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The Chicken, Fox, and Grain: Solving the Problem of CASEVAC.

George A Barbee1, Joshua Causey2

  • 1U.S. Army Western Hemisphere Command.

Journal of Special Operations Medicine : a Peer Reviewed Journal for SOF Medical Professionals
|December 17, 2025
PubMed
Summary

The U.S. Army's casualty evacuation (CASEVAC) strategy needs improvement for large-scale conflicts. A "whole of force" approach, revising doctrine, and enhancing training are recommended for better battlefield casualty care.

Keywords:
CASEVACMEDEVACasymmetric outcomeslarge-scale combat operationslarge-scale conflict

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Area of Science:

  • Military Science
  • Medical Logistics
  • Operational Strategy

Background:

  • Current U.S. Army casualty evacuation (CASEVAC) strategies are insufficient for mass casualty events in large-scale conflicts.
  • Future conflicts with peer adversaries pose a significant threat, potentially overwhelming existing evacuation capabilities.

Purpose of the Study:

  • To analyze the inadequacy of current U.S. Army CASEVAC strategies in large-scale conflict scenarios.
  • To propose actionable recommendations for enhancing the Army's CASEVAC capabilities and capacity.

Main Methods:

  • Review of current Army CASEVAC doctrine and force structure.
  • Analysis of operational requirements for maneuver commanders in high-casualty environments.
  • Development of conceptual frameworks for improving CASEVAC operations.

Main Results:

  • Current CASEVAC doctrine, training integration, and force structure require revision to meet future demands.
  • A "whole of force" approach is advocated, prioritizing maneuver commander needs and operational flexibility.
  • Three key concepts—asymmetric outcomes, different thinking, and bias for action—are proposed to enhance CASEVAC.

Conclusions:

  • The U.S. Army must fundamentally rethink its CASEVAC strategy to effectively manage mass casualties in great power conflicts.
  • Implementing proposed doctrinal, training, and structural changes will improve casualty care and operational readiness.
  • Adopting innovative concepts will provide a competitive edge in future high-intensity warfare.