Heat Casualty on a Timed March
You are the senior cadet of a 26-member flight on a 14 km loaded march. The assessment checkpoint at km 10 closes at 15:40; it is 15:05. Ambient temperature is 34°C, humidity 82%, and there is no shade. Cadet A is vomiting, confused, hot and dry. Cadet B has painful cramps and dizziness but is alert and drinking. One radio has 15% battery and intermittent comms; mobile coverage is absent. A vehicle track lies 700 m east but is not marked on your map. The assessor at the checkpoint has warned that late arrivals lose 20% of the leadership mark. Your flight carries two 5-litre water cans, one first-aid kit with no ice packs, and a stretcher. Two other cadets are struggling but not casualties. You must decide what to do next.
1. Set out your first 10 minutes as a numbered sequence. For each action, state who does it and why.
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- Halt the flight in the nearest shade and set a timer. Do not keep the whole flight standing in the sun.
- Allocate roles: the most first-aid-trained cadet to Cadet A; two cadets to shade, loosen clothing and wet/fan A; one cadet to Cadet B; one cadet to control the water; one cadet to the radio; two fit cadets to check the vehicle track for 100 m, not to disappear down it.
- Treat A as suspected heat stroke, not simple exhaustion: confusion, vomiting, hot and dry skin are red flags. Cool first, move second. Do not force oral fluids while A is confused because of aspiration risk. Monitor breathing.
- Treat B as heat exhaustion: shade, rest, small sips of water if fully alert, and recheck.
- Send a radio message: 'Medical emergency, one suspected heat stroke, grid reference, request evacuation and assessor.' If the radio fails, send two runners with a written message and times.
- If the track is passable, move A by stretcher to it for evacuation; if not, keep A shaded and cooled and wait.
- Do not resume the march until A is evacuated. Check every other cadet for symptoms and ration water. The reasoning is simple: a heat-stroke casualty can deteriorate within minutes, while a 20% mark penalty is recoverable. The mission is not the checkpoint; it is getting 26 people back safely.
2. How do you handle the checkpoint deadline and the assessor?
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Report the casualty to the assessor immediately, before debating the deadline. Give a concise situation report: time, location, casualty, suspected cause, action taken, and request. Ask for medical evacuation and for an extension or an alternative leadership assessment. Put the request in writing if possible and log the time. If the assessor refuses an extension, I would accept the mark consequence rather than split the flight and leave a casualty with too few carers. I would not falsify timings or send the fit cadets ahead to 'bank' the checkpoint. I would ask the assessor to record that the delay was due to a medical emergency, so the board can see the facts. The judgement is that mission command includes the duty to flag a risk upward, not to obey a timetable blindly. A leader who hides a casualty to protect a score is telling the board exactly what kind of officer they would be.
3. What leadership behaviours will you demonstrate, and what will you put in the after-action review?
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Behaviours: calm, clear task allocation, closed-loop confirmation, and visible concern for the casualty. Use task/team/individual: task = evacuation and checkpoint message; team = water, shade, runners; individual = A and B. Keep the rest of the flight informed so rumours do not fill the gap. After-action review should record: time of onset, time of cooling, time of evacuation request, radio battery state, water consumed, and the exact route timing. Ask what could have been prevented: pre-march heat-acclimatisation, extra water, a charged spare radio, a shaded rest plan, and a rehearsed casualty-evacuation drill. The review should not become a blame session; it should produce three fixable actions with owners and dates. The leadership lesson is that the hardest call was not medical knowledge but priority: people before marks, and honesty before looking good.