Military emergency medicine

US Military Emergency Medicine Care Levels

Echelons of Care	Military Hierarchy	Personnel/Facility	Type of Care	Navy/Marine Corps Hierarchy	Army Hierarchy	Rough Civilian Equivalents
I	Unit	Self/Buddy Aid	First aid	Self/Buddy Aid		Community first aid
		Combat Lifesaver	First aid, beginning of emergency treatment	Combat Lifesaver (CLS)		First responders (police, fire)
		Combat medic	Emergency medical treatment	Hospital Corpsman (HM)		EMT-basic
		Battalion aid station	Advanced trauma and medical management	Battalion Aid Station (BAS); Ship’s complement medical staff		Paramedic
II	Division	Medical company (clearing station)	Initial resuscitation	Medical Battalion; Casualty Receiving & Treatment Ships (CRTS);Shock Trauma Platoon (STP); Ship’s complement medical staff		Level IV trauma center
		Field surgical support group	Initial resuscitation	Forward Resuscitative Surgery System (FRSS)		Level III trauma center
III	Corps	Combat support hospital, fleet hospitals	Resuscitative surgery and medical care	Fleet hospital; Hospital ships		Level II trauma center
IV	Echelons above corps	Combat support hospital, host nation hospitals, hospital ships	Definitive care	Overseas medical treatment facilities		Level I trauma center
V	Out of theater (continental US)	Fixed medical facilities	Restorative and rehabilitative care	CONUS military/civilian hospitals		Tertiary and quaternary hospitals

Navy/Marine Corps Echelons of Care

Echelon I

• Self-Aid/Buddy Aid
• Combat Lifesaver (CLS)
  • Advanced first aid training provided to Marines
• Hospital Corpsman (HM)
  • HMs can be forward deployed with Marine platoons and companies to provide EMS basic and paramedic level of care
• Battalion Aid Station (BAS)
  • Staffed with corpsmen, Independent Duty Corpsman (IDC), and Battalio Surgeon
• Ship’s Complement Medical Staff
  • Varies in staff depending on size of ship

Echelon II

• Ship’s Complement Medical Staff
  • Varies in staff depending on size of ship
• Medical Battalion
  • Provides surgical care for the MEF
  • Provides stabilizing surgical procedures
  • Capable of holding patients up to 72 hours
• Casualty Receiving & Treatment Ships (CRTS)
  • Part of an Expeditionary Strike Group (ESG)
  • Provides additional medical capabilities for receiving a mass casualty of up to 50 casualties
• Shock Trauma Platoon (STP)
  • Small forward unit with one physician supporting the MEF specializing in patient stabilization and CASEVAC
  • No surgical capability
• Forward Resuscitation Surgical Suite (FRSS)
  • This surgical suite is pushed as far forward to be close to the combat area to allow surgical treatment of casualties within the “golden hour” after injury
  • Staffed with 8 to 10 personnel (two surgeons, one critical care nurse, one anesthesiologist, and four to six corpsmen)
  • Enough space for one operating room and one pre- and post-operative care room
  • Equipped with cutting-edge surgical gear and takes less than one hour to set up or break down

Echelon III

• • Fleet Hospitals
  • Deployable ground asset but located away from enemy threat providing up to 500 hospital beds, 80 ICU beds, and 6 OR’s
• Hospital Ships
  • USNS Mercy and USNS Comfort
  • Deployable medical assets providing up to 1,000 beds, 100 ICU beds, and 12 OR’s

Echelon IV

• Overseas Medical Treatment Facilities
  • Offers surgical capability found in echelon III, along with further definitive therapy for those patients in the recovery phase

Echelon V

• CONUS Military?Civilan Hospitals
  • Provide full convalescent, restorative, and rehabilitative care to all patients returned to the Continental United States (CONUS).

See Also

• Emergency medical services (EMS)