The United States Army Medical Department delivers high quality medical care throughout the world, many times to remote and austere environments. A major tenet of this care system is the rapid evacuation of combat casualties to hospitals with surgical resuscitation. However, what happens when evacuation is unavailable? This study will explore the current literature and review trends in prehospital care in the Army. Which medical protocols should Army physicians at Role 1 and 2 facilities have available for treatment in lieu of medical evacuation?