CHAP 3, 7, 8, 10 HM1 VIDAL

CHAPTER 3

 Health Services Support (HSS) is a mission area common to every Marine Air-Ground Task Force (MAGTF), regardless of mission.  Size, type, and configuration of HSS capabilities is determined by mission, enemy, terrain, weather, troops and support/time available.

MAGTF ELEMENTS  MARINE CORPS FORCES  MARINE EXPEDITIONARY FORCES  MARINE EXPEDITIONARY UNIT  PHASING SUPPORT ASORE  EXTERNAL MAGTF CAPABILITIES

MARINE CORPS FORCES (MARFOR)  Commanders coordinate/integrate HSS within their AOR  MARFOR surgeon, dental officer, medical planner, and medical admin officer advise MARFOR commander on: ◦ Health of command ◦ Medical logistics ◦ Patient movement ◦ Sanitation ◦ Disease surveillance medical intelligence ◦ Medical personnel issues ◦ Current and future HSS planning

MARINE EXPEDITIONARY FORCES (MEF)  Include surgeon, medical planner, admin officer, preventive medicine officer, HMs and DTs.  MARFOR-OPERATIONAL LEVEL  MEF-TACTICAL LEVEL

ELEMENTS OF THE MEF  1. MARINE DIVISION  2. MARINE AIR WING  3. FORCE SERVICE SUPPORT GROUP ◦ Medical Battalion  Surgical Company  Shock Trauma Platoon ◦ Dental Battalion ◦ Medical Logistics Company

ELEMENTS OF THE MEF  MARDIV consists of: ◦ Division surgeon ◦ Medical planner/administrator ◦ Psychiatrist ◦ HMs  Responsibilities are similar to the MEF  Planning occurs on a company or platoon level with HMs assisting

ELEMENTS OF THE MEF  MAW HQ consists of: ◦ Surgeon ◦ Medical planner/administrator ◦ Environmental health officer ◦ Industrial hygienist ◦ Optometrist ◦ HMs  A MAW has four Marine Aircraft Groups (MAGs). ◦ Each MAG has a surgeon and several HMs

ELEMENTS OF THE MEF  FSSG consists of: ◦ Surgeon (has cognizance over the group aid station) ◦ Health Service Support Officer ◦ Medical battalion with three Surg COs and eight STPs ◦ Dental battalion ◦ Supply battalion through Med Log Co

ELEMENTS OF THE MEF FSSG MEDICAL BATTALION  Provides initial resuscitative HSS  Only source of organic USMC medical support above the aid station  Primary mission: perform emergency medical/surgical procedures that, if not performed, could lead to death or loss of limb/body function  260 holding beds and 9 operating rooms  Consists of H&S CO and three Surg COs.  H&S CO contains 8 STPs with 10 holding beds each  Each Surg CO contains 60 beds and 3 operating rooms

MEFFSSGMED BATTALION H&S CO 8 STPs x 10 BEDS A CO 60 BEDS 3 ORs B CO 60 BEDS 3 ORs C CO 60 BEDS 3 ORs DEN BATTALION SUPPLY BATTALION

ELEMENTS OF THE MEF FSSG MEDICAL BATTALION, SURGICAL COMPANY  HQ platoon  Triage/evacuation platoon  Surgical platoon  Holding platoon  Combat stress platoon  Services platoon (2 lab, pharmacy and x-ray sections)  Components of the Surg CO may be used to reinforce an STP

ELEMENTS OF THE MEF FSSG MEDICAL BATTALION, H&S BATTALION, STP  Smallest most mobile medical support platoon  Can serve as ◦ a beach evacuation station ◦ Reinforcement to a BAS ◦ Operate as an intermediate casualty collecting and clearing point ◦ The forward element of a Surg CO

ELEMENTS OF THE MEF FSSG DENTAL BATTALION  Focuses on emergency dental care  Personnel may perform post-op, ward, CSSR duties

ELEMENTS OF THE MEF FSSG SUPPLY BATTALION, MEDICAL LOGISTICS COMPANY  Maintains medical equipment  Maintains centralized acquisition, storing, and stock rotation  Constructs and resupplies AMAL/ADAL

EXTERNAL MAGTF CAPABILITIES FLEET HOSPITALS  Transportable, medically/surgically intensive, deployable.  Substantially self-supporting and relocatable. HOSPITAL SHIPS (T-AH)  Considered a floating surgical hospital.  Provides acute medical care in support of combat operations at sea and ashore.  Support is provided to ATFs, joint task forces, and combined forces.  Designed to receive patients primarily by helicopter.

MARINE EXPEDITIONARY UNIT (MEU)  Each MEU element deploys with its own organic HSS capability  Includes ◦ STPs ◦ H&S CO, medical battalion elements ◦ Med Log CO detachments ◦ Dental detachments ◦ Surg Co (triage/evacuation platoons)

PHASING SUPPORT ASHORE  During the movement phase of amphibious operations, commander, amphibious task force (CATF) has overall responsibility for HSS services.  Landing force (LF) HSS personnel aboard ATF ships augment with MED/DEN departments to provide care to embarked personnel.  LF Class VIIIA equipment and supplies WILL NOT be used aboard ship unless authorized by the MAGTF commander in support of an overwhelming emergency.  Senior medical officer of each ATF ship is responsible to the ship’s commander for HSS to all personnel

EXTERNAL MAGTF CAPABILITIES CASUALTY RECEIVING AND TREATMENT SHIPS  Largest medical capability of any amphibious ship in the ATF.  Medical spaces include operating rooms, ICUs, quiet room, ward beds, and over-flow beds.  Dental spaces include general dental operating rooms, maxillofacial operating room, and a prosthetics lab.  ATF ships used for CRTSs are LHD, LHA and LPHs.

AUGMENTATION FLEET SURGICAL TEAMS  FSTs HSS augmentation teams assigned to the fleet CINCs.  Combined, PAC/LANT fleets have 9 teams  Provide medical support to routine deployment medical requirements.  Medical support for other peacetime contingencies that cannot be covered will be provided MMARTs

AUGMENTATION MOBILE MEDICAL AUGMENTATION READINESS TEAMS  Provide rapid peacetime response teams of pre- identified medical department personnel trained to augment elements of the operating forces.

AUGMENTATION MEDICAL AUGMENTATION PROGRAM  The means by which operating forces are brought to wartime manning levels by personnel augmentation from CONUS-based activities.  MAP is managed by BUMED.  Staffing may be above authorized staffing or in addition to authorized billets when directed by CNO.  Units participating in MAP include CRTSs, MARFOR HSS units, fleet hospitals and hospital ships.

H&S COMPANY 3 SURGICAL COMPANIES

10 BEDS

DENTAL BATTALION, FSSG

FALSE

SUPPLY BATTALION

NINE

MEDICAL AUGMENTATION PROGRAM (MAP)

CHAPTER 7

 Throughout military history, military forces have lost more personnel to disease and nonbattle injuries than to wounds sustained in combat.  During the Civil War, more federal soldiers died from disease than wounds. ◦ 44, 238 KIA ◦ 49, 205 died from wounds ◦ 186,216 died of disease

PRE-DEPLOYMENT Specific preventive medicine taskings and efforts to be conducted before deployment include:  Collect and disseminate environmental and epidemiological information to elements that might be affected.  Recommend immunization and other preventive measures to counter medical threats.  Train individuals in personal hygiene, personal protective measures, protection equipment, and field sanitation practices.  Assists medical units in completing pre-deployment requirements and preparing for embarkation of preventive medicine equipment.

DEPLOYMENT Specific preventive medicine taskings and efforts to be conducted while deployed include:  Disseminate significant information to commanders and HSS units in theater.  Provide technical oversight on food service operations and procurement.  Provide oversight and testing at water points and bulk water storage areas.  Conducting disease vector and pest surveillance and control when feasible.  Maintain environmental health and pest control equipment  Conduct weekly disease and injury surveillance at all battalions and squadrons.

MEF PREVENTIVE MEDICINE SOURCES  MEF surgeon staff includes a preventive medicine officer with special expertise in preventive medicine and public health.  Assets are found in FSSG’s preventive medicine section of the medical battalion’s H&S company.  Support includes identifying information regarding: ◦ Environmental health factors ◦ Demographics ◦ Living conditions ◦ Water supply ◦ Waste disposal ◦ Insects ◦ Diseases and vector issues ◦ Evaluating local food sanitation, sight and hearing conservation programs.

MOBILE MEDICAL AUGMENTATION READINES TEAM  During peacetime, any operational commander may request preventive medicine MMART assistance from the Chief of Naval Operations via the operational chain of command.

NAVY ENVIRONMENTAL HEALTH CENTER Located in Norfolk, VA and supports operational units by conducting:  Risk screening  Data evaluation  Exposure assessments  Toxicity assessments  Health risk evaluations  Health and safety planning  Environmental risk communication workshops and seminars Supporting activities include:  Navy Environmental Preventive Medicine Units  Navy Disease Vector Ecology and Control Centers  Forward Deployed Laboratory

CHAPTER 8

PHASES  When properly followed, the process ensures that patients only move as far rearward as their healthcare needs dictate.  Occurs in 2 phases: ◦ Evacuation: the movement of patients between point of injury or onset of disease to a facility that can provide the necessary treatment capability. ◦ Medical regulating: the process of selecting destination MTFs with the necessary HSS capabilities for patients being medically evacuated.

DECISION MAKING Includes:  Casualty Sorting (Triage) ◦ Identifies which patients need immediate resuscitation and which patients can tolerate delay in treatment.  Medical Management ◦ Controls the flow of sick and wounded.

MEDICAL EVACUATION ASSETS  All USMC rotary wing transport and utility aircraft have the capability to perform aeromedical evacuation (AE) missions.  Allocation of aircraft to perform the AE mission is at the discretion of the MAGTF commander.  Evacuation concepts used by the USMC are defined as the following: ◦ Dedicated medical evacuation assets are patient movement assets configured for medevac, externally marked with a red cross. They are authorized protection under the Geneva Conventions. ◦ Designated medical evacuation assets are non medical patient movement assets, not externally marked with a cross. Not afforded protection under the Geneva Conventions.

EVACUTION MEDICAL REGULATING

TRIAGE

CHAPTER 10

 G-1/S-1 section of a command is responsible for submitting casualty reports to higher headquarters.  HMs are primary sources of individual casualty data.  Casualty reporting in the MARFOR is addressed in the MCO P Marine Corps Casualty Procedures Manual and in other local guidance in the 3040 series.

FIELD MEDICAL CARD  HMs at the unit level provide the first written info on a casualty through the use of a U.S. Field Medical Card (DD Form 1380).  The FMC is a casualty tag where the original is attached to the casualty and a carbon copy is retained by the HM

IDNTIFICATION TAGS (DOG TAGS)  Essential to casualty ID and recording  Every service member is issued 2 tags that should be worn at all times.  Contains member’s name, SSN, blood type, service component, religious preference, and protective mask size.  Both tags remain with casualty at all times except when remains are buried in the combat area. One tag is attached to grave marker and the other remains with the deceased.

HOSPITAL CORPSMAN

FIELD MEDICAL CARD (DD FORM 1380)

FALSE