MEDEVAC · Lesson 3 of 6

MEDEVAC & 9-Line Request

When a casualty needs evacuation, a 9-Line MEDEVAC request gets help to you — fast. It's a standardized 9-field radio transmission that every team member should be able to recite under pressure.

What is MEDEVAC?

Medical evacuation (MEDEVAC) is the coordinated movement of casualties from the point of injury to a higher echelon of care — typically by rotary-wing aircraft, ground vehicle, or watercraft. In a tactical environment, calling for MEDEVAC is one of the highest-priority actions a first responder can take. Delaying the call, or transmitting an incomplete request, directly costs lives.

The 9-Line format is the NATO/STANAG 3204 standard for requesting medical evacuation. Every field in the transmission exists for a reason: line 1 tells the aircraft where to land, line 3 tells the medical crew what resources to have ready before they lift off, and lines 6–9 give the pilot the tactical picture. Omitting any line forces the receiving unit to ask follow-up questions — burning time when every second matters.

Civilian equivalents exist. Some EMS services, mountain rescue teams, and maritime SAR units operate adapted 9-Line formats or structured METHANE/SMEACS templates that carry the same core data. The underlying principle is identical: give responders what they need to plan, mobilize, and arrive prepared.

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Try it in MedReady

MedReady's /app includes an interactive 9-Line builder that walks you through each field, validates your entries, and generates a ready-to-transmit script. Use it to practice under simulated time pressure.

The 9 Lines

Line	Field	What to Report	Example
1	Location of pick-up site	Grid coordinates or lat/long. Provide a terrain description only if grid is unavailable. Be as precise as possible — the aircraft is navigating to this point.	`Grid 38T LP 123 456`
2	Radio frequency & call sign	Primary comms frequency in MHz and your call sign. The aircraft will contact you on this frequency when inbound.	`46.250, ALPHA`
3	Number of patients by precedence	Report counts per category using the letter codes: A — Urgent (evacuate within 1 hr or die/lose limb) B — Urgent Surgical (<1 hr, requires OR immediately) C — Priority (<4 hr, condition will deteriorate) D — Routine (<24 hr, stable) E — Convenience (no medical reason for urgency)	`1 Alpha, 2 Delta`
4	Special equipment required	A — None B — Hoist (no LZ available) C — Extraction equipment (confined space, entrapment) D — Ventilator	`Alpha (none)`
5	Number of patients by type	L — Litter: non-ambulatory, must be carried A — Ambulatory: walking wounded, self-mobile Report counts for each type.	`1 Litter, 1 Ambulatory`
6	Security at pick-up site	N — No enemy troops in area P — Possibly enemy (uncertain) E — Enemy troops in area X — Escorted (armed escort provided) In hostile areas, this may be passed in code.	`November (no enemy)`
7	Method of marking pick-up site	A — Panels (VS-17 or similar) B — Pyrotechnics C — Smoke — always confirm color verbally after aircraft sees it D — None E — Other (IR strobe, laser, etc.)	`Charlie (smoke), Purple`
8	Patient nationality & status	A — US Military B — US Civilian C — Non-US Military D — Non-US Civilian E — EPW (Enemy Prisoner of War)	`Delta (civilian)`
9	NBC contamination	Report if the casualty or site is contaminated: N — Nuclear B — Biological C — Chemical If no contamination, state "None". This field is critical for crew protection.	`None`

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Line 3 (Precedence) is the most critical field

It determines response time. Urgent = helicopter in the air immediately. Don't downgrade to Priority to "not bother them" — if the casualty needs urgent care, say so. Under-triaging a life-threatening injury to avoid inconveniencing the crew is a fatal mistake.

How to Transmit a 9-Line

Transmission follows a strict sequence. Speak clearly, use phonetic alphabet where required, and pause between lines to allow the receiving unit to copy and read back.

1

Establish comms

Confirm you are on the correct frequency. State your call sign and request the receiving station confirm they are ready to copy. Wait for acknowledgement before proceeding — transmitting into a dead net wastes critical time.
2

Announce the 9-Line

Transmit: "I have a 9-Line MEDEVAC request, standby to copy." This signals the format to the receiving unit and gives them a moment to prepare their copy card or logbook.
3

Transmit lines 1–5

Read each line clearly, state the line number first. Pause after each line and wait for readback. Correct any errors immediately. Lines 1–5 contain the information needed to launch and configure the aircraft — the crew may begin spinning up as soon as they copy line 3.
4

Transmit lines 6–9

These lines contain tactically sensitive information — enemy presence, marking method, patient status — and are transmitted separately. In hostile environments they may be passed in code per unit SOP. Pause for readback after each line.
5

Confirm receipt and get ETA

Receive full acknowledgement from the MEDEVAC unit. Record the estimated time of arrival (ETA) and any special instructions (approach direction, call sign changes, authentication challenges). Relay the ETA to your casualty if conscious — it matters.

Memory Aids

The 9-Line is transmitted under stress, often in darkness, with noise and chaos. These anchors help prevent omissions.

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The Rule of 3s

Lines 1–3 get the aircraft moving. Location, frequency, precedence. Never skip them, never delay them. Everything after line 3 can be updated in flight — but the aircraft can't launch without those three.

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Security Last

Lines 6–9 are transmitted after 1–5 because they're tactically sensitive. Enemy presence (line 6) and marking method (line 7) reveal your position and situation — delay these until the aircraft is already tasked and inbound.

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Smoke Color Discipline

Never announce your smoke color first. Pop smoke, then wait for the aircraft to call out what color they see. Confirm or deny. This prevents enemy forces from popping the same color to draw the aircraft to a false LZ.

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Practice out loud

Practice the 9-Line out loud until it's automatic. Under stress, you need to transmit clearly and calmly. Hesitation or omissions can delay evacuation by critical minutes. Use MedReady's interactive builder to rehearse realistic scenarios with time pressure.