Michael's Dispatches

Slippery Stuff: CASEVAC vs. MEDEVAC

7 December 2011

If you ask ten service members “What is the difference between CASEVAC and MEDEVAC,” you might get six answers.  Five might answer, “I don’t know.”  The other five will surely give five different answers.

I’ve asked dozens and never gotten the same answer twice.  The people I’ve asked include Army Dustoff pilots, Air Force Pedro pilots and crew, and one Marine officer.  I’ve also asked plenty of Generals, Colonels, and senior-ranking enlisted folks.

Bottom line up front: if someone advertises that they know the definition, they don’t.  A single, widely accepted definition does not exist.  Definitions are easy to find in books here and there, but if you poke around enough, you will find that the definitions conflict.

Online dictionaries offer little help.  

According to OxfordDictionaries.com:

CASEVAC

•    evacuation of casualties by air.
•    evacuate (a casualty) by air.

MEDEVAC

•    the evacuation of military or other casualties to hospital in a helicopter or aeroplane:
•    transport (someone) to hospital in a helicopter or aeroplane:

Other dictionaries and military literature render other definitions.  Wikipedia is Wikipedia.

The working definitions of CASEVAC and MEDEVAC are so misleading that you must ask the person using the terms exactly what is meant.  For instance, US Air Force “Pedro” performs CASEVACs.  If you ask a Pedro pilot with hundreds of combat missions behind him, his definitions are likely to be simple:

1)    CASEVAC is armed.
2)    MEDEVAC is unarmed.

The Pedro likely will go on to say that MEDEVACs are protected under the Geneva Conventions and that CASEVACs are not.

I asked an experienced Pedro commander, and got this more granular response:

Well, I don't know that the AF actually has official definitions of either term, but the generally accepted definitions of each among my peers in the AF Rescue community are:

MEDEVAC - evacuation of injured personnel from the battlefield or a low-level care facility to a higher level of care.  In the AF, we generally view this as evacuation from a secured, no-threat landing area where the person is usually "packaged" (had some level of care and/or stabilization).  Sometimes, this can even apply to transport in between FOBs, CASFs, etc.  In fact, it's even called MEDEVAC when a C-17 airlifts people from Bagram to Ramstein.

CASEVAC - is different in that it involves evacuation of injured personnel from the battlefield or the point of their injury, with little or no prior care.  The landing area is not necessarily secured and troops may be actively involved in fighting.  In fact, what really differentiates CASEVAC from MEDEVAC for us is that when conducting CASEVAC we will fight our way in to get the injured person.  Some non-AF people will also add the level of care while en route to their definition - saying there is a higher level of care while en route with a MEDEVAC.  I don't think this really applies with MEDEVAC or CASEVAC on AF [H]H-60s because the PJs are very highly trained medically (in addition to tactically).  All have EMT training and some have up to PA-level training.  In a CASEVAC, they will leave the [H]H-60 to go get the injured person, provide initial medical care (sometimes under fire), bring that person to the helicopter, and treat them on the way home.

If you ask a Dustoff pilot, you’ll get a different answer.  A pilot said to me on the phone that Dustoff are called MEDEVAC because they have medics aboard, and that Pedros are called CASEVAC because they have no medics.  This is false.  Pedros have excellent medics on every flight.  And so by that pilot’s definition, Pedro is MEDEVAC.

Others will say that MEDEVAC aircraft/vehicles are specifically designated for medical evacuations.  Again, this falls flat: Pedros are designated for medical evacuations in Afghanistan, and they are called CASEVAC.  British “Tricky” (call sign for their medical evacuation helicopters) have real doctors aboard, and machine guns.  Army special operations forces often go with real doctors, and always with machine guns.  Their dedicated medical birds don’t wear Red Crosses.  So what are they?  CASEVAC or MEDEVAC?

Marines give another answer.   Let’s don’t even go there.

So I asked a very experienced Army man, and in his wisdom he cut through all the malarkey and put it like this, “You say potAtoe, I say potawtoe.”  He also tells me not to wrestle with pigs when I write something bad about milkooks.  (Few words, simple wisdom.  He’ll probably chastise me via email when he sees that sentence.)

The definitions make no difference, really.  But some people are trying to undermine the message that Dustoff helicopters should go without Red Crosses, and they have hung their greasy hats on the idea that I don’t know the definitions.  In every case, however, the inverse has been true.  I know the many definitions so well that I have mostly avoided the topic to prevent confusion.

Importantly, those people who are undermining the message are trying to leave wounded troops on the battlefield longer.  Many Dustoff and Pedro people, who actually fly these missions, are flooding me with information and encouragement.  All of the Pedro and the majority of Dustoff want the crosses removed from Dustoff helicopters.  Those who are trying to undermine the message are going against the desires of many people who are actually flying these missions today.

Bottom line: If someone says they know the definition of CASEVAC/MEDEVAC, they don’t.

For more information, please read:

PEDROS
RED AIR
GOLDEN SECONDS
FOOL’S GOLD Troops’ Blood
Marked For Destruction
US Army violating Geneva Conventions

After reading the above, please consider joining our private forum.

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