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    U.S.Army Military History InstituteMilitary Intelligence Service Information BulletinWar Department No. 17June 5, 1942 MIS 461

    NOTICE1. Information Bulletins, which have replaced Ten-tative Lessons Bulletins, have a dual purpose: (1)to provide all officers with reasonably confirmedinformation from official and other reliable sources,and (2) to serve as material for lectures to troops.2. Non-divisional units are being supplied with cop-ies on a basis similar to the approved distributionfor divisional commands, which has been indicatedin previous Information Bulletins. Armored, mech-arized cavalry, and medical units are receiving anincreased distribution of this bu' !.etin.3. Each command should circulae available copiesamong its per-'omnel. Reproduction within the mil-itary service is permitted provided the source isstated.4. Suggestions for future bulletins are invited. Anycorrespondence relating to Information Bulletinsmay be addressed directly to the DisseminationBranch, Military Intelligence Service, W ar Depart-ment, Washington, D. C.

    LIBRARYARMY WAR COLLEGECARLISLE BARRACKS, PA,

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    TABLE OF CONTENTS

    Page1. INTRODUCTION 12. FIRST AID 3

    3. METHOD OF EVACUATION 3

    4. FURTHER USES OF THE STRETCHER- 19SLING METHOD

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    REMOVAL OF WOUNDEDFROM TANKS1. IRO=UC1;ION* PROPBRTY OF U.S. ARMY

    Although it is desirable that wounded be movedonly by Medical Department personnel wheneverpossible, knowledge on the part of armored vehiclecrews of the various methods of removing casualtiesfrom the vehicles with the least disturbance of theinjured part of the body will not only lessen suffer-ing but also help to prevent traumatic shock.This bulletin, which describes British methodsof removing tank casualties through the turret, isbased on initial emergency treatment and evacua-tion by the vehicle's crew. It is usually desirable,however, that casualties be removed from the ve-hicle by the exit most readily ac cessible and the onewhich will necessitate the lea. t movement of thewounded soldier. These exits, in U.S. light tanks,are the drive 's hatch and the belly trap door, or,in U.S. medium and heavy tanks, the side doors.Both exits admit a litter upon which the casualtymay be placed and removed with a minimum amountof lifting and moving. However, because of damageto these exits, or for other reasons, methods of re-

    moving wounded through the turret are important.Removal from the turret ordinarily requiressome apparatus' and considerable training. Thesimple British method described in this article re-quires no new equipment. The litter straps can be

    *Comment by the Office of the Surgeon General onevacuation of casualties from armored units.

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    kept inside the tanks, and the litter fastened to theoultside of the tank. Maximum use of the litter isdesirable, but tanks may not always be equippedwith litters, and when the use of a litter is notpracticable, the methods utilizing litter straps areobviously less fatiguing for the bearer and morecomfortable for the casualty than other methods.Company aid men of other units may find consider-able use for the methods of employing litter straps,as described in this bulletin.

    Two factors enter into the speedy and efficientremoval of wounded personnel to medical stations.First, casualties must be concentrated, and, sec-ond, ambulances must be under centralized control.Since it cannot be definitely known beforehand,where, when, or in what units the majority of arm-ored force casualties will occur, it is desirablethat ambulances be kept under central control asmuch as possible and that they be held at one placefrom which they can be dispatched to the pointwhere they are needed most.

    People are innately gregarious, especially inthe face of danger, and above all when wounded andin hostile territory. Consequently, abandoning casu-alties, even though they are critically wounded, isdetrimental to the morale of all personnel; and,conversely, the grouping of wounded at designatedplaces, even though this may involve remaining inthe tank for a short period of action, will performthe very necessary function of raising morale.**End of comment by the Office of the Surgeon Gen-t rj..

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    Removal of Wounded from Tanks 32. FIRST AID

    When a soldier is wounded in a tank, his mor-ale is higher if he knows that his companions inthe tank are capable of rendering first aid andevacuating him from the tank so that he may becollected and receive further necessary t reat -ment from the medical services. A wounded manshould be extracted from the tank as early aspracticable in order to reduce shock and to pre-vent further injury from the movement of the tankA trained crew needs only a few minutes to applyfirst aid and evacuate the casualty from the tankto the ground.

    First aid must be applied to the injured manimmediately. This includes applying a first-aiddressing correctly, arresting bleeding, immobiliz-ing a broken limb, administering morphine ifnecessary, and carefully evacuating the injuredman from the tank. Records written on the cas-ualty's forehead with grease pencil may not be suf-ficiently permanent; accurate particulars shouldbe recorded on the Field Medical Card.* For ex-ample, if morphia is administered, the time andamount given should be shown. The circumstancesof the injury should also be shown in order to aidin determining future policy.*It is interesting to note that British armored ve-hicles carry emergency medical tags which aremade out by the crew members, whereas intheU.S. Army they are made out by a member of theMedical Department.

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    Removal of Wounded rom Tanks 43. METHOD OF EVACUATION

    a. GeneralAlthough many methods of removing casual-ties from tanks have been tried, all have requiredapparatus which for one reason or another has notbeenentirely satisfactory. There have been difficul-ties in the training of the tank crews, in the storageof the apparatus and evacuation of the casualty fromthe tank to the ground, or in the increase of trau-matic shock during the application of more elaborateapparatus.The two-stretcher-sling method has severalobvious advantages:(1) The apparatus is simple and easy to pro-duce and may be replaced quickly in the field.(2) The slings may be stored easily by roll-ing them into a small bundle and stowing them awayin a corner of the tank.(3) The two-sling method causes the min-imum increase in wound shock or injury, and no in-crease in the internal abdominal and chest pres-

    sures, whereas apparatus consisting of jacket, buck-les, straps, and hoists may cause increase of injuryand shock as well as increase of internal pressure.(4) Instruction in the two-sling method iseasy--usually requiring only a matter of minutes.(5) The method is practicable even when, be-

    cause of the severity of his wounds, the casualty isunable to assist.

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    b. TyeS of Armored VehiclesThe two-stretcher-sling method has beensuccessfully tried with the following types of Brit-ish and U.S. armored vehicles:

    nfantry Tanks Oruiser TlnksMark II (Matilda) Mark V (Covenanter)Mark mI (Valentine) Mark VI (Crusader)Mark IV (Valentine) Mark VIa (Cruiser)Mark IV (Churchill) Light American M2A4Light American M3(General Stuart)Medium American M3(General Lee)Medit a;American M3

    wit British turret(General Grant)Light TIks Armored CarsMark VIb HumberMark VII (Tetrarch) DaimlerThis simple method adheres to the principle thatany method used must be capable of extracting anycasualty from any type of tank.

    c. Removal from the Tank(1) Classification of Inuries

    Injuries are divided into wounds abovethe waist and the wounds below the waist. On thissimple classificationis based the application of the

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    Removal of Wounded from Tanks 6

    43 1 14.W3.06

    5 8.4

    Number d Wounds Percentag d Wounds

    Figure L Wound Location Chart for ArmoredUnits in the Ldme East.

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    stretcher-llng methd.*(a) BI y below the Waist Line

    To remove a casualty injured belowthe waist line, the slings are used separately. Aloop is made at the end of each sling, and passed upthe arms and adjusted tothe shoulders and arm-pits, one on either side.The free ends of theslings are taken by twomen standing outside the rturret and, with a gen-tle, steady pull, the cas -ualty is lifted from themain compartment. If ia third ma. is available,he will cont- !l the move-ment of .he injured 'Aman's body as it is beingraised to the turret. Whenthe injured manis raisedsufficiently to rest out-side the turret, his legsare taken clear of the Figure 2. Adjustment ofSlings for Injury below theWaist.*Reports from the Middle East have indicated thelocation but have not given the types of wounds norwhether the wounds were received inside or out-side the tank. Apparently, the largest number ofwounds received by personnel actually in tanks have

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    Removal of Wounded from Tanks 8

    I

    Figure 3. Adjustment of Slings forInjury Above the Waist.

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    Removal of Wounded from Tanks 9tiurret opening and he is lowered to the ground orto a stretcher placed on the tank. Two men cancomplete the entire procedure, although three aredesirable.

    (b) Injury above the WaistThe two slings are so joined as toform one long sling. One free end is gEir;. iM-serted from front to back, or vice versa, so that

    the sling lies between the cleft of the buttocks andunder the crotch (fig. 3). This now forms a firmseat. The injured person is raised and supportedin a sitting position, and the free ends of the slingare passed up to the turret opening. It is import-ant that the casualty should c me out erect, notbending forwards, backwards, or sideways. Toaccomplish this, one man takes L position in rearof the casualty, pulls on the sling end which passesup the front of the injured man, while the otherman, from a position in front of the casualty, pullson the sling which passes up behind the casualty.It should be noted that the free ends of the slingpass up to opposite shoulders of the injured man.By steady pulling, the casualty is hoisted clearofthe turret, his legs are clear from the tank, and heis then brought to the ground.

    (2) Summary of Removal Exits(a) Light Tanks

    Mark VIb--TurretMark VII (Tetrarch)--Turretoccurred in the lower part of the body, that Is, inthe thighs, legs, or feet.

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    Removal of Wounded from Tanks 10Cb) Infantry Tanks

    Mark II (Matilda)--Driver's and gunner's hatchesor turretMark III and IV (Valentine)--Driver's and gun-ner's hatches or turretMark IV (Churchill)- -Side doors, driver's and frontgunner's hatches, or turret

    (c) Cruiser TanksMark V (Convenanter)--Driver's and gunner's hat-ches or turretMark VI (Crusader)--Driver's and gunner's hat-ches or turretMark VIa (Cruiser)--Driver's and gunner's hat-ches or turretLight American M2A4--Driver's hatch or turretLight American M3 (General Stuart)-- Driver'shatch or turretMedium American M3 (General Lee)--Side doors,driver's and gunner's hatches, or turretMedium American M3 with British Turret (Gen-eral Grant)--Side doors, hatches or turret

    (d) Armored CarsDaimler--Side doors or turretHumber--Side doors or turret

    (3) Exceptional Cases(a) General

    The driver and front gunner areevacuated through their own hatches when thesehatches can be opened, but if this is impossible,they can be manhandled into the main compart-ment and then evacuated. This is accomplished

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    Removal o Wounded fom Tanks 11by traversing the turret to get free access from thedriver's or gunner's compartment, by folding baclthe seat rest, by removing the shells and a portionof the shell rack, and by adjusting the gunner's andcommander's seats. Evacuation can then be madethrough the turret.

    (b) Mark III and IV--Valentine1. Injlur below the Waist

    In the Mark m and IV Valentinetanks, which have two openings, the driver must bemoved so that his head is at one side of the tank,face upward (fig. 4). The side to which he is moved

    Figure 4. Manipulating the Casualty

    4 -: '

    Figure 4. Manipulating the Casualty(Valentine Tank).

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    Removal of Wounded from Tanks 12will depend on his injury; that is, if his left leg isinjured, he will be moved to a position where hishead is at the offside of the tank. The sound limbcan be manipulated over the gear and brake handles,which are between his legs in the driving positions

    irh, j ,#

    Figure 5. Lifting the Casualty (Valentine Tank)

    (fig. 5), and the injured leg will require only theminimum of movement. The slings are now appliedto his shoulders and he is evacuated (figs. 6 and 7).

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    Removal of Wounded from Tanks 134. Inlury above the Waist

    When in-jured on one side of his body,inthe.shoulder, arm orchestthe casualty -ismaniulatedwith his head to the sameside of the tank as his in-jury; that s, in the caseof a right side injury, tothe offside of the tank.The sling is appliedto the crotch and -the casualtyevacu-ated.

    Figure 6. Removing the Casualty (Valentine Tank).(c) Infantry Tank, Mark II-Matilla

    In this tank there is one openingfrom the driver's seat. The procedure in placingslings is the same as for the Valentine (fig. 8). Ifthe gun is facing forward and cannot be traversed,

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    Removal of Wounded from Tanks 14

    Figure 7. Carrying the Casualty.the direction of pull will be to one side or the otherof the iun. When thecasualty s trunk isthrough the opening, hewill be turned, with hisback towards the sided tfL taik. He is stead-ied in this position, hislegs are cleared from I 1the openlL, an.d he i.s I ;) \then OW , to the

    "I r-c h[taid~,-ha;hs

    th.e d .--.... ' ; _.gunne r rrnia- be easilymanhatndled. If boththe side doors aredamaged and cannot Figure 8. Pulling Slingsbe opened, these two (Matilda Tank).

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    Removal of Wounded from Tanks 15

    li*

    Figure 9. Removing Figure 10. LoweringCasualty (Matilda Tank). Casualty (Matilda Tank).

    Figure 11. Placing Casualty on the Ground.

    crew members may be evacuated through theirrespective hatch openings. There is also commun-icationbetween the hull compartment and the turret

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    Removal of Wounded from Trek 16

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    Figure 12. Casualty in Churchill or American Tank.

    Figure 13. Side-Door Removal.

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    Removal of Wounded from Tanks 17In U.S. tanks where there are one ormore side entrances to the driver's or front gun-

    ner's compartment, the casualty can be man-handled through the side door as in the Churchill(figs. 12 and 13), even if he is a casualty in the up-per compartment, since both compartments inter-communicate. The reverse also holds good; that is,when both side doors cannot be opened, the casu-alty can be manhandled to the upper compartmentand evacuated through the turret from the upperfighting chamber. The driver and front gunner mayalso be removed through their respective hatches.(e) Lowering the Casualty to the Ground

    In some tanks the injured man maybe manhandled to the ground, but in other theslings are necessary. The slings can be used inthe armpit-shoulder or groin-buttock positions,depending upon the location of the injury. Thecasualty is eased over the edge of the tank and isthen lowered by two men using the slings. Whenthe wounded man is close to the ground, one mantakes both sling ends and holds him in positionwhile the second man climbs off the tank and getsready to receive the casualty. When the man onthe ground receives the casualty, he steadies himagainst the side of the tank (fig. 13) until the otherman comes down to his assistance (fig. 14). Theythen carry the casualty away, a man on either side,facing each other, one supporting the-thigh and legsand the other supporting the trunk and the head.Since the men face one another, the casualty can-not roll off their arms, particularly while he isbeing lowered to the ground (fig. 16)

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    Removal of Wounded from Tanks 18

    Figure 14.Lovering theCasualty.

    Figure 15. Steadying theCasualty.

    Figure 16. Carrying the Casualty Away.

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    . _l:wemoralf Wounded rom TWq 194. FURTfE R USES OF THE STREQTCHER-SLING

    a. ucuglIn addition to the uses described, the two-sling method in the arm-pit shoulder (fig. 17) orgroin-buttock adJustments (figs. 18 and 19) can be

    Figure 17. Lowering Figure 18. LoweringCasualty (Armpit Method). Casualty (GroinMethod).

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    sRemovla of Wounded t. om Tanks 20used for moving the cas-ualty from the ground overwalls or other obstruc-tions.

    b. One-Man Carriage(1) Lvi Cas

    (a) The cas-ualty is laid on his backon the ground, the loopmade from a single slingis placed below the injuredman's thighs (fig. 20), andhis legs are spread-eagled. Sitting betweenthe casualty's legs, thebearer slips his right armand head through the loop,Figure 19. Lowering adjusting it tightly (fig.Casualty (Groin Method-- 21). Taking the casualt sTwo-Man). right wrist in his lefthand, the bearer pulls thecasualty's right arm over

    Figure 20. Placing the Sling on a Lying Casualty.

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    Removal of Wounded from Tanks 21

    Figure 21. Adjustingthe Sling.his right shoulder, andthen slips his right legunder the casualty' sright knee and crookshis foot over to the in-ner sole of the cas-ualty's foot (fig. 22). The bearer now has the cas-ualty strapped to his back with firm control of hisright arm and leg. He slowly rolls over on hisleft side, bringing the casualty over to lie facedownwards on his, the bearer's, back (fig. 23). Thebearer now raises himself to the erect positionwith the casualty sitting in the sling, his arms over

    Figure 23. Turning the Casualty.

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    Removal of Wounded from Tanks 22the bearer's shoulders (figs. 24 and 25). This typeof carriage is ordinarily less fatiguing to the bear-er and mor com-fortable for the cas -ualty than the fire-man s carry or thetwo-man four-hand-ed seat.

    (b) Anothermethod for raisingand carrying a lyingFigure 24. Raising casualty is particu-the Casualty. larly popular In theRussian Army. One continuous loop is made of twoslings and is adjusted to thepatient as shown in figure 26.The bearer then eases himselffull length upon patient, faceuppermost bearing most ofhis own weight on his feet andarms. He slips his armsthrough the loops, tightenstheloops, grasps themf rmly,

    and then rolls over on his facqbringing the patient with himbound to his back by the sling.Finally the bearer carefullyraises himself so that he hasthe patient supported b1 thesling seat onhisback (fig. 27).Figure 25. Carryingthe Casualty.

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    Rem=ovza of Wouade from Tanks 23

    Figure 26. Adjusting Slings (Russian Method).(2) Sitting Casualtv

    (a) To hoist a sittingcasualty into carrying position:, asingle sling is joined to make acontinious looi, which is passedup the casualty D egs to his but-tocks (fig. 28). The bearer thenkneels on his right knee, his backclose to the cas-ualty and passes

    A -I his right arm andhead through theloop. Next, the~- / leans backwards _and tightens the

    ' sling until thecasualty is held

    Figure 28. Sling Figure 27. Carry-Adjustment on ing the CaLsum-ltySitting Casualty. (Russian Method).

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    Removal of Woundy from Tanks 24

    Figure 30. Raisingthe Casualty.close to his back. TheFigure 29. Adjusting bearer now bends forward,the Casualty. holding the arms of the

    casualty over his shoulder(fig. 29); and when wellk1 , forward, with the greaterpart of the casualty's(/[f4: weight well up on hisshoulders, he rises andcarries the casualty away,I tat :/(figs. 30 and 31).

    (b) Ln anothermethod of moving a sittingcasualty, the two slings arejoined to form one con-tinuouS loop. This loop istwisted to form tw o loops.The casualty's feet areslipped through the twoloops and they are passed

    Figure 31. Carryingthe Casualty.

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    Removal of Wounded from Tank 25up the casualty'slegs to his thighs(fig. 32). The car-rier brings theloops over hisshoulder and car-ries the man uponhis back, bearingthe weight on thesling seat with apull on the loopround his shoul- Figure 32. Adjusting Slingders (fig. 33). (Two-Loop Method).

    c. Two-ManCarriageTwo slings are adjusted to form one continu-ous loop which is applied to the patient as shown in

    figure 34. Each man places a loop over his headand shoulder, and the patient is carried with thebearers' inside arms supporting him (fig. 35).

    Figure 33. Carrying Casualty(Two-Loop Method).

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    Removal of Wounded from Tanks 26

    Figure 34. Adjusting the Sling(Two-Man Method).