Monday, 22 September 2014

Bulldog Loadouts: MASSCAS Chest

Capt P, the American PA I worked with in a NATO camp during my most recent deployment to Afghanistan went to Yale University. The Yale football team is the Yale Bulldogs. In an homage to his varsity team, all the load list for medical gear were prefaced with the 'Bulldog" identifier. This is a series of articles on specific loadouts that we packed to support distinct roles within our camp emergency plan. There will be no coverage of the emergency plan or mass casualty plan in this series as the camp is still operational. The gear and supplies used were limited to the supply chain and represent best possible practice at that current time.


The MASSCAS Box had been designed to support the rapid organization, triage and treatment of casualties during a mass casualty incident . The described load out was sufficient to provide basic life support for approximately twenty casualties when combined with the other Bulldog Medical bags. The box could have be loaded onto a Gator or in the back of the Flight Line Ambulance should the primary casualty collection point been compromised or was geographically inappropriate for the tactical situation. This is a load list. There will be no discussion of the plan as the camp in question is still operational and may resemble their current plan. 

Inside the MASSCAS BOX:

1. MASSCAS setup/ triage NCO (black bag green handles)
2. Patient Administration/Dispatch NCO (black folder pouch marked with red cross)
3. 10 Biohazard bags
4. Priority Signs (Immediate, Priority, Routine)
5. 20 Bulldog Battle packs
6. 4 MASCAL Tool necklaces

MASSCAS Setup/Triage NCO
  • High Visibility Vest
  • Roll, Yellow Duct Tape
  • Roll, Yellow CAUTION Tape
  • 2 Pens
  • Black Sharpie™
  • Clipboard
  • 20 Casualty Notes
  • 25 NATO Casualty Tags
  • 5 Red Glowsticks
  • 5 Yellow Glowsticks
  • 5 Green Glowsticks
  • 3 10m rolls of para-cord
  • Angle Head Flashlight
  • 2 extra C cell batteries

  • Patient Numbering Tags
  • 8x10 Lined paper
  • MASSCAS Clipboard
  • 20 Casualty notes
  • 3 9-Liners Laminated
  • Sharpies™
  • Pens

Bulldog Battle Packs (20 in MASSCAS Box)
  • 2 CoTCCC/CCCWG approved tourniquets
  • 1 ACE Bandage
  • 2 Kerlix Sterile Gauze
  • CoTCCC/CCCWG approved hemostatic agents
  • CoTCCC/CCCWG approved chest seals
  • CoTCCC/CCCWG approved needle decompression kits
  • 1 2” or 3” tape
  • CoTCCC/CCCWG approved pressure dressing
  • 1 NPA
  • 1 surgical lubrication pouch
  • 1 Sharpie™ black marker
  • CoTCCC/CCCWG approved casualty tag
  • 1 IR/white glowstick (optional-recommend for OTW packs)

MASSCAS Necklaces
  • Roll of 4” Silk Tape
  • Trauma Shears
  • Black Marker
  • Blue Glowstick
The concept of these 'necklaces' was to provide basic tools for triage and a means of identification for the designated medical chain of command. Simple reality, MASSCAS are chaotic and happen when least expected. This 'necklace ' was designed to ensure everyone was prepared no matter if they showed up in PT kit or a bathrobe.

In closing, this is the setup that we designed in an effort to be prepared for the very real possibility of a mass casualty incident. It was playtested a few times through exercise and ROC drills were it performed well. Thankfully, we never had to 'go live'.

Take Care Out There


  1. This is exactly what we needed in terms of how to set up our trauma chests for a MCI. We won't have all the bells and whistles like you guys do, but we did get a lot of med supplies from our ISAF unit in our AOR before they shipped out. Many thanks for this useful information!

    1. Look at the Medical Battle Packs article for ideas as well. Glad to share.