Medical Evacuation using 'Dust Off'

Aeromedical evacuation by helicopter finally came of age in Vietnam where it's long period of development was eventually formalised into a coherent and successful tactical concept.

Allied forces, and in particular US and ANZAC forces, could expect aerial evacuation from any place of battle within South Vietnam, however remote or wild. More importantly, should they be seriously wounded, they could also expect to be receiving treatment at a major medical installation within an hour or less of pick-up which significantly contributed to survival rates.

Medevec helicopters were not only a welcome sight to hard-pressed aidmen and their wounded patients, but also to the commanders of a unit burdened with casualties since casualties almost completely prevented the unit's ability to maneuver. Unfortunately, despite all the understandings of previous wars, the big red cross denoting non-combat medical personnel, so prominently displayed on US medevac aircraft, were no longer a guarantee of freedom from engagement. In fact, quite the contrary. The enemy knew only to well the allies determination to evacuate their wounded and would often use this fact to specifically lie-in-wait and then deliberately shoot down helicopters engaged on such missions.

Apart from the addition of the red-cross details, the model was painted in exactly the same way as detailed in the article US Aero-Rifle Lift Platoon and I used the same type of model as described in that article. I chose to paint two 'Dust Off' helicopters since I anticipate occasions when more than one ship will be required on the table.

Evacuate those Casualties!

Most Vietnam wargaming rules emphasise the importance of minimising casualties and, for the most part, incorporate this condition into the scenario victory conditions or victory point calculation. In this respect Incoming! is no different. Dealing with friendly casualties in a timely and efficient manner often has a significant impact on the outcome of a game.

For each allied casualty marker remaining on the battlefield at scenario end (even if being attended to by a medic or at a company aid post, i.e. not completely removed from the table) gives 1 Victory Point to the NVA/VC player. In a bitterly contested Company sized engagement this is potentially a lot of enemy victory points. It is therefore incumbent upon the allied player to limit this as far as possible through the use of medical evacuation by whatever means possible (remember that casualties can be removed from the tabletop by vehicular means other than helicopters) and thus denying the NVA/VC player these valuable victory points.

However, the allied player must also make provision for the removal of civilian, as well as military, casualties. The allied player loses 1 Victory Point for each civilian casualty removed from the playing area. In effect, this means that each civilian casualty caused results in the loss of a victory point. The penalty for ignoring civilian casualties and not bothering with them is even more harsh since each civilian casualty not removed from the table loses the allied player 3 Victory Points.

There are a number of points that need to be considered here and which invite feedback from other players of Incoming!:

• A civilian casualty has the potential to lose the allied player more victory points than a military casualty and therefore is likely to be prioritised over military casualties - an unrealistic situation.
• What about civilian casualties caused by the enemy - are these still the responsibility of the allied player and if so, what is to stop the enemy player from deliberately causing these casualties.

One notable effect of this rule regarding civilian casualties is that it has the benefit of making the allied player much less 'gung ho' with regard to causing collateral damage through the over-zealous application of supporting fire and therefore makes the allied player carefully consider his use of overwhelming firepower in any game that is not being fought in a free fire zone.

The movement and evacuation of casualties is not only difficult, but places a considerable drain on the combat resources of a unit. Only fire team, command group and medic stands may carry out casualty evacuation. Heavy weapon stands may not move casualties. A stand involved in casualty evacuation may only evacuate a single casualty figure. Moving a casualty constitutes an action (in this case a 'medevac action') and stands involved may only carry out one of these actions per initiative in order to better reflect the inherent difficulties associated with moving casualties. The action may include a pivot either at the start or end of the movement.

Company Aid Post (CAP)

In most engagements it is prudent to establish a specific area for casualty clearance. The benefits of this are that you have only a single area to secure, a concentration of medical resources at a single point and all casualties gathered at one point ready for quick and efficient evacuation.

In games of company size or larger, it is also a good idea to establish company aid posts (CAP), central points for the treatment and evacuation of all the casualties belonging to a single company. A CAP is created by combining two medic stands into a single CAP stand. This is a voluntary action that can be carried out at any stage in a player's initiative and does not attract reactive fire from the enemy (in effect it is a 'free' action). Only two points need to be considered here. First, the medic stands must be within 1 base width of each other in order to combine. And secondly, once combined to form a CAP, the medics may not revert to their individual status - in effect, the CAP remains in play for the remainder of the game. In addition, the CAP must remain in place and not move from it's current location until ALL casualties at the CAP have been medevaced.

CAPs are particularly vulnerable and are automatically eliminated if contacted by the enemy in close combat. For this reason it is essential that the allied player provides some local security.

There are several benefits associated with forming a CAP, some of which I have already mentioned. Having a central casualty clearing point is more efficient than having casualties being medevaced from all over the battlefield. Also, just looking at things from a security and economy-of-force standpoint, it is easier to secure a single LZ than it is multiple LZs and it can be done with far fewer resources. Having a CAP gives the allied player a better chance of securing a medevac mission as well as a faster response time.

Requesting a Medevac

Dust Off helicopters are requested during a player's initiative. Throw 1D6. The score indicates the number of initiatives delay before the Dust Off arrives. The presence of a CAP significantly reduces this delay. If a CAP is present then apply a -2 modifier to the die roll and if this results in a modified score of less than one then the Dust Off arrives immediately.

A Dust Off helicopter may carry 3 casualty figures.

Having a Dust Off inbound is good news for the casualty but a mixed blessing for the commander. The presence of helicopters on the battlefield introduces a number of concerns relating to Victory Points.

Protect your Helicopters

The victory point penalty for casualties not removed from the tabletop pales into insignificance when compared to the victory points lost as a result of damage to, or destruction of, your medevac helicopter. For each helicopter damaged (this relates to ALL helicopters and not just Medevac), the NVA/VC player receives 10 Victory Points. Even more disastrous is the loss of a helicopter for which the NVA/VC player receives 25 Victory Points.

The lesson here is absolutely clear - protect your helicopters! These rules absolutely force the allied player to be careful when using Medevac and not to treat them in an inconsiderate manner - remember, these aircraft are going to be stationary on the ground at some stage as they take casualties on-board. Being stationary means that they are not only easier to hit but that more weapon types can fire at them (including RPGs and Recoilless Rifles) and they are easier to destroy.

It is critically important that you do the following;

• As far as possible, secure the LZ.
• If the LZ cannot be fully secured then suppress as much of the enemy fire as possible.
• Give your medevac helicopters some gunship support (as they had in reality)
• Get them in and out quickly, do not have them waiting around on the ground.
• Use the early part of your initiative to neutralise the enemy threat and bring your helicopters in at the last moment - if necessary, delay them and bring them in later.
• Don't have your helicopters flying into LZs that are covered by enemy HMGs (the probability of scoring 10+ on two dice is quite high, 1 in 6)

Collect all your casualties into a single clearing point so that the maximum number can be evacuated in the minimum amount of time and thus reducing the time your Dust Off helicopters are exposed to enemy fire.

The Ground Commander's Conundrum

The commander on the ground has his orders. The way in which he carries them out may significantly affect the mission outcome. Casualties are likely and each casualty will significantly reduce his effectiveness. He must carefully consider and decide his scheme of maneuver but he doesn't have much time in which to make his decisions....

Consider this; a US Platoon has a total of 9 stands including six fire-team stands (three rifle squads), an HMG stand, a medic and a platoon HQ stand. The Platoon sustains three casualties which must be moved to the company aid station for medevac - the medic and two rifle stands are ordered to move the casualties. The platoon is left with only a single rifle stand, the HMG stand and the platoon HQ stand and the platoon has been rendered almost combat ineffective despite only losing 30% of it's total number of stands as casualties. In effect, sustaining a single casualty actually results in the loss of a further stand as it becomes involved in medical evacuation.

The lesson is very simple therefore, don't be too 'Gung Ho'. Be wary of placing your forces in a position where they will take unnecessary casualties; always use fire and maneuver and try to suppress an enemy position with fire before moving against it for close combat. Maneuver, maneuver, maneuver and use cover to the maximum. Establish a base of fire in order to gain and maintain fire superiority. Remember, a failure to unsuppress a stand results in a loss of initiative and therefore the more enemy stands that you can suppress, the better. Use ground hugging if necessary. Avoid ambushes and use recon by fire when necessary. Always use your mortars or artillery before moving since they cannot lose you the initiative. Think of it this way, if it was your ass hanging in the wind, would you want to cover that open ground without any covering fire?