1-12. LEVELS OF MEDICAL CARE
As a casualty is evacuated farther rearward in the evacuation chain, the primary
medical treatment facilities become larger and capable of providing more extensive
medical care. No casualty should be evacuated any farther to the rear than his physical
condition or the military situation requires. The types of care available are usually
classified as echelons I-V. Facilities that offer higher levels are also capable of
performing the lower levels. For example, a facility which offers echelon III care can also
perform echelon I and echelon II level care.
a. Echelon I. Echelon I care emphasizes care needed to resuscitate and
stabilize the casualty (such as maintaining an airway, stopping bleeding, and controlling
shock) and to prepare the casualty for evacuation. Echelon I care includes emergency
care provided by nonmedical soldiers and by medical platoon personnel.
(1) Nonmedical soldiers provide basic self-aid and buddy-aid care. Some
nonmedical soldiers, called combat lifesavers, have received additional training and can
provide more advanced procedures (including initiating intravenous infusions to control
shock) as a secondary mission when the military situation permits.
(2) Medical treatment includes the treatment provided by the combat medics,
ambulance crews, and aid station personnel.
b. Echelon II. Echelon II care includes resuscitation and additional emergency
measures as needed, but does not go beyond the measures dictated by the immediate
necessities. The FST's can provide echelon II care at the brigade level.
c. Echelon III. Echelon III care is provided by a medical facility staffed and
equipped to provide care for all categories of patients. The combat support hospital,
mobile Army surgical hospital, and field hospital are examples of facilities providing
echelon III care.
d. Echelon IV/V. Echelon IV and echelon V care is provided by hospitals that are
staffed and equipped for general and specialized medical and surgical care and for
reconditioning and rehabilitation for return to duty. The general hospital in the
communications zone and ZI (CONUS) hospitals are examples of facilities providing
echelons IV-V care.