America’s Army continues to prepare for the challenges of future warfare, but top enlisted leaders say there is one area that urgently needs modernization: the ability to evacuate and treat casualties in large-scale combat against a near-peer enemy.

The lessons from the ongoing war between Russia and Ukraine serve as a sobering warning for what such conflicts could mean for U.S. forces.

Casualty numbers in that war point to a scale of loss that would far exceed what American troops faced during the Global War on Terror, a panel of command sergeants major said this week at the Association of the U.S. Army’s annual meeting in Washington, D.C.

The panel of senior leaders agreed that the Army must address a serious shortcoming in its current capability—the limited ability to move large numbers of wounded soldiers off the battlefield.

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This issue, they emphasized, could become a major vulnerability in any future conflict.

“Everything that has wheels or tracks has a casualty on it, unless it has a main gun on it,” said Command Sgt. Maj. James Light, the top enlisted leader for the Army’s 1st Cavalry Division.

His blunt observation captured the likely reality of a future large-scale engagement, where nearly every vehicle would be pressed into service to evacuate the wounded.

Light explained that armored divisions may be somewhat better positioned to respond, since they have more vehicles across their formations.

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However, lighter units such as Infantry Brigade Combat Teams lack that advantage. These teams would have to rely on Humvees and infantry squad vehicles, which are typically only able to carry one casualty at a time.

Command Sgt. Maj. Oracio Pena, the senior enlisted leader for the Joint Readiness Training Center, stressed how this limitation could hinder rapid medical response in mass-casualty scenarios.

At the same time, the problem goes beyond the number of vehicles.

Command Sgt. Maj. Jesus Gonzalez, the top enlisted leader at the U.S. Army Medical Center of Excellence, pointed out that many platoons and companies still do not have fully developed or practiced casualty evacuation plans.

“Those plans need to be tested during training,” Gonzalez said, emphasizing that preparation is just as important as technology. Without regular rehearsal of evacuation procedures, even the best equipment may fail to save lives when it matters most.

While these concerns highlight current challenges, there are reasons for cautious optimism.

The Army is taking steps to improve both its medical equipment and training. According to Gonzalez, medical personnel are modernizing Warrior Aid and Litter Kits, which are first aid packages designed to give soldiers better immediate care tools in the field.

The Army is also expanding the role of combat paramedics within Mobile Maneuver Battalions to help mitigate evacuation shortfalls.

Technology is another part of the solution. Officials are integrating aerial drones and unmanned ground vehicles to locate casualties and scout safer evacuation routes.

These unmanned systems can deliver medical supplies forward from battalion aid stations to combat medics and lifesavers closer to the front lines.

This innovation could reduce risks to soldiers and speed up life-saving care under fire.

Additionally, the Army is increasing the number of combat lifesavers assigned to each squad, team, vehicle, or crew.

Training for these lifesavers is also being upgraded to include tourniquet conversion, the use of freeze-dried plasma, and rapid blood typing—advances that could make the difference between life and death during intense combat operations.

These efforts reflect a broader understanding that future warfare will be far more complex and deadly than the small-unit counterinsurgency fights of the past two decades.

The Army’s enlisted leaders understand this reality well because they have seen firsthand the importance of fast, effective casualty evacuation in preserving lives and morale.

They are pushing for modernization not out of bureaucratic ambition but from the deeply human desire to make sure that soldiers have the best chance of coming home alive.

At the same time, the discussion reveals an important truth about America’s military readiness: modernization is not just about advanced weapons or technology.

It is about ensuring that the men and women who serve on the front lines are equipped, trained, and supported to survive the battlefield’s harshest realities.

Effective casualty evacuation requires coordination between medical personnel, combat units, and technology—all working seamlessly under fire.

As the Army continues to adapt to new threats, leaders like Light, Pena, and Gonzalez are raising their voices to make sure the human element remains central to that modernization effort.

The ability to save lives on the battlefield, they argue, is just as important as the ability to win battles.

Their message is clear: the nation must invest in practical, effective ways to evacuate and treat its wounded soldiers. Because in the chaos of modern war, every minute counts—and every life matters.

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