Operational Medicine



LESSON ASSIGNMENT

LESSON 3 Combat Health Support of Army Divisions

LESSON ASSIGNMENT Paragraphs 3-1--3-7

LESSON OBJECTIVES After completing this lesson, you should be able to:

3-1. Identify the CHS Echelon 1 and Echelon 2 CHS units and their corresponding functions.

3-2. Identify the levels at which Echelon 1 and Echelon 2 CHS units are found.

3-3. Identify the capability of each CHS unit.

3-4. Identify modular medicine components and the medical facilities to which they belong.

5. Identify the duties and responsibilities of the division medical operations center.

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LESSON 3

COMBAT HEALTH SUPPORT OF ARMY DIVISIONS

3-1. ABOUT THIS LESSON

This lesson builds on the material presented in the previous lesson on the modular medical system. Material is presented on Echelons I (unit-level) and Echelon II (division-level) CHS. Division-level CHS starts at the FEBA and continues to the division rear boundary.

3-2. ECHELON I COMBAT HEALTH SUPPORT FUNCTIONS

At Echelon I, immediate life saving measures, emergency medical treatment (EMT), and advanced trauma management (ATM) are provided to stabilize the patient for evacuation to the echelon that can provide required medical treatment. The combat medics provide EMT while treatment squad modules with an assigned physician and a physician assistant (PA) provide ATM. Echelon I also provides routine medical treatment (sick call services) to return soldiers to duty, disease and nonbattle injury (DNBI) prevention, and evacuation of the sick and wounded.

3-3. ECHELON I AT THE UNIT

a. Self-Aid/Buddy Aid. Echelon I care starts at the unit with self-aid/buddy-aid. This is first aid (emergency or immediate life-saving care) given to a sick, injured, or wounded person administered by the person himself (self-aid) or by a fellow soldier (buddy-aid). All soldiers are trained as part of the common soldier tasks in a variety of first aid procedures to respond appropriately to life-threatening situations.

b. Combat Lifesaver. The combat lifesaver is a non-medical soldier trained beyond common task first aid and assigned an additional duty as combat lifesaver. Such a soldier performs combat lifesaver duties only when the tactical situation permits.

c. Combat Medic. The combat medic is the first individual in the CHS chain who is medically trained. He is a medical specialist (MOS 91B) and is trained to the same level as an emergency medical technician (EMT) in the private sector.

3-4. THE MEDICAL PLATOON

The medical platoon consists of a headquarters section, a treatment squad, an ambulance section, and a combat medic section. The medical platoon operates the battalion aid station (BAS). The BAS is 100 percent mobile and has no holding capability.

a. Mission. The medical platoon's mission is to provide Echelon I CHS to its battalion and to elements in the battalion area lacking their own medical support.

b. Platoon Headquarters. The platoon headquarters is the command, control, and communications (C3) element for the medical platoon. The headquarters consists of the platoon leader and platoon sergeant. They also serves as members of the treatment squad.

c. The Medical Officer. In a treatment squad, the medical corps (MC) officer serves as the medical platoon leader, and also as the battalion surgeon. When the treatment squad is split into two teams, the medical officer leads one of the teams.

d. The Field Medical Assistant. The field medical assistant (a physician assistant [PA]) serves as the medical platoon leader in the absence of the MC officer. The field medical assistant is responsible for administration and logistics. When the treatment squad is split into two teams, the field medical assistant leads one of the teams.

e. Treatment Squad. The treatment squad provides EMT, ATM, routine medical care, and DNBI prevention to soldier and runs the battalion aid station (BAS). The treatment squad can be employed as a single unit or split into two treatment teams to provide CHS in two different locations at the same time. The treatment squad of the medical platoon normally establishes the BAS in or near the vicinity of the combat trains; a place where Class III (petroleum, oil, and lubricant [POL]) and Class V (ammunition) support is located. When the treatment squad is split into two teams, each team consists of either the MC or PA, a medical NCO (MOS 91B), and two medical specialists (one of which serves and the driver/radiotelephone operator).

f. Ambulance Section. The number of ambulance squads in the ambulance section varies according to the type of parent battalion (mechanized infantry, airborne, air assault, light, armor, cavalry). Each ambulance squad has two teams. Each team consists of an ambulance and two medical specialists (MOS 91B). One serves as the ambulance driver and radio operator. The other provides medical care en route to the BAS.

g. Medical Platoon Ambulances. Medical platoon ambulances are responsible for evacuating patients from the company aid posts to the BAS. Ambulances can be positioned forward with supported companies or remain with the BAS. The type of ambulance used, wheeled or track, depends upon the type of unit being supported.

h. Combat Medic Section. The number of combat medics assigned to the section varies by type of parent battalion. The combat medic module (medic plus one aidbag) provides initial treatment along the FEBA and the forward line of own troops (FLOT). Troops may be scouting or doing reconnaissance ahead of the FLOT. The combat medics are attached to the combat companies and provide medical care to soldiers at the site of the injury. The senior medic in the company establishes a company aid post in the company area. Patients who cannot walk to the aid post are moved to the aid post by litter teams, manual carries, or military vehicles. The movement of patients to the aid post is the responsibility of the combat unit.

3-5. THE FORWARD SUPPORT MEDICAL COMPANY

Normally, there are three forward support medical companies per division (one per brigade). Each forward support medical company (FSMC) consists of a company headquarters, a treatment platoon, and an ambulance platoon.

a. Forward Support Medical Company Mission. The overall mission of the FSMC is to provide Echelon I and Echelon II CHS to units in the brigade support area (BSA). The FSMC also provides advice and assistance, evacuates patients from BAS and other areas within the BSA, and reinforce and reconstruct supported BASs (for example, provide an ambulance squad to a BAS that has lost one of their squads).

b. Capabilities. The FSMC is 100 percent mobile. It establish a clearing station in the BSA which provides Echelon II care. The clearing station can hold patients who will return to duty within 72 hours. An FSMC in a light division normally has a holding capacity of 20 cots. An FSMC in a heavy division, airborne division, or air assault division can hold 40 patients.

c. Company Headquarters. The company headquarters is the C3 element for the FSMC. It assists in developing the brigade medical support plan and manages all evacuation assets and Class VIII (medical) for the supported brigade.

d. Treatment Platoon. The treatment platoon consists of the platoon headquarters, a treatment section, and an area support section.

(1) Platoon headquarters. The platoon headquarters directs the disposition of patients received at the clearing station and coordinates evacuation from the clearing station. The platoon leader is a physician who also serves on a treatment team in the area support section.

(2) Treatment section. The treatment section consists of two treatment squad modules. Each treatment squad is manned and equipped identically to the treatment squad in medical platoons that it supports. These treatment squads facilitate reinforcement or reconstitution of the medical platoon's BASs.

(3) Area support section. The area support section consists of an area support squad, an area treatment team (light division) or area treatment squad (heavy division), and a patient holding squad. Combined, they form the clearing station.

(a) The area support squad provides ancillary support to facilitate initial resuscitative treatment. This support includes emergency and sustaining dental care, limited laboratory procedures, and limited X-ray capability.

(b) The area treatment team/squad forms the base of the clearing station, where initial resuscitative treatment begins. It is nearly identical to the other treatment teams/squads, except that lacks tactical vehicle modules.

(c) The patient holding squad module supports patients expected to be returned to duty within 72 hours. Its holding capability contributes significantly to the provision of resuscitative care and the return to duty (RTD) rate. It gives Echelon II units the flexibility to hold patients who are not serious enough to be evacuated to higher echelons.

e. Ambulance Platoon. The ambulance platoon consists of a platoon headquarters and ambulance squads.

(1) The ambulance platoon headquarters is the C2 element for the platoon. It manages and coordinates all evacuation missions.

(2) The number and type of ambulance squads (wheel squads vs. wheel and track squads) is a function of the type of parent division.

(3) The primary responsibility of ambulances assigned to the FSMC is to evacuate patients from the supported BASs. Their secondary responsibility is to evacuate patients from units within the BSA. These squads can also reinforce or reconstitute medical platoon ambulances.

3-6. THE MAIN SUPPORT MEDICAL COMPANY

There is one main support medical company (MSMC) per division. It is located in the division support area (to the rear of the supported BSAs).

a. Main Support Medical Company Mission. The MSMC provides Echelons I and II CHS to units operating in the division support area (DSA) by establishing a clearing station in the DSA. The MSMC is 100 percent mobile and can reinforce or reconstitute supported FSMC elements.

(1) Organic surgical capability. The MSMC in the airborne and air assault divisions are the only divisional medical companies with organic surgical capability.

(2) Organic air ambulance capability. The MSMC in the air assault division is the only divisional medical company with organic air ambulances.

b. Structure of the Main Support Medical Company. The structure of the MSMC is very similar to that of the FSMC except that additional sections are available. The MSMC has a company headquarters, a treatment platoon, and an ambulance platoon just like the FSMC. [Note: The MSMC area support section has a treatment squad regardless of the type of parent unit and the ambulances are all wheeled vehicles.] Sections that are part of a MSMC, but not a FMSC, are listed below.

(1) Mental health section. The mental health section of the MSMC provides limited psychiatric care to combat stress casualties. It evaluates the effects of battle fatigue and operates the division mental health program.

(2) Preventive medicine section. The preventive medicine section provides preventive medicine services to division units and conducts field sanitation team training.

(3) Optometry section. The optometry section performs routine eye examinations, provides emergency treatment for eye injuries, and fabricates and repairs single-vision lens devices.

(4) Division medical supply office. The division medical supply office (DMSO) procures, stores, and distributes medical logistics (Class VIII) for the division and performs maintenance on biomedical equipment.

3-7. THE DIVISION MEDICAL OPERATIONS CENTER

a. Mission. The division medical operations center (DMOC) staff is responsible to the division support command (DISCOM) commander for staff supervision of CHS within the DISCOM. Its mission is to plan, coordinate, and synchronizes CHS for the division. The DMOC, a primary staff section for the DISCOM headquarters, interfaces regularly with all division and corps medical units and interfaces closely with the DISCOM staff.

b. Organization. The DMOC is subdivided into four branches: the medical operations branch, the medical materiel management branch, the patient disposition and reports branch, and the medical communications branch.

c. Medical Operations Branch. The medical operations branch:

(1) Plans and ensures that Echelons I and II CHS for the division conforms to doctrine.

(2) Develops and maintains division medical troop basis to ensure task organization for mission accomplishment.

(3) Ensures that division standing operating procedures (SOP), plans, policies, and CHS procedures are prepared and executed.

(4) Coordinates and directs patient evacuation from division to corps.

(5) Monitors medical training and provides information to the division surgeon.

(6) Coordinates movement of enemy prisoners of war (EPW) casualties.

d. Medical Material Management Branch. The medical material management branch:

(1) Plans, coordinates, and prioritizes medical logistics and medical equipment maintenance programs for the division.

(2) Provides the medical logistics input to the CHS plan.

(3) Monitors the theater army medical management information system (TAMMIS), emergency medical supply requests to the medical logistics battalion, and DMSO operations.

(4) Establishes and maintains the medical critical items list.

(5) Monitors division medical maintenance programs.

(6) Establishes priorities for division blood requirements.

(7) Determines the medical logistics support package requirements.

(8) Manages the disposition of captured medical materials.

e. Medical Communications Branch. The medical communications branch:

(1) Operates radio and wire communications.

(2) Coordinates communications with the DISCOM communications branch and the signal battalion.

(3) Establishes and maintains amplitude modulation (AM) and frequency modulation (FM) improved high-frequency radio communications with subordinate medical companies and supporting corps medical units.

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