9-Line, also called a 9-Line MEDEVAC Request, is a military request for medical evacuation arranged into nine numbered groups of information. It combines the pickup location and contact at that location with patient numbers, evacuation precedence, special equipment, transport type and local conditions. This allows the responsible forces to assess an evacuation task and prepare suitable vehicles. The US Army uses the format for both ground and air evacuation; German AirMedEvac usage calls it the Nine-Liner. For injured isolated personnel, it becomes usable when an established military communication link can pass the request to forces able to undertake the task.
The nine fields in the US Army format
The numbers determine where each piece of information belongs. A recipient can therefore identify individual details and ask about them even when parts of the connection fail. The following overview explains the US Army field arrangement. Lines 6 and 9 change between its wartime and peacetime versions.
| Line | Information | Purpose for pickup |
|---|---|---|
| 1 – Location | Coordinates of the intended pickup site with unambiguous grid and zone information. | The forces need to reach the correct place and plan their route to it. The numbers from an abbreviated map grid may be ambiguous outside their reference. |
| 2 – Contact | Radio frequency and call sign of the contact at the pickup site, with a call sign suffix where applicable. | The crew needs contact with the requesting party while travelling and on arrival to coordinate changes or the details of pickup. |
| 3 – Precedence | Patient numbers separated by evacuation precedence. | The organization assigning vehicles needs to prioritize competing requests. A total alone does not describe the urgency of the requirement. |
| 4 – Special equipment | Required special capabilities, such as a rescue hoist, extraction equipment or medical ventilation equipment. | These capabilities must be available on an appropriate vehicle. The ability to transport patients does not by itself provide a hoist or the equipment needed for a particular care requirement. |
| 5 – Transport type | Numbers of litter patients and ambulatory patients who can be transported sitting. | The crew must configure litter and seating positions appropriately; the combination also affects how many vehicles are needed. |
| 6 – Security or injuries | Wartime: security at the pickup site, possible or confirmed enemy forces and the need for armed escort. Peacetime: numbers and types of wounds, injuries or illnesses, including relevant known details. | In wartime, the field addresses the threat and protection needed for pickup. In peacetime, injury or illness information supports preparation of care and equipment. |
| 7 – Marking | The available or intended method of marking the site, such as a signal panel, or the fact that no marking is available. | The crew needs to identify the precise pickup site. A reported marking method must actually be available there. |
| 8 – Nationality and status | Patient nationality and military, civilian or enemy prisoner of war status. | This supports planning of the destination facility and any necessary guards. It does not replace medical precedence in line 3. |
| 9 – Contamination or terrain | Wartime: relevant chemical, biological, radiological or nuclear contamination. Peacetime: terrain at and around the pickup or landing site, recognizable reference features and obstacles to access. | Contamination affects the choice of assets and mission execution. Terrain information helps assess access or approach, particularly when a hoist pickup may be necessary. |
The pickup site must fit the person’s actual condition. An injured person who cannot reach a nominated clearing has not provided a usable meeting point. Coordination therefore also needs their actual location and the movement they can still manage. Coordinates are passed with their reference; an uncertain position fix remains identifiable as uncertain. When a request is relayed, line 2 retains the original requesting party’s contact at the pickup site. If an intermediary substitutes its own radio details, the crew may reach that intermediary for questions but fail to reach the person at the site.
Precedence, transport type and required capabilities
The US Army categories are Urgent, Urgent-Surg, Priority, Routine and Convenience. Urgent covers threats to life, limb or eyesight, or the risk of serious complications. Urgent-Surg identifies a need for urgent far-forward surgical care. Priority covers a need for prompt movement, for example because the condition may deteriorate or particular treatment is unavailable locally. Routine applies where significant deterioration during the delay is not expected; Convenience concerns medical convenience rather than medical necessity. These categories rank requests by need. Assigned precedence is not a promised arrival time.
Classification draws on assessment of the patient and situation by the medic or responsible person present. Someone without the relevant training who can only describe their own condition provides concrete observations: visible bleeding, increasing difficulty breathing, a companion’s reduced responsiveness or their own inability to walk. A suspected diagnosis is not presented as an established finding. Known changes help the recipient clarify the requirement; invented blood pressure readings or a guessed blood group distort it.
Lines 3 and 5 describe different characteristics of the same patients. An urgent patient may be able to sit; a litter patient may have a different evacuation precedence. The numbers in the precedence groups and the numbers by transport type must account for the same people in total. It must also be clear when someone can sit but cannot get to the vehicle unaided. Simply reporting them as “ambulatory” leaves the forces unaware of that movement limitation. Special equipment in line 4 follows the actual access or care requirement. “Hoist required” identifies a capability needed for pickup; it does not establish that a suitable aircraft is available.
Transmission, readback and updates
US training teaches transmission of lines 1 to 5 first so that processing and preparation of the task can begin. Lines 6 to 9 follow as soon as possible and may also be added while a flight is already under way. This order provides location, contact and transport requirements early. It does not make the remaining details dispensable: a newly identified threat or contamination may immediately change the planned pickup.
Information remains in the agreed line order. After an interruption, it must be clear which line was received and which is missing. Readback has the recipient repeat what they understood; the sender can then correct a misheard location, transposed number or wrong assignment to a field. An intermediary relays the received information exactly. A receipt acknowledgement initially means that the message has arrived. For air evacuation, medical mission authorization and aviation launch approval are separate decisions; patient needs, weather, terrain, threats and available assets inform them.
If the condition, patient numbers, contact or intended pickup site changes, the new information must explicitly replace the previous report. The same applies to changed security conditions or marking. A timed observation of condition shows whether it is still current. “No enemy forces seen” describes the extent of the sender’s observation; “pickup site secure” asserts an assessed situation. Suspected contamination is likewise reported as suspected. Unknown details are not filled with reassuring guesses.
A technically capable enemy can intercept an unprotected message and attack patients and the evacuation crew at the reported pickup site. The intended protected means of transmission and the communication routes established for the operation therefore belong in preparation. If protected communication is unavailable, the risk of disclosure and the immediate danger to the patient have to be considered together. Someone who has not yet established contact can use available writing materials to preserve known location, condition and mobility details, including changes. Immediate self-aid or buddy aid and response to an immediate threat must not wait for a completely filled request.
National use and MIST
In Bundeswehr usage, the Nine-Liner prepares the AirMedEvac crew for location and contact, casualty numbers and precedence, lying or seated transport, injury type, security, marking, patient characteristics and hazards at the pickup site. Transmission uses the established national or operation-specific form. Someone working with US forces needs to reconcile the arrangement of lines 4, 6 and 9 in particular: special equipment, security or injury information, and contamination or terrain must not be placed where the recipient expects a different item.
MIST adds mechanism of injury, identified injuries, signs and symptoms, and treatment already given. These details prepare the medical handover and are passed on during an actual transfer, preferably with any available documentation. In the US procedure, MIST follows the 9-Line request as soon as its information is available; evacuation should not wait for missing MIST details. Subsequent deterioration or a new intervention belongs in the updated medical information so that the receiving party does not work from an outdated condition.
Site marking, identity and physical recovery
The marking in line 7 connects the reported location to a recognizable point on the ground. For panels or smoke, the US procedure has the approaching crew state the colour it observes and the requesting party confirm it. This checks the association with the observed marking. Personal authentication of isolated personnel instead checks whether the person actually reached is the person being sought; it follows the prepared personnel recovery procedure. Precise coordinates, a matching call sign and the nationality in line 8 do not answer that identity question.
When a person is injured under enemy threat, the tasked forces also need to reach them, deal with the local danger and take charge of them. This may require a linkup on the ground or special extraction before patient transport itself. The person contributes usable information on location, condition, remaining mobility and available means, and updates those details when contact is established. Those details give the forces a concrete requirement: whom they are to pick up at which reachable location, what capabilities are needed and what obstacles remain.