Trauma- Focused Individual Training Revised and Updated January 2005

Infantry Unit of Action Design X Numbers are adjusted as documentation is refined Approved Infantry BCT 3,385 IN BCT 10/0/9/19 I I BCT HHC I I I I I I FIRES I I SPT I I 298 122 1,598 (799 X2) 471 405 491 RSTA BTB HHC C2 Enhancements Increased staff Surg Sec 2/0/1/3 Deputy Cdr MP PLT JFIRES (ECOORD, NLEC, JTACP) SUAV HQ TX TM 1/0/4/5 SIG Co TOC NODAL Plt SIG SPT Plt NET OPS Tm MI Co ISR Analysis Plt 0/0/1/1 ISR Integration Plt HUMINT Sec 1 Common Ground Station EN Co EN Plt x 2 Equip Section Surveillance Trp 0/0/4/4 TUAV Plt Ground Support Radar Plt Multi Sensor Plt (PROPHET, GSR) CDR Dep CDR CP1 CP2 Chaplain PAO HHC 3 x Rifle Co 3 x Rifle Plt Weapons Co 4 x Plt Forward Support Co 3/0/47/50 HHT Motorized Recon Trp (2) Dismounted Recon Trp Forward Support Co 3/0/34/37 HHB TA PLT (1 Q36) TUAV Firing Btry x 2 (2x8) 105mm (T) Forward Support Co 2/0/15/17 HHC Enhanced Staff Disto CO Add drivers Trans Plt Maint CO Med CO 2/0/2/4 11/0/69/80 Two Inf Bns used as start point Provides LRAS3-equipped Recon Capability Applied current systems to enable “Quality of Firsts” ISR teams: Brigade TUAV, PROPHET, Ground Surveillance Radar, SUAV, Bde Recon Squadron w/2 Mounted Recce Trp, 1 Dismounted, 1 Surveillance Trp Infantry Squads: 72 (54 Rifle, 18 Weapons) Sniper: 3 (10man Tms) Infantry: 744 (72 squads x 9 + 12 wheeled assault squads x 8) Recon Tms: 30 ITAS/TOW: 12 Javelin: 60 MK19:60 105MM(T): 16 120MM Mortars: 12 81mm: 8

INF Brigade Combat Team RSTA Squadron Medical Platoon HHT MED PLT HQ 1/0/1/2 TREATMENT SQUAD EVAC SECTION CBT MEDIC SECTION 2/0/6/8 0/0/18/18 0/0/9/9 3/0/34/37

INF Brigade Combat Team RSTA Squadron Medical Platoon HQs MED PLT HQ 2 Fld Med Asst PLT SGT RSTA has same requirements as other aid stations. Therefore one Type IIIa will suffice. 1/0/1/2 MC4 AN/TYQ-105 (V) 1 1 AN/TYQ-108 (V) 3 1 PERSONNEL 70BO2 - FLD MED ASST 1 68W4O - PLATOON SGT 1 MAJOR EQUIPMENT HMMWV, CARGO 1 VRC-89F 1 FBCB2 1 BCIS 0 EPLRS 1 GPS 1 D41659 1

INF Brigade Combat Team RSTA Squadron Medical Platoon Treatment Squad 2x4=8 2/0/6/8 PERSONNEL 62BO3 – PLT LDR (SURGEON) 1 65DO3 - PHYSICIANS ASST 1 68W3O- TMT SQD LDR 1 68W2O- EMER TMT NCO 2 68W1O - MEDICAL SPC (E4) 1 68W1O - MEDICAL SPC (E3) 2 TREATMENT TEAM TREATMENT TEAM CBPS CBPS MAJOR EQUIPMENT CBPS 2 MTV 1 TRL, 3/4T 2 TRL, MTV DROPSIDE 1 TRMT SQD should have 2 CBPS trmt platforms w/ trlr and 1 MTV w/trlr Are the M51 shelters going to be removed by AMEDDC&S? Surgeon Med NCO Med NCO PA Med NCO Med SPC Med SPC Med SPC MC4 AN/TYQ-105 (V) 1 8 AN/TYQ-106 (V) 1 2 C4 VRC-92F 2 GPS 3 FBCB2 3 D41659 3 VRC-90F 1 EPLRS 3 BCIS 3

INF Brigade Combat Team RSTA Squadron Evacuation Section NCO Amb Driver SPC MED SPC EVAC SECTION 18 Two Evac Teams (Area Support) 0/0/18/18 MED SPC RECON TROOP RECON TROOP DSMT RECON TROOP HHT EVAC TEAM Amb Driver Evac NCO EVAC TEAM Amb Driver Evac NCO EVAC TEAM Amb Driver Evac NCO MAJOR EQUIPMENT M997 6 EVAC TEAM C4 VRC-90F 6 EPLRS 6 BCIS 6 GPS 6 FBCB2 6 D41659 6 Evac NCO Amb Driver MED SPC MED SPC MED SPC MED SPC MC4 AN/TYQ-105 (V) 1 18 PERSONNEL 68W2O- AIDE/EVAC NCO 5 68W1O - AMB AIDE/DRIVER (E3) 7 68W1O – MED SPC 6

INF Brigade Combat Team RSTA Squadron Combat Medic Section DSMT RECON RECON RECON Platoon Medics CBT Med NCO Platoon Medics CBT Med NCO Platoon Medics CBT Med NCO PERSONNEL 68W30 - EMER CARE SGT 3 68W1O - COMBAT MEDIC(E4) 6 MC4 AN/TYQ-105 (V) 1 9 0/0/9/9

Medical Task Organization as of 20041117

Trauma Focused Individual Training “T-FIT” Instructor Name: Title: Unit:

Why Do We Give a Crap About This? Who is the biggest life-saver on the battlefield?

Him?

YOU!

Why Do We Give a Crap About This? What is the best medicine on the battlefield?

The Best Medicine is Superior Firepower!

Is this squad combat effective?

What this course IS about Teaching basic, practical life-saving techniques that 11B infantrymen can use on the battlefield Teaching not only the “what” but the “why” Breaking some bad habits that we (the medical world) and the Army (i.e. JRTC) have taught you Keeping you doing what infantrymen do best (i.e. killing people and breaking things)

What this course is NOT about Making you an EMT Making you a 91W Making you comfortable starting IV’s

What do we want to do in the next 30 minutes? At the end of this block of instruction, the student will be able to: Identify the major sources and locations of combat injuries and the soldiers most affected. Explain the value of training infantry soldiers to accomplish basic medical tasks. List some examples of “bad habits” to avoid in combat casualty care.

Who gets wounded in war?

Distribution of Wounding in Vietnam by Occupation Infantry - 71.8% of those wounded Artillery - 2.2% of those wounded Direct Correlation between a Lack of Combat Experience and Increased Wounding

Vietnam - Marine Corps Wounded Mean Age - 20.7 years old Distribution by Pay Grade E1 - E3 - 71.2% of those wounded E4 - E6 - 25.6% of those wounded Officers - 2.7% of those wounded

YOU are the most important person when it comes to treating wounded soldiers!

Because nobody else is there in enough time to make a difference! Why? Because nobody else is there in enough time to make a difference!

Time to death after initial wounding

What are the major sources of wounds in combat?

Fragments from exploding anti-tank weapon

M-16 assault rifle 5.56mm GSW (exit)

Causes of Combat Wounds (WWI, WWII, Korea, Vietnam, Middle East)

Where do soldiers get hit?

War Wound Distribution Extremities Chest 13% Upper 21% Lower 35% Abdomen 5% Head & Neck 17% Other 9% Upper Extremities Lower Extremities Abdomen Head & Neck Chest Other

Bottom Line on Wound Location: Extremities Extremity wounds (arms and legs) are the most common. Range from minor to life-threatening. Are a place where you (the 11B) can have a significant impact.

Bottom Line on Wound Location: Head Wounds Head wounds are the second most common combat wound. They are a major source of combat deaths. Generally they are either survivable or not (no matter what you – or your medics - do).

Bottom Line on Wound Location: Torso Wounds Torso wounds are the third most common. They are (like head wounds) a major source of combat deaths. There are certain ones you can impact.

What can YOU do to keep yourself or your soldiers alive?

While on patrol, your arm is hit by an RPG 11

What to do with a hole in your arm? Sit down, pull out your MILES card and wait for the OC to come assess you. Scream “medic, medic” and wait for your platoon medic to arrive. Kiss your ass goodbye, you’re going to die. Have a combat lifesaver start an IV. Apply a tourniquet.

Answer: E. And the soldier lived. Massive soft tissue injury from RPG Indent from Tourniquet Answer: E. And the soldier lived. 11

Trans-Abdominal High Velocity GSW (fatal)

Summary The most common sources of combat wounds are: Fragments Bullets Blast and burns and all other The most common places to get hit are: Arms and legs Head Torso

Summary Who primarily gets wounded/killed in combat Young men ages 18 – 24 Predominantly infantrymen Almost entirely enlisted men with 2nd Lieutenants being at highest risk of death among officers Which wounds most commonly cause death? Head and Chest Wounds Where do most deaths occur? On the battlefield (mostly at the point of wounding and within <5 minutes of wounding) Relatively few die once reaching a hospital

Summary Simple things that you can do to keep yourself or your buddies alive. Stop bleeding – quickly. Keep shooting (the “best medicine”) We need to train and fight smarter Combat is not MILES play IV’s are NOT the bottom line

QUESTIONS?