personnel in a combat zone.
Line 4: Special Equipment required-
C- Extraction Equipment- i.e. jungle penetrator
Line 5: Number of Patients by type:
A- Litter- cannot walk on their own
B- Ambulatory- able to self move to MEDEVAC platform
Line 6: Security of Pickup area-
N- No enemy troops in area
P- Possible enemy troops in area (approach with caution)
E- Enemy troops in area (approach with caution)
X-Enemy troops in area (armed escort required)
Line 7: Method of Marking at pickup site (important: always ensure marking equipment is available to the marking personnel. If you are going to throw purple smoke, ensure you have purple smoke on hand)
A- Panels- i.e. VF-17 panel
B- Pyrotechnical equipment- i.e. pen flare, red star cluster
C- Smoke signal- (provide smoke color)
E- Other- i.e. IR flash or beacon
Line 8: Patient Nationality and Status
A- US Military
B- US Civilian
C- Non-US Military
D- Non-US Citizen
Line 9: NBC Contamination
*During peacetime provide terrain of pickup site
M.I.S.T. Report- The M.I.S.T. Report has recently been incorporated into the 9Line MEDEVAC format and traditionally comes after the 9Line Format. The M.I.S.T. Report stands for:
M – Mechanism of injury (mine, GSW, RPG, RTA etc)
I – Type of Injury (found and or suspected)
S – Signs (pulse rate, blood pressure, respiratory rate)
T – Treatment given (morphine, tourniquet etc)
A/C – adult/child (include age if known)
Example of 9 Line MEDEVAC:
“Bravo five this is Victor two, request 9 line MEDEVAC”
“Victor two this is Bravo five prepared to copy”
“Line one, one eight sierra whisky papa one two tree one four fife one seven”
“Line two, two seven zero zero Bravo Five”
“Line tree, alpha one, bravo tree”
“line four, alpha”
“line five, alpha four”
“How copy over?”
At this point the MEDEVAC line will repeat all given and initiate movement for MEDEVAC. Once in the air the operator will relay final four lines in the same manner given.
Remember, training to send in a 9Line is important for all personnel on the ground. You never know when YOU may be calling in a MEDEVAC and you never want to wait until the situation to take place to figure out that you are unable to call it in properly.
An easy way to keep a 9Line on you at all times to carry the RE Factor Tactical 9 Line MEDEVAC format. These are available in our webstore. They are made in the USA of tough marine grade vinyl. In addition they are specifically cut to fit on the back of a PRC-148 radio or the buttstock of a rifle. Click here for more information.