Contents
Army Health System
Doctrine Smart Book
16 March 2023
Approved for public release; distribution is unlimited.
16 March 2023
AHS Doctrine Smart Book
1
Foreword
As the Army continues to transition from counterinsurgency and counterterrorism to large-scale combat
operations, the United States Army Medical Center of Excellence remains fully committed to promulgating the
Army’s cultural evolution. Training, leadership and education, and force modernization must focus on Army
Health System support to large-scale combat operations in multidomain environments. Doctrine is the
foundation of Army operations and it is imperative that Army Medical personnel understand and incorporate
doctrine as we train to employ our medical capabilities.
Doctrine provides a common language that communicates the mission, functions, and capabilities of units in the
current force and outlines how those capabilities can be employed. The Army Health System Doctrine Smart
Book consolidates this information into one abbreviated publication, which makes it easier to find the most
significant aspects of Army medical doctrine.
Leaders have a responsibility to seek self-development and develop their subordinates through the leadership
and education and training domains. The Army Health System Doctrine Smart Book is a useful tool to energize
Soldiers to seek more detailed information on how we employ medical capabilities in support of Army, joint,
and multinational operations.
With the conflict in Eastern Europe and the prioritization of efforts in the Pacific Region, the strategic
environment has grown increasingly complex, demanding a more agile force that must adapt to operating in a
changing operational environment. We must build on insights and observations to change how we think about,
plan for, and conduct Army Health System support operations. Doctrine will be in a continual state of revision
over the next several years as doctrine developers endeavor to keep up with evolving capability developments
related to providing Army Health System support to the force.
While we cannot predict the future, we can be certain that the force will continue to rely on operational Army
medical forces to preserve Soldier lethality and survivability. Going forward, operational medical forces will
continue to transition in support of the United States Army’s contribution to joint strategic requirements. Our
doctrine will continue to serve as the framework by which we provide medical support; it is incumbent upon
leaders to ensure our doctrine is inculcated into the training, leadership and education, and professional
development of our units, leaders, and Soldiers.
MICHAEL J. TALLEY
MAJOR GENERAL, U.S. ARMY
COMMANDING
This publication is available at the MEDCoE Doctrine Division’s MilSuite site
(https://www.milsuite.mil/book/docs/DOC-609342).
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Headquarters
Medical Center of Excellence
Fort Sam Houston, TX, 16 March 2023
Army Health System
Doctrine Smart Book
Contents
Page
PREFACE....................................................................................................................9
PART ONE
ARMY HEALTH SYSTEM OVERVIEW
Operational Environment ...........................................................................................11
Army Health System Operational Framework ...........................................................11
Tactical Combat Casualty Care (Army) (FM 4-02) ....................................................14
Army Health System Principles (FM 4-02) ................................................................16
Roles of Medical Care (Army) (FM 4-02) ..................................................................18
Medical Functions (FM 4-02) .....................................................................................22
PART TWO
ARMY HEALTH SYSTEM DOCTRINE HIERARCHY AND SUMMARIES
Army Health System Publications by Medical Function ............................................35
PART THREE ARMY HEALTH SYSTEM UNIT SYNOPSIS
Army Command and Support Relationships .............................................................67
Theater Medical Command .......................................................................................70
Medical Command (Deployment Support) ................................................................75
Medical Brigade (Support) .........................................................................................80
Medical Battalion (Multifunctional) .............................................................................84
Hospital Center ..........................................................................................................87
Field Hospital (32-bed) ..............................................................................................94
Hospital Augmentation Detachment (Surgical 24-bed) ...........................................102
Hospital Augmentation Detachment (Medical 32-bed) ............................................106
Hospital Augmentation Detachment (Intermediate Care Ward 60-bed) .................110
Medical Detachment, Minimal Care ........................................................................113
Hospital Augmentation Team, Head and Neck .......................................................116
Medical Detachment, Forward Resuscitative and Surgical (FRSD)........................118
Medical Detachment (Prolonged Care Augmentation Detachment) (FY25) ...........123
Medical Company (Area Support) ...........................................................................126
Medical Company (Ground Ambulance) .................................................................129
Medical Company, Air Ambulance (15 Aircraft) ......................................................131
Medical Logistics Management Center ...................................................................133
Medical Logistics Company .....................................................................................136
Medical Detachment, Blood Support .......................................................................140
Medical Detachment, Optometry .............................................................................143
Dental Company (Area Support) .............................................................................145
Medical Detachment (Veterinary Services) .............................................................148
Medical Detachment, Combat and Operational Stress Control .............................152
Medical Detachment, Preventive Medicine .............................................................155
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Area Medical Laboratory / Medical Detachment, Global Medical Field
Laboratory ............................................................................................................... 157
Brigade Support Medical Company (Airborne, Armor, Infantry, and Stryker) ......... 161
Medical Platoon ....................................................................................................... 165
Medical Sections/Squad .......................................................................................... 168
Medical Teams ........................................................................................................ 170
PART FOUR THE ARMY HEALTH SYSTEM IN SUPPORT OF THE COMPETITION
CONTINUUM
Army Health System Support to the Competition Continuum ................................. 177
Competition Below Armed Conflict .......................................................................... 183
Crisis ........................................................................................................................ 200
Armed Conflict ......................................................................................................... 215
Appendix A
Army Health System Terms .................................................................................. 235
Appendix B
Army Health System Symbology ......................................................................... 242
Appendix C
The Surgeon and Surgeon Section at Echelon .................................................. 253
Appendix D
Joint Medical Capabilities .................................................................................... 279
References .............................................................................................................. 279
United States Armed Forces Roles of Care Comparision ....................................... 279
Joint Evacuation Capabilities .................................................................................. 288
Appendix E
Health Information Systems ................................................................................. 293
Glossary .......................................................................................................................................... 297
Section I – Acronyms and Abbreviations ........................................................... 297
Figures
Figure 1-1. Army Health System Logic Chart ................................................................................ 12
Figure 1-2. Army Health System Operational Framework ............................................................. 13
Figure 1-3. Army Roles of Care ..................................................................................................... 19
Figure 1-4. The Army Health System Medical Functions ............................................................... 23
Figure 3-1. HHC, Theater Medical Command Task Organization ................................................. 74
Figure 3-2. Notional Deployed Theater Medical Command ........................................................... 74
Figure 3-3. HHC, Medical Command (Deployment Support) Task Organization .......................... 79
Figure 3-4. HHC, Medical Brigade (Support) Task Organization ................................................... 83
Figure 3-5. HHD, Medical Battalion (Multifunctional) Task Organization ....................................... 86
Figure 3-6. HHD Hospital Center Task Organization ..................................................................... 90
Figure 3-7. Hospital Center Configurations .................................................................................... 91
Figure 3-8. Hospital Center Command and Control ....................................................................... 92
Figure 3-9. Hospital Center Task Organization .............................................................................. 92
Figure 3-10. Notional 240 bed hospital center configuration ......................................................... 93
Figure 3-11. Notional Field Hospital (32-bed) Configuration........................................................ 100
Figure 3-12. Field Hospital (32-bed) Task Organization .............................................................. 101
Figure 3-13. Hospital Augmentation Detachment (Surgical 24-bed) Task Organization ............. 105
Figure 3-14. Hospital Augmentation Detachment (Medical 32-bed) Task Organization ............. 109
Figure 3-15. Hospital Augmentation Detachment (ICW 60-bed) Task Organization ................... 112
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Figure 3-16. Minimal Care Detachment (120-Cot) Task Organization.........................................115
Figure 3-17. Complete Forward Resuscitative Surgical Detachment Task Organization ............121
Figure 3-18. Split-Based Forward Resuscitative Surgical Detachment Task Organization .........121
Figure 3-19. Prolonged Care Augmentation Detachment Task Organization (FY25) .................125
Figure 3-20. Medical Company (Area Support) Task Organization .............................................128
Figure 3-21. Medical Company (Ground Ambulance) Task Organization ...................................130
Figure 3-22. Medical Company (Air Ambulance) Task Organization ...........................................132
Figure 3-23. Medical Logistics Management Center Task Organization (FY25) .........................135
Figure 3-24. Medical Logistics Company Task Organization .......................................................139
Figure 3-25. Medical Detachment, Blood Support Task Organization .........................................142
Figure 3-26. Medical Detachment, Optometry Task Organization ...............................................144
Figure 3-27. Dental Company (Area Support) Task Organization ...............................................147
Figure 3-28. Medical Detachment (Veterinary Services) Task Organization ...............................151
Figure 3-29. Combat and Operational Stress Control Task Organization ...................................154
Figure 3-30. Medical Detachment, Preventive Medicine Task Organization ...............................156
Figure 3-31. Area Medical Laboratory Task Organization (Current) ............................................160
Figure 3-32. Global Medical Field Laboratory Task Organization (FY25)....................................160
Figure 3-33. Brigade Support Medical Company (IBCT) Task Organization ...............................164
Figure 3-34. Medical Platoon Task Organization .........................................................................167
Figure 3-35. Notional Medical Section Task Organization ...........................................................169
Figure 4-1. Army strategic contexts and operational categories ..................................................177
Figure 4-2. Army Health System support to the Army strategic context competition ...................179
Figure 4-3. Army Health System support to the Army strategic context crisis .............................181
Figure 4-4. Army Health System support to the Army strategic context armed conflict ...............183
Figure 4-5. Medical Command and Control in Competition .........................................................186
Figure 4-6. Operational Public Health in Competition ..................................................................187
Figure 4-7. Veterinary Services in Competition ............................................................................189
Figure 4-8. COSC in Competition.................................................................................................190
Figure 4-9. Dental Services in Competition ..................................................................................191
Figure 4-10. Laboratory Services in Competition .........................................................................192
Figure 4-11. Medical Treatment in Competition ...........................................................................193
Figure 4-12. Hospitalization in Competition .................................................................................194
Figure 4-13. Medical Evacuation in Competition ..........................................................................196
Figure 4-14. Medical Logistics (Class VIIIa) in Competition ........................................................198
Figure 4-15. Medical Logistics (Class VIIIb) in Competition ........................................................199
Figure 4-16. Medical Maintenance in Competition .......................................................................199
Figure 4-17. Medical Command and Control in Crisis .................................................................202
Figure 4-18. Operational Public Health in Crisis ..........................................................................203
Figure 4-19. Veterinary Services in Crisis ....................................................................................204
Figure 4-20. COSC in Crisis .........................................................................................................205
Figure 4-21. Dental Services in Crisis ..........................................................................................206
Figure 4-22. Laboratory Services in Crisis ...................................................................................207
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Figure 4-23. Medical Treatment in Crisis ..................................................................................... 208
Figure 4-24. Hospitalization in Crisis ............................................................................................ 210
Figure 4-25. Medical Evacuation in Crisis .................................................................................... 211
Figure 4-26. Medical Logistics (Class VIIIa) in Crisis ................................................................... 214
Figure 4-27. Medical Logistics (Class VIIIb) in Crisis ................................................................... 214
Figure 4-28. Medical Maintenance in Crisis ................................................................................. 215
Figure 4-29. Medical Command and Control in Armed Conflict .................................................. 219
Figure 4-30. Operational Public Health in Armed Conflict .......................................................... 220
Figure 4-31. Veterinary Services in Armed Conflict ..................................................................... 221
Figure 4-32. COSC in Armed Conflict .......................................................................................... 222
Figure 4-33. Dental Services in Armed Conflict ........................................................................... 223
Figure 4-34. Laboratory Services in Armed Conflict .................................................................... 224
Figure 4-35. Medical Treatment in Armed Conflict ...................................................................... 226
Figure 4-36. Hospitalization in Armed Conflict ............................................................................. 229
Figure 4-37. Medical Evacuation in Armed Conflict ..................................................................... 231
Figure 4-38. Medical Logistics (Class VIIIa) in Armed Conflict .................................................... 232
Figure 4-39. Medical Logistics (Class VIIIb) in Armed Conflict .................................................... 233
Figure 4-40. Medical Maintenance in Armed Conflict .................................................................. 233
Figure C-1. Surgeon link to medical and warfighting functions .................................................... 253
Figure C-2. Medical function alignment to Army warfighting functions ........................................ 254
Figure C-3. Surgeon and protection/sustainment cell coordination and synchronization matrix . 256
Figure C-4. BCT AHS coordination, synchronization, and execution relationships ..................... 266
Figure D-1. United States Military Roles of Care Service Comparison ....................................... 280
Tables
Table 1-1. Medical command and control function (primary tasks and purposes) (FM 4-02) ....... 24
Table 1-2. Medical treatment (organic and area support) function (primary tasks and purposes)
(FM 4-02) ...................................................................................................................... 25
Table 1-3. Hospitalization function (primary tasks and purposes) (FM 4-02) ................................ 26
Table 1-4. Medical evacuation function (primary tasks and purposes) (FM 4-02) ......................... 27
Table 1-5. Medical logistics function (primary tasks and purposes) (FM 4-02) ............................. 27
Table 1-6. Operational public health function (primary tasks and purposes) (FM 4-02) ................ 28
Table 1-7. Veterinary services function (primary tasks and purposes) (FM 4-02) ......................... 29
Table 1-8. Veterinary services treatment (primary tasks and purposes) (FM 4-02) ...................... 29
Table 1-9. Combat & operational stress control function (primary tasks & purposes) (FM 4-02) .. 30
Table 1-10. Behavioral health/neuropsychiatric treatment (primary tasks & purposes)
(FM 4-02) ...................................................................................................................... 30
Table 1-11. Preventive dentistry (primary tasks and purposes) (FM 4-02).................................... 31
Table 1-12. Dental services function (primary tasks and purposes) (FM 4-02) ............................. 31
Table 1-13. Medical laboratory services function (primary tasks and purposes) (FM 4-02) .......... 31
Table 1-14. Clinical laboratory services (primary tasks and purposes) (FM 4-02) ........................ 32
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Table 3-1. Army command and support relationships....................................................................68
Table 3-2. Army support relationships ...........................................................................................69
Table 3-1. Hospital Center Fuel Consumption, Space, and Transportation Requirements ...........91
Table 4-1. List of abbreviations for Figures 4-1 through 4-40 ......................................................175
Table C-1. Coordination between surgeon/surgeon section and staff elements .........................257
Table C-2. Medical reports ...........................................................................................................258
Table C-3. Brigade combat team surgeon section .......................................................................261
Table C-4. Combat aviation brigade surgeon section ..................................................................261
Table C-5. Division sustainment brigade surgeon section ...........................................................262
Table C-6. Security forces assistance brigade surgeon section ..................................................262
Table C-7. Field artillery brigade surgeon section ........................................................................262
Table C-8. Engineer brigade surgeon section ..............................................................................262
Table C-9. Military police brigade surgeon section ......................................................................262
Table C-10. Signal brigade surgeon section ................................................................................263
Table C-11. Sustainment brigade surgeon section ......................................................................263
Table C-12. Maneuver enhancement brigade surgeon section ...................................................263
Table C-13. Military intelligence expeditionary brigade surgeon section .....................................263
Table C-14. Medical brigade clinical operations section ..............................................................264
Table C-15. Special Forces group surgeon section .....................................................................264
Table C-16. Ranger regiment surgeon section ............................................................................265
Table C-17. Aviation regiment (special operations) surgeon section...........................................265
Table C-18. Civil affairs brigade surgeon section ........................................................................265
Table C-19. Psychological operations group surgeon section .....................................................266
Table C-20. Division surgeon section and support area command post .....................................270
Table C-21. Corps surgeon section..............................................................................................273
Table C-22. Theater medical command clinical services and force health protection section ....273
Table C-23. Theater sustainment command surgeon section .....................................................273
Table C-24. Expeditionary sustainment command surgeon section ............................................274
Table C-25. Chemical biological, radiological, and nuclear command surgeon section ..............274
Table C-26. Army Surgeon Section, Variant 1 .............................................................................276
Table C-27. Army Surgeon Section, Variant 2 .............................................................................276
Table C-28. Army Surgeon Section, Variant 3 .............................................................................277
Table C-29. Army Surgeon Section, Variant 4 .............................................................................277
Table C-30. Army Surgeon Section, Variant 5 .............................................................................277
Table C-31. Army Surgeon Section, Variant 6 .............................................................................278
Table C-32. Army Surgeon Section, Variant 7 .............................................................................278
Table D-1. United States Army medical and casualty evacuation capabilities ............................289
Table D-2. United States Navy and Marine Corps casualty evacuation capabilities ...................289
Table D-3. United States Navy ship capabilities and staffing ......................................................290
Table D-4. United States Air Force aircraft capacities .................................................................291
Table E-1. Theater Medical Information Program-Joint (TMIPS-J) Applications .........................293
Table E-2. Other system applications ..........................................................................................294
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Table E-3. Sample health information system training strategy................................................... 295
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Preface
Preface
The Army Health System Doctrine Smart Book is a concise collection of Army Health System summaries
that reflects current approved doctrine.
Part One provides a summary of the Army Health System and its ten medical functions.
Part Two provides a visual representation of the Army Health System’s doctrinal hierarchy and its
corresponding Army and joint doctrine. It illustrates the hierarchy as it applies to the Joint Publication 402, Joint Health Services; Field Manual 4-02, Army Health System; and Army Health System Army
techniques publications. It follows on with one-page synopses of each current approved Army Health
System doctrinal publication. Each synopsis contains the characteristics, fundamentals, terms, and ideas as
they are discussed in each publication.
Part Three consists of doctrinal synopsis of each Army Health System unit. Each synopsis contains the
table of organization and equipment, task organization, personnel breakdown, and doctrinal employment as
they are portrayed in the approved Section 1 and discussed in various Army Health System doctrinal
publications.
Part Four discusses the Army Health System by the Army’s contribution (competition below armed conflict,
crisis, and armed conflict) to the joint strategic context (cooperation, competition below armed conflict,
and armed conflict).
Appendix A depicts the Army terms that the United States Army Medical Center of Excellence (MEDCoE)
is the proponent for.
Appendix B depicts approved Army Health System symbology.
Appendix C depicts the surgeon and surgeon sections at echelon.
Appendix D depicts Joint Roles of Care and evacuation capabilities and capacities.
Appendix E depicts health information system descriptions and training strategy.
The principal audience for this publication is all readers of Army Health System doctrine—military, civilian,
and contractor.
This publication uses Department of Defense terms where applicable.
The proponent and preparing agency of the Army Health System Doctrine Smart Book is the MEDCoE,
Doctrine Division. Send questions, comments, and recommendations to Commander, MEDCoE, ATTN:
ATMC-FD (Doctrine Division), 2377 Greeley Road, Joint Base San Antonio, Fort Sam Houston, Texas
78234-7731 or by e-mail to usarmy.jbsa.medical-coe.mbx.ameddcs-medical-doctrine@army.mil.
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Army Health System
PART ONE
ARMY HEALTH SYSTEM OVERVIEW
The Army Health System (AHS) is a component of the Military Health System (MHS)
that is responsible for operational management of the force health protection (FHP)
and health service support (HSS) missions for training, predeployment, deployment,
and post deployment operations. Army Health System includes all mission support
services performed, provided, or arranged by the operational medicine forces to
support FHP and HSS mission requirements for the Army and as directed, for joint,
intergovernmental agencies, coalition, and multinational forces. The AHS is a
complex system of systems that is interdependent and interrelated and requires
continual planning, coordination, and synchronization to clear the battlefield of
casualties effectively and efficiently and to provide the highest standard of care to our
wounded or ill Soldiers.
OPERATIONAL ENVIRONMENT
1-1. The future operational environment (OE) and our forces’ challenges to operate across the range of
military operations represents the most significant readiness requirement. The logic chart (Figure 1-2 on
page 13) begins with an anticipated OE that includes considerations during large-scale combat operations
(LSCO) against a peer threat. Next, it depicts the Army's contribution to joint operations through the Army’s
strategic roles. Within each phase of a joint operation, the Army's operational concept of unified land
operations guides how Army forces conduct operations. In large-scale ground combat, Army forces
combine offensive, defensive, and stability tasks to seize, retain, and exploit the initiative in order to shape
OEs, prevent conflict, conduct large-scale ground combat, and consolidate gains. The philosophy of mission
command guides commanders, staffs, and subordinates in their approach to operations. The command and
control (C2) warfighting function enables commanders and staffs at echelon to coordinate, synchronize, and
integrate combat power across multiple domains to achieve unity effort. Throughout operations, Army
forces maneuver to achieve and exploit positions of relative advantage across all domains to achieve
objectives and accomplish missions.
1-2. The AHS logic chart depicts how operational medicine forces support the maneuver force with
medical C2, FHP, and HSS mission requirements when operating within the competition continuum.
Operational medicine forces provide AHS support to the Army and as directed, for joint, inter-governmental
agencies, coalition, and multinational forces in support of the competition continuum. For more information
on AHS support to the Army strategic roles (contexts), refer to Field Manual (FM) 4-02, Appendix B.
ARMY HEALTH SYSTEM OPERATIONAL FRAMEWORK
1-3. The AHS operational framework expounds on the AHS logic chart by depicting each operational
medicine formation and where it most likely located at echelon in support of armed conflict (see Figure 11 on the page 12). The figure illustrates the AHS principles (conformity, proximity, flexibility, mobility,
continuity, and control) and the medical C2 required to support maneuver forces. For example, the medical
units located in the division support area are not organic to the division and are dotted icons to represent the
possibility that medical capabilities can have a command and support relationship at all echelons in order to
be positioned to best support mission requirements.
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Part One
Figure 1-1. Army Health System Logic Chart
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Figure 1-2. Army Health System Operational Framework
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Part One
TACTICAL COMBAT CASUALTY CARE (ARMY) (FM 4-02)
1-4. Tactical combat casualty care (TCCC) is divided into the three phases- care under fire, tactical field
care, and tactical evacuation care. Tactical combat casualty care occurs during a combat mission and is the
military counterpart to prehospital emergency medical treatment. Tactical combat casualty care in the
military is most commonly provided by enlisted personnel and includes self-aid and buddy aid (first aid),
combat lifesaver (enhanced first aid), and enlisted combat medics and critical care flight paramedics in the
Army, corpsmen in the United States Navy (USN), United States Marine Corps, and United States Coast
Guard, and both medics and pararescue men in the United States Air Force (USAF). Tactical combat
casualty care focuses on the most likely threats, injuries, and conditions encountered in combat and on a
strictly limited range of interventions directed at the most serious of these threats and conditions.
CARE UNDER FIRE
1-5. In the care under fire phase, combat medical personnel and their units are under effective hostile fire
and are very limited in the care they can provide. In essence, only those lifesaving interventions that must
be performed immediately are undertaken during this phase.
TACTICAL FIELD CARE
1-6. During the tactical field care phase, medical personnel and their patients are no longer under effective
hostile fire and medical personnel can provide more extensive patient care. In this phase, interventions
directed at other life-threatening conditions, as well as resuscitation and other measures to increase the
comfort of the patient may be performed. Physicians and physician assistants at battalion aid stations or
during tailgate medicine support also provide TCCC. During tactical field care, personnel must be prepared
to transition back to care under fire, or to prepare the casualty for tactical evacuation, as the tactical situation
dictates. Tailgate medical support refers to an economy of force device employed primarily to retain
maximum mobility during movement halts or to avoid the time and effort required to set up a formal,
operational treatment facility (for example, during rapid advance and retrograde operations). For more
information on tactical field care see ATP 4-02.4 and ATP 4-02.6.
TACTICAL EVACUATION
1-7. In the tactical evacuation phase, casualties are transported from the battlefield to medical treatment
facilities (MTFs). Medical treatment facility refers to any facility established for the purpose of providing
medical treatment. This includes battalion aid stations, Role 2 facilities, dispensaries, clinics, and hospitals.
Evacuation can be by either medical evacuation (MEDEVAC) (dedicated platforms [ground or air] manned
with dedicated medical providers) or casualty evacuation (CASEVAC) (ranging from nondedicated, but
tasked, platforms [ground or air] augmented with medical equipment and providers to platforms of
opportunity without medical equipment or providers).
Note. The TCCC initiative originated with the Naval Special Warfare Command and later
continued by the United States Special Operations Command. Special operations forces do not
have a dedicated, designed, and equipped MEDEVAC capability. Therefore, they use
nonmedical platforms augmented with medical personnel to perform the evacuation function.
Tactical evacuation is not used within conventional Army forces. The approved doctrinal
categories of CASEVAC and MEDEVAC as defined throughout Army doctrine has not changed,
however, during this phase of TCCC both types of evacuation occur, depending upon the
availability of assets and the time window available to execute the evacuation process. Time is
of the essence to evacuate as quickly as possible in order to clear the battlefield and return
Soldiers to duty as far forward as possible. When the patient cannot be returned to duty, they
continue moving through the continuum of care to where further treatment can be provided.
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CASUALTY EVACUATION
1-8. Casualty evacuation is the movement of casualties aboard nonmedical vehicles or aircraft without en
route medical care. Also called CASEVAC (ATP 4-02.13). Casualty evacuation encompasses a wide
spectrum of potential capability- depending on the mix of transport platform, medical equipment, and
medical providers allocated to the mission. At the upper end of the spectrum, nondedicated platforms can
be outfitted with the requisite medical equipment and MEDEVAC assets. At the lower end of the spectrum,
CASEVAC can be no more than the transport of casualties using platforms of opportunity with no medical
equipment or medical providers (in using such assets, the risk of not moving the casualty must outweigh the
risk evacuating him/her in such a manner). Effective CASEVAC complements MEDEVAC by providing
additional evacuation capacity when number of casualties (workload) or reaction time exceeds the
capabilities of MEDEVAC assets. Casualty evacuation requires detailed assessment and planning in order
to achieve an effective integration of MEDEVAC and CASEVAC capabilities. Casualties transported in
CASEVAC platform may not receive proper en route medical care or be transported to the appropriate MTF
that can best address the casualty’s medical needs. This may have an adverse impact on the casualty’s
prognosis, long-term disability or even death may result. For more information on CASEVAC, refer to ATP
4-02.13. For more information on MEDEVAC, refer to ATP 4-02.2.
MEDICAL EVACUATION
1-9. Medical evacuation is the timely and effective movement of the wounded, injured, or ill to and
between MTFs on dedicated and properly marked medical platforms with en route care provided by medical
personnel. Also called MEDEVAC (ATP 4-02.2). A patient is a sick, injured or wounded individual who
receives medical care or treatment from medically trained personnel.
1-10. The Army MEDEVAC system is comprised of dedicated, standardized MEDEVAC platforms
(ground and air ambulances). These ambulances have been designed, staffed, and equipped to provide en
route medical care to patients being evacuated and are used exclusively to support the medical mission, in
accordance with the law of land warfare and the Geneva Conventions. The focus of the MEDEVAC mission
coupled with the dedicated ambulances permit a rapid response to calls for medical support. The provision
of en route care on medically equipped vehicles or aircraft greatly enhances the patient’s potential for
recovery and may reduce long-term disability by maintaining the patient’s medical condition in a more
stable manner. En route care refers to the care required to maintain the phased treatment initiated prior to
evacuation and the sustainment of the patient’s medical condition during evacuation (ATP 4-02.2).
1-11. The United States Army is tasked with providing intratheater aeromedical evacuation (AE) as the
only Service with dedicated air ambulances. The United States Army provides intratheater AE to all land
maneuver forces (once ashore) and also provides support to ship-to-shore and shore-to-ship patient
movement requirements.
1-12. The USAF AE system operates within the “operational or theater strategic” environment and provides
the vital linkage between the roles of care for regulated patients over extended distances and to continental
United States (CONUS) for final patient disposition. The USAF AE is performed by designated fixed-wing
platforms configured with standardized medical equipment and staffed with medical professionals who
provide the timely, efficient movement and en route care of the wounded, injured, or ill personnel. The
standardization of equipment and medical professionals aboard USAF AE assets ensures the continuity of
care between roles of medical care. For these reasons, USAF AE is the sole provider of patient movement
from Role 3 to Role 4 and is the preferred means of patient movement over great distances within a given
area of operations (AO). Patient movement is the act of moving a sick, injured, wounded, or other person
to obtain medical and/or dental treatment. Functions include medical regulating, patient evacuation, and en
route medical care (ATP 4-02.2). For more information on AE, refer to DODD 5100.01, JP 4-02, and ATP
4-02.2.
PATIENT EVACUATION
1-13. In today’s OE, the reduced medical footprint forward places a high demand on en route care
capabilities. Consequently, patient evacuation capabilities are even more critical than in the past and the
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Part One
United States Army in coordination with the other Service medical elements must integrate with lift
operations, as well as with the associated capabilities of multinational forces.
ARMY HEALTH SYSTEM PRINCIPLES (FM 4-02)
1-14. The principles of the AHS are the foundation—enduring fundamentals—upon which the delivery of
health care in a field environment is founded. The principles guide medical planners in developing operation
plans (OPLANs) which are effective, efficient, flexible, and executable. AHS plans are designed to support
the operational commander’s scheme of maneuver while still retaining a focus on the delivery of health
care.
1-15. The AHS principles apply across all medical functions and are synchronized through medical mission
command and close coordination and synchronization of all deployed medical assets through medical
technical channels.
CONFORMITY
1-16. Conformity with the operation order (OPORD) is the most basic element for effectively providing
AHS support. In order to develop a comprehensive concept of operations, the medical commander must
have direct access to the operational commander. AHS planners must be involved early in the planning
process to ensure that we continue to provide AHS support in support of the Army’s strategic roles of shape,
prevent, LSCO, and consolidate gains. Once the plan is established it must be rehearsed with the forces it
supports. In operations with a preponderance of stability tasks, it is essential that AHS support operations
are in consonance with the combatant commander’s (CCDR’s) area of responsibility (AOR) engagement
strategy and have been thoroughly coordinated with the supporting assistant chief of staff, civil affairs (CA).
PROXIMITY
1-17. Proximity is to provide AHS support to sick, injured, and wounded Soldiers at the right time and the
right place and to keep morbidity and mortality to a minimum. AHS support assets are placed within
supporting distance of the maneuver forces which they are supporting, but not close enough to impede
ongoing operations. To support the operational commander’s plan, it is essential that AHS assets are
positioned to rapidly locate, acquire, treat, stabilize, and evacuate combat casualties. Peak workloads for
AHS resources occur during combat operations.
FLEXIBILITY
1-18. Flexibility is being prepared to, and empowered to, shift AHS resources to meet changing
requirements. Changes in plans or operations make flexibility in AHS planning and execution essential. In
addition to building flexibility into the OPLAN to support the commander’s scheme of maneuver, the
medical commander must also ensure that he has the flexibility to rapidly transition from one level of
violence to another across the range of military operations. As the current era is one characterized by
persistent conflict, the medical commander may be supporting simultaneous actions characterized by
different decisive actions, such as offensive, defensive, or stability tasks. The medical commander exercises
his command authority to effectively manage his scarce medical resources so that they benefit the greatest
number of Soldiers in the AO. For example, there are insufficient numbers of forward resuscitative and
surgical detachments (FRSDs) to permit the habitual assignment of these organizations to each brigade
combat team ( BCT). Therefore, the medical commander, in conjunction with the command surgeon,
closely monitors these valuable assets so that he can rapidly reallocate or recommend the reallocation of
this lifesaving skill to the BCTs in contact with the enemy and where the highest number of Soldiers will
potentially receive traumatic wounds and injuries. Prolonged combat, intense engagements, and LSCO
diminish unit combat effectiveness. When a medical unit is degraded to become combat ineffective and no
longer able to provide AHS support effectively, reconstitution may be required.
1-19. Reconstitution consists of those actions that commanders plan and implement to restore units to a
desired level of combat effectiveness commensurate with mission requirements and available resources
(ATP 3-21.20). Reconstitution may include—removing a unit from combat; replenishing it with external
assets; reestablishing a chain of command; training a unit for future operations; and reestablishing unit
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cohesion. Reconstitution operations include reorganization and regeneration. For more information on
reconstitution, refer to FM 4-95 (reconstitution doctrine) and ADP 3-90.
1-20. Reorganization is the action to shift resources within a degraded unit to increase its combat
effectiveness. Medical commanders use reorganization to restore capability and improve HSS effectiveness
within a degraded unit. Reorganization is possible at tactical level.
1-21. Regeneration is the rebuilding of a unit. It requires large-scale replacement of personnel, equipment,
and supplies. Medical units also undergo regeneration and are rebuilt through large-scale replacement of
personnel, equipment, and Class VIII resupply. Regeneration requires support from higher, is time
sensitive, and more resource intensive.
1-22. Maximizing the return to duty rate of injured or ill personnel in forward operating units is a major
portion of the AHS contribution to the reconstitution effort. Maximizing the return to duty rate of combat
Soldiers contributes to the pool of personnel available for reconstitution of degraded units.
MOBILITY
1-23. Mobility is the principle that ensures that AHS assets remain in supporting distance to support
maneuvering forces. The mobility, survivability (such as armor plating), and sustainability of AHS units
organic to maneuver elements must be equal to the forces being supported. Major AHS headquarters (HQs)
in EAB continually assess and forecast unit movement and redeployment. AHS support must be continually
responsive to shifting medical requirements in an OE. In noncontiguous operations, the use of ground
ambulances may be limited depending on the security threat in unassigned areas and air ambulance use may
be limited by environmental conditions and enemy air defense threat. Therefore, to facilitate a continuous
evacuation flow, MEDEVAC must be a synchronized effort to ensure timely, responsive, and effective
support is provided to the tactical commander. The only means available to increase the mobility of AHS
units is to evacuate all patients they are holding. AHS units anticipating an influx of patients must medically
evacuate patients they have on hand prior to the start of the engagement.
CONTINUITY
1-24. Continuity in care and treatment is achieved by moving the patient through progressive, phased roles
of care, extending from the POI or wounding to the CONUS-support base. Continuity of care refers to an
attempt to maintain the role of care during movement at least equal to the care provided at the preceding
facility (FM 4-02.) Each type of AHS unit contributes a measured, logical increment in care appropriate to
its location and capabilities. In recent operations, lower casualty rates, availability of rotary-wing air
ambulances, and other mission, enemy, terrain and weather, troops and support available, time available,
civil considerations, and informational considerations (METT-TC (I)) factors often enable a patient to be
evacuated from the POI directly to the supporting Role 3 hospital. In more traditional operations, higher
casualty rates, extended distances, and patient condition may necessitate that a patient receive care at each
role of care to maintain his physiologic status and enhance his chances of survival. The medical commander,
with his depth of medical knowledge, his ability to anticipate follow-on medical treatment requirements,
and his assessment of the availability of his specialized medical resources can adjust the patient flow to
ensure each Soldier receives the care required to optimize patient outcome. The medical commander can
recommend changes in the theater evacuation policy to adjust patient flow within the deployed setting. A
major consideration and an emerging concern in future conflicts is providing prolonged care within all roles
of care when evacuation is delayed. The Army’s future OE is likely to be complex and challenging and
widely differs from previous conflicts. Operational factors will require the provision of medical care to a
wide range of combat and noncombat casualties for prolonged periods that exceed current evacuation
planning factors.
CONTROL
1-25. Control is required to ensure that scarce AHS resources are efficiently employed and support the
operational and strategic plan. It also ensures that the scope and quality of medical treatment meets
professional standards, policies, and United States (U.S.) and international law. As the AHS is comprised
of 10 medical functions which are interdependent and interrelated, control of AHS support operations
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requires synchronization to ensure the complex interrelationships and interoperability of all medical assets
remain in balance to optimize the effective functioning of the entire system. Within the AO, the most
qualified individual to orchestrate this complex support is the medical commander due to his training,
professional knowledge, education, and experience. In a joint and multinational environment, it is essential
that coordination be accomplished across all Services and unified action partners to leverage all of the
specialized skills within the AO. Due to specialization and the low density of some medical skills within
the MHS force structure, the providers may only exist in one Service (for example, the United States Army
has the only veterinary corps officers in the MHS).
ROLES OF MEDICAL CARE (ARMY) (FM 4-02)
1-26. A basic characteristic of organizing modern AHS support is the distribution of medical resources and
capabilities to facilities at various levels of command, diverse locations, and progressive capabilities, which
are referred to as roles of care. See figure 1-3 for a graphic representation of all Roles of Care.
1-27. Definitive care refers to (1) that care which returns an ill or injured Soldier to full function, or the best
possible function after a debilitating illness or injury. Definitive care can range from self-aid when a Soldier
applies a dressing to a grazing bullet wound that heals without further intervention, to two weeks bed rest
in theater for Dengue fever, to multiple surgeries and full rehabilitation with a prosthesis at a CONUS
medical center or Department of Veteran’s Affairs hospital after a traumatic amputation. (2) That treatment
required to return the Service member to health from a state of injury or illness. The Service member's
disposition may range from return to duty to medical discharge from the military. It can be provided at any
role depending on the extent of the Service member's injury or illness. It embraces those endeavors which
complete the recovery of the patient (FM 4-02).
1-28. Definitive treatment refers to the final role of comprehensive care provided to return the patient to the
highest degree of mental and physical health possible. It is not associated with a specific role or location in
the continuum of care; it may occur in different roles depending upon the nature of the injury or illness (FM
4-02).
1-29. As a general rule, no role of care will be bypassed except on grounds of medical urgency, efficiency,
or expediency. The rationale for this rule is to ensure the stabilization/survivability of the patient through
TCCC, and far forward resuscitative surgery is accomplished prior to movement between MTFs (Roles 1
through 3).
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Figure 1-3. Army Roles of Care
CASUALTY RESPONSE (NONMEDICAL PERSONNEL)
1-30. Nonmedical personnel performing first aid procedures assist the combat medic in their duties. First
aid is administered by an individual (self-aid or buddy aid) and enhanced first aid is provided by the combat
lifesavers. A combat lifesaver is a nonmedical Soldier of a unit trained to provide enhanced first aid as a
secondary mission (currently the proponent for this term is FM 4-02 but will be moved to Army Techniques
Publication (ATP) 4-02.11 when published).
Self-Aid and Buddy Aid
1-31. Each individual Soldier is trained in a variety of specific first aid procedures. These procedures
include aid for chemical casualties with particular emphasis on lifesaving tasks. This training enables the
Soldier or a buddy to apply first aid to alleviate potential life-threatening situations. Each Soldier is issued
an individual first aid kit to accomplish first aid tasks. First aid refers to urgent and immediate lifesaving
and other measures which can be performed for casualties (or performed by the victim themselves) by
nonmedical personnel when medical personnel are not immediately available (currently the proponent for
this term is FM 4-02 but will be moved to ATP 4-02.11 when published).
Combat Lifesaver
1-32. The combat lifesaver is a nonmedical Soldier selected by the unit commander for additional training
beyond basic first aid procedures. A minimum of one individual per squad, crew, team, or equivalent-sized
unit should be trained. The primary duty of this individual does not change. The additional duty of the
combat lifesavers is to provide enhanced first aid for injuries, based on their training, before the combat
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medic arrives. Combat lifesaver training is normally provided by medical personnel during direct support
of the unit. The training program is managed by the senior medical person designated by the commander.
Members of Special Forces operational detachment teams receive first aid training at the combat lifesaver
level.
ROLE 1
1-33. The first medical care a Soldier receives is provided at Role 1 (also referred to as unit-level medical
care). This role of care includes—
⚫ Immediate lifesaving measures.
⚫ Disease and nonbattle injury (DNBI) prevention.
⚫ Combat and operational stress preventive measures.
⚫ Patient location and acquisition (collection).
⚫ Medical evacuation from supported units (point of injury [POI] or wounding, company aid posts,
or casualty/patient collection points) to supporting MTFs.
⚫ Treatment provided by designated combat medics or treatment squads. (Major emphasis is placed
on those measures necessary for the patient to return to duty or to stabilize him and allow for his
evacuation to the next role of care. Return to duty refers to a patient disposition which, after
medical evaluation and treatment, when necessary, returns a Soldier for duty in his unit (FM 402). These measures include maintaining the airway, stopping bleeding, preventing shock,
protecting wounds, immobilizing fractures, and other emergency measures, as indicated.)
1-34. Role 1 medical treatment is provided by the combat medic or flight paramedic during air evacuation
or by the physician, the physician assistant, or the health care specialist in the battalion aid station
(BAS)/Role 1 MTF. Emergency Medical Treatment (EMT) refers to the immediate application of medical
procedures to the wounded, injured, or sick by specially trained medical personnel (FM 4-02). In Army
special operations forces, Role 1 treatment is provided by special operations combat medics, special forces
medical sergeants, or physicians and physician assistants at forward operating bases, special forces
operating bases, or in joint special operations task forces. Role 1 includes—
⚫ Tactical combat casualty care (immediate far forward care) consists of those lifesaving steps that
do not require the knowledge and skills of a physician. The combat medic is the first individual
in the medical chain that makes medically substantiated decisions based on medical military
occupational specialty-specific training.
⚫ At the BAS, the physician and the physician assistant are trained and equipped to provide TCCC
to the combat casualty. This element also conducts routine sick call when the operational
situation permits. Like elements provide this role of medical care at brigade and echelons above
brigade (EAB).
⚫ During MEDEVACs, Role 1 treatment is provided by the combat medic (during ground
evacuation) or by the critical care flight paramedic (during air evacuation) to an MTF. Critical
care flight paramedics are trained and equipped to provide advanced en route care to the combat
casualty.
ROLE 2
1-35. At this role, care is rendered at the Role 2 MTF which is operated by the area support squad, medical
treatment platoon of medical companies. Here, the patient is examined and his wounds and general medical
condition are evaluated to determine his treatment and evacuation precedence, as a single patient among
other patients. Tactical combat casualty care including beginning resuscitation is continued, and if
necessary, additional emergency measures are instituted, but they do not go beyond the measures dictated
by immediate necessities. The Role 2 MTF has the capability to provide packed red blood cells (liquid),
limited x-ray, clinical laboratory, operational dental support, combat and operations stress control (COSC),
preventive medicine, and when augmented, physical therapy and optometry services. The Role 2 MTF
provides a greater capability to resuscitate trauma patients than is available at Role 1. Those patients who
can return to duty within 72 hours (1 to 3 days) are held for treatment. This role of care provides MEDEVAC
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from Role 1 MTFs and also provides Role 1 medical treatment on an area support basis for units without
organic Role 1 resources.
1-36. Patients who are nontransportable due to their medical condition may require resuscitative surgical
care from a FRSD collocated with a Role 2 medical company (refer to Army doctrine on the FRSD).
Nontransportable patient is a patient whose medical condition is such that he could not survive further
evacuation to the rear without surgical intervention to stabilize his medical condition. (Currently the
proponent is FM 4-02 but will be moved to ATP 4-02.2 when revised). The FRSD is assigned to the theater
medical command (TMC) or medical brigade (support) (MEDBDE [SPT]) and attached to a Role 3 hospital
when not operationally employed. However, the FRSD is only attached to a Role 2 medical company for
resuscitative surgical care capability support when employed.
1-37. Role 2 AHS assets are located in the—
⚫ Brigade support medical companies (BSMCs), assigned to modular brigades which include the
airborne, armored, infantry, and the Stryker brigade combat teams (SBCTs).
⚫ Medical companies (area support) (MCAS) which is an EAB asset that provides direct support to
the modular division and support to EAB units on an area basis.
1-38. The North Atlantic Treaty Organization (NATO) descriptions of Role 2 are—
⚫ A Role 2 basic MTF can provide reception, triage, resuscitation, and damage control surgery,
short term holding capacity for at least six and a postoperative care capability for at least two
patients.
⚫ An enhanced Role 2 MTF can provide enhanced diagnostics and mission essential specialist care
(including in theater surgery). They have at least two surgical teams, with respective emergency
and postoperative care capabilities, x-ray, laboratory, blood bank, pharmacy, sterilization,
dentistry, and a short term holding capacity of 25 patients.
Note. The United States Army forces subscribe to the basic definition of a Role 2 MTF providing
greater resuscitative capability than is available at Role 1. It does not subscribe to the
interpretation used by NATO forces Allied Joint Publication-4.10(B) (Role 2 basic and Role 2
enhanced) and JP 4-02 (Role 2 light maneuver and Role 2 enhanced) that a surgical capability is
mandatory at this role.
1-39. The United States Army does not provide damage control surgery and does not provide surgical
capability at Role 2 unless an FRSD is collocated with the Role 2 medical company to provide forward
surgical intervention.
ROLE 3
1-40. At Role 3, the patient is treated in an MTF staffed and equipped to provide care to all categories of
patients, to include resuscitation, initial wound surgery, damage control surgery, and postoperative
treatment. This role of care expands the support provided at Role 2. Patients who are unable to tolerate and
survive movement over long distances receive surgical care in a hospital as close to the supported unit as
the tactical situation allows. This role includes provisions for—
⚫ Coordination of patient evacuation through medical regulating.
⚫ Providing care for all categories of patients in an MTF with the proper staff and equipment.
⚫ Providing support on an area basis to units without organic medical assets.
ROLE 4
1-41. Role 4 medical care is found in CONUS-based hospitals and other safe havens. If mobilization
requires expansion of military hospital capacities, then the Department of Veteran’s Affairs and civilian
hospital beds in the National Disaster Medical System are added to meet the increased demands created by
the evacuation of patients from the AO. The support-based hospitals represent the most definitive medical
care available within the AHS.
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MEDICAL FUNCTIONS (FM 4-02)
1-42. The AHS is a complex system of systems (see figure 1-4 on page 23). The systems which comprise
the AHS are divided into medical functions which align with medical disciplines and scientific knowledge.
There is also a distinct set of primary tasks and purposes associated with each medical functions that outline
the major capabilities and focuses provided by each function (see tables 1-1 through 1-14 starting on page
24). These systems are interrelated and interdependent and must be meticulously and continuously
synchronized to reduce morbidity and mortality and to maximize patient outcome. Definitions of medical
C2, FHP, and HSS are—
MEDICAL COMMAND AND CONTROL (OPERATING WITHIN THE COMMAND AND CONTROL
SYSTEM)
1-43. Medical C2 is a function within the C2 system. Medical C2 consists of coordinating, synchronizing,
integrating, and planning FHP and HSS across echelons of command, physical domains, and joint
warfighting functions. The medical C2 function includes the medical chain of command that provides C2
of operational health and medical forces and includes the surgeon’s “clinical, medical, and technical control”
at echelon of coordinating, synchronizing, integrating, and planning FHP and HSS on behalf of the
commander.
FORCE HEALTH PROTECTION
1-44. Force Health Protection is a continuous process that begins with the Soldier’s entry into the military
and is continuous throughout the Soldier’s military career. Force health protection includes establishing and
sustaining a healthy and fit force, health promotion and nutrition programs, the identification of the health
threat in all settings (in both deployed and garrison settings), the development and implementation of
personnel protective measures to reduce exposure to health hazards and mitigating the adverse effects of the
impact of health threats to military personnel.
1-45. Definitions of FHP:
⚫ (Joint) Measures to promote, improve, or conserve the behavioral and physical well-being of
Service members to enable a healthy and fit force, prevent injury and illness, and protect the force
from health hazards. Also called FHP. (JP 4-02)
⚫ (Army) Force health protection are measures that promote, improve, or conserve the behavioral
and physical well-being of Soldiers comprised of preventive and treatment aspects of medical
functions that include combat and operational stress control, dental services, veterinary services,
operational public health, and laboratory services. Enabling a healthy and fit force, prevent injury
and illness, and protect the force from health hazards.
HEALTH SERVICE SUPPORT
1-46. Health service support pertains to the treatment and MEDEVAC of patients from the battlefield and
the required Class VIII supplies, equipment, and services to necessary to sustain these operations. Health
service support encompasses three components: direct patient care, MEDEVAC, and medical logistics
(MEDLOG).
⚫ Direct patient care aspects of the AHS mission. It includes medical treatment (organic and area
support) and hospitalization. Health Service Support includes the treatment of CBRN patients.
⚫ Medical evacuation to include medical regulating, and the provision of en route care to patients
being transported.
⚫ Medical logistics inclusive of all functional subcomponents and services to include blood
management.
1-47. Definitions of HSS
⚫ (Joint) All services performed, provided, or arranged to promote, improve, conserve, or restore
the mental or physical well-being of personnel. Also called HSS.
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⚫
(JP 4-02) (Army) Health service support is support and services performed, provided, and
arranged by the Army Medicine to promote, improve, conserve, or restore the behavioral and
physical well-being of personnel by providing direct patient care that include medical treatment
(organic and area support) and hospitalization, medical evacuation to include medical regulating,
and medical logistics to include blood management.
Figure 1-4. The Army Health System Medical Functions
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Table 1-1. Medical command and control function (primary tasks and purposes) (FM 4-02)
Primary Task
Purpose
• Ensure unity of Army Health System support effort.
• Train subordinates on command and control and the application of
mission command.
Command forces
• Make timely and effective Army Health System support decisions and
act.
• Inform and influence leaders to provide the right mix of medical
capabilities.
• Regulate the Army Health Service support of subordinate and
supporting units.
• Direct and coordinate the actions of medical assets to meet
commander’s intent.
Control operations
• Ensure the medical functions within the protection and sustainment
warfighting functions are coordinated and synchronized for linkage
between these varied commands and staffs.
• Direct actions by establishing responsibilities and limits that prevent
subordinate medical unit actions from impeding one another.
• Maintain situational understanding of Army Health Services command
and control systems and the common operational picture.
• Employ the operations process to integrate and synchronize the force
health protection and health service support medical functions.
Drive the operations process
• Integrate numerous processes such as intelligence preparation of the
battlefield, medical intelligence, and the military decision-making
process.
• Ensure execution of Army Health System support supports the CCDR's
decisions and intent.
• Support the commander’s decision making.
Establish the command and
control system
• Prepare and communicate directives to subordinate and supporting
medical units.
• Facilitate the integration of medical information systems in support of
Army Health System.
• Advise the commander on the health of the command and how best to
provide Army Health System support for commander’s freedom of
movement.
• Ensure medical standards are established, implemented, and monitored
throughout the operational area.
Provide technical supervision
• Advise commanders on implementation of protective action posture
including chemoprophylaxis, restriction of movement, isolation, and
quarantine to prevent and control the spread of diseases.
• Provide consultation and support to subordinate medical units or
elements.
• Provide reachback capability to the Defense Health Agency (DHA)
continental United States-support base medical treatment facilities in the
areas of various medical disciplines and specialties.
• Provide oversight over medical care to Soldiers, civilians, and
detainees.
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Table 1-2. Medical treatment (organic and area support) function (primary tasks and
purposes) (FM 4-02)
Primary task
Provide first aid
Purpose
Decrease killed-in-action rate. This task is performed by nonmedical
Soldiers performing self-aid, buddy aid, and/or combat lifesaver support
prior to arrival of the combat medic and/or other health care personnel.
Provide tactical combat
casualty care
Provide lifesaving intervention at the point of injury or wounding. This
task is performed by the combat medic who locates, acquires, stabilizes,
and evacuates patients with combat trauma. At echelons above brigade,
this task is referred to as emergency medical treatment in noncombat
operations.
Provide forward resuscitative
surgery
Provide a damage control surgery capability close to the point of injury or
wounding. This care is provided by a forward surgical team collocated
with a Role 2 medical treatment facility.
Conduct routine sick call
Provide primary care services as close to patient’s unit as possible.
Provide patient holding
Provide a short-term holding capability (not to exceed 72 hours) for
patients requiring minimal care prior to returning to duty.
Promote casualty prevention
measures
Promote wellness and enhance Soldier medical readiness to decrease
morbidity and mortality. There are no operational public health or combat
and operational stress control assets at Role 1; however, they are
available at Role 2.
Provide medical evacuation
Provide medical evacuation by ground ambulance on an area support
basis and to provide en route medical treatment during transport.
Provide physical therapy
Role 2 medical treatment facilities may be augmented with a physical
therapy team to provide assistance in strengthening the Soldier’s physical
resiliency, assistance in the prevention of neuromusculoskeletal injuries,
and treatment of Soldiers with neuromusculoskeletal injuries allowing
them to return to duty as soon as possible.
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Table 1-3. Hospitalization function (primary tasks and purposes) (FM 4-02)
Primary task
Purpose
Provide essential care
Includes first responder care, initial resuscitation and stabilization as well as
treatment and hospitalization in order to either return the patient to duty within the
theater evacuation policy, or to begin initial treatment required for optimization of
outcome.
Perform triage and
emergency care
Provides for the receiving of incoming patients to assess their medical condition,
provide emergency medical treatment, and transfer them to the appropriate
functional area within the hospital.
Provide outpatient
services
Provides patient care and family medicine consultation services, evaluation and
treatment of dermatological and gynecological diseases, injuries, disorders,
orthopedic and physical therapy services; sick call operations and comprehensive
routine medical care to include electrocardiographs in the medical services clinic.
Manage inpatient care
Provides nursing and medical services in intermediate and intermediate care wards
in order to prepare patients for surgery, manage postoperative recovery, monitor
patients, and prepare them for further evacuation.
Perform clinical laboratory
and blood banking
Performs analytical procedures in hematology, urinalysis, chemistry, blood banking,
and microbiology screening. Includes all routine blood grouping and typing,
abbreviated cross-matching procedures, emergency blood collection, and
storage/issuing liquid blood components and fresh frozen plasma.
Provide radiology services
Provides radiological services to all areas of the hospital and operates on a 24-hour
basis to include computed tomography in the newly designed field hospitals.
Conduct physical therapy
Provides a physical-occupational clinic to evaluate and treat neuromusculoskeletal
injuries, minor soft tissue wounds to include burn wound treatment, behavioral
health, injury prevention, and human performance optimization.
Provide medical logistics
Provides Class VIII management, requisitioning, and resupply as well as
maintenance on medical equipment. Coordinates with supporting medical logistics
company and medical detachment (blood support) for required external medical
logistics support.
Provide emergency and
essential dental care
Provides emergency and essential dental services and consultation for patients and
staff in order treat urgent dental cases or prevent dental emergencies.
Perform general and
specialty surgery
Perform initial surgery for battle and nonbattle injuries and follow-on surgery for
patients received from other medical treatment facilities to include general,
orthopedic, and obstetrics-gynecological surgical services in order to return patients
to duty or stabilize them for further evacuation.
Provide anesthesia
services
Provides anesthesia and respiratory services for the hospital that includes respiratory
therapy by specifically trained technicians and the ability to provide mechanical
respiratory assistance in intensive care units and the operating rooms.
Provide pharmacy support
Operates a fully functioning pharmacy and exercises appropriate control,
accountability, and distribution of medications and controlled substances to both
inpatients and outpatients as prescribed by medical staff.
Manage nutrition care
Provides food service management, meal preparation, modified diet food
preparation, and distribution of foods to patients and staff.
Provide behavioral health
services
Provides outpatient psychiatry and inpatient neuropsychiatric consultation and
education services.
Provide patient
administration services
Admission and disposition of patients, maintaining patient records, security of patient
valuables, statistical reporting, patient privacy policies, and coordination for patient
evacuation out of theater.
Provide consultation
support
Provide specialty medical consultation to Role 1 and 2 medical providers to enhance
the care given in forward areas, potentially eliminating the need to evacuate some
patients rearward.
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Table 1-4. Medical evacuation function (primary tasks and purposes) (FM 4-02)
Primary task
Purpose
Acquire and locate
Provide a rapid response to acquire wounded, injured, and ill personnel.
Clear the battlefield of casualties and facilitate and enhance the tactical
commander’s freedom of movement and maneuver. This task is performed
by the medical evacuation crew of the evacuation platform.
Treat and stabilize
Maintain or improve the patient’s medical condition during transport and
provide en route care as required. This task is performed by medical
evacuation crewmembers and providers when necessary.
Provide intra-Theater Medical
Evacuation
Provide rapid evacuation utilizing dedicated assets to the most appropriate
role of care. Provide a capability to cross-level patients within the theater
hospitals and to transport patients being evacuated out of theater to staging
facility prior to departure. This task is performed by the evacuation
platforms in the medical company (ground ambulance) and medical
company (air ambulance).
Provide emergency movement
of medical personnel,
equipment, and supplies
Provide a rapid response for the emergency movement of scarce medical
resources throughout an operational environment.
Table 1-5. Medical logistics function (primary tasks and purposes) (FM 4-02)
Primary task
Execute medical materiel
procurement
Purpose
Program funding, develop, acquire, and field the most cost-effective and
efficient medical materiel support to satisfy materiel requirements generated
by doctrinal and organizational revisions to tables of organization and
equipment, as well as user-generated requirements, state-of-the-art
advancements, and initiatives to enhance materiel readiness.
Conduct Class VIII
management and coordinate
distribution
Provide intensive management and coordinated distribution of specialized
medical products and services required to operate an integrated Army Health
System anywhere in the world in peace and throughout the competition
continuum.
Perform medical equipment
maintenance and repair
Perform appropriate maintenance checks, services, repairs, and tests on
medical equipment set component equipment items as specified in
applicable technical manuals or manufacturer operating instructions.
Conduct optical fabrication
and repair
Fabricate and repair prescription eyewear that includes spectacles,
protective mask inserts, and similar ocular devices for eligible personnel in
accordance with applicable Army policies and regulations.
Provide blood management
(and coordination for
distribution)
Provide collection, manufacturing, storage, and distribution of blood and
blood products to echelons above brigade Army Health System units.
Provide coordination for distribution of blood and blood products to Role 2
medical treatment facilities and forward surgical teams.
Perform centralized
management of patient
movement items
Support in-transit patients, exchange in-kind patient movement items without
degrading medical capabilities, and provide prompt recycling of patient
movement items from initial movement to the patient’s final destination.
Conduct health facilities
planning and management
Provide a reliable inventory of facilities that meet specific codes and
standards, maintains accreditation, and affords the best possible health care
environment for the Soldiers, Family members, and retired beneficiaries.
Provide medical contracting
support
Ensure the establishment and monitoring of contracts for critical medical
items and services.
Ensure hazardous medical
waste management and
disposal
Ensure the proper collection, control, transportation, and disposal of
regulated medical waste in accordance with applicable Army and host-nation
policies and regulations.
Ensure production and
distribution of medical gases
Ensure the production, receipt, storage, use, inspection, transportation, and
handling of medical gases and their cylinders in accordance with all
applicable regulations.
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27
Part One
Table 1-6. Operational public health function (primary tasks and purposes) (FM 4-02)
Primary task
Conduct Health Surveillance and
Epidemiology
Purpose
• Collect, analyze, and interpret health-related data effectively on the
health status of Army personnel throughout their time in service.
• Identify populations at risk of disease, injury, behavioral, or social
health conditions and the associated risk and protective factors.
Conduct Occupational Health
• Prevent injury and illness by identifying and evaluating
occupational health hazards and preventing or limiting those
exposures.
• Optimize protection and readiness of Army personnel in all
environments and protect the health of populations exposed to
occupational hazards.
• Provide occupational illness and injury prevention and mitigation.
Monitor environmental health
• Prevent injury and illness by identifying and evaluating
environmental health hazards and limiting exposures.
• Optimize Soldier protection and readiness in all environments and
protect the health of personnel and other relevant populations
exposed to environmental hazards.
• Ensure compliance with environmental health standards.
Provide occupational and
environmental medicine
• Provide consultative support, when requested, for—
- health surveillance and epidemiology services
- non-clinical occupational health services
- environmental health services
• Respond to accidental, intentional, and unintentional exposures to
Army personnel.
Conduct operational public health
• Ensure healthy and ready forces, sustain health readiness, and
provide technical consultation support on public health issues.
• Identify and articulate force health protection recommendations,
and direct, lead, and assess operational public health activities.
• Establish baseline health conditions, capture data on occupational
and environment health exposures, prescribe chemoprophylaxis as
necessary, train field sanitation teams, and provide general Public
Health support and consultation for unit leaders.
Conduct Health Risk Assessment
• Enable risk management in order to optimize Soldier protection.
• Estimate risks posed by identified health hazards exposure.
Provide clinical public health
• Deliver preventive medicine services to promote protective factors
and mitigate risk factors for disease and disability.
• Provide consultation to other healthcare providers and decision
makers on medical, behavioral, and environmental conditions of
public health significance.
• Provide services necessary for the prevention and control of
communicable diseases.
Provide community-based
prevention and health promotion
• Improve health readiness across the force.
• Empower individuals and communities to engage in healthy
behaviors.
• Provide health promotion initiatives focused on the Performance
Triad.
Perform public health toxicology
• Support Army medicine and acquisition, research, and
development programs.
• Provide toxicological assessments of all new and potentially
hazardous materials.
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Contents
Table 1-6. Operational public health function (primary tasks and purposes) (FM 4-02)
(continued)
Primary task
Purpose
• Provide analytical services in support of Army personnel health
readiness.
Perform public health laboratory
services
• Participate in appropriate laboratory networks.
• Provide specialized clinical testing’s; radiochemistry and laboratory
support for health physics; and analysis of diseases of military Public
Health significance.
Deliver public health
communication
Enable the overall Army Public Health Program and supports services to
inform, educate, and empower people about health issues.
Provide public health
emergency management
• Provide synchronization ensuring seamless coordination between the
installation and the local public health community during a public health
emergency.
• Ascertain the existence of cases suggesting a public health emergency
and recommend implementation of control measures (to include
declaration of a public health emergency) to the senior commander.
Table 1-7. Veterinary services function (primary tasks and purposes) (FM 4-02)
Primary task
Provide animal medical care
Conduct food protection
activities
Execute veterinary public health
activities
Purpose
Provide veterinary medical care for military and contract working dogs
and other government owned animals.
Ensure quality, food safety, food defense of food sources and storage
areas to ensure wholesome food supply for deployed forces.
Reduce transmission of zoonotic disease threats to deployed forces and
mitigate the impact of animal diseases of operational importance to
working animals or continental U.S. agricultural systems.
Table 1-8. Veterinary services treatment (primary tasks and purposes) (FM 4-02)
Primary task
Purpose
Provide preventive care
Maintenance of health to optimize working dog detection and patrol
capability to detect threats to Service members.
Conduct sick call
Treatment of routine DNBI and noncombat related emergencies as close
to the working dog’s unit as possible to minimize lost working days.
Perform K9 tactical combat
casualty care
Provision of lifesaving stabilization and care as close to the working dog’s
point of injury as possible to maximize survival rates.
Perform resuscitation and
emergency surgical stabilization
Provision of resuscitative surgical care on an area support basis to
maximize survival rates.
Provide hospitalization services
Provision of short-term hospitalization capability (not to exceed 72 hours)
for military and contract working dogs requiring direct veterinary care to
reduce medical evacuation and maximize return to duty rates.
Support medical evacuation
In order to maximize survival rates of working dogs during medical
evacuation to higher roles of care, veterinary personnel may be required
to augment standard medical personnel and be allowed access to
working dog patients en route.
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Part One
Table 1-9. Combat & operational stress control function (primary tasks & purposes) (FM 4-02)
Primary task
Implement combat and
operational stress control plan/
program
Purpose
Prevent combat and operational stress reaction.
Perform combat and
operational stress control unit
needs assessment
Provide command with global assessment of the unit, with considerations
of multiple variables that may affect leadership, performance, morale, and
operational effectiveness of the organization.
Conduct traumatic event
management for potentially
traumatic event
Assist in the transition of units and Soldiers who are exposed to
potentially traumatic events by building resilience, promoting
posttraumatic growth, and/or increasing functioning and positive changes
in the unit.
Screen and evaluate Soldiers
with maladaptive behaviors to
rule out neuropsychiatric/
behavioral health conditions
Provide diagnosis, treatment, and disposition for Soldiers with
neuropsychiatric/behavioral problems.
Conduct combat and
operational stress restoration
and reconditioning programs to
include warrior resiliency
training
Provide Soldiers rest/restoration within or near their unit area for rapid
return to duty and to prevent posttraumatic stress disorder.
Perform command-directed
evaluation for Soldier’s
behavioral health status
Determine if Soldiers’ mental state renders them at risk to themselves or
others or may affect their ability to carry out their mission.
Screen patients with potential
behavioral health issues for
signs/symptoms of mild
traumatic brain injury
Rule out mild traumatic brain injury for Soldiers seeking assistance with
behavioral health issues. If appropriate, refer individuals for follow-up
medical examination.
Table 1-10. Behavioral health/neuropsychiatric treatment (primary tasks & purposes) (FM 402)
Primary task
Identify and diagnose
behavioral health/
neuropsychiatric disorder/
disease
Stabilize patient
30
Purpose
Identify and initiate treatment for patients with behavioral health/
neuropsychiatric disease processes.
Stabilize behavioral health/neuropsychiatric patients for evacuation from
the theater for treatment of disease process in the continental United
States-support base.
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Contents
Table 1-11. Preventive dentistry (primary tasks and purposes) (FM 4-02)
Primary task
Conduct periodic examination
of Soldiers’ teeth, gums, and
jaw
Classify Soldiers’ dental
conditions in the dental
classification system and
determine Soldiers’ dental
readiness status
Provide training to Soldiers and
units on measures to take to
mitigate the adverse impact of
dental threats
Purpose
Identify dental deficiencies and recommend follow-up courses of action.
Determine Soldiers dental classification and dental readiness status.
Provide training/education to Soldiers and unit leaders on identifying
dental threats, taking preventive measures to mitigate or eliminate the
dental threat, and ensuring Soldiers are practicing good oral hygiene.
Table 1-12. Dental services function (primary tasks and purposes) (FM 4-02)
Primary task
Purpose
Provide comprehensive dental
care
Restore an individual to optimal oral health, function, and aesthetics.
Normally provided in continental United States-support base.
Provide operational dental care
Provide treatment in austere environments for Soldiers engaged in
operations. Operational care is provided in the area of operations and
consists of emergency dental care and essential dental care.
Conduct emergency dental care
Relieve oral pain, eliminate acute infection, control life-threatening oral
conditions (hemorrhage, cellulitis, or respiratory difficulty) and treat
trauma to teeth, jaws, and associated facial structures.
Conduct essential dental care
Prevent potential dental emergencies and maintain the overall oral fitness
of Soldiers at levels consistent with combat readiness.
Perform oral maxillofacial
surgery
Provide oral maxillofacial surgery capability to minimize loss of life and
disability resulting from oral and maxillofacial injuries and wounds within
the area of operations.
Table 1-13. Medical laboratory services function (primary tasks and purposes) (FM 4-02)
Primary task
Purpose
Provide analytical,
investigational, and consultative
capabilities
• Identify chemical, biological, radiological, and nuclear threat agents in
biomedical specimens and other samples from the area of operations.
Provide special environmental
control and containment
Evaluate biomedical specimens for the presence of highly infectious or
hazardous agents of operational concern.
Provide data and data analysis
Support medical analyses and operational decisions.
Conduct medical laboratory
analysis
Support the diagnosis of zoonotic and significant animal diseases that
impact on military operations.
Deploy modular sections or
sectional teams
Interface with preventive medicine teams, veterinary teams, forwarddeployed Army Health System units, biological integrated detection
system teams, and chemical company elements operating in the area of
operations.
16 March 2023
• Assist in the identification of OEH hazards and endemic diseases.
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31
Part One
Table 1-14. Clinical laboratory services (primary tasks and purposes) (FM 4-02)
Primary task
Provide analysis of medical
specimens
Provide blood banking services
Purpose
• Provide for the identification, diagnosis, and treatment of diseases and
pathogens.
• Provide blood-banking services to include capability to type and cross
match blood samples and perform limited testing of whole blood.
• Provide laboratory support to type and cross match blood specimens
for transfusion services.
• Provide limited testing of blood products.
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Army Health System Doctrine Hierarchy and Summaries
PART TWO
Army Health System Doctrine
Hierarchy and Summaries
The United States Army Medical Center of Excellence is the proponent for Army
medical doctrine. Field Manual 4-02 is the capstone doctrinal publication within the
Army medical doctrine hierarchy. The remaining ATPs are subordinate publications
to FM 4-02 and therefore support and expand, in greater detail, the concepts contained
in FM 4-02.
There are 28 doctrinal publications under the Army Medicine doctrinal publication
library that are either currently published or in development. As requirements change
or concepts become capabilities, publications get revised, new publications are
created, or publications are rescinded. In accordance with Training and Doctrine
Command policies and regulations, it takes 18 to 24 months to revise or create a
doctrinal publication, not accounting for the extensive research required prior to
starting the formal development process.
Part Two contains a brief summary of each of the Joint Health Services and Army
operational medicine doctrine publications. While some publications contain the
same or very similar content as other medical doctrine, the Joint and Training and
Doctrine Command guidance is to not repeat significant amounts of content between
publications and that references to other publications should be provided so the reader
can seek additional information on a specific topic.
Note. These summaries are of Joint health services and Army operational medicine
current/proposed publications. They do not reflect scheduled and periodic updates.
16 March 2023
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33
Part Two
ATP 4-02.1
ST 4-02.1
ATP 4-02.2
Army Medical
Logistics
Army Medical
Logistics
Enterprise
Medical
Evacuation
ATP 4-02.4
Medical Platoon
ATP 4-02.5
ATP 4-02.6
Casualty Care
The Medical
Company
(Role 2)
To Be
Rescinded
Yet Published
ATP 4-02.7
ATP 4-02.8
ATP 4-02.10
MTTP for HSS
in a CBRN
Environment
Force Health
Protection
Theater
Hospitalization
To Be
Rescinded
Yet Published
ATP 4-02.11
(TC 4-02.1)
ATP 4-02.12
Casualty
Response
AHS
Command and
Control
Not Yet
Published
Not Yet
Published
ATP 4-02.20
ATP 4-02.25
ATP 4-02.18
ATP 4-02.19
Operational
Public Health
Veterinary
Services
Dental
Services
Not Yet
Published
Not Yet
Published
ATP 4-02.43
ATP 4-02.46
ST 4-02.52
ATP 4-02.55
AHS Support
to Army SOF
AHS Support to
Detainee
Operations
Mild
TBI/Concussion
AHS Support
Planning
ATP 4-02.17
Combat and
Operational
Stress Control
Not Yet
Published
To be Added to
ATP 4-02.20
and Rescinded
34
ATP 4-02.84
ATP 4-02.85
MTTP for the
Treatment of
Biological
Warfare Agent
Casualties
MTTP for the
Treatment of
Chemical Warfare
Agent Casualties
and Conventional
Military Chemical
Injuries
ATP 4-25.12
Unit Field
Sanitation Teams
To be Added to
ATP 4-02.17
and Rescinded
AHS Doctrine Smart Book
Medical
Detachment,
FRSD
ATP 4-25.13
Casualty
Evacuation
ATP 4-02.42
AHS Support
to Stability and
DSCA Tasks
To be Added to
ATP 4-02.10
and Rescinded
ATP 4-02.82
Occupational
and
Environmental
Health Site
Assessment
Navy is
proponent.
ATP 4-02.83
MTTP for the
Treatment of
Nuclear and
Radiological
Casualties
TC 4-02.3
Field Hygiene
and Sanitation
To be Added to
ATP 4-02.17
and Rescinded
16 March 2023
Army Health System Hierarchy and Summaries
ARMY HEALTH SYSTEM PUBLICATIONS BY MEDICAL
FUNCTION
JOINT PUBLICATION 4-02, JOINT HEALTH SERVICES (11 DEC 2017, C1, 28 SEP 2018)
FIELD MANUAL 4-02, ARMY HEALTH SYSTEM (17 NOV 2020, C1, 14 JUL 2022)
MEDICAL COMMAND AND CONTROL
⚫ ATP 4-02.12, Army Health System Command and Control (Not yet published)
⚫ ATP 4.02.42, Army Health System Support to Stability and Defense Support of Civil Authorities Tasks (9 JUN 2014)
⚫ ATP 4.02.43, Army Health System Support to Special Operations Forces (17 DEC 2015)
⚫ ATP 4.02.46, Army Health System Support to Detainee Operations (24 AUG 2021)
⚫ ATP 4-02.55, Army Health System Support Planning (30 MAR 2020)
MEDICAL TREATMENT (ORGANIC AND AREA SUPPORT)
⚫ ATP 4-02.4, Medical Platoon (12 MAY 2021)
⚫ ATP 4-02.5, Casualty Car (10 MAY 2013) (Being rescinded after ATP 4-02.11, Casualty Response is published)
⚫ ATP 4-02.6, The Medical Company (Role 2) (8 NOV 2022)
⚫ ATP 4-02.7, MTTP for Health Service Support in a CBRN Environment (15 MAR 2016)
⚫ ATP 4-02.11, Casualty Response (Currently TC 4-02.1, First Aid until published)
⚫ ATP 4-02.83, MTTP for the Treatment of Nuclear and Radiological Casualties (5 MAY 2014)
⚫ ATP 4-02.84, MTTP for the Treatment of Biological Warfare Agent Casualties (21 NOV 2019)
⚫ ATP 4-02.85, MTTP for Chemical Warfare Agent Casualties and Conventional Military Chemical Injuries (2 AUG
2016)
⚫ TC 4-02.1, First Aid (21 JAN 2016) (Being rescinded after ATP 4-02.11, Casualty Response is published)
HOSPITALIZATION
⚫ ATP 4-02.10, Theater Hospitalization (14 AUG 2020)
⚫ ATP 4-02.25, The Medical Detachment, Forward Resuscitative and Surgical (7 DEC 2020) (Will be added to ATP
4-02.10 and rescinded)
MEDICAL EVACUATION (INCLUDING MEDICAL REGULATING)
⚫ ATP 4-02.2, Medical Evacuation (12 JULY 2019)
⚫ ATP 4-25.13, Casualty Evacuation (30 JUN 2021)
MEDICAL LOGISTICS (INCLUDING BLOOD MANAGEMENT)
⚫ ATP 4-02.1, Army Medical Logistics (29 OCT 2015)
⚫ ST 4-02.1, Army Medical Logistics Enterprise (7 FEB 2012)
DENTAL SERVICES
⚫ ATP 4-02.19, Dental Services (14 AUG 2020)
OPERATIONAL PUBLIC HEALTH
⚫ TC 4-02.3, Field Hygiene and Sanitation (Will be added to ATP 4-02.17 and rescinded)
⚫ ATP 4-25.12, Unit Field Sanitation Teams (Will be added to ATP 4-02.17 and rescinded)
⚫ ATP 4-02.17, Operational Public Health (Not yet published)
⚫ ATP 4-02.82, Occupational and Environmental Health Site Assessment (1 APR 2012) (Navy is the proponent for
this publication.)
COMBAT AND OPERATIONAL STRESS CONTROL
⚫ ATP 4-02.20, Combat and Operational Stress Control (Not yet published)
⚫ ST 4-02.52. Mild Traumatic Brain Injury/Concussion (6 MAR 2012) (Will be added to ATP 4-02.20 and rescinded)
VETERINARY SERVICES
⚫ ATP 4-02.18, Veterinary Services (Not yet published)
MEDICAL LABORATORY SERVICES (INCLUDING CLINICAL AND ENVIRONMENTAL LABORATORIES)
⚫ ATP 4-02.8, Force Health Protection (Being rescinded)
Note. The following Army Medicine doctrinal publications (ATP 4-02.11 [TC 4-02.1], ATP 4-02.12, ATP 4-02.17,
ATP 4-02.18, and ATP 4-02.20) are new publications or are currently being updated and/or revised. Throughout part
2, any proposed chapters will be listed from the program directive and are subject to change.
16 March 2023
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35
Part Two
JP 4-02
Joint Health Services
Chapter 1, OVERVIEW
• Military Health System
• Principles of Joint Health Services
• Joint Health Services Capabilities
• Defense Health Agency
Chapter 2, HEALTH SERVICE SUPPORT
• Casualty Management
• Patient Movement
• Medical Logistics
• Health Information Management
Chapter 3, FORCE HEALTH PROTECTION
• Casualty Prevention
• Preventive Medicine
• Comprehensive Health Surveillance and Risk Management
• Biosurveillance
• Combat and Operational Stress Control
• Preventive Dentistry
• Vision Readiness
• Hearing Conservation
• Laboratory Services
• Veterinary Services
Chapter 4, ROLES AND RESPONSIBILITIES
• Command and Control
• Joint Force Surgeon
• Organizing the Joint Force Surgeon’s Office
• Joint Force Surgeon’s Office Battle Rhythm
• Joint Force Surgeon Reachback
• Staff Organizations
Chapter 5, HEALTH SUPPORT OPERATIONS
• Combat Operations
• Stability Actions
• Civil-Military Operations
• Defense Support of Civil Authorities
• Multinational Operations
• Detainee Operations
• Operations in a CBRNE
• Special Operations Forces
• Operational Contract Support
Chapter 6, JOINT HEALTH PLANNING
• Health Support Planning Considerations
• Planning Joint Medical Logistics
• Medical Planning Tools
APPENDICES
• PATIENT MOVEMENT
• MEDICAL LOGISTICS SUPPORT
• CASUALTY PREVENTION
• INTELLIGENCE SUPPORT TO JOINT HEALTH SUPPORT
• FEDERAL COORDINATING CENTERS/PATIENT RECEPTION AREAS
• BLOOD MANAGEMENT
• SERVICE COMPONENT TRANSPORTATION / MEDICAL EVACUATION
ASSETS
• IMPACTS OF THE LAW OF WARFARE AND MEDICAL ETHICS
• PLANNING CHECKLISTS
• REFERENCES
• ADMINISTRATIVE INSTRUCTIONS
JP 4-02 provides
doctrine to plan,
prepare, and
execute joint
and combined
health services
across the
range of military
operations.
Joint doctrine
established in
this publication
applies to the
Joint Staff,
commanders
of combatant
commands,
subordinate
unified
commands, joint
task forces,
subordinate
components of
these
commands, the
Services, and
combat support
agencies.
December 2017 (C1, September 2018)
https://jdeis.js.mil/jdeis/index.jsp?pindex=27&pubId=662
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Army Health System Hierarchy and Summaries
FM 4-02
Army Health System
PART 1 ARMY HEALTH SYSTEM
ARMY HEALTH SYSTEM OVERVIEW
• Operational Environment
• Warfighting Functions
• Tactical Combat Casualty Care
• Army Health System Principles
• Global Health Engagement
ARMY HEALTH SYSTEM COMMAND
AND CONTROL
• Overview of Army Echelons
• Medical Command and Control
Organizations
• Medical Commander, Command
Surgeon, and Line Commander
ARMY HEALTH SYSTEM AND THE
EFFECTS OF THE LAW OF LAND
WARFARE AND MEDICAL ETHICS
• The Law of Lan Warfare
• Geneva Conventions
• Medical Ethics
DENTAL SERVICES
• Dental Services Preventive
Dentistry
• Dental Services Treatment
Aspects
LABORATORY SERVICES
• Area Medical Laboratory Support
• Clinical Laboratory Support
DIRECT PATIENT CARE
• Medical Treatment (Organic and
Area Support)
• Hospitalization
MEDICAL EVACUATION
• Integrated Medical Evacuation
System
• Medical Regulating
• Strategic Medical
Evacuation/Patient Movement
ARMY HEALTH SYSTEM
OPERATIONS
• Planning for Army Health System
Support
• Support to Decisive Action
• Setting the Theater, Theater
Opening, Early Entry, and
Expeditionary Medical Operations
• Support to Detainee Operations
PART 2 FORCE HEALTH
PROTECTION
PART 3 HEALTH SERVICE
SUPPORT
MEDICIAL LOGISTICS
• Medical Logistics Management in
an Operational Environment
• Medical Logistics Support for
Roles and 2 Medical Treatment
Facilities
• Medical Logistics Support for Role
3 Medical Treatment Facilities
• Medical Logistics Support to Joint
Health Services
APPENDICES
OPERATIONAL PUBLIC HEALTH
ARMY HEALTH SYSTEM
SUPPORT TO THE ARMY’S
STRATEGIC ROLES
VETERINARY SERVICES
• Veterinary Responsibilities
• Food Protection Mission
• Animal Care Mission
• Veterinary Public Health
COMMAND AND SUPPORT
RELATIONSHIPS
COMBAT AND OPERATIONAL
STRESS CONTROL
• Combat and Operational Stress
Control Responsibilities
• Programs and Resources
• Behavioral Health and
Neuropsychiatric Treatment
Aspects
SURGEON AND SURGEON
SECTION
INSTITITUINAL FORCE
SUPPORT TO THE
OPERATIONAL ARMY
ARMY HEALTH SYSTEM
SYMBOLS
FM 4-02 provides
doctrine for the
Army Health
System (AHS) in
support of the
modular force.
The
AHS is the
overarching
concept of
support for
providing timely
AHS support to
the tactical
commander. It
discusses the
current AHS force
structure
modernized under
the Department of
the Army
approved
Medical
Reengineering
Initiative and the
Modular Medical
Force that is
designed to
support the
brigade combat
teams and
echelons above
brigade units
November 2020 (C1, July 2022)
https://armypubs.army.mil
16 March 2023
AHS Doctrine Smart Book
37
Part Two
* ATP 4-02.1
ATP 4-02.1
Army Medical Logistics
Chapter 1, OVERVIEW OF MEDICAL LOGISTICS
• The Army Health System
• Levels of Sustainment
• Medical Logistics Support
Army Medical
Logistics
Chapter 2, MEDICAL LOGISTICS ORGANIZATIONAL STRUCTURE
• Theater Medical Logistics Support
• Medical Logistics Support Organizations in the Operating Force
• Operational guidance on the AHS’ echelon above brigade mission
command
Chapter 3, MEDICAL LOGISTICS OPERATIONS
• Medical Force Generation and Readiness
• Force Protection
• Force Sustainment
• Redeployment
• Class VIII Contingency Materiel
• Defense Support of Civil Authorities
Chapter 4, MEDICAL LOGISTICS INFORMATION SYSTEMS AND
COMMUNICATION
• Current Systems
• External Enablers
• Common Operational Picture
• Medical Logistics Automated Information System Operational Concept
Chapter 5, MEDICAL EQUIPMENT MAINTENANCE
• Role of Medical Equipment Maintenance
• Medical Equipment Maintenance Capabilities and Responsibilities at
Each Role of Care
• Continental United States-Based Organizations
Chapter 6, OPTICAL SUPPORT
• Theater Optical Support
• Optical Equipment Sets
Chapter 7, BLOOD SUPPORT
• Theater Blood Support
• Storage and Distribution of Blood Products
Chapter 8, HEALTH FACILITY PLANNING AND MANAGEMENT
• Expeditionary Health Facility Management
• Roles and Responsibilities
• Health Facility Planning Considerations During Contingency Operations
APPENDICES
• Patient Movement Items
• Automatic Identification Technology
• Medical Logistics Planning
FM 4-02.1
addresses the
role of MEDLOG
in the AHS. It
covers MEDLOG
operations from
the support
battalions at the
tactical level to
the theater
medical
command and
theater
sustainment
command where
the critical
crossover occurs
between theater
strategic/operatio
nal agencies
within the AHS
and commands
and the
operational units
providing
logistics support
in-theater.
October 2015
https://armypubs.army.mil
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Army Health System Hierarchy and Summaries
ST 4-02.1
ST 4-02.1
Army Medical Logistics Enterprise
Chapter 1, ARMY MEDICAL LOGISTICS ENTERPRISE
• Military Function
• Military Problem
• Solution
Chapter 2, ARMY MEDICAL LOGISTICS ENTERPRISE IMPLEMENTATION
FRAMEWORK
• Organize the Army Medical Logistics Enterprise
• Networking the Army Medical Logistics Enterprise
• Project the Medical Force
• Sustain the Medical Force
• Synchronizing Medical Logistics Support to the Army Health System
Chapter 3, MEDICAL MATERIEL MANAGEMENT AND SUPPLY SUPPORT
• General
• Organizations for Medical Materiel Management and Supply Support
• Materiel Management and Supply Support for Medical Force Projection
• Materiel Management and Supply Support for Medical Force Sustainment
Chapter 4, MEDICAL EQUIPMENT MAINTENANCE AND REPAIR SUPPORT
• General
• Organizations for Medical Equipment Life Cycle Management
• Medical Force Projection
• Medical Force Sustainment
Chapter 5, BLOOD SUPPORT
• Organization of the Armed Services Blood Program
• Army Blood Programs Roles and Responsibilities
• Tactical Blood Support
• Future Armed Services Blood Support
• Future Army Blood Program Support
Chapter 6, OPTICAL FABRICATION AND REPAIR
• General
• Key Optical Fabrication Organizations
• Optical Support to Force Projection
• Optical Fabrication Support to Force Sustainment
Chapter 7, MEDICAL ACQUISITION
• Acquisition Organizations
• Acquisition Concepts of Operation
Chapter 8, HEALTH FACILITIES
• Overview
• Health Facilities Support Concepts
• Health Facility Assets in the Generating Force
• Concept of Support for Deployment Operations
APPENDICES
• Key Shaping Forces
• The Army Functional Concept For Sustainment
• Key Capability Gaps and The Joint Medical Logistics and Infrastructure Support
Joint Capability Document
• Army Medical Logistics Enterprise Required Capabilities
• Defense Medical Logistics Goals
• To-Be Attributes of Defense Medical Logistics Enterprise
• The Army Medical Logistics and The Joint Supply Enterprises
February 2012
https://www.milsuite.mil/book/docs/DOC-468193
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AHS Doctrine Smart Book
Army Medical
Logistics
Enterprise
ST 4-02.1 describes the
concept of operations for
how Army medical
logistics will support
future military operations.
It proposes an Army
Medical Logistics
Enterprise as the core
theme for the provision of
specialized medical
products and services
required to generate,
project, and sustain
expeditionary medical
forces and deliver AHS
support to the force. This
special text describes
operation of the Army
Medical Logistics
Enterprise and serves as
a blueprint to organize,
network, and implement
the collaborative
framework necessary to
support unified land
operations.
This publication is for use
by training developers,
medical, and nonmedical
commanders and staff for
information and planning
purposes. It does not
establish requirements
for military units and/or
organizations that have
not been developed,
staffed, and approved
through the force
development process. It
is based on current
policies, doctrine,
lessons, observations,
and insights from ongoing
operations and provides
a basis of information
upon which future
concepts, policies, and
doctrine may be
developed. Current
actions being staffed will,
upon approval,
incorporate these
changes into relevant
doctrine, technical
guides, and Army
regulations.
39
Part Two
ATP 4-02.2
ATP 4-02.2
Medical Evacuation
Chapter 1, THE ARMY HEALTH SYSTEM OPERATIONS AND MEDICAL
EVACUATION
• Army Health System
• Medical Evacuation
• Medical Evacuation versus Casualty Evacuation
Chapter 2, ARMY MEDICAL EVACUATION
• Medical Evacuation Support
• Medical Evacuation Requests
• Medical Evacuation Units, Elements, and Platform Considerations
• Medical Evacuation at Unit Level
• Exchange of Property
• Key Activities During Specific Operations
• Medical Evacuation Support for Operations Conducting Offense,
Defense, and Stability Tasks
• Medical Evacuation Support for Army Special Operations Forces
• Medical Evacuation in Urban Operations
• Army Support to Civil Authorities
• Other Types of Medical Evacuation Support Missions
• Medical Evacuation in Specific Environments
Chapter 3, MEDICAL EVACUATION RESOURCES
• Maneuver Battalion Medical Platoon Ambulance Squad
• Evacuation Platoon – Medical Company (Brigade Support Battalion)
and Ambulance Platoon – Medical Company (Area Support)
• Medical Company (Ground Ambulance)
• Medical Company (Air Ambulance) 15 HH-60
• Medical Company (Air Ambulance) UH-72 Light Utility Helicopter
Chapter 4, THEATER EVACUATION POLICY
Chapter 5, OPERATIONAL AND TACTICAL EVACUATION PLANNING
• Theater Medical Evacuation Planning Responsibilities
• Planning Process
Chapter 6, MEDICAL REGULATING
APPENDICES
• GENEVA CONVENTIONS AND MEDICAL EVACUATION
• EXAMPLE OF THE MEDICAL EVACUATION PLAN AND
OPERATIONS ORDER
• EXAMPLE OF THE MEDICAL EVACUATION REQUEST
• EXAMPLE OF THE MEDICAL EVACUATION ACTIVITIES DURING
OPERATIONS
Medical Evacuation
ATP 4-02.2 provides
doctrine and
techniques for
conducting medical
evacuation and
medical regulating
operations. Medical
evacuation
encompasses both the
evacuation of Soldiers
from the point of injury
(POI) or wounding to a
medical treatment
facility (MTF) staffed
and equipped to
provide essential care
in theater and further
evacuation from the
theater to provide
definitive, rehabilitative,
and convalescent care
in the continental
United States
(CONUS) and the
movement of patients
between MTFs or to
staging facilities.
Medical evacuation
entails the provision of
en route medical care;
supports the joint
health service support
system; and links the
continuum of care. In
addition, it discusses
the difference between
medical evacuation
and casualty
evacuation
(CASEVAC), as well as
coordination
requirements for and
the use of nonmedical
transportation assets to
accomplish the
CASEVAC mission.
July 2019
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Army Health System Hierarchy and Summaries
ATP 4-02.4
ATP 4-02.4
Medical Platoon
Chapter 1, ROLE OF THE MEDICAL PLATOON
• Role 1 Army Health System Overview and Common Medical Platoon
Capabilities
• Medical Platoon Key Personnel and Medical Platoon Task Organization
• Employment of the Medical Platoon
• Brigade and Echelon above Brigade Assets in Support of the Medical
Platoon
Chapter 2, COMMAND AND CONTROL
• Platoon Mission Command
• Planning Considerations
• Troop-Leading Procedures and the Five-Paragraph Operation Order
• Military Decision-Making Process
• Risk Management
• Rehearsals and Pre-Combat Checks and Inspections
• After Action Reviews
• Communication
Chapter 3, ARMY HEALTH SYSTEM SUPPORT TO OPERATIONS
• Army Health System Support to the Offense
• Army Health System Support to the Defense
• Army Health System Support to Stability and DSCA Operations
• Army Health System Support to Night Operations
• Army Health System Support in Mountain Warfare and Cold Weather
• Army Health System Support to Jungle Operations
• Army Health System Support to Desert Operations
• Army Health System Support to Urban Operations
• Army Health System Support to Subterranean Operations
• Army Health System Support to Wet Gap Crossings
• Army Health System Support to Air Assault Operations
• Army Health System Support to Airborne Operations
Chapter 4, SUSTAINMENT
• Basics of Sustainment and Sustainment Planning
• Medical Platoon Supply Operations
• Maintenance
• Disposition of Remains and Army Health System Support to Detainees
Chapter 5, CHEMICAL, BIOLOGICAL, RADIOLOGICAL, AND NUCLEAR
OPERATIONS
• Mission-Oriented Protective Posture and Actions During and After an
Attack
• Unit Decontamination and Role 1 HSS in a CBRN Environment
• Role 1 MTF Decontamination, Patient Decontamination, and Treatment
Operations
• Unmasking Procedures
• Additional Proficiency Skills for Medical Personnel
APPENDICES
• ANALOG REPORTS
• MEDICAL BATTLE DRILLS
• PATIENT EVACUATION
• FORCE HEALTH PROTECTION AND MEDICAL READINESS
• MEDICAL TRAINING CONSIDERATIONS
• SYMBOLOGY
• TACTICAL STANDARD OPERATING PROCEDURE
Medical Platoon
ATP 4-02.4,
Medical Platoon
provides
information on the
structure and
operation of Role 1
medical platoons
that are organic to
maneuver
battalions and
squadrons. The
tactics, techniques,
and procedures
(TTPs) provided are
not all-inclusive. It
outlines the
responsibilities of
the medical platoon
and provides
information on
planning,
rehearsing, and
conducting AHS
support at Role 1. It
provides TTPs for
directing,
controlling, and
managing AHS
support at the
platoon/section
level. It describes
the troop-leading
procedures for AHS
support operations
and identifies
interface and
coordination
requirements with
other brigade
medical elements.
May 2021
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16 March 2023
AHS Doctrine Smart Book
41
Part Two
* ATP 4-02.5
ATP 4-02.5
Casualty Care
Chapter 1, OPERATIONAL CONSIDERATIONS
• Guide for Geneva Conventions Compliance and Eligibility for Care
Determination
• Employment of Field Medical Units and Hospitals
• Health Service Support in Specific Operational Environments
• Tactical Combat Casualty Care and the Joint Theater Trauma Registry
Casualty Care
Chapter 2, MEDICAL TREATMENT (ORGANIC AND AREA SUPPORT)
• Modular Medical Support System
• Medical Company (Area Support)
Chapter
3,
HOSPITALIZATION
(MISSIONS,
ASSIGNMENTS,
CAPABILITIES, LIMITATIONS, BASIS OF ALLOCATION, MOBILITY,
EMPLOYMENT, AND CONCEPT OF OPERATIONS)
• The 248-Bed Combat Support Hospita
• Headquarters and Headquarters Detachment 248-Bed Combat Support
Hospital
• Hospital Company A (84 Bed)
• Medical Detachment (Minimal Care)
• Hospital Augmentation Team (Head and Neck)
• Hospital Augmentation Team (Special Care)
• Hospital Augmentation Team (Pathology)
• Medical Team (Renal Hemodialysis)
• Medical Team (Infectious Disease)
• Forward Surgical Team
Chapter 4, TREATMENT ASPECTS OF COMBAT AND OPERATIONAL
STRESS CONTROL
• Combat and Operational Stress Control Triage
• Precautions and Differential Diagnostic Problems Associated with
Combat and Operational Stress Control Triage
• Behavioral Health Treatment
Chapter 5, TREATMENT ASPECTS OF DENTAL SERVICES
• Categories of Dental Care
• Dental Classification
• Alternate Wartime Roles
• Organization and Functions of Dental Units
• Dental Clinical Operations
APPENDICES
• PLANNING FACTORS
• NUTRITION CARE OPERATIONS
• MILD TRAUMATIC BRAIN INJURY/CONCUSSION
To Be Rescinded after publication of ATP 4-02.11.
SEE NOTE ON PAGE 34.
ATP 4-02.5
addresses the
casualty care
aspects of the
health service
support mission
under the
sustainment
warfighting function.
It describes the
various
organizational
designs for the
units providing this
support and
doctrinal guidance
on the employment
of these
organizations and
their functional
capabilities.
This publication
implements or is in
consonance with
the several North
Atlantic Treaty
Organization
(NATO)
International
Standardization
Agreements
(STANAGs) and
American, British,
Canadian,
Australian, and
New Zealand
(ABCA) standards
and publication.
May 2013
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Army Health System Hierarchy and Summaries
ATP 4-02.6
ATP 4-02.6
The Medical Company (Role 2)
Chapter 1, THE ARMY HEALTH SYSTEM
• Army Operations Doctrine
• Overview of the Army Health System
• Eligibility of Care Determination
• Global Health Engagement
Chapter 2, ORGANIZATION AND FUNCTIONS OF THE MEDICAL COMPANY
• Medical Company, Brigade Support
• Medical Company, Area Support
• Medical Company, Multidomain Task Force
• Organization and Functions of the Medical Company Subordinate
Elements
Chapter 3, EMPLOYMENT AND OPERATION OF THE MEDICAL COMPANY
• Employment of the Medical Company
• Operations of the Medical Company
Chapter 4, ARMY HEALTH SYSTEM SUPPORT TO OPERATIONS
• Conducting Army Health Support for Military Actions
• Role 2 Support in Specific Environments
• Role 2 Support to Specific Operations
Chapter 5, MEDICAL COMPANY (ROLE 2) SUPPORT FOR THE DEFENSE
• Overview of Defensive Operations
• Army Health System Support Planning for the Defense
Chapter 6, MEDICAL COMPANY (ROLE 2) SUPPORT FOR THE OFFENSE
• Overview of Offensive Operations
• Army Health System Support Planning for the Offense
• Army Health System Support to Maneuver
Chapter 7, ORGANIZATION AND FUNCTIONS OF THE DIVISION AND
BRIGADE
• Organization and Functions of the Division
• Organization and Functions of Brigade Combat Teams
Chapter 8, MEDICAL ENABLERS
• Force Health Protection Enablers
• Health Service Support Enablers
• Integration of Medical Enablers into Role 2 Operations
Chapter 9, COMMAND AND CONTROL
• Command and Control
• Echelons Above Brigade Medical Staff Officers and Sections
• Brigade Combat Team Surgeons, Medical Staff Sections, and Medical
Leaders
Chapter 10, MEDICAL INFORMATION SYSTEMS
• Medical Information Systems
• Employment of the Medical Communications for Combat Casualty Care
System
APPENDICES
• ARMY HEALTH SYSTEM SUPPORT ESTIMATES, PLANNING, AND
REHEARSALS
• MASS CASUALTY OPERATIONS
• RECORDS, REPORTS, AND PLANNING TOOLS
• MANAGEMENT OF GROUND AMBULANCE OPERATIONS
• TELEMEDICINE TACTICS, TECHNIQUES, AND PROCEDURES
• WASTE MANAGEMENT
• MEDICAL TRAINING
The Medical
Company (Role 2)
ATP 4-02.6, Medical Companies
(Role 2) provides information on
the structure and operation of
medical companies in a Role 2
capacity within the theater of
operation. It is directed toward
the medical company leadership
as well as the medical platoon
leader and platoon sergeant
who conduct medical operations
to the Role 1 battalion aid
stations from the Role 2 medical
treatment facility (MTF). The
tactics, techniques, and
procedures provided are not allinclusive. They provide a way of
performing a particular mission
but may require medical support
based on mission, enemy,
terrain, troops, time available,
and civilian considerations.
This publication provides
information on how force health
protection and health service
support are provided by medical
organizations, medical
companies, and sections
organic to the division and
corps. It outlines the
responsibilities of the medical
company. It provides definitive
information and doctrinal tools
on planning, rehearsing, and
conducting Army Health System
Support at Role 2. It provides
tactics, techniques, and
procedures for directing,
controlling, and managing Army
Health System support at the
company level. It describes the
troop leading procedures and
military decision-making
processes required for medical
support and identifies interface
and coordination requirements
with other brigade, division, and
corps medical elements.
November 2022
https://armypubs.army.mil
16 March 2023
AHS Doctrine Smart Book
43
Part Two
* ATP 4-02.7
ATP 4-02.7
MTTP HSS in a CBRN Environment
Chapter 1, CHEMICAL, BIOLOGICAL, RADIOLOGICAL, AND NUCLEAR
ASPECT OF HEALTH SERVICE SUPPORT
Chapter 2, CASUALTY PREVENTION
Chapter 3, CASUALTY CARE AND MANAGEMENT
Multiservice
Tactics,
Techniques, and
Procedures for
Health Service
Support in a CBRN
Environment
Chapter 4, MEDICAL EVACUATION IN A CHEMICAL, BIOLOGICAL,
RADIOLOGICAL, AND NUCLEAR ENVIRONMENT
Chapter 5, PATIENT DECONTAMINATION
Chapter 6, VETERINARY SERVICE SUPPORT
Chapter 7, PREVENTIVE MEDICINE / PUBLIC HEALTH COMMAND
Chapter 8, MEDICAL LABORATORY SUPPORT
Chapter 9, COMBAT AND OPERATIONAL STRESS CONTROL
Chapter 10, MEDICAL LOGISTICS SUPPORT
Chapter 11, HOMELAND DEFENSE
Chapter 12, COLLECTIVE PROTECTIVE SHELTER SYSTEMS
APPENDICES
• CHEMICAL, BIOLOGICAL, RADIOLOGICAL, AND NUCLEAR
CASUALTY ESTIMATION
• HEALTH SERVICE SUPPORT CHEMICAL, BIOLOGICAL,
RADIOLOGICAL, AND NUCLEAR ANNEX TO AN OPERATION ORDER
• SERVICE-SPECIFIC CHEMICAL, BIOLOGICAL, RADIOLOGICAL,
AND NUCLEAR DEFENSE CAPABILITIES
• VETERINARY GUIDELINES FOR FOOD CONTAMINATION AND
DECONTAMINATION
ATP 4-02.7
provides
information for use
by the component
commanders and
their staffs,
command
surgeons, medical
planners, and
individuals
responsible for HSS
in a CBRN
environment.
Commanders have
the direct
responsibility for
protecting their
forces within a
CBRN environment.
On future
battlefields, failure
to properly plan and
execute CBRN
defensive
operations may
result in significant
casualties,
disruption of
operations, and
even mission
degradation.
Further, the
commander’s
mission and
execution plans
must address the
implications of HSS
in a CBRN
environment.
March 2016
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Army Health System Hierarchy and Summaries
* ATP 4-02.8
ATP 4-02.8
Force Health Protection
Chapter 1, FORCE HEALTH PROTECTION AND THE PERFORMANCE
TRIAD
• Force Health Protection
• Performance Triad
Force Health
Protection
Chapter 2, PREVENTIVE MEDICINE
• Disease and Nonbattle Injury and the Health of the Command
• Purpose of Preventive Medicine
• Medical Detachment (Preventive Medicine)
• Preventive Medicine Mission
• Major Preventive Medicine Programs and Services
• Employment of Preventive Medicine Assets
• Health Surveillance
• Base Camp Development
To Be
Rescinded
Chapter 3, VETERINARY SERVICES
• Veterinary Support in Military Operations
• Veterinary Support Structure
• Veterinary Service Staff Positions
• Veterinary Roles of Medical Care
• Veterinary Service Support for Subsistence
Chapter 4, COMBAT AND OPERATIONAL AND STRESS CONTROL
INTERVENTIONS AND ACTIVITIES
• Overview of Combat and Operational Stress Control
• Combat and Operational and Stress
• Principles and Subfunctions of Combat and Operational Stress Control
• Combat and Operational Stress Control Interventions and Activities
• Unit Ministry Team Support
• Mental Health Sections
• Medical Detachment, Combat and Operational Stress Control
Chapter 5, PREVENTIVE DENTISTRY (THIS CHAPTER IS
SUPERSEDED BY ATP 4-02.19)
Chapter 6, AREA MEDICAL LABORATORY
• Area Medical Laboratory Services
• Area Medical Laboratory Services
• Area Medical Laboratory
APPENDICES
• DETERMINATION OF ELIGIBILITY FOR CARE OF MILITARY
WORKING DOGS AND OTHER GOVERNMENT-OWNED ANIMALS]
To Be Rescinded after publication of ATP 4-02.17, ATP 402.18, and ATP 4-02.20.
SEE NOTE ON PAGE 34.
ATP 4-02.8, Force
Health Protection, is the
current Army Health
System doctrinal
publication in which the
following 5 protection
related medical functions
are described:
preventive medicine;
veterinary services; area
medical laboratory
services; and the
preventive aspects of
dental services and
combat and operational
stress control. This
publication will ultimately
be superseded by
updated individual
doctrinal references for
each of these 5 medical
functions.
ATP 4-02.8 focuses on
Force Health Protection
support to unified land
operations. This doctrine
is based on Department
of Defense and
Department of the Army
policies; Department of
Defense directives;
Department of Defense
instructions; Army
regulations; Army
doctrine publications;
field manuals; Army
technique publications;
technical bulletins
(medical); technical
manuals; technical
guides; training circulars;
lessons learned from
recent military
operations; and
approved Army doctrine.
March 2016 (C1 August 2020)
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45
Part Two
ATP 4-02.10
ATP 4-02.10
Theater Hospitalization
Chapter 1, THEATER HOSPITALIZATION OVERVIEW
• Hospitalization as a Medical Function
• Hospitalization Tasks
• Principles of the Army Health System
• Role 3 Medical Treatment Facilities
Chapter 2, COMBAT SUPPORT HOSPITAL (ORGANIZATIONS AND
FUNCTIONS)
• The 248-bed combat support hospital
• Headquarters and Headquarters Detachment 248-Bed Combat Support
Hospital
• Hospital Company A (84 Bed)
• Combat Support Hospital Layout Example
Chapter 3, HOSPITAL CENTER ORGANIZATIONS AND FUNCTIONS
• Introduction to the Hospital Center
• Headquarters and headquarters Detachment, Hospital Center
• Field Hospital (32-Bed)
• Hospital Augmentation Detachment Surgical (24-bed)
• Hospital Augmentation Detachment Medical (32-bed)
• Hospital Augmentation Intermediate Care Ward 60-bed
• Concept of Employment
• Hospital Center Command Relationships
• Hospital Center Layout Examples
• Hospital Center Requirements Computations
• Time to Establish the Hospital
Chapter 4, HOSPITAL AND SURGICAL AUGMENTATION
• Hospital Augmentation Team (Head and Neck)
• Medical Detachment (Minimal Care, 120-Bed)
• Medical Team, Forward Surgical
• Medical Detachment, (Forward Resuscitative and Surgical)
Theater
Hospitalization
ATP 4-02.10
provides a
discussion about
hospitalization, as
one of the ten
medical functions,
as well as tactics,
techniques, and
procedures to
plan and employ
a Role 3 Army
hospital and
hospital
augmentation
organizations
within an area of
operations.
Chapter 5, OPERATIONAL CONSIDERATIONS
• Employment of Field Medical Units and Hospitals
• Class VIII Supply and Logistics Operations in a Hospital
• Army Health System Support in specific Operational Environments
• Deceased Personnel
Chapter 6, LAW OF LAND WARFARE AND GENEVA CONVENTIONS
• Law of Armed Conflict
• Geneva Conventions
APPENDICES
• HOSPITAL PLANNING FACTORS
• NUTRITION CARE OPERATIONS
• INFORMATION SYSTEMS
• HOSPITAL WASTE
• HOSPITAL SAFETY
• HOSPTIALIZATION SUPPORT TO ARMY STRATEGIC ROLES
August 2020
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Army Health System Hierarchy and Summaries
ATP 4-02.11
ATP 4-02.11
Casualty Response
PART ONE
CASUALTY RESPONSE
Chapter 1, CASUALTY RESPONSE FOR ARMY UNITS
• Casualty Operations
• Duties and Responsibilities
• Casualty Collection Point Operations
• Contaminated Casualty Care
Casualty Response
Not Yet
Published
Chapter 2, CASUALTY RESPONSE FOR MARINE UNITS
• Medical Support in an Amphibious Operation
Chapter 3, CASUALTY RESPONSE FOR NAVAL UNITS
Chapter 4, CASUALTY RESPONSE FOR AIR FORCE UNITS
PART TWO
TACTICAL COMBAT CASUALTY CARE
Chapter 5, TACTICAL COMBAT CASUALTY CARE
• General Information
• Understanding Vital Body Functions and Systems
• Tactical Combat Casualty Care Tiered Skills
• Training Requirements
• Training Procedures
• Online Resources
• Principles and Application of Tactical Combat Casualty Care
• Phases of Tactical Combat Casualty Care
• Medical Equipment
Chapter 6, TACTICAL COMBAT CASUALTY CARE SKILLS FOR ALL
SERVICE MEMBERS
Chapter 7, TACTICAL COMBAT CASUALTY CARE SKILLS FOR
COMBAT LIFESAVERS
Chapter 8, PREVENTION AND CONTROL OF SHOCK
ATP 4-02.11
serves as a
primary doctrine
reference for
holistic casualty
response.
Implementation of
the techniques
presented in this
publication enable
Service Members
to execute
casualty
response, render
first aid, and
prevent greater
harm to injured
Service Members.
Chapter 9, PERFORM FIRST AID FOR SPECIFIC INJURIES
Chapter 10, FIRST AID FOR FRACTURES
Chapter 11, FIRST AID FOR CLIMATIC INJURIES
Chapter 12, FIRST AID FOR BITES AND STINGS
Chapter 13, FIRST AID IN A CHEMICAL, BIOLOGICAL, RADIOLOGICAL,
AND NUCLEAR ENVIRONMENT
Chapter 14, FIRST AID FOR COMBAT AND OPERATIONAL STRESS
CONTROL
Chapter 15, RESCUE BREATING
Chapter 16, IMPALEMENT INJURIES
Chapter 17, TRANSPORTING A CASUALTY
Procedures and
tasks provided in
ATP 4-02.11,
enable every
Soldier to perform
those tasks to
provide the
casualty response
until evacuated or
relieved by
appropriately
trained medical
personnel.
Chapter 18, SICKLE CELL TRAIT
Tentative Completion Date: 4QTR FY24.
SEE NOTE ON PAGE 34.
New Publication
In Development
16 March 2023
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Part Two
ATP 4-02.12
ATP 4-02.12
Army Health System Command and Control
PART ONE
MEDICAL COMMAND AND CONTROL
Chapter 1, Medical Command and Control Overview
• Medical Command and Control Defined
• Operational Environment
• Introduction to the Army health System
• Medical Commander, Command Surgeon, and Line Commander
• Eligibility of Care Determination
• Global Health Engagement
Chapter 2, Effects of the Law of Armed Conflict on Army Health System
Command and Control
PART TWO
ARMY HEALTH SYSTEM COMMAND AND CONTROL
WITHIN ORGANIZATIONS
Chapter 3, Medical Command and Control at Brigade and Below
Organizations
Chapter 4, Medical Command and Control at Echelons above Brigade
Organizations
Chapter 5, Medical Battalion (Multifunctional)
Chapter 6, Medical Brigade (Support)
Chapter 7, Theater Medical Command
PART THREE
ARMY HEALTH SYSTEM CONTROL FOR THE SURGEON
AND SURGEON SECTION
Chapter 8, Battalion Surgeon
Chapter 9, Brigade Surgeon
Chapter 10, Division Surgeon
Chapter 11, Corps Surgeon
Chapter 12, Theater Surgeon
Chapter 13, Surgeon’s Role in Planning Army Health System Support
Operations
APPENDICES
• REPORTS
• MEDICAL COMMAND AND CONTROL, CONTROL, AND SUPPORT
RELATIONSHIPS
• COMMAND POST OPERATIONS
• MEDICAL PLANNING CONSIDERATIONS (TO INCLUDE JOINT AND
MULTINATIONAL OPERATIONS)
• MEDICAL COMMON OPERATIONAL PICTURE, MEDICAL
SYNCHRONIZATION SKETCH (MATRIX), AND ARMY HEALTH SYSTEM
OPERATIONAL OVERLAY
• MEDICAL INTELLIGENCE
• TELEMEDICINE TACTICS, TECHNIQUES, AND PROCEDURES
• ARMY HEALTH SYSTEM SYMBOLOGY
• TACTICAL STANDARD OPERATING PROCEDURE (SURGEON/SPO)
Tentative Completion Date: 2QTR FY24.
SEE NOTE ON PAGE 34.
Army Health
System Command
and Control
Not Yet
Published
ATP 4-02.12
provides medical
command and
control doctrine
for the provision
of Army Health
System (AHS)
support at all
echelons. It
discusses all
roles of care
within the theater
to include a
discussion of the
AHS as the
overarching
concept of
support for
providing timely
medical support
to the tactical
commander. This
publication is
designed for use
by commanders,
surgeons, their
staffs, and all
medical units that
are involved in
the planning and
execution of
medical
operations at all
echelons.
New Publication
In Development
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Army Health System Hierarchy and Summaries
ATP 4-02.13
ATP 4-02.13
Casualty Evacuation
Chapter 1, CASUALTY EVACUATION
• Casualty Evacuation and the Army Health System
• Command Responsibility and Planning
• Casualty Training and Rehearsals
• Casualty Collection Points
Chapter 2, MANUAL EVACUATION METHODS
• Casualty Handling
• Manual Carries
• Drags
Chapter 3, LITTER EVACUATION
• Standard Litters
• Improvised Litters
Chapter 4, CASUALTY EVACUATION PLATFORMS
• Ground Vehicles Used for Casualty Evacuation
• Army Nonmedical Aircraft
• Army Watercraft
• Alternative Platforms
Chapter 5, ROUGH TERRAIN CONSIDERATIONS
• Rough Terrain
• Rough Terrain Planning Considerations
• Techniques for Negotiating Hazards During Casualty Evacuation
Chapter 6, CASUALTY EVACUATION IN SPECIFIC ENVIRONMENTS
• Mountainous Terrain
• Jungle Terrain
• Desert Terrain
• Extreme Cold
• Urban Terrain
Chapter 7, CASUALTY EVACUATION IN A MASS CASUALTY
SITUATION
• Mass Casualty Situations
• Casualty Management
APPENDICES
• EXAMPLE OF A MASS CASUALTY PLAN
• LITTER EVACUATION TRAINING
• 9-LINE MEDICAL EVACUATION REQUEST
• CASUALTY EVACUATION CHECKLIST
Casualty
Evacuation
ATP 4-25.13
provides doctrine
for conducting
casualty
evacuation
(CASEVAC).
Casualty
evacuation
encompasses
both the
evacuation of
Soldiers from the
point of injury or
wounding to a
medical treatment
facility (MTF) and
the coordination
requirements for
the use of
nonmedical
transportation
assets to
accomplish the
CASEVAC
mission.
June 2021
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Part Two
ATP 4-02.17
ATP 4-02.17
Operational Public Health
PART ONE
FUNCTION
THE
OPERATIONAL
PUBLIC
HEALTH
MEDICAL
Operational Public
Health
Chapter 1, OPERATIONAL PUBLIC HEALTH OVERVIEW
Chapter 2, LEVELS OF OPERATIONAL PUBLIC HEALTH SUPPORT
Chapter 3, OPERATIONAL PUBLIC HEALTH TO STABILITY
OPERATIONS AND DEFENSE SUPPORT OF CIVIL AUTHORITIES
Chapter 4, HEALTH AND MEDICAL SURVEILLANCE PROCEDURES
• Health Surveillance
• Medical Surveillance
Chapter 5, PREVENTIVE MEDICINE MEASURES
Chapter 6, OPERATIONAL PUBLIC HEALTH MEDICINE PROGRAMS
AND SERVICES
• PART TWO
OPERATIONAL PUBLIC HEALTH UNITS, STAFF,
AND DEPLOYMENT
Chapter 7, MEDICAL DETACHMENT (PREVENTIVE MEDICINE)
Chapter 8, AREA MEDICAL LABORATORY
Chapter 9, ARMY
PERSONNEL
MEDICINE
OPERATIONAL
PUBLIC
HEALTH
Chapter 10, OPERATIONAL PUBLIC HEALTH IN AN AREA OF
OPERATIONS
APPENDICES
• PLANNING/PREPARATIONS FOR PREVENTIVE MEDICINE IN
MILITARY OPERATIONS
• PREVENTIVE MEDICINE SUPPORT TO BASE CAMPS
• PREVENTIVE MEDICINE SITE SURVEY CHECKLIST
• OPERATIONAL PUBLIC HEALTH SUPPORT TO THE ARMY’S FOUR
STRATEGIC ROLES
Not Yet
Published
ATP 4-02.17,
Operational Public
Health, provides
doctrinal
information
concerning the
mission, primary
tasks,
organizations, and
personnel for
operational public
health services
throughout the
range of military
operations. It also
provides
procedures for
directing,
controlling, and
managing
operational public
health assets in the
area of operations
(AO).
TENTATIVE COMPLETION DATE: 3QTR FY25.
ATP 4-02.17, when
published, will be
the proponent
publication for the
operational public
health medical
function and
preventive medicine
organizations. It is
one of the Army
Health System’s 10
medical functions
(see FM 4-02).
SEE NOTE ON PAGE 34.
New Publication
In Development
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Army Health System Hierarchy and Summaries
ATP 4-02.18
ATP 4-02.18
Veterinary Services
Chapter 1, VETERINARY SUPPORT IN MILITARY OPERATIONS
• Veterinary Mission Statement
• Veterinary Services, and Support
• Food Protection and Quality Assurance
• Veterinary Medical Care
• Veterinary Public Health
• Non-Combatant Evacuation Operations
• Global Health Engagement
• Defense Support to Civil Authorities
• Veterinary Personnel and the Geneva Conventions
Chapter 2, EMPLOYMENT OF VETERINARY UNITS
• Employment and Deployment of Veterinary Units
• Veterinary Facilities
• Medical Detachment (Veterinary Service Support)
• Subordinate Organizations to the Medical Detachment (Veterinary Service
Support)
Chapter 3, OTHER VETERINARY SERVICE SUPPORT
• Veterinary Services Staff Positions
• Duties of the Veterinary Staff Officer
• Military Working Dog Units
• Area Medical Laboratory
• Special Operations Forces
• Civil Affairs Units
• U.S. Navy Marine Mammal Systems
• North Atlantic Treaty Organization
Chapter 4, VETERINARY SERVICE SUPPORT FOR SUBSISTENCE
• Food Protection
• Levels of Veterinary Support for Food Safety and Defense
• Subsistence Stock
• Subsistence Support to Deployed Forces
Chapter 5, VETERINARY SERVICE SUPPORT FOR ANIMAL MEDICAL CARE
• Veterinary Roles of Medical Care
• Human Healthcare Provider Training and Clinical Practice Guidelines
• Class VIII Resupply for Animal Medical Care
• Medical Equipment Maintenance Support
Chapter 6, VETERINARY SERVICE SUPPORT FOR NONCOMBATANT
EVACUATION OPERATIONS
Chapter 7, VETERINARY SERVICE FOR STABILITY AND DEFENSE SUPPORT
TO CIVIL AUTHORITIES
Chapter 8, VETERINARY SERVICE SUPPORT IN A CHEMICAL, BIOLOGICAL,
RADIOLOGICAL, AND NUCLEAR ENVIRONMENT
APPENDICES
• FORMAT FOR VETERINARY ESTIMATE
• ARMY OF EXCELLENCE K-SERIES TABLE OF ORGANIZATION AND
EQUIPMENT VETERINARY SERVICE IN MILITARY OPERATIONS
• MILITARY WORKING DOG PROGRAM VETERINARY SERVICE
• DETERMINATION OF ELIGIBILITY OF CARE OF MILITARY WORKING
DOGS AND OTHER GOVERNMENT-OWNED
• NONCOMBATANT EVACUATION OPERATIONS PET PLANNING TEMPLATE
Veterinary Services
Not Yet
Published
Currently
veterinary service
is covered in FM
4-02, Army Health
System and ATP
4-02.8, Force
Health Protection.
Once published,
ATP 4-02.18 will
provide basic
veterinary service
doctrine as a
medical function
and the tactics,
techniques, and
procedures
required for
veterinary service
organizations and
staff members in
a theater of
operations. It
focuses on
current Army
Health System
doctrine. The
tactics,
techniques, and
procedures are
all-inclusive.
TENTATIVE COMPLETION DATE: 3QTR FY24.
SEE NOTE ON PAGE 34.
•
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Part Two
ATP 4-02.19
ATP 4-02.19
Dental Services
Chapter 1, OVERVIEW OF DENTAL SERVICES
• Importance of Army Dentistry
• Army Dental Readiness
• Levels of Dental Care
• Categories of Dental Care
• Dental Classification
• Additional Wartime Roles
• Eligibility Determination for Dental Care
Chapter 2, DENTAL STAFF POSITIONS AND RESPONSIBILITIES
• Dental Staff Positions and Responsibilities Overview
• Dental Staff Officer and Noncommissioned Officer Positions Army
• Medical Command (Deployment Support)
• Medical Brigade (Support)
Chapter 3, ORGANIZATION AND EMPLOYMENT OF DENTAL
CAPABILITIES
• Concept of Operations
• Medical Evacuation of Dental Patients
• Dental Treatment Capabilities located in the Close Area
• Dental Treatment Capabilities located in the Consolidation Area
• Dental Treatment Capabilities located in the Joint Security Area
• Dental Treatment Capabilities located in the Strategic Support Area
Chapter 4, EMPLOYMENT OF THE DENTAL COMPANY (AREA
SUPPORT)
• Operational Information
• Administrative Information
Chapter 5, DENTAL UNIT OPERATIONS
• Establishing the Dental Treatment Facility
• Administrative Tools and Requirements
• Treatment Facility Operations
Dental Services
ATP
4-02.19
provides the basic
doctrine and the
tactics,
techniques, and
procedures
required for the
dental
service
support (DSS) in a
theater
of
operations (TO).
It focuses on
current
Army
Health
System
(AHS)
doctrine.
The
tactics,
techniques, and
procedures
are
not all-inclusive.
Chapter 6, DENTAL SERVICES SUPPORT TO UNIQUE MISSIONS
• Dental Support to Stability Operations
• Dental Support to Special Operations
• Dental Support to Detainee Operations
• Dental Support to Chemical, Biological, Radiological, and Nuclear
Operations
APPENDICES
• DENTAL EQUIPMENT SETS
• QUALITY ASSURANCE PLANS
• SAMPLE CLINICAL STANDING OPERATING PROCEDURE
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Army Health System Hierarchy and Summaries
ATP 4-02.20
ATP 4-02.20
Combat and Operational Stress Control
PART ONE THE COMBAT AND
OPERATIONAL STRESS CONTROL
MEDICAL FUNCTION
Chapter 1, COMBAT AND OPERATIONAL
STRESS CONTROL PROGRAM
• Combat and Operational Stress Control
Program Overview
• Intervention and Control for the Combat
and Operational Stress Threat
• Principles and Functional Areas for
Combat and Operational Stress Control
Chapter 2, BEHAVIORAL HEALTH AND
COMBAT AND OPERATIONAL STRESS
CONTROL ELEMENTS IN THE AREA OF
OPERATION
• Medical Detachment, Combat and
Operational Stress Control
• Behavioral Health Resources in an Area
of Operations
Chapter 3, COMBAT AND OPERATIONAL
STRESS CONTROL OPERATIONS
• Combat and Operational Stress Control
Professional Disciplines and Professional
Consultants
• Deployment and Employment of the
Medical Detachment, Combat and
Operational Stress Control
Chapter 4, CONSULTATION AND
EDUCATION
• Principles and Tenets of Consultation
and Education
• Consultation, Education, and Planning
• Transition Management and Support in
the Deployment Cycle
Chapter 5, UNITS NEEDS ASSESSMENT
• Principles and Tenets of Unit Needs
Assessment
• Focus and Methods of Unit Needs
Assessment
Chapter 6, TRAUMATIC EVENT
MANAGEMENT
• Overview of Traumatic Event
Management
• Cool Down Meeting
• Leader led After Action Debriefing
Chapter 7, RECONSTITUTION
• Purpose of Unit Reconstitution Support
and Reconstitution Process
TENTATIVE COMPLETION DATE: 1QTR
FY25.
SEE NOTE ON PAGE 34.
Chapter 8, COMBAT AND
OPERATIONAL STRESS CONTROL
TRIAGE
• The Triage Process
• Precautions and Different
Diagnostic Problems with Triage
• Emergency and Full Stabilization
Combat and
Operational Stress
Control
Not Yet
Published
Chapter 9, COMBAT AND
OPERATIONAL STRESS SOLDIER
RESTORATION
• Soldier and Line of Soldier
Restoration
Chapter 10, RECONDITIONING
• Reconditioning Program
• Tenants, Procedures of
Reconditioning, and Evacuation
Policy
PART TWO COMBAT AND
OPERATIONAL STRESS CONTROL
UNITS, STAFF, AND DEPLOYMENT
CHAPTER 11, MEDICAL
DETACHMENT (COMBAT AND
OPERATIONAL STRESS CONTROL)
• Mission, Assignment,
Dependencies, Basis of Allocation,
Capabilities, Functions, and
Mobility
CHAPTER 12, COMBAT AND
OPERATIONAL STRESS CONTROL IN
AN AREA OF OPERATION
• Preventive Medicine Officer (MC);
Public Health Dentist (DC);
Veterinary Preventive Medicine
Officer (VC); Army Public Health
Nurse (ANC); Environmental
Science and Engineer Officer (MS);
Enlisted Behavioral Health
Specialist (MOS 68X)
• Combat and Operational Stress
Control Staff
• Army Service Component
Command, Corps, Division, Medical
Command (Deployment Support),
Medical Brigade (Support), Medical
Battalion (Multifunctional), and
Medical Company, Brigade Support
Battalion
APPENDICES
• COMMAND DIRECTED
BEHAVIORAL HEALTH
EVALUATION
• COSCWARS
• MILITARY ACUTE CONCUSSION
EVALUATION
• UNIT NEEDS ASSESSMENT
SURVEY
ATP 4-02.20
provides doctrinal
information, as
well as
techniques, and
procedures for
employing
combat and
operational stress
units and
implementing
behavioral health
programs in
deployed
operations. It
addresses
operational
considerations,
planning,
functional
capacities, and
capabilities of
combat and
operational stress
control units and
associated
behavioral health
system program
capabilities.
New Publication
In Development
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Part Two
ST 4-02.52
ST 4-02.52
Mild Traumatic Brain Injury / Concussion
Chapter 1, OVERVIEW AND HISTORICAL PERSPECTIVE
• Mild Traumatic Brain Injury/Concussion Care Overview
• Army Enterprise Management Strategy for Mild Traumatic Brain
Injury/Concussion
• Department of Defense Policy Guidance
• Command and Medical Responsibilities
• Theater Evacuation Policy
Chapter 2, OPERATIONAL FORCE PLANNING CONSIDERATIONS
• Planning and Task-Organization
• Planning Checklist
• Operational Technique
Chapter 3, OPERATIONAL FORCE RESOURCES AND CAPABILITIES
• Medical Command (Deployment Support)
• Medical Brigade (Support)
• Medical Battalion (Multifunctional)
• Combat Support Hospital
Chapter 4, GENERATING FORCE AND OTHER RESOURCES AND
CAPABILITIES
• Overview of Care Provided by the Generating Force
• United States Army Medical Command Organizations
• Other Department of Defense and Federal Resources
APPENDICES
• MILD TRAUMATIC BRAIN INJURY TREATMENT ALGORITHMS
Being Added to ATP 4-02.20 as a Chapter: 3QTR FY24.
Mild Traumatic
Brain Injury /
Concussion
To Be
Rescinded
ST 4-02.52 provides
emerging information and
guidance on mild
traumatic brain injury
including the continuum
of medical care from the
point of injury through
continued care provided
by the Department of
Veterans Affairs. The
publication describes an
overview of mild
traumatic brain
injury/concussion policies
and guidelines issued by
the Department of
Defense and Department
of the Army. This
publication is for use by
training developers, and
medical and nonmedical
commanders and their
staff for information and
planning purposes.
This special text does not
establish requirements
for military units and/or
organizations that have
not been developed,
staffed, and approved
through the force
development process.
This publication is based
on current policies,
doctrine, lessons,
observations, and
insights from ongoing
operations and provides
a basis of info1mation
upon which future
concepts, policies, and
doctrine may be
developed. Current
actions being staffed will,
upon approval,
incorporate these
changes into relevant
doctrine, Anny
regulations, and technical
guides.
SEE NOTE ON PAGE 34.
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Army Health System Hierarchy and Summaries
ATP 4-02.25
ATP 4-02.25
The Medical Detachment, Forward Resuscitative and Surgical
Chapter 1, THE FORWARD RESUSCITATIVE AND SURGICAL
DETACHMENT
• Mission
• Damage Control Resuscitation and Surgery
• Assignment
• Limitations
• Mobility
• Dependencies
• Basis of Allocation
Chapter 2, ORGANIZATION AND CAPABILITIES
• Organization
• Personnel and Capabilities
• Administration/Supply Section
• Duties and Responsibilities
• Forward Resuscitative Section
• Duties and Responsibilities
• Forward Surgical Section
• Duties and Responsibilities
Chapter 3, TRAINING
• Training the Detachment
• Rehearsals Blood Support
• Standard Operating Procedures
Chapter 4, DEPLOYMENT
• Deploying the Detachment
• Planning
• Critical Information Requirements
• Medical Equipment Maintenance and Repair
• Blood and Blood Support
• Establishing the Surgical Facility
• Displacement and Redeployment
• Disposition of Remains
Being Added to ATP 4-02.10 as a Chapter: 3QTR FY24.
SEE NOTE ON PAGE 34.
The Medical
Detachment,
Forward
Resuscitative and
Surgical
To Be
Rescinded
FM 4-02 provides
doctrine for the
Army Health
System (AHS) in
support of the
modular force.
The
AHS is the
overarching
concept of
support for
providing timely
AHS support to
the tactical
commander. It
discusses the
current AHS force
structure
modernized under
the Department of
the Army
approved
Medical
Reengineering
Initiative and the
Modular Medical
Force that is
designed to
support the
brigade combat
teams and
echelons above
brigade units
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55
Part Two
ATP 4-02.42
ATP 4-02.42
AHS Support to Stability and DSCA
Chapter 1, STABILITY OVERVIEW
• Stability Operations
• Lead Federal Agency
• National Strategy and Defense Policies
• Regional Focus
Chapter 2, ESSENTIAL STABILITY TASKS
• Primary Stability Tasks
• Establish Civil Security
• Restore Essential Services
• Support to Economic and Infrastructure Development
Chapter 3, ARMY HEALTH SYSTEM SUPPORT TO STABILITY TASKS
• Building Partner Capacity
• Civil-Military Operations
• Legal Considerations
• Medical Support to Stability Tasks
Chapter 4, MEDICAL PLANNING FOR STABILITY
• Planning for Contingency Operations
• Transition and End State
• Medical Planning Considerations for Stability
• Army Health System Support to Joint Operations
Chapter 5, DEFENSE SUPPORT OF CIVIL AUTHORITIES OVERVIEW
• Defense Support of Civil Authorities
• National and Defense Policy
• Primary Defense Support of Civil Authorities Tasks
• National Emergency Management
Chapter 6, ARMY HEALTH SYSTEM SUPPORT TO DEFENSE SUPPORT
OF CIVIL AUTHORITIES TASKS
• Department of Defense Medical Support for Domestic Incidents
• Legal Considerations
• Army Health System Support
Chapter 7, INTERORGANIZATIONAL COORDINATION
• Coordination Requirements
• Coordination in Support of Stability Tasks
• Coordination in Support of Defense Support of Civil Authorities
• National Response Resources
• National Response Framework Support Agencies
• Other Emergency Response Resources
APPENDICES
• ARMY HEALTH SYSTEM SUPPORT ASSESSMENTS
• SECTION OF TITLE 10, UNITED STATES CODE, PERTAINING TO
FOREIGN HUMANITARIAN ASSISTANCE
AHS Support to
Stability and DSCA
ATP 4-02.42
establishes Army
Health System
support doctrine
and provides the
guiding principles
for the provision of
medical support to
stability and
defense support of
civil authorities
(DSCA) tasks.
The principal
audience for this
publication is
commanders, their
staffs, medical
planners, and
personnel at all
levels.
Commanders at all
levels ensure their
Soldiers operate in
accordance with the
law of war and the
rules of
engagement. (See
FM 27-10.)
This manual is a
guide for providing
AHS support to
stability and DSCA
tasks in an area of
operations. This
publication applies
to all three
COMPOS, unless
otherwise stated.
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Army Health System Hierarchy and Summaries
* ATP 4-02.43
ATP 4-02.43
AHS Support to Special Operations Forces
AHS Support to
Special Operations
Forces
Chapter 1, OVERVIEW OF ARMY HEALTH SYSTEM SUPPORT
• Purpose
• Roles of Medical Care
• Principles of the Army Health System
• Army Health System Medical Functions
Chapter 2, SPECIAL OPERATIONS FORCES MISSIONS AND ACTIVITIES
• Core Activities of Army Special Operations Forces
• Special Operations Core Activities
• Mission Tasking Authority
• Army Special Operations Force Organizations
• Medical Capabilities of Army Special Operations Forces
• Medical Personnel in Army Special Operations Forces
Chapter 3, ARMY HEALTH SYSTEM AND ARMY MEDICAL DEPARTMENT
FUNCTIONS IN SUPPORT OF ARMY SPECIAL OPERATIONS FORCES
• Medical Evacuation
• Medical Treatment (Organic and Area Support)
• Hospitalization
• Medical Logistics
• Preventive Medicine Services
• Veterinary Services
• Dental Services
• Combat and Operational Stress Control
• Medical Laboratory Services
• Medical Mission Command
• Conventional Versus Special Operations Forces Army Health System
Support
Chapter 4, PLANNING ARMY HEALTH SYSTEM SUPPORT TO ARMY
SPECIAL OPERATIONS FORCES
• Health Threats
• Army Special Operations Forces Planning for Army Health System Support
Chapter 5, ARMY SPECIAL OPERATIONS FORCES IN A
OPERATIONS AREA
• The Joint Task Force
• Special Operations Forces in Joint Operations
• Army Health System Considerations in Joint Task Force Planning
JOINT
Chapter 6, MEDICAL LOGISTICS SUPPORT TO ARMY SPECIAL
OPERATIONS FORCES
• The Army Special Operations Forces Medical Logistics Requirements
• Duties and Responsibilities for the Management of Medical Logistics
APPENDICES
• ARMY SPECIAL OPERATIONS FORCES AND MEDICAL
CONSIDERATIONS IN THE LAW OF WAR
• PLANNING MEDICAL EVACUATION FOR ARMY SPECIAL
OPERATIONS FORCES
• MISSION COMMAND STRUCTURES AND INTEGRATING ELEMENTS
OF SPECIAL OPERATIONS FORCES IN THE JOINT CAMPAIGN
ATP 4-02.43 provides
the authoritative
doctrine for the Army
Medical Department’s
Army Health System
support of Army
special operations
forces (ARSOF) as
part of the protection
and sustainment
warfighting functions
support to unified land
operations. Army
special operations
forces that are
specifically organized,
trained, and equipped
to conduct and
support special
operations. The
acronym ARSOF
represents special
forces, special
mission units,
Rangers, civil affairs,
military information
support operations,
and Army special
operations aviation
forces assigned to the
United States Army
Special Operations
Command, which are
all supported by the
special operations
sustainment brigade.
This publication also
discusses joint
special operations
and provides a limited
discussion of other
Services capabilities.
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Part Two
ATP 4-02.46
ATP 4-02.46
AHS Support to Detainee Operations
Chapter 1, OVERVIEW OF ARMY HEALTH SYSTEM SUPPORT TO
DETAINEE OPERATIONS
• Detainee Medical Care
• Detainee Categories
• Legal Considerations
• Ethical Considerations for the Medical Treatment of Detainees
AHS Support to
Detainee
Operations
Chapter 2, ROLES, RELATIONSHIPS, AND FUNCTIONS
• Roles and Functions
• Civilian Organizations
Chapter 3, MEDICAL GUIDELINES FOR DETAINEE OPERATIONS
• General Considerations
• Prior to Transfer to an Theater Detention Facility
• Detention Facility Support
• Detainee Outprocessing
• Medical Logistics
• Detainee Descendent Affairs
Chapter 4, ARMY HEALTH SYSTEM FUNCTIONAL SPECIALTIES
• Nursing Support to Detainee Operations
• Nutritional Care
• Eye Care
• Ear and Hearing Care
• Behavioral Health Services
• Public Health
• Pharmacy Services
• Dental Care
• Veterinary Services
APPENDICES
• MEDICAL CODE OF CONDUCT IN DETAINEE OPERATIONS
• MEDICAL INPROCESSING EVALUATION TOOLS
• PUBLIC HEALTH INSPECTION CHECKLIST
• PLANNING CHECKLIST FOR ARMY HEALTH SYSTEM SUPPORT
TO DETAINEE OPERATIONS
• SAMPLE EXTRACT MISSION ESSENTIAL TASK LIST WITH
COLLECTIVE TASKS
• LINGUIST SUPPORT
• IMMUNIZATIONS
ATP 4-02.46
establishes
guidelines for
medical support to
detainee operations
as part of the Army
Health System
(AHS) in the area of
responsibility. It
discusses
command structure
and staff operations
necessary to
provide AHS
support to
detainees.
This manual is
designed for use by
commanders and
their staffs in the
planning and
execution of
providing AHS
support to
detainees. ATP 402.46 is not a
stand-alone manual
and must be used
in combination with
other publications.
These publications
are noted
throughout the
manual and a
consolidated listing
is provided in the
references.
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Army Health System Hierarchy and Summaries
ATP 4-02.55
ATP 4-02.55
Army Health System Support Planning
Chapter 1, ARMY HEALTH SYSTEM IN UNIFIED LAND OPERATIONS
• The Role of Army Health System
• Doctrine
• Army Health System
• Roles of Medical Care
• The Application of Army Health System
Chapter 2, ARMY HEALTH SYSTEM MEDICAL FUNCTIONS
• Medical Command and Control
• Medical Treatment (Organic and Area Support)
• Medical Evacuation
• Dental Services
• Preventive Medicine Services
• Combat and Operational Stress Control
• Veterinary Services
• Medical Logistics
• Medical Laboratory Services
Chapter 3, ARMY HEALTH SYSTEM SUPPORT PLANS AND ORDERS
• Principles of Planning
• Army Health System Support planning
• The Army Health System Support Estimate
• Format of the Army Health System Estimate
• Mission
• Course of Action
• Army Health System Support Analysis
• Evaluation and Comparison of Courses of Action
• Conclusion
• Running Estimates
• The Army Health System Support Plan and Order
• Preparation of the Plan
• Responsibility
• Purpose and Scope
• Format
Chapter 4, COMPUTATIONS
• Terminology
• Classification of Patients
• Army Health System Support for Other Special Category Patients
• Army Health System Support for Enemy Prisoners of War
• Patient Admission Rates
• Patient Admission Rate Computation
• Calculation of Patient Evacuation Requirements
• Time Factors
• Computations
• Automated Methodologies
APPENDICES
• ARMY HEALTH SYSTEM ESTIMATES
• ARMY HEALTH SYSTEM ALLOCATION
• ARMY HEALTH SYSTEM ESTIMATES
• EVACUATION CAPABILITY’S LOCATION
• MEDIACL SITUATION REPORT
• MEDICAL STATUS REPORT
• JOINT MEDICAL CAPABILITIES
Army Health
System Support
Planning
ATP 4-02.55 provides
guidance to the
medical commander,
medical planner, and
command surgeon at
all levels of command
in planning Army
Health System (AHS)
support for unified
land operations.
Users must be
familiar with unified
land operations
established in ADP 30; the operations
process as stated in
ADP 5-0; Army plans
and orders production
as promulgated in FM
6-0; mission
command systems of
tactical units and the
mission command
process established
in ADP 6-0; AHS
support described in
FM 4-02; and the
Joint Health Service
Support system
described in JP 4-02.
This manual provides
the basic framework
for initiating the
planning process for
AHS support. The
planning process for
AHS support includes
all ten medical
functions (Chapter 2);
however, detailed
doctrinal information
is contained in the
specific Army medical
doctrine and not in
this publication.
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Part Two
ATP 4-02.82
ATP 4-02.82
Occupational and Environmental Health Site Assessment
Chapter 1, BACKGROUND
• General
• Occupational and Environmental Health Site Assessment
• Conceptual Site Model
• Occupational and Environmental Health Site Assessment Activities
Chapter 2, OCCUPATIONAL AND ENVIRONMENTAL
ASSESSMENT, PHASE I: PREDEPLOYMENT ACTIVITIES
• General
• Predeployment Activities
HEALTH
SITE
Chapter 3, OCCUPATIONAL AND ENVIRONMENTAL HEALTH
ASSESSMENT, PHASE II: DEPLOYMENT ACTIVITIES
• General
• Site Interviews and Reconnaissance
‒
On-Site/Off-Site Interviews
‒
On-Site/Off-Site Reconnaissance
• Pathway Screening
• Build Consolidated Conceptual Site Model
• Occupational and Environmental Health Site Assessment Report
‒
Service Preventive Medicine Personnel with Access to Defense
Occupational and Environmental Health Readiness System
• Service Preventive Medicine Personnel without Access to Defense
Occupational and Environmental Health Readiness System
‒
Peer Review
SITE
Chapter 4, OCCUPATIONAL AND ENVIRONMENTAL
ASSESSMENT, PHASE III: ADDITIONAL DATA COLLECTION
• General
• Occupational and Environmental Health Sampling
SITE
HEALTH
Chapter 5, OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE
ASSESSMENT, PHASE IV: OCCUPATIONAL AND ENVIRONMENTAL HEALTH
RISK ASSESSMENT
APPENDICES
• JOINT SERVICE: OCCUPATIONAL AND ENVIRONMENTAL HEALTH SITE
ASSESSMENT TEMPLATE
• EXAMPLE OCCUPATIONAL AND ENVIRONMENTAL HEALTH THREAT
SCENARIO AND SAMPLING AND ANALYSIS PLAN
‒
Occupational and Environmental Health Threat Scenario
‒
Conceptual Site Model
‒
Occupational and Environmental Health Sampling and Analysis Plan
‒
Ambient Air: Sampling and Analytical Method(s)
‒
Soil: Sampling and Analytical Method(s)
‒
Occupational and Environmental Health Sampling and Analysis Plan Site
Map
• EXAMPLE DEFENSE OCCUPATIONAL AND ENVIRONMENTAL HEALTH
READINESS SYSTEM OCCUPATIONAL AND ENVIRONMENTAL HEALTH
• SITE ASSESSMENT REPORT
‒
Defense Occupational and Environmental Health Readiness System
‒
Occupational and Environmental Health Site Assessment
‒
Example Survey Report
• PERIODIC OCCUPATIONAL AND ENVIRONMENTAL MONITORING
SUMMARY MILITARY DEPLOYMENT EXAMPLE
Multiservice
Tactics,
Techniques, and
Procedures for
Occupational and
Environmental
Health Site
Assessment
ATP 4-02.82
provides
guidance to
deployed Service
preventive
medicine
personnel who
plan to conduct
occupational and
environmental
health site
assessments
(OEHSAs) on
military
installations in a
theater
operational
environment. This
publication
provides specific
tactical
references to
facilitate the
execution of an
OEHSA to identify
and document
occupational and
environmental
health (OEH)
threat conditions
that may affect
the current and
future health of
deployed military
personnel.
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Army Health System Hierarchy and Summaries
ATP 4-02.83
ATP 4-02.83
MTTP for the Treatment of Nuclear and Radiological Casualties
Chapter 1, NUCLEAR AND RADIOLOGICAL THREAT
• Nuclear and Radiological Weapons
• Medical Sources
• Nuclear Weapons Incidents
• Terrorism and Radiological Dispersal Devices
• Terrorism and a Single Nuclear Detonation
• Nuclear Warfare
Chapter 2, HAZARDS OF NUCLEAR AND RADIOLOGICAL EVENTS
• Types of Ionizing Radiation
• Units of Measure
• Penetration and Shielding
• Nuclear Detonation
• Nuclear Detonation Thermal Radiation Hazards
• Nuclear Detonation Radiation
• Range of Damage
• Radioactive Contamination Hazards
Chapter 3, TREATMENT OF HIGH-DOSE RADIOLOGICAL
COMBINED INJURY CASUALTIES
• Nuclear Detonation
• Ionizing Radiation Effects on Cells and Tissues
• Radiation-Induced Early Transient Incapacitation
• Diagnosis, Severity, and Triage of Radiation Casualties
• Biodosimetry
• Treatment of Radiation Subsyndromes
• Combined Injury: Blast, Thermal, and Radiological Injuries
AND
Chapter 4, RADIOACTIVE CONTAMINATION
• Measuring Levels of Contamination
• External Contamination, Irradiation, and Acute Local Radiation Injury
• Internal Contamination and Irradiation
Chapter 5, LOW-LEVEL RADIATION
• Low-Level Radiation Characteristics and Hazards
• Delayed/Late Health Effects
• Prevention, Initial Actions, and Medical Care and Follow-Up
Chapter 6, PSYCHOLOGICAL EFFECTS AND TREATMENT
COMBAT AND OPERATIONAL STRESS REACTION CASUALTIES
• Psychological Casualties
• Radiation Dispersal Devices and Nuclear Incidents
APPENDICES
• MEDICATIONS
• LEVELS OF IDENTIFICATION
• TREATMENT BRIEFS (CLINICAL GUIDELINES)
• RADIATION AND RISK COMMUNICATION
OF
Multiservice
Tactics,
Techniques, and
Procedures for the
Treatment of
Nuclear and
Radiological
Casualties
ATP 4-02.83 serves as
a guide and a reference
on the recognition and
treatment of nuclear
and radiological
casualties.
It classifies and
describes potential
nuclear and radiological
threats and hazards.
Further, this publication
describes—
1. The biological
aspects of blast,
thermal radiation, and
ionizing radiation and its
effects on organs and
systems of the body.
2. Procedures for first
aid, medical diagnosis,
personnel treatment,
and management of
nuclear and radiological
casualties.
3. Effective
communication when
concerns are high
and/or trust is low
during a major radiation
event.
The material in this
publication is applicable
to both the nuclear
environment and to
other operations where
high- or low-level
radiation hazard exists;
this includes Defense
Support of Civil
Authorities during
weapons of mass
destruction
consequence
management
operations.
May 2014 https://armypubs.army.mil
(Army Medicine is the lead service and proponent for this publication. Other Service’s
designations are MCRP 4-11.1C / NTRP 4-02.23 / AFMAN 44-161[I])
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Part Two
ATP 4-02.84
ATP 4-02.84
MTTP for the Treatment of Biological Warfare Agent Casualties
Chapter 1, BIOLOGICAL WARFARE AGENTS
• Background
• Threat
• Employment of Biological Warfare Agents
• Novel Threat Agents
• Classification
• Dissemination
• Routes of Entry
• Prevention
• Medical Countermeasures
• Physical Protection
• Hazard Management
• Infection Control
• Casualty Management
Chapter 2, RECOGNITION
• Epidemiology
• Warning and Detection
• Surveillance
• Sample Collection
• Medical Reporting
• United States Public Health Biological Warfare Monitoring and
Assessment
Chapter 3, BACTERIAL AGENTS
Chapter 4, VIRAL AGENTS
Chapter 5, TOXIN AGENTS
Chapter 6, IDENTIFICATION TECHNOLOGIES FOR BIOLOGICAL
WARFARE AGENTS
APPENDICES
• SPECIMEN COLLECTION, HANDING, AND TRANSPORT
• PATIENT DECONTAMINATION
• MEDICAL MANAGEMENT AND TREATMENT IN BIOLOGICAL
WARFARE OPERATIONS
• BIOLOGICAL WARFARE AGENTS’ CLINICAL DIAGNOSTIC
ALGORITHM
Multiservice
Tactics,
Techniques, and
Procedures for the
Treatment of
Biological Warfare
Agent Casualties
FM 4-02.84 serves
as a guide and a
reference for trained
members of the
Armed Forces
Medical Services
and other medically
qualified personnel
on the recognition
and treatment of
biological warfare
(BW) agent
casualties. Its
purpose is to provide
an overview of
potential BW agents
directed against
human beings, the
problems that might
be created during an
attack in which a BW
agent is utilized, and
the current methods
available to medical
personnel for
recognizing,
preventing, and
managing these
problems.
Information
contained in this
publication may also
be relevant for the
diagnosis and
treatment of patients
with naturally
acquired diseases or
illnesses due to
pathogens with BW
potential.
November 2019 https://armypubs.army.mil
Army Medicine is the lead service and proponent for this publication. Other Service’s
designations are MCRP 4-11.1C / NTRP 4-02.23 / AFMAN 44-156_!P
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Army Health System Hierarchy and Summaries
* ATP 4-02.85
ATP 4-02.85
MTTP for the Treatment of Chemical Warfare Agent
Casualties and Conventional Military Chemical Injuries
Chapter 1, CHEMICAL WARFARE AGENT CASUALTIES
• Military Employment of Chemical Warfare
• Routes of Entry
• Classification of Chemical Warfare Agents
• Means of Delivery of Chemical Warfare Agents
• Diagnosis of Exposure to Chemical Warfare Agents
Chapter 2, CHOKING (LUNG-DAMAGING) AGENTS
• Central/Peripheral Pulmonary Agents
• Properties of Phosgene
Chapter 3, NERVE AGENTS
• Physical and Chemical Properties
• Absorption, Protection Against, and Effects of Nerve Agents
• Clinical Presentation and Diagnosis of Nerve Agent Poisoning
• Prevention, Treatment of Nerve Agent Poisoning, and Antidotes
Chapter 4, BLOOD (CYANIDE) AGENTS
• Protection
• Hydrogen Cyanide and Cyanogen Chloride
Chapter 5, BLISTER (VESICANT) AGENTS
• Self-Aid
• Precautions for Receiving Casualties
• Mustard, Lewisites, and Phosgene Oxime
Chapter 6, INCAPACITATING AGENTS
• Anticholinergics, Indoles, and Other Agents
Chapter 7, RIOT CONTROL AGENTS (IRRITANT/VOMITING AGENTS)
Chapter 8, OBSCURANTS
• Protection Against Obscurants
• Petroleum Oil, Zinc Oxide, Sulfur, Titanium, phosphorus, and colored
Obscurants
Chapter 9, INCENDIARY AGENTS
Chapter 10, TOXIC INDUSTRIAL CHEMICALS
APPENDICES
• RECOGNITION OF A CHEMICAL CASUALTY
• HANDLING OF CONTAMINATED CLOTHING AND EQUIPMENT AT
MEDICAL TREATMENT FACILITIES
• MEDICAL MANAGEMENT AND TREATMENT IN CHEMICAL
ENVIRONMENT OPERATIONS
• IMMEDIATE DECONTAMINATION PROCEDURES
• PRETREATMENT REGIMEN AND NERVE AGENT ANTIDOTES
ADMINISTRATION
• CHEMICAL WARFARE AGENTS AND TOXIC INDUSTRIAL CHEMICAL
IMMEDIATE/EMERGENCY TREATMENT READY REFERENCE
• LEVELS OF IDENTIFICATION
• TREATMENT OF MILITARY WORKING DOGS EXPOSED TO A
CHEMICAL ENVIRONMENT
Multiservice Tactics,
Techniques, and
Procedures for
Treatment of
Chemical Warfare
Agent Casualties
and Conventional
Military Chemical
Injuries
FM 4-02.85
provides tactics,
techniques, and
procedures and is
designed for use
as a reference for
trained members
of the Armed
Forces Medical
Services and
other medically
qualified
personnel on the
recognition and
treatment of
chemical warfare
(CW) agent
casualties and
conventional
military chemical
injuries.
Additionally, this
publication
provides
information on
first aid (self-aid
and buddy aid)
and enhanced
first aid (combat
lifesaver [United
States (U.S.)
Army and U.S.
Marine Corps]) for
these casualties.
August 2016 https://armypubs.army.mil
(Army Medicine is the lead service and proponent for this publication. Other
Service’s designations are MCRP 4-11.1A / NTRP 4-02.22 / AFTTP [I] 3-269)
16 March 2023
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63
Part Two
ATP 4-02.XX
ATP 4-02.XX
Laboratory Services
At the tactical level, clinical laboratory services are used exclusively at Role 2
and Role 3. At the theater strategic / operational level, the Area Medical
Laboratory provides environmental laboratory services to the theater.
Laboratory services staff personnel are located within the TMC’s MEDLOG
Support Section and the MEDBDE (SPT),Clinical Operations Section.
Laboratory
Services
Not Yet
Published
Laboratory services for both clinical and environmental laboratories is
identified in operational medicine doctrine as one of the Army Health System’s
10 medical functions. There is currently no Operational Medicine doctrinal
publication specifically for medical laboratory services. Information about this
medical function can be found in FM 4-02, ATP 4-02.6, ATP 4-02.7, ATP 402.8, and ATP 4-02.10.
Currently MEDCoE Doctrine Division is weighing
the benefits of establishing a stand along
laboratory services doctrinal publication.
Currently FM 402, ATP 4-02.6,
ATP 4-02.7, ATP
4-02.8, and ATP
4-02.10 provide
basic doctrine on
tactics,
techniques, and
procedures
required for the
laboratory
services (clinical
and
environmental) in
a TO. They focus
on current AHS
doctrine. The
tactics,
techniques, and
procedures are
not all-inclusive.
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Army Health System Hierarchy and Summaries
ATP 4-25.12
ATP 4-25.12
Unit Field Sanitation Teams
Chapter 1, UNIT FIELD SANITATION TEAMS
Chapter 2, HEALTH THREATS TO SOLDIERS IN THE FIELD
• Soldier Responsibilities
• Commanders and Unit Leaders Responsibilities
Chapter 3, UNIT WATER SUPPLY
• Maintaining Unit Water Supply
• Sources of Water in the Filed
• Waterborne Pathogens
• Approved Field Water Disinfectants
• Water Storage Systems
• Approved Water Purification Procedures
• Inspecting, Cleaning, and Sanitizing Water Storage Equipment
Chapter 4, FOOD SERVICE SANITATION
• Foodborne Pathogens
• Hygiene Standards for Food Handlers
• Pest Control
Chapter 5, WASTE MANAGEMENT
Chapter 6, PEST MANAGEMENT
• Mammals
• Arthropods
Chapter 7, HEAT INJURY
• Basics of Heat Injury Risk
• Types of Heat Injury and Heat-Related Conditions
• Prevention Strategies
• Heat Injury Prevention Tools
Chapter 8, COLD INJURY
• Basics of Cold Injury Risk
• Cold and Wet (Nonfreezing) Cold Injuries
• Other Conditions Associated with Cold Weather
• Cold Injury Prevention Tools
Chapter 9, TOXIC INDUSTRIAL MATERIAL HAZARDS
Chapter 10, NOISE HAZARDS
Chapter 11, EXERCISE COLLAPSE ASSOCIATED WITH SICKLE CELL
TRAIT
Being added to ATP 4-02.17 and Rescinded: 3QTR FY25.
SEE NOTE ON PAGE 34.
Unit Field
Sanitation Teams
To Be
Rescinded
ATP 4-25.12,
provides
guidance for
establishing,
training, and
employing unit
field sanitation
teams.
Implementation of
the techniques
presented in this
publication will
enable
commanders to
maintain a fit and
healthy force
capable of
accomplishing the
mission in any
environment.
ATP 4-25.12,
when published,
will be the
proponent
publication for the
unit field
sanitation teams
April 2014 (C1, July 2022)
https://armypubs.army.mil
16 March 2023
AHS Doctrine Smart Book
65
Part Two
TC 4-02.3
TC 4-02.3
Field Hygiene and Sanitation
Chapter 1, HEALTH THREATS IN MILITARY OPERATIONS
• Disease and Nonbattle Injuries
• Health Threats
• Predisposing Factors
• Preventive Medicine Measures
Chapter 2, INDIVIDUAL PREVENTIVE MEDICINE MEASURES
• Soldier Responsibilities
• Personal Hygiene
• Oral Hygiene
• Sanitation
• Waste Management in the Field
• Physical Fitness
• Water- and Foodborne Illness
• Arthropods, Rodents, and Other Animal Threats
• Immunizations and Chemoprophylaxis
• Heat Injury
• Cold Injury
• Toxic Industrial Materials
• Protect Self and Mission from Toxic Industrial Materials
• Noise Hazards
• Sleep Deprivation
Chapter 3, UNIT-LEVEL PREVENTIVE MEDICINE MEASURES
• Leader Responsibilities
• Plan and Prepare for Hot Weather Operations
• Plan and Prepare for Cold Weather Operations
• Plan for and Enforce Preventive Measures for Carbon Monoxide
Poisoning and Fire Prevention
• Plan for and Enforce Preventive Measures for Toxic Industrial Materials
• Plan for and Enforce Protective Measures for Noise Hazards
• Plan for and Enforce Sleep Discipline
• Ensure Welfare, Safety, and Health of the Unit
APPENDICES
• TECHNIQUES AND PROCEDURES FOR DISINFECTING WATER
Being Added to ATP 4-02.17 and Rescinded: 3QTR FY25.
SEE NOTE ON PAGE 34.
Field Hygiene and
Sanitation
To Be
Rescinded
TC 4-02.3 provides
hygiene and
sanitation guidance
for Soldiers in the
field and while
deployed. The
publication outlines
individual and
leader
responsibilities and
describes individual
and leader
preventive medicine
measures and
guidance for
Soldiers.
Implementation of
the techniques
presented in this
publication enable
individual Soldiers
to remain healthy in
the field and enable
commanders to
maintain a fit and
healthy force
capable of
accomplishing the
mission in any
environment.
The principal
audience for TC 402.3 is
commanders,
subordinate
leaders, individual
Soldiers,
Department of
Defense (DOD)
civilians and
contractors.
May 2015
https://armypubs.army.mil
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AHS Doctrine Smart Book
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Army Health System Doctrine Unit Synopsis
PART THREE
Army Health System Unit Synopsis
Part Three provides a brief description of the Army command and support
relationships followed by summaries of operational medicine units and how they are
employed to provide FHP and HSS in a deployed environment. Each summary
contains a brief description of the mission, assignment and dependencies,
employment basis of allocation, capabilities, functions, and mobility of the unit.
Where appropriate, additional considerations and graphical aids are provided in an
effort to simplify the understanding of some of our operational medicine formations.
At the top of each of the summaries is the correct doctrinal military symbol that
represents the operational medicine unit discussed below it. In many cases, the
summaries started with the unit’s Section 1 of its table of organization and equipment
(TOE). Section 1’s provide a basic description of a unit and is always a good place to
begin when learning what the unit was designed and resourced to accomplish.
ARMY COMMAND AND SUPPORT RELATIONSHIPS
ORGANIC
3-1. Organic forces are those assigned to and forming an essential part of a military organization. Organic
parts of a unit are those listed in its table of organization for the United States Army, United States Air Force
(USAF), and United States Marine Corps (USMC), and are assigned to the administrative organizations of
the operating forces for the United States Navy (USN). Joint command relationships do not include the
term organic because a joint forces command is not responsible for the organizational structure of units. The
organic command relationship is unique in that the relationship is inherent in unit force structure; units that
have an organic command relationship with a parent unit are an integral part of the parent unit TOE. As a
result, the organic command relationship cannot be further delegated. Commanders with organic
subordinate units may designate any of the other four command relationships to the subordinate unit.
Commanders with organic subordinate units have administrative control (ADCON) authority and
responsibility for the subordinate units.
ASSIGNED AND ATTACHED
3-2. Commanders establish the assigned and attached command relationships by placing a subordinate
unit under the command of another organization for a specified period of time. An assigned command
relationship is relatively permanent. The gaining organization controls and administers the units or
personnel for the primary function, or greater portion of the functions, of the unit or personnel. An attached
command relationship is relatively temporary. The attachment may be for a specific mission or phase of an
operation. The commander establishes these command relationships in an OPORD issued to the subordinate
commander and specifies the duration of the relationship in the order. Unless specifically stated in the
OPORD, these command relationships includes ADCON authority and responsibility for the gaining
command. Once the assignment or attachment duration has lapsed, the unit returns to its parent unit.
OPERATIONAL CONTROL AND TACTICAL CONTROL
3-3. Commanders establish the operational control (OPCON) and tactical control (TACON) command
relationships by placing a subordinate unit under the command of another organization for a specified period
of time. The OPCON is the authority to perform those functions of command over subordinate forces
16 March 2023
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Part Three
involving organizing and employing commands and forces, assigning tasks, designating objectives, and
giving authoritative direction necessary to accomplish the mission. The TACON is a command authority
over units made available for tasking that is limited to the detailed direction and control of movements or
maneuvers within the operational area necessary to accomplish missions or tasks assigned. The commander
establishes these command relationships in an OPORD issued to the subordinate commander and specifies
the duration of the relationship in the order. Unless specifically stated in the OPORD, these command
relationships do not include ADCON authority and responsibility for the gaining command. Once the
duration of the relationship has lapsed, the unit returns to its parent unit.
Table 3-1. Army command and support relationships
Then inherent responsibilities:
Provide
liaison
to:
Establish/
maintain
communication
’s with:
Have
priorities
established
by:
Can impose
on gained
unit further
command or
support
relationship
of:
Organic
HQ
N/A
N/A
Organic HQ
Attached;
OPCON;
TACON; GS;
GSR; R; DS
Gaining
Army HQ
OPCON
As
required
by
OPCON
As required by
OPCON
ASCC or
Serviceassigned HQ
As required
by OPCON
HQ
Gaining
unit
Gaining
Army HQ
Gaining
unit
As
required
by
gaining
unit
Unit to which
attached
Gaining unit
Attached;
OPCON;
TACON; GS;
GSR; R; DS
Parent unit
and
gaining
unit;
gaining
unit may
pass
OPCON to
lower HQ1
Parent
unit
Gaining
unit
As
required
by
gaining
unit
As required by
gaining unit
and parent unit
Gaining unit
OPCON;
TACON; GS;
GSR; R; DS
Parent unit
Parent
unit
Gaining
unit
As
required
by
gaining
unit
As required by
gaining unit
and parent unit
Gaining unit
TACON;GS
GSR; R; DS
Have
command
relationship with:
May be
taskorganized
by:1
Unless
modified,
ADCON
Are
assigned
position
or AO by:
Organic
All
organic
forces
organized
with the
HQ
Organic
HQ
Army HQ
specified
in
organizing
document
Assigned
Gaining
unit
Gaining
HQ
Gaining
unit
Attached
OPCON
Gaining
unit
TACON
Gaining
unit
If relationship is:
Note: 1 In NATO, the gaining unit may not task-organize a multinational force. (See TACON.)
ADCON
administrative control
HQ
headquarters
AO
area of operations
N/A
not applicable
ASCC
Army Service component command
NATO
North Atlantic Treaty Organization
DS
direct support
OPCON
operational control
GS
general support
R
reinforcing
GSR
general support-reinforcing
TACON
tactical control
ARMY SUPPORT RELATIONSHIPS
3-4. Army support relationships are direct support, general support, reinforcing, and general supportreinforcing. Army support relationships are not command authorities and are more specific than joint
support relationships.
3-5. In order for unit commanders to be able to plan and develop viable support concepts, they must know
the type and quantity of units supported and for how long. The commander’s higher headquarters provides
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Army Health System Unit Synopsis
this information by task-organizing subordinate units and designating clear support relationships between
each subordinate unit and supported units. This information is communicated via an OPORD.
3-6. Direct support is a support relationship requiring a force to support another specific force and
authorizing it to answer directly to the supported force’s request for assistance (joint doctrine considers
direct support as a mission rather than a support relationship). A unit assigned a direct support relationship
retains its command relationship with its parent unit but is positioned by and has priorities of support
established by the supported unit.
3-7. Reinforcing support is a support relationship requiring a force to support another supporting unit.
Only like units can be given a reinforcing mission. A unit assigned a reinforcing support relationship retains
its command relationship with its parent unit, but is positioned by the reinforced unit. A unit that is
reinforcing has priorities of support established by the reinforced unit first, and then by the parent unit.
3-8. General support-reinforcing is a support relationship assigned to a unit to support the force as a
whole and to reinforce another similar-type unit. A unit assigned a general support-reinforcing support
relationship is positioned and has priorities established by its parent unit and secondly by the reinforced
unit.
3-9. General support is that support which is given to the supported force as a whole and not to any
particular subdivision thereof. Units assigned a general support relationship are positioned and have
priorities established by their parent unit.
AREA SUPPORT
3-10. Area support is NOT a support relationship and is a task given to sustainment units that directs them
to support units transiting or operating within a specified geographic boundary and for which a support
relationship has not been established. This is normally for units that are in immediate need of support and
are not near their organic or designated supporting unit. Area support is not a support relationship and is
not synonymous with general support.
Then inherent responsibilities:
If
relations
hip is:
Have
command
relationship with:
May be
task
organized
by:
Receives
sustainment
from:
Are
assigned
position or
an area of
operations
by:
Provide
liaison to:
Parent
unit
Parent
unit
Parent
unit
Supported
unit
Supported
unit
Parent
unit
Parent
unit
Parent
unit
Reinforced
unit
Reinforced
unit
Direct
support1
Reinforcing
Establish/
maintain
communications
with:
Parent
unit;
supported
unit
Parent
unit;
reinforced
unit
Have
priorities
established
by:
Can
impose on
gaining
unit
further
command
or support
relationship by:
Supported
unit
See note1
Reinforced
unit; then
parent unit
Not
applicable
General
support–
reinforcing
Reinforced
Reinforced Parent unit;
unit and as
Parent
Parent
Parent
unit and as
then
Not
Parent unit
required
unit
unit
unit
required by
reinforced
applicable
by parent
parent unit
unit
unit
General
As
As
support
Parent
Parent
Parent
required
Not
Parent unit
required by Parent unit
unit
unit
unit
by parent
applicable
parent unit
unit
Note:1 Commanders of units in direct support may further assign support relationships between their subordinate
units and elements of the supported unit after coordination with the supported commander.
Table 3-2. Army support relationships
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69
Part Three
THEATER MEDICAL COMMAND
(Approved: 19 March 2021)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08650K000
HHC, THEATER MEDICAL
COMMAND
81
8
83
0
172
08651KA00
OPERATIONAL COMMAND POST
(OCP), HHC, THEATER MEDICAL
COMMAND
38
3
42
0
83
08651KB00
MAIN COMMAND POST (MCP),
HHC, THEATER MEDICAL
COMMAND
43
5
41
0
89
MISSION
Core Mission. Medical C2 of theater medical units providing AHS support in theater AO.
Doctrinal Mission. Provide C2 for AHS support (for the HSS and FHP missions), administrative assistance,
and staff and technical assistance for assigned and attached medical units.
GENERAL MISSION ESSENTIAL TASKS
Conduct C2 including planning, preparing, executing, and assessing an operation.
Protect the force which includes conducting local security, employing survivability measures, employing
Chemical Biological Radiological Nuclear Explosive (CBRNE) protection, and conducting personnel
recovery operations.
Provide sustainment which includes conducting logistics support, conducting human resources support, and
providing HSS.
CORE CAPABILITIES MISSION ESSENTIAL TASKS
Manage AHS for the HSS and FHP missions. Plan AHS support.
Direct HSS which includes providing medical C2, supervision of medical treatment and combat casualty
care, MEDEVAC and medical regulating, hospitalization, clinical laboratory services, behavioral
health/neuropsychiatric treatment, MEDLOG and blood management, treatment of CBRN patients, as well
as the treatment aspects of preventive medicine and veterinary services.
Direct FHP to include medical C2, veterinary services for food inspection and animal care missions, medical
surveillance and occupational and environmental health surveillance, COSC, preventive dentistry, and
laboratory services.
ASSIGNMENT
Army Headquarters and Headquarters Battalion, Army service component command (ASCC).
DEPENDENCIES
This unit is dependent on the following: Army Headquarters and Headquarters Battalion, TOE 51000K000
for religious, legal, FHP, finance, and personnel and administrative services. This organization requires
field feeding company, for field feeding support.
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Army Health System Unit Synopsis
EMPLOYMENT
The TMC provides appropriate staff sections for command, control, and support to assigned or attached
units in the Theater of Operation (TO).
BASIS OF ALLOCATION
One per theater.
CAPABILITIES
This unit provides—
⚫ Command and control of theater medical units providing FHP in the Theater AO
⚫ Subordinate medical organizations to provide medical capabilities to the BCT, BSMC.
⚫ Advice to the ASCC Commander and other senior level commanders on the medical aspects of
their operations.
⚫ Staff planning, supervision of operations, and administration of assigned and attached medical
units.
⚫ Coordination and integration of strategic capabilities from the sustaining base to units in the
Theater AO.
⚫ Advice and assistance in facility selection and preparation.
⚫ Army Medical Support to Other Services (ASOS)/Title 10 responsibilities of the Commander.
⚫ Coordination with the United States Air Force (USAF) Theater Patient Movement Requirements
Center (TPMRC) for medical regulating and movement of patients from MTFs.
⚫ Consultation services and technical advice in all aspects of medical and surgical services.
⚫ Functional staff to coordinate medical plans and operations, hospitalization, operational public
health, MEDEVAC, MEDLOG, blood management, dental service, veterinary services, nutrition
care, combat stress control, medical laboratory services, and area medical support to support
units.
⚫ Coordination and orchestration of MEDLOG operations to include Class VIII supply, distribution,
medical maintenance and repair support, optical fabrication, and blood management.
⚫ Planning and support for Single Integrated Medical Logistics Manager (SIMLM), when
designated.
⚫ Veterinary support for zoonotic disease control and investigation and inspection of subsistence.
⚫ Preventive medical support for medical, occupational and environmental health (OEH)
surveillance, potable water inspection, pest management, food facility inspection, and control of
medical and non-medical waste.
⚫ Legal advice to the Commander, staff, subordinate Commanders, service members, and other
authorized persons.
⚫ Monitoring of medical threats within the AOR and ensures required capabilities to mitigate threats
are identified.
⚫ The Unit Ministry Team (UMT) which will provide religious support to the Command. They will
coordinate with the Headquarters (HQ) UMT for required religious support throughout the AOR
and provide consultation capability to subordinate MCDS UMTs.
⚫ Advisor and consultant for all maintenance operations to subordinate units.
FUNCTIONS
Command Section
This section provides C2 and management of all medical command services. Personnel of this section
supervise and coordinate the operations and administrative services of the Command Section.
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Part Three
Chief of Staff Section
This sections plans, directs, and coordinates the execution of the staff functions. Reviews organization
activities and recommends changes, as necessary, to the Commander.
Inspector General Section
This section conducts command inspections and investigations and provides Inspector General (IG)
assistance, as required.
Public Affairs Section
This section serves as the commands focal point for command information, public information, and
community relations matters.
Staff Judge Advocate
Supervises the administration of military justice and other legal matters for soldiers. Advises the
Commander, staff, and subordinate Commanders on legal matters. Provides legal services on military law,
administrative and contract law, claims, criminal law, legal assistance, operational law, and other related
legal matters.
Unit Ministry Team
Serves as the advisor to the commander and provides religious support and pastoral care ministry for
assigned staff and subordinate organizations.
ACofS G1 Section
Serves as the advisor to the commander on personnel issues and provides administrative services for the
command.
ACofS, G1 Personnel Management Actions
Provides overall administrative services for the command to include personnel management and personnel
actions, awards, decorations, and leaves.
ACofS G2 Section
This section provides security, intelligence, and force protection of the TMC.
ACofS G3 Section
Serves as advisor to the Commander and provides broad planning guidance, policies, and programs for
command organizations and operations.
ACofS G3, Current Operations Branch
Provides security, plans and operations, deployment, relocation, and redeployment of the Command.
Theater Patient Movement Center
This center is responsible for medical regulation of all patients in the Theater and preparation of patient
statistical reports. Coordinates with TPRMC/joint patient movement requirements center for all patients
leaving the Theater. Works with the USAF for all strategic patient movement. Maintains 24 hours
continuous operations.
ACofS G4 Section
Serves as advisor to the commander and provides supervision and coordination of logistics, food service,
supply, transportation, and maintenance support for the subordinate units.
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ACofS G4, Medical Logistics Support Section
This section is responsible for providing planning, policies, and programs for MEDLOG operations.
Coordinates and synchronizes the execution of the MEDLOG mission in the Theater. This includes Class
VIII supply operations, medical maintenance support, optical fabrication, and blood management.
ACofS G5 Plans
This section is responsible for all operational planning functions of the TMC.
ACofS G6 Section
Provides for all aspects of automation and communications-electronics for the Command. Assists the
Commander and Staff on C2 signal requirements, capabilities, and operations.
ACofS G8 Section
Directs and monitors all finance and accounting functions for the Command, to include budget planning,
contract payments, and internal review.
Civil Affairs Section
This section facilitates and develops assessments of host nation country's medical infrastructure to assist the
Theater Commander in planning and executing FHP in the TO. Assist the Commander in preparing medical
functional studies, assessments, and estimates of how displaced persons affect U.S. MTFs.
Clinical Services
Serves as the commander's principal consultants for AHS HSS planning and policies within the theater.
Force Health Protection Section
Serves as the commander's principal consultants for Army FHP service planning and policies within the
theater.
Company Headquarters
Provides company level command, supply management, local security, unit level maintenance, and all other
life support requirements.
MOBILITY
The Operational Command Post is 100 percent mobile and able to transport all of its TOE equipment in a
single lift using organic vehicles.
The Main Command Post is 20 percent mobile and able to transport a fifth of its TOE equipment in a single
lift using organic vehicles.
The Theater Medical Command will be dependent on appropriate elements of the theater for supplemental
transportation.
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Figure 3-1. HHC, Theater Medical Command Task Organization
Figure 3-2. Notional Deployed Theater Medical Command
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Army Health System Unit Synopsis
MEDICAL COMMAND (DEPLOYMENT SUPPORT)
(Revised: 6 February 2018)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08640K000
MEDCOM (DS)
79
8
85
0
172
08641KA00
MEDCOM (DS) OPERATIONAL
COMMAND POST (OCP)
37
3
43
0
83
08641KB00
MEDCOM (DS) MAIN
COMMAND POST (MCP)
42
5
42
0
89
MISSION
Core Mission. Command and control of EAB medical units providing AHS support in theater. It is the
theater enabling command responsible for C2, integration, synchronization, and execution of all AHS
support operations within the AOR.
Doctrinal Mission. Serves as the theater medical command responsible for providing C2 for AHS support
(which includes HSS and FHP), administrative assistance, and staff and technical assistance for assigned
and attached medical units.
GENERAL MISSION ESSENTIAL TASKS
Conduct C2 including planning, preparing, executing, and assessing theater medical operation
Protect the force which includes conducting local security, employing survivability measures, employing
chemical, biological, radiological, and nuclear (CBRN) protection, and conducting personnel recovery
operations.
CORE CAPABILITIES MISSION ESSENTIAL TASKS
Manage AHS for the HSS and FHP missions. Plan AHS support.
Direct HSS which includes providing medical C2, supervision of medical treatment and combat casualty
care, MEDEVAC and medical regulating, hospitalization, clinical laboratory services, behavioral
health/neuropsychiatric treatment, MEDLOG and blood management, treatment of CBRN patients, as well
as the treatment aspects of preventive medicine and veterinary services.
Direct FHP to include medical C2, veterinary services for food inspection and animal care missions, medical
surveillance and occupational and environmental health surveillance, COSC, preventive dentistry, and
laboratory services.
ASSIGNMENT
Army Headquarters and Headquarters Battalion, ASCC.
DEPENDENCIES
This unit is dependent on the following: Army service component command for religious, legal, FHP,
finance, and personnel and administrative services. This organization requires field feeding company, for
field feeding support.
EMPLOYMENT
The MEDCOM (DS) provides appropriate staff sections for command, control, and support to assigned or
attached units in the theater.
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BASIS OF ALLOCATION
One per theater.
CAPABILITIES
This unit provides—
⚫ Command and control of EAB medical units providing FHS and HSS in the theater AO.
⚫ Subordinate medical organizations to provide medical capabilities to the BCT, BSMCs, and at
EAB.
⚫ Advice to the ASCC commander, surgeon, and other senior level commanders on the medical
aspects of their operations.
⚫ Staff planning, supervision of operations, and administration of assigned and attached medical
units.
⚫ Coordination and integration of strategic capabilities from the sustaining base to units in the
theater AO.
⚫ Advice and assistance in facility selection and preparation.
⚫ Army support to other services and Title 10 responsibilities of the commander.
⚫ Coordination with the USAF theater patient movement requirements center (TPMRC) for
medical regulating and movement of patients from MTF.
⚫ Consultation services and technical advice in all aspects of medical and surgical services.
⚫ Functional staff to coordinate medical plans and operations, hospitalization, preventive medicine
(PVNTMED), tactical and strategic MEDEVAC, MEDLOG, blood management, dental service,
veterinary services, nutrition care, COSC, medical laboratory services, and area medical support
to support units.
⚫ Coordination and orchestration of MEDLOG operations to include Class VIII supply,
distribution, medical maintenance and repair support, optical fabrication, and blood management.
⚫ Planning and support for SIMLM, when designated.
⚫ Veterinary support for zoonotic disease control and investigation and inspection of subsistence.
⚫ Preventive medical support for medical, occupational and environmental health (OEH)
surveillance, potable water inspection, pest management, food facility inspection, and control of
medical and nonmedical waste.
⚫ Legal advice to the commander, staff, subordinate commanders, service members, and other
authorized persons.
⚫ Monitoring of health threats within the AOR and ensures required capabilities are identified to
mitigate the threats.
⚫ The unit ministry team (UMT) which will provide religious support to the command. They will
coordinate with the HQ UMT for required religious support throughout the AOR and provide
consultation capability to subordinate MEDCOM (DS) UMTs.
⚫ The maintenance personnel will augment the maintenance capability of the unit that performs
field maintenance on the unit's organic vehicles and power equipment.
FUNCTIONS
Command Section
This section provides C2 and management of all Medical Command services. Personnel of this section
supervise and coordinate the operations and administrative services of the Command Section.
Chief of Staff Section
This sections plans, directs, and coordinates the execution of the staff functions. Reviews organization
activities and recommends changes, as necessary, to the Commander.
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Deputy Chief of Staff, Personnel
Serves as advisor to the Commander on personnel issues and provides administrative services for the
command.
Personnel Management/Actions
Provides overall administrative services for the command to include personnel management and personnel
actions, awards, decorations, and leaves.
Current Operations Branch
Provides security, plans and operations, deployment, relocation, and redeployment of the Command.
Plans Branch
Provides security, plans and operations, deployment, relocation, and redeployment of the Command.
Intelligence/Operations Branch, G2/3
Provides security, plans and operations, deployment, relocation, and redeployment of the medical command
(deployment support).
Theater Patient Movement Center
This center is responsible for medical regulation of all patients in the Theater and preparation of patient
statistical reports. Coordinates with TPRMC/joint patient movement requirements center for all patients
leaving the Theater. Works with the USAF for all strategic patient movement. Maintains 24 hours
continuous operations.
Deputy Chief of Staff, Logistics
Serves as advisor to the commander and provides supervision and coordination of logistics, food service,
supply, transportation, and maintenance support for the subordinate units.
Medical Logistics Support Section
This section provides planning, policies, and programs for MEDLOG operations. Coordinates and
synchronizes the execution of the MEDLOG mission in the Theater. This includes Class VIII supply
operations, medical maintenance support, optical fabrication, and blood management.
Civil Affairs Section
This section facilitates and develops assessments of host nation country's medical infrastructure to assist the
Theater Commander in planning and executing FHP in the TO. Assist the Commander in preparing medical
functional studies and assessments and estimates of how displaced persons affect U.S. MTFs.
Deputy Chief of Staff, Information Management
Provides for all aspects of automation and communications-electronics for the Command. Assists the
Commander and Staff on C2 signal requirements, capabilities, and operations.
Deputy Chief of Staff, Comptroller
Directs and monitors all finance and accounting functions for the Command, to include budget planning,
contract payments, and internal review.
Clinical Services
Serves as the Commander's principal consultants and the Command's technical advisers in pharmacy,
optometry, and COSC.
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Veterinary Services
Serves as the Commander's principal consultant and the Commands technical advisor. Assumes the TriService Executive Agent responsibilities for veterinary support within the Theater.
Preventive Medicine Section
This section serves as the Commander's principal consultant and the Commands preventive medicine and
environmental science advisors.
Inspector General Section
This section conducts command inspections and investigations and provides Inspector General assistance
as required.
Public Affairs Section
This section serves as the Commands focal point for Command information, public information, and
community relations matters.
Staff Judge Advocate
Supervises the administration of military justice and other legal matters for Medical Command Soldiers.
Advises the commander, staff, and subordinate commanders on legal matters. Provides legal services on
military law, administrative and contract law, claims, criminal law, legal assistance, operational law, and
other related legal matters.
Company Headquarters
Provides company level command, supply management, local security, unit level maintenance, and all other
life support requirements.
Unit Ministry Team
Serves as advisor to the Commander and provides religious support and pastoral care ministry for assigned
staff and subordinate organizations.
MOBILITY
The Operational Command Post and Main Command Post require 100 percent mobile of its TOE
equipment to be transported in a single lift using organic vehicles.
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Figure 3-3. HHC, Medical Command (Deployment Support) Task Organization
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MEDICAL BRIGADE (SUPPORT)
(Approved: 8 February 2022)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08420K100
HHC, MEDICAL BRIGADE
35
6
59
0
100
08422KDA00
MEDICAL BRIGADE, EARLY
ENTRY MODULE
15
4
22
0
41
08422KB00
MEDICAL BRIGADE,
EXPANSION MODULE
8
0
16
0
24
08422KC00
MEDICAL BRIGADE, CAMPAIGN
MODULE
12
2
21
0
35
MISSION
Core mission. Medical C2 of theater medical units providing AHS support for BCTs/division/corps, joint
and multinational forces.
Doctrinal mission: Provide scalable C2 for assigned or attached medical functional modules task-organized
in support of a deployed division/corps.
GENERAL MISSION ESSENTIAL TASKS
Conduct C2 including planning an operation, preparing for an operation, executing an operation, and
assessing an operation.
Protect the force which includes conducting local security operations, employing survivability measures,
employing CBRN protective measures, and conducting personnel recovery operations.
Provide sustainment which includes conducting logistics support, conducting human resources support, and
providing HSS.
CORE CAPABILITIES MISSION ESSENTIAL TASKS
Manage AHS support for the HSS and FHP missions to include planning AHS support.
Direct HSS which includes providing medical C2, supervising the following: medical treatment and combat
casualty care, MEDEVAC and medical regulating, hospitalization, clinical laboratory services, behavioral
health and neuropsychiatric treatment, MEDLOG and blood management, treatment of CBRN patients,
preventive medicine services, and veterinary services.
Direct FHP which includes providing medical C2, and supervising the following: veterinary service for food
inspection and animal care missions, medical surveillance and occupational and environment health
surveillance, combat and operation stress control, preventive dentistry, and laboratory services.
ASSIGNMENT
Assigned to the TMC.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate elements within the theater for religious, legal, FHP, finance, and personnel and
administrative services.
⚫ The quartermaster supply company, or equivalent for Class I rations.
⚫ The engineer company, or equivalent, for site selection, waste disposal, and minor construction.
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⚫
The headquarters and headquarters detachment (HHD) movement control battalion, for
supplemental transportation requirements.
⚫ The medical detachment (veterinary services) (MDVS), for zoonotic disease control and
investigation and the inspection of medical and nonmedical rations to include suspected
contaminated rations and disposition recommendations.
⚫ The medical detachment, PVNTMED, for food facility inspection, vector control, and control of
medical and nonmedical waste.
⚫ Field feeding company, for field feeding support.
EMPLOYMENT
The headquarters and headquarters company (HHC), MEDBDE (SPT), is employed throughout the
division/corps AO, and provides reinforcement/reconstitution support to BCT medical companies in each
of the maneuver BCTs. The MEDBDE (SPT) may be employed as a whole, early entry module (EEM),
expansion module (EM), and campaign module, (CM), or it may incrementally deploy modules as required
by METT-TC (I) factors. It is designed to employ the EEM initially, followed by the EM, and then by the
CM as the theater matures. At a minimum, this organization requires the capabilities of the EEM and EM
module.
BASIS OF ALLOCATION
One per two to six subordinate battalions or like units such as the hospital center. The first MEDBDE (SPT)
deploys with the first two subordinate battalions sized units.
CAPABILITIES
This organization provides—
⚫ A rapidly responsive early entry Army medical C2 module that can quickly integrate into the early
entry deployment sequence for crisis management.
⚫ Full spectrum continuous Army medical C2 in support of all Army BCT, division/corps, joint,
and multinational forces.
⚫ Operational medical plugs augmentation to Role 2 BCT medical companies.
⚫ Advice to division/corps and BCT commanders on the medical aspects of their operations.
⚫ Medical staff planning, operational and technical supervision, and administrative assistance for
medical battalions (multifunctional) (MMBs) and hospitals operating in the division/corps AO.
⚫ Coordination with the supporting TPMRC for medical regulating and MEDEVAC from MMBs
and hospitals to supporting Role 4 MTFs and CONUS.
⚫ Medical consultation services and technical advice in the following areas:
⚫ PVNTMED (medical surveillance, environmental health, sanitary engineering, and medical
entomology).
⚫ Nursing services.
⚫ Dental services.
⚫ COSC and neuropsychiatric care.
⚫ Veterinary services (including food safety and inspection, animal medicine, and veterinary
preventive medical services).
⚫ Nutrition care.
⚫ Laboratory support services.
⚫ Advise and provide recommendations for the conduct of civil-military operations.
⚫ Control and supervision of Class VIII supply and re-supply movement to include blood
management. When designated by the combatant commander, serves as the SIMLM.
⚫ A joint-capable Army medical C2 capability when augmented with appropriate joint assets.
⚫ Coordination of Army support to other Services for the ship-to-shore/shore-to-ship MEDEVAC
mission.
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FUNCTIONS
S1 Section
This section provides overall administrative services for the command, to include personnel administration,
and coordinates with elements of supporting agencies for finance personnel, legal, and administrative
services.
S2 Section
This section performs all-source intelligence assessments and estimates for the command. Advises the
commander and staff on nuclear/chemical surety and CBRN operations.
S3 Section
This section is responsible for plans and operations, deployment, relocation and redeployment of the Brigade
and supervising MEDEVAC operations for both air and ground.
S3 Operations Branch
This branch is responsible for authenticating and publishing plans and orders. Exercises staff supervision
over AHS support activities, advises the commander and staff on nuclear/chemical surety and CBRN
operations.
S3 Plans Branch
This branch is responsible for current planning in the MEDBDE (SPT) AO, to include deliberate and crisis
planning. Additionally, it plans for future operations in excess of 72 hours and prepares major regional
contingency plans for the MEDBDE (SPT). Further, it prepares, authenticates, and publishes AHS support
plans and OPLANs to include the integration of annexes and appendixes prepared by other staff sections.
S3 Patient Movement Branch
This branch is responsible for maintaining 24 hour coordination and oversight responsibility for patient
regulating and administration within the Brigade AO.
S4 Logistics Operations Branch
This branch monitors, coordinates, and facilitates MEDLOG operations within the command. This includes
Class VIII supply and re-supply, blood management and distribution, medical equipment maintenance and
repair, medical gases, and optical lens fabrication and repair.
S9 Section
This section is responsible for the integration of civil-military operations planning within the MEDBDE
(SPT). Conducts area assessments and estimates on the impact of the local populace on U.S. MTFs to
include the assessment of the host/foreign nation medical infrastructure in planning for and executing health
care delivery.
S6 Section
This section provides for all aspects of automation and CE for the command. Determines C2 signal
requirements, capabilities, and operations. Also, provides advice and consultation on medical automated
systems in use within the Brigade.
Clinical Operations Section
This section serves as the commander’s principal consultants and technical advisors for the command in
general medicine, PVNTMED to include Neuropsychiatric Care, COSC and behavioral health. The
behavioral health team provides advice and assistance in the areas of behavioral health and COSC.
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Company Headquarters
Provides C2 of the company. Develops the occupation plan, training and morale, welfare, and recreation
activities, life support activities, field sanitation, and supply for headquarters personnel. Provides unit
vehicle maintenance organic to or allocated for use by the headquarters.
MOBILITY
Early Entry Module. This unit is 100 percent mobile and is able to transport all of its TOE equipment in a
single lift using organic vehicles.
The Expansion Module requires 10 percent of its TOE equipment to be transported in a single lift using
organic vehicles.
The Campaign Module requires 10 percent of its TOE equipment to be transported in a single lift using
organic vehicles.
The Medical Brigade (Support) may be dependent on appropriate elements of the theater, corps, or division
for supplemental transportation.
Figure 3-4. HHC, Medical Brigade (Support) Task Organization
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MEDICAL BATTALION (MULTIFUNCTIONAL)
(Revised: 6 February 2018)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08485K000
MEDICAL BATTALION
(MULTIFUNCTIONAL)
16
2
54
0
72
08486KA00
EARLY ENTRY ELEMENT,
MED BN (MMB)
11
1
32
0
44
08486KB00
CAMPAIGN SUPPORT
ELEMENT, MED BN (MMB)
5
1
22
0
28
MISSION
To provide a scalable, flexible and modular medical C2, administrative assistance, logistical support, and
technical supervision capability for assigned and attached medical organizations (companies and
detachments) task-organized for support of deployed forces.
ASSIGNMENT
To a TMC or a MEDBDE (SPT).
DEPENDENCIES
⚫
This unit is dependent upon appropriate elements of the theater for religious, legal, FHP, finance,
and personnel and administrative services.
⚫ Field feeding company, for field feeding support.
EMPLOYMENT
Normally employed in a TMC, or MEDBDE (SPT) AO.
BASIS OF ALLOCATION
One per three to six subordinate company/detachment size units.
CAPABILITIES
This organization provides the following as shown in their respective TOEs.
EARLY ENTRY ELEMENT
HQs detachment, MMB provides medical C2, staff planning, supervision of operations, medical and general
logistics support as required, and administration of the assigned and attached units conducting FHP
operations in its supported AO.
⚫ Task organization of medical assets.
⚫ Advice to senior commanders in the AO on the medical aspects of their operations.
⚫ Coordination of medical regulating and patient movement within the AO.
⚫ Monitoring, planning, and coordinating ground and air evacuation within the battalion AO.
Coordinating air evacuation support requirements with the supporting aviation unit, and
synchronizing the air evacuation plan into the overall MEDEVAC plan.
⚫ Consultation and technical advice on preventive medicine (medical entomology, medical and
OEH surveillance, and sanitary engineering), COSC, medical records administration, veterinary
services, nursing practices and procedures, dental services, and automated medical information
systems to supported units.
⚫ Guidance for facility site selection and area preparation.
⚫ Monitoring and supervising MEDLOG operations, to include Class VIII supply/re-supply.
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⚫
Consolidated property book support.
Unit level maintenance for wheeled vehicles and power generation equipment and wheeled
vehicle recovery operations support to assigned or attached units.
⚫ Organizational communications equipment maintenance support for the battalion.
⚫ Food service support for staff and assigned/attached medical units.
⚫ Consolidated maintenance support for assigned/attached medical units. MCAS, medical company
(ground ambulance) (MCGA), medical detachment (blood support), medical detachment
(COSC), MDVS.
⚫
CAMPAIGN SUPPORT ELEMENT
HQs detachment, MMB provides augmentation of medical C2 in, personnel, logistics, AHS support,
medical operations, preventive medicine, behavioral health, automation, maintenance, and food service to
the MMB (early entry element).
Individuals of this organization can assist in the coordinated defense of the unit's area or installation.
This unit does perform field maintenance on all organic equipment except communications security
(COMSEC) equipment.
FUNCTIONS
Command Section
This section provides medical C2 of assigned and attached medical companies and detachments.
S1 Section
This section provides overall administrative services for the command, to include personnel administration,
and coordinates with elements of supporting agencies for finance, personnel, legal, and administrative
services.
S2/S3 Section
This section is responsible for security, plans and operations, deployment, relocation, and redeployment of
the battalion and its assigned and attached units. The battalion's primary net control station is in this section.
S4 Section
This section is responsible for coordination, control, and management of logistics for assigned and attached
units.
FHP Operations
Is responsible for the planning, coordination, and execution of the FHP and HSS mission within the
battalion's AOR. Supervises the operations of the MEDLOG, operations, preventive medicine, and mental
health sections.
Medical Logistics Section
This section is responsible for the planning, coordination, and execution of the Class VIII mission within
the battalion's AOR. This includes blood and medical maintenance management.
Medical Operations Section
This section is responsible for the planning, coordination, and execution of the FHP area support mission
within the battalion's AOR. This includes management of area medical support (Role 1 and 2), evacuation,
and area dental support.
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Preventive Medicine Section
This section is responsible for the planning, coordination, and execution of the preventive medicine mission
within the battalion's AOR. This includes management of preventive medicine and veterinary assets.
Mental Health Section
This section is responsible for the planning, coordination, and execution of the COSC mission within the
battalion's AOR. Collects and records social and psychological data.
S6 Section
This section is responsible for all aspects of information management, automation, and C-E support to
assigned and attached units. The battalion's alternate net control station is in this section.
Detachment Headquarters
Headquarters provides for billeting, discipline, security, training, and administration for personnel assigned
to the HHD.
Battalion Maintenance Section
Under the staff supervision of the battalion S4, this section provides unit level maintenance for wheeled
vehicles assigned to the HHD and assigned or attached units without unit level maintenance capability.
MOBILITY
Early Entry Module. This unit is 100 percent mobile and is able to transport all of its TOE equipment in a
single lift using organic vehicles.
The Campaign Module requires approximately 15 percent mobility for its TOE equipment until it is attached
to the Early Entry Element of the MMB, then it requires 100 percent mobility of its TOE equipment to be
transported in a single lift using organic vehicles.
The MMB may be dependent on appropriate elements of the theater, corps, or division for supplemental
transportation.
Figure 3-5. HHD, Medical Battalion (Multifunctional) Task Organization
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HOSPITAL CENTER
(Revised: 22 April 2021)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08976K000
HHD HOSPITAL CENTER
10
0
17
0
27
08988K000
FIELD HOSPITAL (32 BED)
49
3
114
0
166
08977K000
HOSPITAL AUGMENTATION
DETACHMENT (SURGICAL 24
BED)
33
0
33
0
66
08978K000
HOSPITAL AUGMENTATION
DETACHMENT (MEDICAL 32
BED)
19
0
27
0
46
08979K000
HOSPITAL AUGMENTATION
DETACHMENT (ICW 60 BED)
10
0
23
0
33
INTRODUCTION
The HHD, hospital center and field hospital (32-bed) comprise the core and lowest denominator of the
hospital center. The field hospital (32-bed) is the only unit that provides complete clinical
capabilities/staffing required to be designated as a Role 3 MTF. This hospital is deliberately designed to be
self-supporting while remaining light, transportable, and expandable. The HHD, hospital center and field
hospital (32-bed) are designed as the first increments to be deployed in support of an expeditionary force
and can be expanded incrementally to a maximum of a 240-bed hospital. The HHD, hospital center can
command one to two field hospitals (32-bed), with requisite augmentation detachments and teams, in one
or separate locations (dual-based operations) without staff augmentation.
There are five distinct elements, with associated TOEs, that make up the hospital center: 1) HHD, hospital
center; 2) the field hospital (32-bed); 3) hospital augmentation detachment (medical 32-bed); 4) hospital
augmentation detachment (surgical 24-bed); and 5) hospital augmentation detachment (ICW 60-bed). When
referring to the organization as a whole (or at least the HHD and one or more of the subordinate units), it is
generally called the hospital center (not field hospital). The field hospital is the 32-bed subordinate unit that
is one component within the hospital center.
MISSION
The HHD, hospital center provides mission command for up to two field hospitals (32-bed) and requisite
augmentation detachments all in one location or dual based.
ASSIGNMENT
Assigned to the (MEDBDE (SPT).
DEPENDENCIES
This unit is dependent upon, but not necessarily limited to, the following:
⚫ Appropriate elements of the theater for religious, legal, AHS support, finance, and personnel and
administrative services, mortuary affairs, security of EPW/retained/detained patients and U.S.
prisoner patients, transportation services when single lift requirements exceed unit capability,
vehicle recovery operations, transportation and equipping for return to duty (RTD) personnel, to
include individual clothing and equipment, seasonal outer garments, chemical protection
garments, and shower and laundry services not related to patient care.
⚫ Quartermaster supply company for Class I, II, III and VII supplies and to provide potable water
and unclassified map support.
⚫ Medical logistics company (MLC) for Class VIII support. Augmentation of personnel for medical
equipment maintenance and repair, as required.
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⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
Field hospital (32-bed), nutritional care section for feeding of HQs staff.
Horizontal construction company to construct field hospital platforms.
Prime power battalion, to generate long term hard-stand electrical power and provide advice and
technical assistance for electrical power and distribution, and for relief of tactical generators as
required for the hospital.
MDVS support for zoonotic disease control and investigation, food safety and defense inspections
of medical and nonmedical rations to include suspected CBRN contaminated rations (as
directed), and provision of disposition instructions for contaminated rations.
Expeditionary signal company to provide automatic switching services for both analog and digital
voice and data traffic, tactical multichannel high capacity transmission systems, and multichannel
satellite ground terminals.
Casualty liaison team for accurate and timely casualty information, facilitates real-time casualty
information for commanders, and assists in the management of casualty operations as needed.
The medical company (air ambulance) (MCAA) to provide Intratheater AE support to and
between roles of care within the AO, transportation of emergency Class VIII resupply, and
movement of medical personnel.
The USAF AE liaison team for coordinating intertheater patient evacuations.
In addition to the augmentation detachments routinely associated with the hospital center, the
following specialty augmentation teams/detachment can be attached to increase medical specialty
and support capabilities as needed: hospital augmentation team, head and neck; medical team,
forward surgical; medical detachment, minimal care
EMPLOYMENT
Deploys into a joint operations area (JOA) providing mission command to assigned and attached units
providing hospitalization and outpatient services for all classes of patients within the theater. It is important
to note that the HHD, hospital center is designed to be able to provide mission command of two field
hospitals (32-bed) in two separate locations, not one field hospital (32-bed) split in two locations. The field
hospital (32-bed) is not designed to be split.
RULE OF ALLOCATION
One per a maximum of two field hospitals (32-bed), and hospital augmentation detachments, up to a total
of 240-beds. If medical planners determine that one HHD, hospital center cannot adequately provide
mission command of two separated field hospitals (32-bed) due to distance and insufficient
communications, a second HHD, hospital center should be requested. Attaching a minimal care detachment
(120 cots) does not count against the 240-bed maximum the HHD can C2.
CAPABILITIES
This unit provides—
⚫ Mission command of organic and attached elements, to include AHS support planning, policies,
and support operations within the hospital's AO.
⚫ Provide information to commanders and staff on the health of the command and on health aspects
affecting the unit's mission(s) or AHS support.
⚫ Indefinite dual-base capability as required; it can provide C2 of two field hospitals (32-beds) and
associated augmentation detachments collocated as one hospital or in two separate locations.
⚫ Augmentation to the field hospital (32-bed), motor maintenance section.
⚫ Individuals of this organization are provided weapons for personal defense and protection of the
patients under their care.
⚫ This unit does not perform field maintenance on all organic equipment to include COMSEC
equipment.
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FUNCTIONS
Command section
This section provides mission command for elements of the hospital and coordination for hospitalization
support within the hospital’s AO. The command section provides advice to supported tactical commanders
on the health of the command and provides medical surveillance activities within the AO. Command and
staff personnel provide supervision and coordination of administrative, logistics, operations, medical,
surgical, nursing, and hospital ministry services. The commander should consider combining the HHD staff
with that of the field hospital (32-bed) it is collocated with. Neither staff is extremely robust; this technique
allows for a more capable 24 hour staffing. In order to separate functions of the two staffs, another technique
is for the HHD staff to focus “up and out” while the field hospital (32-bed) staff focuses “down and in.”
Clinical operations section
This section consists of the principal consultants and technical advisors for the command in medical,
surgical, and nursing care and manages health care provider credentialing and administration, as well as
clinical care quality assurance, treatment protocol management, and AHS support and training; establishes
patient management policies, and ensures facilities and resources are adequate to treat all types of disease
and injury, to include CBRN casualties; provides staff supervision of clinical activities throughout the
hospital to include proper staffing of the subordinate hospital elements; plans and coordinates health services
clinical resources within the hospital; plans and coordinates clinical medical resources to provide effective
and consistent treatment of wounded, injured, or sick personnel so as to return to duty or evacuate from the
AO; monitors clinical policies, protocols, and procedures pertaining to the medical and surgical treatment
of sick, injured, and wounded personnel; plans and monitors the provision of combat casualty care within
assigned or attached hospital elements; monitors the management of clinical specialties including Modified
Table of Organization and Equipment (MTOE) Assigned Personnel (MAP) and rotation policy.
S1 section
This section provides human resources services for the hospital center and subordinate elements attached
and assigned, to include personnel administration, mail distribution, and awards and decorations; maintains
leave and rest and recuperation schedules; coordinates for morale, welfare, and recreation support; prepares
and manages correspondence for the command; maintains unit personnel readiness status; ensures personnel
and deployment manifests are maintained and manages the personnel replacement program; coordinates
with the senior medical unit's public affairs officer for protocol and public affairs support.
S2/S3 section
This section plans and coordinates medical resources to provide effective and consistent treatment of
wounded, injured, or sick personnel so as to return to full duty or evacuate from the AO; plans and
coordinates health services resources within the hospital; assists in maintaining situational understanding
by coordinating for current medical intelligence and the common operating picture with the MEDBDE
(SPT) and TMC counterintelligence and human intelligence staff officer/operations staff officer/assistant
chief of staff, operations; maintains tactical situational understanding through coordination with supported
units; assists in coordinating AHS training requirements and execution in the hospital; develops mass
casualty (MASCAL) plans and determines the medical workload requirements based upon the casualty
estimate within the hospital’s AO; develops, synchronizes, and coordinates hospitalization support within
the AO to support the commander’s decisions, planning guidance, and intent; evaluates and interprets
medical statistical data; provides support to the commander for plans, intelligence, operations, security,
deployment, redeployment, and relocation of the hospital center and subordinate elements.
S4 section
This section monitors MEDLOG services within the hospital and supported units; monitors health services
and FHP resources within the hospital; determines MEDLOG requirements and priorities; adapts medical
equipment sets (MES) for a specific scenario to include adding items based on forecasted types of injuries;
monitors the requisition, procurement, storage, maintenance, distribution, management, and documentation
of Class VIII materiel, and special hospital items of subsistence required for patient care; provides planning,
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programming, coordinating, and supervision of all activities concerning the internal logistical operations of
the hospital center and subordinate elements; maintains and manages the hospital's property book;
coordinates for external logistical support requirements such as (nonorganic) equipment transportation
support, inbound resupply tracking and contracts; coordinates for resupply of all classes of supply; monitors
equipment (medical and nonmedical) status, reporting, and repair programs.
S6 section
This section provides for all aspects of automation and CE for the command; determines signal
requirements, capabilities, and operations; provides advice and consultation on medical automated systems
used within the hospital center and subordinate elements; ensures internal and external communication
connectivity within the hospital and subordinate elements; establishes and maintains internal data and
patient digital records.
Transportation section
This section provides organic transportation required for mission accomplishment of the field hospital (32bed); provides transportation for the HHD, hospital center; coordinates for external transport support when
the mission demands exceed organic transportation assets. The HHD owns the majority of the vehicles for
the entire hospital while the field hospital (32-bed) provides the majority of the drivers and motor
maintenance. The two elements, as well as the other augmentation detachments, are very dependent on one
another for prioritizing and moving critical medical capabilities.
MOBILITY
The Hospital Center’s organic vehicles are capable of transporting 100 percent of its TOE equipment and
provide transportation for the field hospital (32-bed).
The Hospital Center’s organic vehicles can transport 35 percent of the field hospital’s (32-bed) TOE
equipment in a single lift with personnel augmentation from the field hospital (32-bed) to assist in driving
the vehicles.
The Hospital Center may be dependent on appropriate elements of the theater, corps, or division for
supplemental transportation.
Figure 3-6. HHD Hospital Center Task Organization
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Table 3-1. Hospital Center Fuel Consumption, Space, and Transportation Requirements
Figure 3-7. Hospital Center Configurations
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Figure 3-8. Hospital Center Command and Control
Figure 3-9. Hospital Center Task Organization
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Figure 3-10. Notional 240 bed hospital center configuration
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FIELD HOSPITAL (32-BED)
(Revised: March 2021)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08988K000
FIELD HOSPITAL (32 BED)
49
3
114
0
166
MISSION
Provide hospitalization and outpatient services for all classes of patients within the theater.
ASSIGNMENT
Assigned to the HHD, hospital center.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate external elements for religious, legal, AHS support, finance, personnel and
administrative, and logistical services, mortuary affairs, security of EPW patients and U.S.
prisoner patients, transportation support when single lift requirements exceed unit capability,
vehicle recovery operations, transportation and equipping for RTD personnel, to include
individual clothing and equipment, seasonal outer garments, chemical protection garments, and
shower and laundry services not related to patient care.
⚫ Quartermaster supply company for Class I, II, III and VII supplies and to provide potable water
and unclassified map support.
⚫ Medical logistics company for Class VIII support. Augmentation of personnel for medical
equipment maintenance and repair, as required.
⚫ Horizontal construction company to construct field hospital platforms.
⚫ Prime power battalion to generate electrical power and to provide advice and technical assistance
for electrical power and distribution.
⚫ Medical detachment (veterinary services) for zoonotic disease control and investigation, food
safety and defense inspections of medical and nonmedical rations to include suspected CBRNcontaminated rations (as directed), and provision of disposition instructions for contaminated
rations.
⚫ Expeditionary signal company to provide automatic switching services for both analog and digital
voice and data traffic, tactical multichannel high capacity transmission systems, and multichannel
satellite ground terminals.
⚫ Casualty liaison team for accurate and timely casualty information, facilitates real-time casualty
information for commanders, and assists in the management of casualty operations as needed.
⚫ The MCAA to provide Intratheater AE support to and between roles of care within the AO,
transportation of emergency Class VIII resupply, and movement of medical personnel.
⚫ The USAF AE liaison team for coordinating intertheater patient evacuations.
In addition to the augmentation detachments routinely associated with the field hospital (32-bed), the
following specialty augmentation teams/detachment can be attached to increase medical specialty and
support capabilities as needed: hospital augmentation team, head and neck; FRSD; medical detachment,
minimal care.
EMPLOYMENT
The field hospital (32-bed) is designed to be employed with the HHD, hospital center, and will provide
mission command, Role 3 hospitalization, and outpatient services in an AO. It is important to note that
providing Role 3 medical capabilities in two locations, controlled by one HHD, hospital center is performed
by two field hospitals (32-bed) in two separate locations, not one field hospital (32-bed) split in two
locations. An individual field hospital (32-bed) is not designed to be split.
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With the hospital being a newly designed and fielded unit, very little data exists on the length of time it
takes to establish operations. However, based on comparisons with the CSH and a small number of field
training exercises, it will take approximately 72 hours for the field hospital to establish limited Role 3
capabilities (EMT, surgery, ICU beds, CMS, and ancillary services required to support surgery). It will also
take another 48-72 hours to establish the entire field hospital (32-bed) with the full complement of its
capabilities.
BASIS OF ALLOCATION
Large-scale combat operations for brigade and EAB hospital direct admissions per 100
occupied beds:
⚫
1.11 field hospitals/100 wounded in action (WIA).
⚫ 0.66 field hospitals/100 DNBI.
⚫ 0.39 field hospitals/100 nerve.
⚫ 0.82 field hospitals/100 blister.
For Theater direct admissions per 100 occupied beds:
⚫
0.82 field hospitals/100 WIA.
0.45 field hospitals/100 DNBI.
⚫ 0.48 field hospitals/100 nerve.
⚫ 0.47 field hospitals/100 blister.
⚫
For theater hospital transfer admissions per 100 occupied beds:
⚫
0.77 field hospitals/100 WIA.
0.31 field hospitals/100 DNBI.
⚫ 0.93 field hospitals/100 nerve.
⚫ 0.13 field hospitals/100 blister.
⚫
For theater hospital transfer admissions with skip:
⚫
0.69 field hospitals/100 WIA.
⚫ 0.21 field hospitals/100 DNB.
⚫ 0.92 field hospitals/100 nerve.
⚫ 0.92 field hospitals/100 blister.
STABILIZE
⚫
Apply MCO rule for US supported forces and add for directed support for host nation population
at risk (PAR) at 1 field hospital (32 bed) per 50,000.
ENABLE CIVIL AUTHORITY
⚫
Basis of allocation adjustments will be based on roles of care directed and PAR supported.
ROLE 3 HOSPITAL PLANNING TOOL
The MEDCoE, Computational Sciences Division, developed an Excel spreadsheet modeling tool to assist
planners in determining the requisite hospital elements to provide Role 3 medical care in an AO. The tool
is currently named ATP 4_02_FH_Solver_Production_with NEO and can be obtained by emailing
MEDCoE Doctrine Division at usarmy.jbsa.medical-coe.mbx.ameddcs-medical-doctrine@army.mil.
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Note. When the tool is opened, enable editing, enable content, and select one of the populations
at risk categories in the drop-down listings. The medical planner will enter the correct population
at risk (PAR) and estimated beds occupied by four different categories of patients. The
spreadsheet will then calculate the beds and units required to support the estimation of occupied
beds. The medical planner can enter information in column J and review the results of beds
required versus beds allocated by various hospital unit compositions or configurations.
CAPABILITIES
This unit provides—
⚫ Company level mission command of organic elements to include AHS support, planning, policies,
and support operations within the hospital's AO and is capable of operating up to 72 hours with
its initial basic load of supply.
⚫ Information to commanders and their staff on the health of their command and on health aspects
affecting the unit's mission(s) or AHS.
⚫ Indefinite dual-base capability when attached to the hospital center.
⚫ Hospitalization for up to 32 patients consisting of one (1) ward providing intensive nursing care
for up to twelve (12) patients and one (1) ward providing intermediate nursing care for up to
twenty (20) patients.
⚫ Surgical capability, including general, orthopedic, and obstetrics-gynecological based on two OR
tables capable of providing 36 OR hours per day.
⚫ Emergency treatment to receive, triage, and resuscitate casualties to include not only military
personnel, but Department of Defense (DOD) civilian employees and contractors, local nationals,
detainees, EPWs/retained/detained personnel as required.
⚫ Pharmacy, clinical laboratory, blood banking, radiology/computed tomography and nutrition care
service for patients and organic staff.
⚫ Personnel administration, patient administration, unit maintenance, medical and nonmedical
logistics, laundry services for direct patient-related linen and shower facilities for ambulatory
patients and direct patient care providers.
⚫ Coordination with the USAF TPMRC for medical regulating and movement of patients from the
theater.
⚫ Technical advice and consultation on medical automated information systems and programs such
as the theater medical information program and medical communications for combat casualty
care (MC4).
⚫ All work areas and assemblages deploy with three days of supply on hand within identified
MMSs.
⚫ Provides hospital nutrition services.
⚫ Field maintenance support to all elements of the hospital, and all attached and assigned units.
⚫ Individuals of this organization (except the chaplains) are provided weapons for personal defense
and protection of the patients under their care.
FUNCTIONS
Command section
This section provides internal mission command and management of the hospital. It provides administrative
support, prepares unit plans for movement, routine and medical support operations, and mission-related task
organization. The commander may consider combining the HHD staff with that of the field hospital (32bed). Neither staff is extremely robust; this technique allows for a more capable 24 hour staffing. In order
to separate functions of the two staffs, another technique is for the HHD staff to focus “up and out” while
the field hospital (32-bed) staff focuses “down and in.”
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Company headquarters
This headquarters provides mission command of the field hospital (32-bed). Personnel of this section
supervise and coordinate the operations and administrative services. Provides logistical functions for the
hospital element and attached units, to include general and medical supplies; environmental control of
patient treatment areas; power and vehicle maintenance; fuel distribution; and equipment records and repair
parts management. Provides laundry services for direct patient care providers and patients and coordinates
with appropriate elements within the theater for all other laundry support. Provides shower services for
patients and health care providers.
Operations section
This section plans and coordinates medical resources to provide treatment of wounded, injured, or sick
personnel involving return to duty or evacuation from the hospital's AO. Plans and coordinates AHS
resources within the hospital's AO. Assists in maintaining situational awareness by coordinating for current
AHS support information with operations sections at the next higher, adjacent, and subordinate HQs. Assist
in coordinating AHS training requirements and execution in the hospital. Develops mass casualty plans,
and determines the medical workload requirements based upon the casualty estimate within the hospital's
AO. Develops, synchronizes, and coordinates AHS within the hospital's AO to support the commander's
decisions, planning guidance, and intent. Coordinates AHS training requirements and execution. Provides
support to the commander for plans, intelligence, operations, security, deployment, redeployment and
relocation of the field hospital and subordinate elements. Responsible for the installation, operation,
management and maintenance of the information management systems. Establishes and maintains secure
and nonsecure local area network, MC4, theater medical information program, and automated logistics in
all sections of the hospital and attached units.
Patient administration section
This section secures and accounts for patients’ valuables. Prepares patient-statistical reports for the hospital
and coordinates reporting to the appropriate mission command structure. Coordinates requests for patient
evacuation and provides reports to higher HQs. Coordinates with patient's unit and mortuary affairs for
prompt removal of remains and personal effects.
Nutrition care section
This section provides food service management, meal preparation, modified diet preparation, distribution
of foods to patients and staff, and medical nutrition therapy to include dietetic planning, patient education,
supervision and control of overall nutritional care operations. Provides nutrition care services for patients,
EPW/retained/detained patients while ensuring culturally appropriate foods are provided according to
command guidance. Serves as the command advisor on health and nutrition.
Supply and services section
This section provides logistical functions for the hospital and attached units, to include medical supplies;
medical maintenance management; blood management; water distribution, waste disposal, environmental
control of patient treatment areas, and temporary hospital morgue.
Motor maintenance section
This section performs field maintenance functions on organic wheeled vehicles, power generation,
quartermaster-chemical equipment and environmental control units.
Laundry/shower section
This section provides laundry services for direct patient care providers and patients; coordinates with
supporting element for all other laundry support not directly related to patient care. Provides shower services
for patients and health care providers.
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Triage/Pre-Op/EMT section
This section provides for the receiving, triaging, and stabilizing of incoming patients. The staff will receive
patients, assess their medical condition, provide EMT, and transfer them to the appropriate areas within the
field hospital. The staff will be trained in advanced trauma management, and EMT, as appropriate. The
staff monitors patient conditions and prepares those requiring immediate surgery for the OR. The litter
bearers are responsible for the transportation of patients within the hospital unit. The EMT personnel read
from and input to the automated clinical record, using available information systems for both inpatient and
outpatients. They use automated tools for access to medical and essential operational information. The
section communicates directly with incoming evacuation platforms (ground and air) to provide en route
consultation and to ensure readiness to receive incoming patients. The section also provides on-site and
remote consultation services via digital means when available.
Operating room/Central materiel services section
This section provides supervision of the OR and CMS. It schedules nursing staff, prepares and maintains
the OR and CMS, and maintains surgical and nursing standards within these areas. It functions with the
anesthesia section to perform initial surgery for battle and nonbattle injuries and follow-on surgery for
patients received from other MTFs. It provides general, orthopedic, obstetrics-gynecological surgical
services with two (2) OR tables for a total of 36 hours of table time per day. It uses automated tools to
maintain projected OR schedules and determine OR surgical backlog in terms of projected hours to complete
each surgery and numbers of patients. It provides records and reports to the commander. The staff reads
from and inputs to the automated clinical record using available information systems. It accesses digital xray files for patient care during surgery. The section functions with the hospital augmentation detachment
(surgical 24-bed) as one surgical service, when consolidated.
Anesthesia service section
This section provides anesthesia and respiratory services for the hospital. It provides supervision and
administration of anesthetics to patients undergoing surgery. The section coordinates with and assists the
EMT section in trauma care services. When consolidated, it functions with the hospital augmentation
detachment (surgical 24-bed) anesthesia and respiratory services as one service.
Nursing service section
This section is responsible for the management of daily operations of nursing services throughout the
hospital, to include scheduling and supervision of nursing staff: preparation and coordination of duty
rosters; emergency mass casualty plans and contingency staffing. It plans, organizes, executes, and directs
nursing care practices and activities of the hospital. This section ensures clinical training and readiness of
medical personnel. It also ensures the clinical validation of medical equipment sets and the readiness of
clinical standing operating procedures. The section plans, coordinates, and supervises the layout and design
of the clinical aspects of the physical facilities.
ICU
This section provides one (1) 12-bed ICU for critically injured or ill patients and are responsible to the
Nursing Service Section. The ICU provides intensive care for up to twelve (12) patients requiring the most
intensive monitoring/care. The ICUs manage surgical and/or medical patients, adult and/or pediatric, whose
physiological status is so disrupted that they require immediate and continuous medical and nursing care.
The staff is specially trained with the clinical and managerial skills necessary to deliver safe nursing care to
patients with complex nursing and medical problems. The ICU is also used as a preoperative stabilization
area and postanesthesia recovery area for patients either awaiting surgery or recovering from surgery.
Note. Of the 12-Beds, only 10 are resourced with all of the requisite capabilities of a fully
functioning ICU bed (nursing staff, intravenous pumps, and ventilators). These 2 beds can be
and are typically used as transition beds for patients awaiting evacuation, for patients that are too
complex for the ICW, or simply as overflow beds.
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ICW
This section provides one (1) ICW that manages surgical or medical patients whose conditions require
observation for real or potential life-threatening disease/injury. The acuity of care may range from those
requiring constant observation to those patients able to ambulate and begin to assume responsibility for their
care. Although not routine, ICW patients may require monitoring devices and ventilator support. The ICW
consists of 20 beds.
Pharmacy section
This section is responsible for developing, coordinating, and executing programs and policies ensuring safe
and appropriate medication use within the field hospital. The following are key functions performed by the
pharmacy section personnel. Develop, maintain, and publish the approved hospital formulary; screen all
medication orders for drug-drug, drug-nutrient interactions, or medication allergies; monitor individual
medication therapies for safe and appropriate disease state management; recommend alternative drug
regimens to meet situational requirements; monitor and report on all medication-related patient safety
problems; provide consultation services to medical and logistical staff; monitor and enforce hospital-wide
quality control of pharmaceuticals; provide outpatient pharmacy services; provide inpatient pharmacy
services, including sterile products preparation services; provide drug/medication information services;
provide bulk drug and controlled substance distribution support for patient care areas; provide direct patient
care services, and provide pharmacy supply and support services. The pharmacy section exercises
appropriate control and accountability for all controlled substances and rosters with signature documentation
for all individuals approved by the field hospital commander to prescribe, receive, order, or distribute
controlled drugs. The pharmacy section provides outpatient medications for the required number of days to
complete therapy and/or the supply of medications required for AE out of theater. It uses automated systems
for requisition of pharmacy supplies and interfaces with other unit sections for bulk pharmacy orders and
with the supply and services section for re-supply.
Laboratory services/blood bank section
This section performs analytical procedures in hematology, urinalysis, chemistry, blood banking, and
limited basic microbiology screening. Attachment of the hospital augmentation detachment (surgical 24bed) and/or the hospital augmentation detachment, (medical 32-bed) is required if analytical microbiology
capability is required. The section provides blood banking services, including all routine blood grouping
and typing, and abbreviated cross-matching procedures, emergency blood collection, and blood inventory
management. This section provides storage and issues liquid blood components and fresh frozen plasma. It
coordinates with the supply and services section and directly with the medical detachment (blood support)
and blood program office for blood supply and re-supply requirements. It provides automated records and
reports of current and projected blood status to the commander and higher HQs.
Radiology section
This section provides radiological services to all areas of the field hospital and operates on a 24-hour basis.
The radiologist is responsible for the clinical standard operating procedures and policies.
Computed tomography (CT)
This section provides specialized radiological services to all areas of the hospital. The section provides
diagnostic data concerning foreign bodies in the orbit and eyeball, mediastinum, near the diaphragm and in
other borderline locations in the chest. This section provides essential information for orthopedic injuries
guiding surgical repair.
Hospital ministry team
This section provides religious support and pastoral care ministry for patients, assigned staff, and
subordinate organizations.
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MOBILITY
Dependent upon the HHD, hospital center, the field hospital (32 bed) is approximately 35 percent mobile
using organic and HHD transportation assets. This company-sized organization may be dependent on
appropriate elements of the theater, corps, or division, for supplemental transportation.
Figure 3-11. Notional Field Hospital (32-bed) Configuration
Not including living areas, the field hospital (32-bed) requires approximately 6.78 acres.
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Figure 3-12. Field Hospital (32-bed) Task Organization
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HOSPITAL AUGMENTATION DETACHMENT
(SURGICAL 24-BED)
(Revised: 31 August 2021)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08977K000
HOSPITAL AUGMENTATION
DETACHMENT (SURGICAL
24 BED)
33
0
33
0
66
MISSION
Augments the capabilities of the field hospital (32-bed) with thoracic, urology, oral maxillofacial surgical
capabilities, 24 additional ICU beds, outpatient services, and microbiology.
ASSIGNMENT
Assigned to the HHD, hospital center.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate external elements for religious, legal, AHS support, finance, personnel and
administrative, and logistical services, mortuary affairs, security of EPW/retained/detained
patients and U.S. prisoner patients, transportation services when single lift requirements exceed
unit capability, vehicle recovery operations, transportation and equipping for RTD personnel, to
include individual clothing and equipment, seasonal outer garments, chemical protection
garments, and shower and laundry services not related to patient care.
⚫ Quartermaster supply company for Class I, II, III and VII supplies and to provide potable water
and unclassified map support.
⚫ Medical logistics company for Class VIII support. Augmentation of personnel for medical
equipment maintenance and repair, as required.
⚫ Field hospital (32-bed), nutritional care section for feeding of hospital staff and patients.
⚫ Horizontal construction company to construct field hospital platforms.
⚫ Prime power battalion to generate electrical power and to provide advice and technical assistance
for electrical power and distribution.
⚫ Medical detachment (veterinary services) for zoonotic disease control and investigation, food
safety and defense inspections of medical and nonmedical rations to include suspected CBRNcontaminated rations (as directed), and provision of disposition instruction for contaminated
rations.
⚫ Expeditionary signal company to provide automatic switching services for both analog and digital
voice and data traffic, tactical multichannel high capacity transmission systems, and multichannel
satellite ground terminals.
⚫ Casualty liaison team for accurate and timely casualty information, facilitates real-time casualty
information for commanders, and assists in the management of casualty operations as needed.
In addition to the augmentation detachments routinely associated with the field hospital (32-bed), the
following specialty augmentation teams/detachment can be attached to increase medical specialty and
support capabilities as needed: hospital augmentation team, head and neck; FRSD; medical detachment,
minimal care.
EMPLOYMENT
Deploys to a theater or JOA providing additional surgical, capabilities, 24 ICU beds, outpatient clinic, and
microbiology to the field hospital (32-bed). Once attached to the field hospital (32-bed), this unit loses
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much of its own autonomy and identity. It is intended to augment a hospital that already possesses much of
its capabilities and therefore, gets absorbed into the field hospital (32-bed) surgical configuration.
BASIS OF ALLOCATION
Large-scale combat operations for brigade and echelon above brigade direct admissions per
100 occupied beds:
•
•
•
1.11 surgical detachments/100 wounded in action (WIA).
0.00 surgical detachments/100 DNBI.
0.20 surgical detachments/100 nerve and surgical detachments/100 blister.
For theater hospital direct admissions per 100 occupied beds:
•
•
•
•
0.75 surgical detachments/100 WIA.
0.00 surgical detachments/100 DNBI.
0.00 surgical detachments/100 nerve.
0.00 surgical detachments/100 blister.
For theater hospital transfer admissions per 100 occupied beds:
•
•
•
•
0.57 surgical detachments/100 WIA.
0.00 surgical detachments/100 DNBI.
0.00 surgical detachments/100 nerve.
0.00 surgical detachments/100 blister occupied beds.
For theater hospital transfer admissions with skip:
•
•
•
•
0.38 surgical detachments/100 WIA.
0.00 surgical detachments/100 DNBI.
0.00 surgical detachments/100 nerve.
0.00 surgical detachments/100 blister occupied beds.
STABILIZE
⚫
Apply MCO rule for US supported forces model did not earn surgical detachments for host nation
population-at-risk (PAR). All requirements for surgical were earned by the Field Hospital.
Enable Civil Authority
⚫
Basis of allocation adjustments will be based on roles of care directed and PAR supported.
CAPABILITIES
This unit provides—
⚫ Augmentation of surgical capability for thoracic, orthopedic, and oral maxillofacial surgery based
on two (2) OR tables for a total of thirty-six (36) operating table hours per day.
⚫ Augmentation of hospitalization with up to 24 patients consisting of two (2) wards providing
intensive care nursing.
⚫ Consultation and outpatient clinic services for patients referred from other MTFs.
⚫ Psychiatry, public health nursing, and physical therapy services.
⚫ Three days’ supply of basic load within identified MMSs in all work areas and deployed
assemblages.
⚫ Individuals of this organization are provided weapons for personal defense and protection of the
patients under their care.
⚫ This unit supplements the medical maintenance capabilities of the field hospital, (32-bed).
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FUNCTIONS
Supply and services section
This section augments the supply and services functions within the field hospital (32-bed) to increase
logistics capabilities (medical, utilities, and generator maintenance, and MEDLOG.
Operating room/Central materiel services section
This section incrementally expands the operative capabilities of the hospital with two OR tables and staffed
for 36 operating hours per day. Provides sterilization and operator maintenance of equipment.
Anesthesia service section
This section incrementally expands the anesthesia and respiratory service capacities of the hospital.
Provides supervision and administration of anesthetics to patients undergoing surgery.
ICUs
This section incrementally expands the capacity of the hospital to care for critically injured or ill patients.
Nursing care is performed for those patients who require close observation and vital sign monitoring,
complex nursing care, and mechanical respiratory assistance. This section also serves as preoperative
stabilization and post anesthesia recovery area.
Specialty clinics section
This section provides ambulatory care expansion capabilities of the field hospital (32-bed) to primary care,
family practice, and psychiatry. Provides patient care and family medicine consultation services, evaluation
and treatment of dermatological and gynecological diseases, injuries, disorders, orthopedic and physical
therapy services. Provides outpatient psychiatry and inpatient neuropsychiatric consultation and education
services. Provides an obstetrics-gynecology clinic with the basic medical supplies and equipment necessary
to evaluate, diagnose, and clinically manage routine patient complaints related to the female reproductive
system. Provides an orthopedic clinic with the basic medical supplies and equipment necessary to evaluate,
diagnose and clinically manage musculoskeletal conditions, to include mobile cast capability. Provides the
supplies and equipment to conduct sick call operations and comprehensive routine medical care to include
electrocardiographs in the medical services clinic. Provides a physical-occupational clinic to evaluate and
treat neuromusculoskeletal injuries, minor soft tissue wounds to include burn wound treatment, behavioral
health, injury prevention, and human performance optimization.
Microbiology section
This section provides additional capability to the field hospital (32-bed) to accomplish aerobic and anaerobic
cultures, limited parasitology and antibiotic susceptibility testing.
MOBILITY
The Hospital Augmentation Detachment (Surgical 24-Bed) has no organic vehicles and relies on the HHD,
hospital center and theater assets for mobility. This detachment may be dependent on appropriate elements
of the theater, corps, or division, for supplemental transportation.
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Figure 3-13. Hospital Augmentation Detachment (Surgical 24-bed) Task Organization
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HOSPITAL AUGMENTATION DETACHMENT
(MEDICAL 32-BED)
(Revised: 31 August 2021)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08978K000
HOSPITAL AUGMENTATION
DETACHMENT (MEDICAL
32 BED)
19
0
27
0
46
MISSION
Augments the field hospital (32-bed) with operational dental care, one additional ICU ward (12-Beds), one
ICW ward (20-Beds), additional microbiology capabilities and outpatient services for all classes of patients.
ASSIGNMENT
To the HHD, hospital center.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate external elements for religious, legal, AHS support, finance, personnel and
administrative, and logistical services, mortuary affairs, security of EPW/retained/detained
patients and U.S. prisoner patients, transportation services when single lift requirements exceed
unit capability, vehicle recovery operations, transportation and equipping for RTD personnel, to
include individual clothing and equipment, seasonal outer garments, chemical protection
garments, and shower and laundry services not related to patient care.
⚫ Quartermaster supply company for Class I, II, III and VII supplies and to provide potable water
and unclassified map support.
⚫ Medical logistics company for Class VIII support. Augmentation of personnel for medical
equipment maintenance and repair, as required.
⚫ Field hospital (32-bed), nutritional care section for feeding of hospital staff and patients.
⚫ Horizontal construction company to construct field hospital platforms.
⚫ Prime power battalion to generate electrical power and to provide advice and technical assistance
for electrical power and distribution.
⚫ Medical detachment (veterinary services) for zoonotic disease control and investigation, food
safety and defense inspections of medical and nonmedical rations to include suspected CBRNcontaminated rations (as directed), and provision of disposition instruction for contaminated
rations.
⚫ Expeditionary signal company to provide automatic switching services for both analog and digital
voice and data traffic, tactical multichannel high capacity transmission systems, and multichannel
satellite ground terminals.
⚫ Casualty liaison team for accurate and timely casualty information, facilitates real-time casualty
information for commanders, and assists in the management of casualty operations as needed.
In addition to the augmentation detachments routinely associated with the field hospital (32-bed), the
following specialty augmentation teams/detachment can be attached to increase medical specialty and
support capabilities as needed: hospital augmentation team, head and neck; FRSD; medical detachment,
minimal care.
EMPLOYMENT
Deploys to a theater providing augmentation of additional intensive and intermediate medical care,
additional microbiology capabilities and outpatient services to the field hospital (32-bed). Once attached to
the field hospital (32-bed), this unit loses much of its own autonomy and identity. It is intended to augment
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a hospital that already possesses much of its capabilities and therefore, gets absorbed into the field hospital
(32-bed) operations.
BASIS OF ALLOCATION
LSCO for brigade/and EAB hospital direct admissions per 100 occupied beds:
⚫
0.50 medical detachments/100 wounded in action (WIA)
0.58 medical detachments/100 DNBI.
⚫ 0.20 medical detachments/100 nerve.
⚫ 0.72 medical detachments/100 blister.
⚫
For theater hospital direct admissions per 100 occupied beds:
⚫
0.07 medical detachments/100 WIA
⚫
0.40 medical detachments/100 DNBI.
⚫ 0.42 medical detachments/100 nerve.
⚫ 0.41 medical detachments/100 blister.
For theater hospital transfer admissions from the theater per 100 occupied beds:
⚫
0.20 medical detachments/100 WIA
0.27 medical detachments/100 DNBI.
⚫ 0.81 medical detachments/100 nerve
⚫ 0.12 medical detachments/100 blister.
⚫
For theater hospital transfer admissions with skip per 100 occupied beds:
⚫
0.31 medical detachments/100 WIA
⚫ 0.18 medical detachments/100 DNBI.
⚫ 0.81 medical detachments/100 nerve
⚫ 0.81 medical detachments/100 blister.
Stabilize
⚫
Apply MCO rule for US supported forces and add for directed support for host nation population
at risk (PAR) at one (1) medical detachment (32 bed hospital augmentation, medical) per 57,000.
Enable Civil Authority
⚫
Basis of allocation adjustments will be based on roles of care directed and PAR supported.
CAPABILITIES
This unit provides—
⚫ Augmentation to the field hospital (32-bed) with hospitalization for up to 32 patients consisting
of one (1) ward providing intensive care nursing for up to 12 patients, requiring the most intensive
monitoring/care, and one (1) ward providing intermediate care nursing for up to twenty (20)
patients.
⚫ Augmentation to the specialty clinic with consultation and outpatient clinic services for patients
referred from other MTFs, as well as additional psychiatry, community health nursing, and
physical therapy capabilities.
⚫ Operational dental care consisting of emergency dental care and essential dental care designed to
circumvent potential dental emergencies.
⚫ Augmentation to the hospital with additional personnel for patient administration, logistical and
nutritional care services.
⚫ Three days of supply within all sections and MMSs.
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⚫
Individuals of this organization are provided weapons for personal defense and protection of the
patients under their care.
⚫ Supplements the supply and services section within the hospital (medical, utilities, and generator
maintenance and MEDLOG.
FUNCTIONS
Detachment Headquarters
Once attached to a field hospital (32-bed), has little ability to do extensive C2 functions. The commander
functions as the clinical head nurse in the ICW and the detachment senior NCO is a wardmaster.
Nutrition care section
This section augments the hospital with additional personnel for the nutrition care section providing
nutrition services.
Supply and services section
This section augments the supply and services section of the hospital with additional personnel to increase
the logistical functions (medical, utilities, and generator maintenance and MEDLOG.
Anesthesia service section
This augments the hospital with additional personnel to incrementally expand the anesthesia and respiratory
service capacities of the hospital.
ICU
This section augments the hospital with one 12-bed ICU providing for critically injured or ill patients. The
ICU manages surgical and/or medical patients, adult and/or pediatric patients whose physiological state is
so disrupted that they require immediate and continuous medical and nursing care.
ICW
This section augments the hospital with one ICW managing surgical or medical patients whose conditions
require observation for real or potential life-threatening disease/injury. The acuity of care may range from
those requiring constant observation to those patients able to ambulate and begin to assume responsibility
for their care. The ICW ward consists of 20-Beds.
Specialty clinics section
This section augments the hospital’s specialty clinics section, providing additional outpatient capabilities.
Provides limited inpatient neuropsychiatric services and preventive medicine surveillance of disease and
nonbattle injuries. In addition, provides inpatient and outpatient on-site consultations and provides public
health nursing support in the identification and treatment of illnesses resulting from the health threat in the
AO.
Dental section
This section provides dental services and consultation for patients and staff. Dentist will augment the
hospital with additional combat casualty care capabilities during mass casualty situations.
Microbiology section
This section augments the hospital with additional microbiology capabilities.
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MOBILITY
The Hospital Augmentation Detachment (Medical 32-Bed) has no organic vehicles and relies on the HHD
hospital center’s transportation section for mobility. This detachment may be dependent on appropriate
elements of the theater, corps, or division, for supplemental transportation.
Figure 3-14. Hospital Augmentation Detachment (Medical 32-bed) Task Organization
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HOSPITAL AUGMENTATION DETACHMENT
(INTERMEDIATE CARE WARD 60-BED)
(Approved: 20 January 2017)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08979K000
HOSPITAL AUGMENTATION
DETACHMENT (ICW 60 BED)
10
0
23
0
33
MISSION
The hospital augmentation detachment (ICW 60 bed) augments the capabilities of the field hospital (32 bed)
with three additional ICWs providing intermediate nursing care and additional personnel to support nutrition
and patient administration capabilities.
ASSIGNMENT
Assigned to the HHD, hospital center.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate external elements for religious, legal, AHS support, finance, personnel and
administrative, and logistical services, mortuary affairs, security of EPW patients and U.S.
prisoner patients, transportation services when single lift requirements exceed unit capability,
vehicle recovery operations, transportation and equipping for RTD personnel (to include
individual clothing and equipment, seasonal outer garments, chemical protection garments, and
shower and laundry services not related to patient care).
⚫ Quartermaster supply company for Class I, II, III and VII supplies and to provide potable water
and unclassified map support.
⚫ Medical logistics company for Class VIII support. Augmentation of personnel for medical
equipment maintenance and repair, as required.
⚫ Horizontal construction company to construct field hospital platforms.
⚫ Prime power battalion to generate electrical power and to provide advice and technical assistance
for electrical power and distribution.
⚫ MDVS support for zoonotic disease control and investigation, food safety and defense inspections
of medical and nonmedical rations to include suspected CBRN-contaminated rations (as
directed), and provision of disposition instruction for contaminated rations.
⚫ Expeditionary signal company to provide automatic switching services for both analog and digital
voice and data traffic, tactical multichannel high capacity transmission systems, and multichannel
satellite ground terminals.
⚫ Casualty liaison team for accurate and timely casualty information, facilities real-time casualty
information for commanders, and assists in the management of casualty operations as needed.
⚫ USAF AE liaison team for coordinating patient evacuations.
EMPLOYMENT
Deploys into an AO to augment the field hospital (32-bed), engaged in the operational support of
hospitalization and outpatient services for all classes of patients within the theater.
BASIS OF ALLOCATION
LSCO, for brigade/and EAB hospital direct admissions per 100 occupied beds:
⚫
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0.61 ICW detachments/100 wounded in action (WIA)
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⚫
0.66 ICW detachments/100 DNBI.
0.39 ICW detachments/100 nerve.
⚫ 0.82 ICW detachments/100 blister.
⚫
For theater hospital direct admissions per 100 occupied beds:
⚫
0.82 ICW detachments/100 WIA.
0.45 ICW detachments/100 DNBI.
⚫ 0.48 ICW detachments/100 nerve.
⚫ 0.47 ICW detachments/100 blister.
⚫
For theater hospital transfer admissions per 100 occupied beds:
⚫
0.77 ICW detachments/100 WIA.
0.31 ICW detachments/100 DNBI.
⚫ 0.93 ICW detachments/100 nerve.
⚫ 0.13 ICW detachments/100 blister.
⚫
For theater hospital transfer admissions with skip per 100 occupied beds:
⚫
0.69 ICW detachments/100 WIA.
⚫ 0.21 ICW detachments/100 DNBI.
⚫ 0.92 ICW detachments/100 nerve.
⚫ 0.92 ICW detachments/100 blister.
Stabilize:
⚫
Apply major combat operations rule for US supported forces and add for directed support for host
nation PAR at one (1) medical detachment (60-bed hospital augmentation, ICW) per 50,000.
Enable Civil Authority:
⚫
Basis of allocation adjustments will be based on roles of care directed and PAR supported.
CAPABILITIES
This unit provides—
⚫ Hospitalization for up to 60 patients consisting of three (3) wards providing intermediate nursing
care.
⚫ Augmentation to the patient administration and nutrition care sections.
⚫ Individuals of this organization are provided weapons for personal defense and protection of the
patients under their care.
⚫ This unit does not perform field maintenance on all organic equipment to include COMSEC
equipment.
⚫ This unit supplements the maintenance and nutrition care capabilities of the field hospital, (32bed).
FUNCTIONS
Nutrition Care Section
This section augments the field hospital with additional personnel to increase nutrition services.
Patient Administration Section
This section augments the field hospital with additional personnel to increase patient administration
services.
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ICW
This section augments the field hospital with three (3) ICWs to increase the intermediate nursing care by
managing surgical or medical patients whose conditions require observation for real or potential lifethreatening disease/injury. The acuity of care may range from those requiring constant observation to those
patients able to ambulate and begin to assume responsibility for their care. The role of care and acuity of
these patients may fluctuate depending on the intensity of their injury or illness. Although not routine, ICW
patients may require monitoring devices and ventilator support. Each ICW consists of 20-Beds.
MOBILITY
The Hospital Augmentation Detachment (ICW 60-Bed) has no organic vehicles and relies on the HHD
hospital center’s transportation section for mobility. This detachment may be dependent on appropriate
elements of the theater, corps, or division, for supplemental transportation.
Figure 3-15. Hospital Augmentation Detachment (ICW 60-bed) Task Organization
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MEDICAL DETACHMENT, MINIMAL CARE
(Revised: 2 April 2020)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08949K000
MED DET, MINIMAL CARE
7
0
31
0
38
MISSION
To provide minimal care/convalescent care, hospitalization, nursing, and rehabilitative services in support
of theater hospitals.
ASSIGNMENT
To a MEDBDE (SPT), and normally attached to a Role 3 hospital.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate elements within the theater for religious, legal, FHP, finance, and personnel and
administrative services.
⚫ The hospital to which attached for food service, water distribution, personnel and administrative
services, unit health services, patient administration, medical maintenance, supply (all classes),
and unit maintenance for the detachment's communication equipment and power generation.
⚫ The hospital to which attached for additional power requirements.
⚫ The dental company (area support) (DCAS) and the COSC for augmentation of treatment
capabilities.
EMPLOYMENT
The Medical Detachment, Minimal Care provides nursing, physical therapy, and occupational therapy
services for those patients expected to return to duty (RTD) within the theater evacuation policy or who are
awaiting further MEDEVAC. Each squad of the detachment may be employed separately providing 40
minimal care cots per squad.
BASIS OF ALLOCATION
This unit supports the requirement for all Combat Zone Minimal Care Ward (MCW) bed requirements (25%
of the total wounded in action (WIA)/disease and non-battle injury (DNBI); 21.5% of Blister; and 55% of
Nerve) and all communications zone (COMMZ) MCW bed requirements (75% of the total bed requirements
with an 70% skip policy). To get total bed requirements, Minimal Care Detachment, bed requirements must
be added to the intensive care unit (ICU)/intermediate care ward (ICW) bed requirements generated by the
Corps and EAC Hospital.
CAPABILITIES
This unit provides—
⚫ C2 of organic elements to include HSS, planning, policies, and support operations within the
detachments AOR.
⚫ Information to commanders and their staffs on the health and status of Soldiers in their command.
⚫ Augmentation of the hospital to which attached to provide hospitalization and minimal nursing
care for up to 120 ambulatory patients and for reconditioning and rehabilitation for those patients
who can return to duty within the theater evacuation policy or who are awaiting further
MEDEVAC.
⚫ Physical therapy and occupational therapy services for patients.
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⚫
⚫
⚫
⚫
⚫
⚫
Augmentation for the emergency nursing capabilities of the hospital to which attached during
mass casualty situations.
Augmentation to the nutrition care capabilities of the hospital to which attached to support patient
feeding of this detachment.
Augmentation to the patient administration section of the hospital to which attached to support
patient records.
Three days of supply level for all organic elements upon deployment and during routine
operations.
Individuals of this organization can assist in the coordinated defense of the unit's area or
installation.
This unit does not perform field maintenance on any organic equipment to include COMSEC
equipment.
FUNCTIONS
The function of this detachment is to perform minimal care nursing, occupational therapy, and physical
therapy for the patients admitted to the hospital to which attached and to other eligible personnel as
determined by the TMC and MEDBDE (SPT). Organic personnel of the detachment set up and break down
unit shelters and power-generating equipment in preparation for detachment operations or detachment
movement, set up the nursing care and occupational therapy, physical therapy areas, and perform routine
minimal care nursing and rehabilitation and reconditioning for ambulatory patients expected to return to
duty within the theater evacuation policy or who are awaiting MEDEVAC and require continued nursing
supervision to include those individuals being monitored after suspected biological warfare agent and
communicable disease contact. The detachment is normally attached to the hospital and provides a
detachment headquarters, an occupational and physical therapy section, and three minimal care wards with
40 cots in each ward.
Detachment Headquarters
The section provides C2 and administrative support. Performs unit plans and movement, routine and
specialized operations, mission-related task organization, and coordinates directly with the hospital to which
attached. Personnel of the headquarters and support section provide maintenance and supply and services
to augment the respective sections of the hospital to which attached.
Occupational and physical therapy section
This section provides occupational therapy and physical therapy services to the detachment's inpatients.
Personnel in this section augment the respective sections of the hospital to which attached.
Minimal care ward (40 Cot) (X3)
This section three minimal care nursing squads provide nursing supervision and management of medical or
surgical patients who are ambulatory and partially self-sufficient and are in the final stages of recovery,
awaiting return to duty, or who are awaiting further MEDEVAC. The focus of nursing management is on
an aggressive therapeutic environment which speeds recovery for RTD or which ensures stabilization and
preparation for MEDEVAC. Nursing personnel administer medications and treatments which cannot be
done by the patient and provide instruction in self-care and post hospitalization health maintenance. Nursing
personnel coordinate with the occupation/physical therapy personnel for rehabilitation and reconditioning
of patients. Nursing personnel also coordinate with the hospital to which attached for routine and emergency
medical treatment needs of patients.
MOBILITY
The Medical Detachment (Minimal Care [120 Cot]) requires 35 percent mobility of its TOE equipment to
be transported in a single lift using organic equipment. This organization does not have organic lift capability
and requires transportation support for movement. This unit has 181,305 pounds (16,600 cubic feet) of
TOE assets requiring transportation.
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Figure 3-16. Minimal Care Detachment (120-Cot) Task Organization
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HOSPITAL AUGMENTATION TEAM, HEAD AND NECK
(Revised: 10 January 2020)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08527KA00
HOSP AUG TM, HEAD & NECK
9
0
9
0
18
MISSION
To provide ear, nose and throat surgery, neurosurgery and eye surgery augmentation in support of theater
hospitals and consultative services as required.
ASSIGNMENT
To a TMC or MEDBDE (SPT), and normally attached to a Role 3 hospital.
DEPENDENCIES
This unit is dependent on—
⚫ Appropriate elements within the theater for religious, legal, FHP, finance, and personnel and
administrative services.
⚫ The hospital to which it is attached will provide sheltered OR, commonly used equipment, pre
and postoperative nursing care for all patients, field feeding (to include patient field feeding),
FHP, personnel and administrative services, unit level maintenance, transportation, security,
patient administration, coordination of MEDEVAC, power to support all equipment (except that
related to the Computerized Tomography) and all classes of supply.
EMPLOYMENT
This team will be employed with and further attached to hospitals.
BASIS OF ALLOCATION
One per 650 conventional hospital patients in the theater.
CAPABILITIES
This unit provides—
⚫ Initial and secondary ear, nose, and throat surgery and consultation services in support of theater
hospitals.
⚫ Initial and secondary neurosurgery and consultation services in support of theater hospitals.
⚫ Initial and secondary eye surgery and consultation services in support of theater hospitals.
⚫ Augmentation to the hospital operating room surgical and nursing services.
⚫ A MMS radiology, computerized tomography which enables the hospital to perform
computerized tomography examinations.
⚫ Three days of supply for use upon deployment and during routine operations.
⚫ Individuals of this organization can assist in the coordinated defense of the unit's area or
installation.
⚫ This unit does not perform field maintenance on any organic equipment.
FUNCTIONS
The function of the hospital augmentation team (head and neck) is to provide preoperative assessment and
perform neurosurgery; ear, nose, and throat surgery; and ophthalmic surgery for patients admitted to the
hospital to which the unit is attached. The team will also provide the hospital with neurosurgical, ophthalmic,
and otolaryngological consultation services and postoperative follow up.
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The equipment for the hospital augmentation team (head and neck) no longer includes the MMS (radiology,
CT). This set is provided by the field hospital (32 bed) so the hospital augmentation team (head and neck)
can perform CT scans prior to surgery and will decrease the requirement for exploratory surgery. The
hospital augmentation team (head and neck) does not include an OR and work areas and will perform
surgery utilizing the OR and central materiel supply complex of the hospital to which it is attached. When
attached to the hospital, it falls under the supervision of the chief, professional services.
MOBILITY
The Hospital Augmentation Team (Head and Neck) has no organic mobility. This unit has 55,046 pounds
(5,031 cubic feet) of TOE assets requiring external transportation support.
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MEDICAL DETACHMENT, FORWARD
RESUSCITATIVE AND SURGICAL (FRSD)
(Approved: 19 January 2017)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08528KA00
MEDICAL DETACHMENT,
FORWARD RESUSCITATIVE AND
SURGICAL (FRSD)
13
0
7
0
20
08528KB00
MEDICAL DETACHMENT,
FORWARD RESUSCITATIVE AND
SURGICAL (FRSD) AIRBORNE
13
0
7
0
20
MISSION
The FRSD provides forward damage control resuscitation and damage control surgery in support of unified
land operations, either independently, or as part of a future unified action partner coalition, for short and
extended military HSS operations.
ASSIGNMENT
Assigned to TMC or MEDBDE (SPT) and attached to a Role 3 hospital when not operationally employed
and further attached forward to a Role 2 medical company. When the FRSD is attached to a Role 2 BSMC,
MCAS, or when co-located with another service Role 2 medical organization capable of meeting its support
requirements, the FRSD can provided urgent initial surgery for otherwise nontransportable patients. In this
configuration, the FRSD and Role 2 MTF maximize health system synergies and capabilities such as access
to x-ray, ancillary support, patient holding and proximity to evacuation modalities. In this configuration,
the FRSD when co-located with a role II facility provides a surgical element much smaller than the Role 3
MTF. The FRSD may also augment a Role 3 MTF to provide additional surgical capability if required.
DEPENDENCIES
This unit is dependent upon—
⚫ Appropriate elements within the theater for religious, legal, FHP, finance, and personnel and
administrative services.
⚫ When operationally attached to a BSMC (Airborne, Armor, Infantry, and SBCTs), the brigade
medical supply office/section provides medical equipment maintenance and repair and Class VIII
A and B (blood) resupply. The BCTs general support aviation battalion (GSAB) for patient AE.
In the corps (EAB), the MMB for medical maintenance and repair and Class VIII A and B (blood)
resupply. The MLC and medical detachment, blood support, and ground ambulance evacuation
of patients, MCGA.
⚫ Appropriate elements of the sustainment brigade, quartermaster company (aerial delivery support)
or the brigade support battalion (BSB) (airborne), Infantry BCT (airborne) for rigging when
airdrop operations are required (airborne only).
⚫ If deployed as part of a multinational or coalition force, joint task force, or in support of special
operations forces, it is critical that the HSS planner consider personnel and equipment
augmentation in the following areas: command, control and communications, medical operations
planning, power generation, vehicle maintenance, food service, force protection, patient
administration, pharmacy, patient holding, instrument sterilization, Class VIII resupply, medical
equipment maintenance and repair, x-ray services, medical laboratory services, and sick call
(primary care physician).
⚫ Field feeding support is provided by the organization to which it is attached.
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EMPLOYMENT
The FRSD is assigned to the TMC, MEDBDE (SPT), and attached to a Role 3 hospital, when not
operationally employed and further attached to a Role 2 medical company.
BASIS OF ALLOCATION
One per committed armored, infantry (not including infantry BCT [airborne]). One per BCT assigned to a
theater conducting stability and reconstruction operations.
CAPABILITIES
This unit provides—
⚫ A standardized, rapidly deployable, networked, self-mobile, modular, and scalable resuscitative
and surgical team capable of supporting short (<72hr) and extended (>72hr) operations, including
the ability to support split based operations. The team will be modular and scalable, with the
ability to provide emergency treatment to receive, triage, and prepare incoming patients for
surgery, and provide the required surgery and continued postoperative care the following
configurations to support single or split based operations.
⚫ Complete FRSD, consisting of the following components: administration/supply, two surgical
and two resuscitative elements (20 personnel). In this configuration the FRSD provides
emergency treatment to receive, triage, and prepare 30 incoming casualties for surgery over a 72
hour period; provides the required surgery and continued postoperative care for critically
wounded/injured patients with organic MES. Postoperative care can manage 8 patients over 6
hours postsurgery.
⚫ Two resuscitative and surgical elements, capable of supporting split based operations, each
consisting of administration/supply, surgical and resuscitative sections (10 personnel). In this
configuration the FRSD provides emergency treatment to receive, triage, and prepare 12
incoming casualties for surgery over a 72 hour period; provides the required surgery and
continued postoperative care for critically wounded/injured patients with organic MES.
Postoperative care can manage 4 patients over 6 hours postsurgery.
⚫ Two surgical elements, capable of supporting very short duration (24 hours) operations, consisting
of only a surgical element (6 personnel). In its smallest configuration, the single surgical element
provides emergency treatment to receive, triage, and prepare 4 incoming casualties for surgery.
It also provides the required surgery and limited continued postoperative care for those critically
wounded/injured patients over a period of 24 hours with its organic MES.
⚫ Urgent initial surgery for otherwise nontransportable patients, primarily when attached to a Role
2 MTF to maximize health system synergies (e.g., access to x-ray, ancillary support, patient
holding, proximity to evacuation modalities), or when co-located with another organization
capable of meeting its support requirements.
⚫ HSS operations for both short (<72hr) and extended (>72hr) duration missions dependent on
METT-TC (I), provided that it achieves its personnel work rest cycles and gains associated
dependency support (see 8.0).
⚫ Postoperative acute nursing care for up to 8 patients simultaneously for up to 6 hours prior to
further patient evacuation.
⚫ Technical advice and assistance to the supported unit surgeon and the surgeon section/medical
operations center for the surgical services portion of the supported unit plans and policies.
⚫ Surgical augmentation of the Role 3 MTFs surgical capability.
⚫ Individuals of this organization can assist in the coordinated defense of the unit's area or
installation.
⚫ This unit does not perform field maintenance on organic equipment to include COMSEC
equipment.
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Configuration
Personnel (PAX) In Each Element
Capabilities
Admin/Supply
Surgical
Resuscitative
Emergency Treatment
Post-Op Care for
FRSD (20 PAX)
2 PAX
12 PAX
6 PAX
30 over 72 hrs
8 over 6 hrs
Split-based (10 PAX)
1 PAX
6 PAX
3 PAX
12 over 72 hrs
4 over 6 hrs
Surgery (6 PAX)
0
6 PAX
0
4 over 24 hrs
Limited
FUNCTIONS
Administration/supply section
This section provides unit-level administration, supplies management, maintenance and operational
planning support. The cell is led by the senior clinician of the FRSD, whose primary function is as the O5
61J clinician within the surgical section.
Surgical section
This section provides surgical services including anesthesia services, infection control and damage control
surgery as well as postoperative care including; initial burn management, continuing trauma resuscitation
(e.g. blood products, parenteral fluids, advanced airway management, IV/IO/Central line placement, etc.),
and critical care services (e.g. management of mechanical ventilation, advanced wound management and
postoperative recovery care (e.g. pain management, pulmonary therapy, fluid resuscitation). To enable the
most efficient surgical throughput, each surgical section is designed to be supported by a resuscitation
section. A surgical section can be employed separately from the FRSD for very short duration operation
(24hr), normally conducted in support of special operations forces missions. The surgical section can
provide limited ancillary services to include point of care lab assay measurement and imaging modalities to
assist with ongoing assessment and to guide further treatments and interventions.
Resuscitative section
This section provides advanced trauma management including initial burn management and trauma
resuscitation (e.g., blood products, parenteral fluids, advanced airway management, IV/IO/Central line
placement, etc.). The resuscitative section can also provide limited ancillary services with point of care lab
assay measurement and imaging modalities (such as, ultrasound) to assist with initial assessment and
ongoing patient management and treatment.
MOBILITY
The FRSD requires 100 percent mobility of its TOE equipment to be transported in a single lift using organic
equipment.
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Figure 3-17. Complete Forward Resuscitative Surgical Detachment Task Organization
Figure 3-18. Split-Based Forward Resuscitative Surgical Detachment Task Organization
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Visual Depiction:
PARA 101
ADMINISTRATION/SUPPLY SECTION
O5 61J FRSD Chief/General Surgeon
O2 70B67 Field Medical Assistant
E7 68W40 Detachment SGT
O2 - 70B
O5 - 61J
PARA 102
FORWARD SURGICAL SECTION
O4 61M Orthopedic Surgeon (MAP)
O4 66S Critical Care Nurse
O3 66F Clinical Nurse Anes (MAP)
E6 68D30 Operating Room NCO
E5 68C20 Practical Nurse
O4 61J General Surgeon (MAP)
O4 61M Orthopedic Surgeon (MAP)
O3 66F Clinical Nurse Anes
O3 66S Critical Care Nurse
E5 68D20 Operating Room SGT
E4 68C10 Practical Nurse SP
E7 - 68W
PARA 103
FORWARD RESUSCITATIVE SECTION
O3 62A Emergency Physician (MAP)
O3 66T Emergency Nurse
E5 68W20 Emergency Care SGT
O3 62A Emergency Physician
O3 66T Emergency Nurse
E5 68W20 Emergency Care SGT
5k Gen
FRSD Chief
General Surgeon
O4 - 61M
Field Medical
Assistant
O4 - 66S
Det
SGT
O3 - 66F
E6 - 68D
E5 - 68W
5k Gen
MAP
MAP
Ortho
Surgeon
Critical Care
Nurse
CRNA
OR
NCO
Practical
Nurse
O4 - 61J
O4 - 61M
O3 - 66F
O3 - 66S
E5 - 68D
E4 – 68C
MAP
MAP
General
Surgeon
Ortho
Surgeon
CRNA
Critical Care
Nurse
OR
SGT
Practical
Nurse
O3 - 62A
O3 - 66T
E5 - 68W
O3 - 62A
O3 - 66T
E5 - 68W
ER
Emergency Emergency
Physician
Nurse
Care SGT
ER
Physician
Emergency Emergency
Care SGT
Nurse
MAP
Basic Configuration
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MEDICAL DETACHMENT (PROLONGED CARE
AUGMENTATION DETACHMENT) (FY25)
(Approved: 19 March 2021)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08987K000
MEDICAL DETACHMENT
(PROLONGED CARE
AUGMENTATION DETACHMENT)
32
0
31
0
63
MISSION
Provides Role 2 medical companies and FRSDS operating at EAB or within BCT AO with additional
capability and capacity to provide prolonged care and en route critical care. The PCAD's sections augments
the prolonged care capabilities and capacity of the division or BCT medical assets when MEDEVAC is
delayed or denied due to the tactical or OE. The detachment can provide or augment patient care for
protracted periods during delayed evacuation; and continue to provide or augment en route care to patients
from the tactical level through all Roles of Care to include CONUS on all evacuation platforms.
ASSIGNMENT
This detachment is aligned with a Corps HHC, MEDBDE (SPT) and attached to the HHD, Hospital Center
when not operationally employed and further attached to a Role 2 medical company.
DEPENDENCIES
This unit is dependent upon—
⚫ Appropriate elements within theater Army for transportation, religious, legal, FHP, finance, and
personnel and administrative services.
⚫ Elements of the Hospital Center (Role 3) to provide medical equipment maintenance/repair and
Class VIIIa and VIIIb (Blood) resupply, when attached.
⚫ Medical Company (Role 2) to provide medical equipment maintenance/repair and Class VIIIa
and VIIIb (Blood) resupply, when attached.
⚫ Supported units’ non-standard evacuation platforms for CASEVAC.
⚫ Medical Company, Ground Ambulance for the ground evacuation of patients.
⚫ Medical Company, Air Ambulance for AE of patients.
⚫ Medical Logistics Company for Class VIII support. Augmentation of personnel for medical
equipment maintenance and repair and Class VIIIa resupply, as required.
⚫ Medical Detachment, Blood Support for Class VIIIb (Blood) resupply.
⚫ The unit to which it is assigned for maintenance of organic equipment (non-medical).
EMPLOYMENT
The Prolonged Care Augmentation Detachment is assigned to a Corps aligned MEDBDE (SPT) and
attached to an HHD, Hospital Center when not operationally employed. Elements of the PCAD can be
further attached to a Medical Company (Role 2).
BASIS OF ALLOCATION
1 per Corps.
CAPABILITIES
This unit provides—
⚫ Prolonged care to patients in forward medical units or augmentation of existing capability.
⚫ En route critical care during patient evacuation or augmentation of existing capability.
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⚫
Augmentation of critical care in strategic evacuation platforms.
Individuals of this organization are provided weapons for personal defense and protection of the
patients under their care.
⚫ This unit does not perform field maintenance on any organic equipment.
⚫
FUNCTIONS
Headquarters Section
Provides C2, administrative and logistical support. Also provides, direct supervision, operational planning
and coordination for deployment, relocation, and redeployment, coordination for life support and security.
Prolonged Care Section (X5)
Prolonged Care Section consists of twelve personnel, organized as three squads of four personnel (Physician
Assistant (65D), Critical Care Nurse (66S) or Emergency Room Nurse (66T), Licensed Practical Nurse
(68C), and Combat Medic (68W)). The prolonged care squad operates alongside the Role 2 BSMC/MCAS
or attached FRSD, on MEDEVAC ambulances, both ground and air, on non-standard evacuation platforms
used for CASEVAC, or on STRATEVAC aircraft. Prolonged care squads can be further employed as two
teams of two personnel, a team being a combination of one officer and one enlisted.
MOBILITY
The PCAD has no organic mobility and requires external transportation support from appropriate elements
of the theater, corps, division, or brigade.
The PCAD is currently in the development stage of identifying its medical equipment sets. Once identified,
the cube and weight will be annotated here.
NOTES
The PCAD is a new unit. There will be a total of three (3) in the Army. One (1) COMPO 1 and two (2) in
COMPO 3. The COMPO 1 PCAD is tentability scheduled to be activated in FY25 while the two remaining
COMPO 3 PCADs are scheduled for activation in FY26.
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Figure 3-19. Prolonged Care Augmentation Detachment Task Organization (FY25)
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MEDICAL COMPANY (AREA SUPPORT)
(Revised: 22 August 2019)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08457K000
MEDICAL COMPANY (AREA SPT)
13
0
63
0
76
MISSION
To provides Role 1 and Role 2 AHS support to units located in the AO of the MCAS.
ASSIGNMENT
Assigned to an MMB.
DEPENDENCIES
This unit is dependent upon—
⚫ Appropriate elements of the theater for religious, legal, FHP, finance, and personnel and
administrative services.
⚫ FRSD for surgical augmentation of nontransportable patients requiring surgical intervention in
preparation for evacuation by air ambulance.
⚫ Field feeding company, for field feeding support.
⚫ MCAA for rotary-wing air ambulance support.
⚫ MCGA for ground MEDEVAC.
EMPLOYMENT
The MCAS is employed with the MMB and is employed primarily at EAB in the corps and division support
areas. It provides area AHS support for designated non BCT units/troops.
BASIS OF ALLOCATION
1 per 10,000 non-BCT troops supported in the committed BCT/div HQs/corps HQs and committed theater
area.
CAPABILITIES
This unit provides—
⚫ C2 of attached units which include medical planning and coordination of patient movement within
and outside of the MCAS’s AO.
⚫ Treatment
of patients with DNBI, triage of mass casualties, EMT, initial
resuscitation/stabilization, advanced trauma life support, and preparation for further evacuation
of ill, injured, and wounded patients who are incapable of returning to duty within 72 hours.
⚫ Treatment squads which are capable of operating independently of the MCAS for limited periods
of time.
⚫ Evacuation of patients from units within the MCAS’s AO to the treatment squads of the MCAS.
⚫ Emergency medical supply/resupply to units operating within the AO of the MCAS.
⚫ Behavioral health consultation and support, to include coordinating operations of attached COSC
elements operating within the AO of the MCAS.
⚫ Pharmacy services, and multi-shift laboratory and radiological services commensurate with Role
2 AHS MTFs.
⚫ Emergency dental care to include stabilization of maxillofacial injuries, sustaining dental care
designed to prevent or intercept potential dental emergencies, and limited preventive dentistry.
⚫ Patient holding for up to 40 patients per MCAS.
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⚫
Outpatient consultation services for patients referred from units with only Role 1 AHS support
capabilities.
⚫ Food service support for staff, patients, and other medical elements (attached) dependent upon
the MCAS for support. Staff is military occupational specialty (MOS) 92G and not trained to
provide or provisioned to provide special diets. Role 3 elements have the required staff and
provisioned for patients in need of specialized dietary requirements.
⚫ Individuals of this organization can assist in the coordinated defense of the unit’s area or
installation.
This unit does not perform field maintenance on organic equipment (including COMSEC equipment) except
for medical equipment. The medical maintenance personnel will perform limited maintenance on the unit's
organic medical equipment. The remaining maintenance personnel will augment the maintenance capability
of the unit that performs field maintenance on the unit’s organic vehicles and power equipment.
FUNCTIONS
Company HQs
Provides C2 for the company and other medical units that may be attached. Also provides general and
medical supply/re-supply, arms maintenance, chemical, CBRN operations and communications-equipment
support to organic and attached elements.
Mental health section
This section provides training and advice in the control of stressors, the promotion of positive combat stress
behaviors, and the identification, handling, and management of misconduct stress behavior and battle
stressed soldiers. It coordinates COSC training for supported units through the MCAS company commander
and battalion psychiatrist. The section collects and records social and psychological data and counsels
personnel with personal, behavioral, or psychological problems.
Treatment platoon HQs
The treatment platoon operates a Role 2 MTF. It receives, triages, treats, and determines the disposition of
patients based upon their medical condition. This platoon provides professional services in the areas of
minor surgery, internal medicine, general medicine, and general dentistry. In addition, it provides basic
diagnostic laboratory and radiological services and patient holding support.
Medical treatment squads (X2)
This section provides emergency and routine sick call treatment to soldiers assigned to units within the AO.
These squads can perform their functions while located in the company area, or they can split and operate
as separate treatment teams (Team A and Team B) for limited periods of time. While operating in these
separate modes, they may operate up to four treatment stations. They can be assigned to reinforce or
reconstitute similar treatment squads.
Area support squad
This section includes a dental element, a medical laboratory element, and an X-ray element, which has field
x-ray capabilities. Provides for basic services commensurate with Role 2 medical treatment.
Area support treatment squad
This is the base medical treatment element of a Role 2 MTF (does not deploy away from the MCAS) and is
not used to reinforce or reconstitute other medical units. It provides sick call services and initial resuscitative
treatment, both advanced trauma medicine and EMT, for supported units.
Patient holding squad
This section operates the holding ward facility within a corps/division. The holding ward is staffed and
equipped to provide care for up to 40 patients.
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Ambulance platoon HQs
This is the C2 for ambulance platoon operations. It maintains communications to direct ground ambulance
evacuation of patients. It provides ground ambulance evacuation support for units receiving area support
from the MCAS to the company's treatment squad location (MTF) or to the supporting Role 3 MTF.
Ambulance squad (X4)
Ground evacuation of patients from units and organic treatment squads/teams (aid stations) within the
support sector of the MCAS. Ambulance squad personnel perform TCCC, EMT, evacuate patients, and
provides for their continued care.
MOBILITY
The MCAS is 100 percent mobile and is able to transport all of its TOE equipment in a single lift using
organic vehicles.
Figure 3-20. Medical Company (Area Support) Task Organization
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MEDICAL COMPANY (GROUND AMBULANCE)
(Revised: 6 February 2018)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08453K000
MED CO, GROUND AMBULANCE
4
0
61
0
65
MISSION
To provide ground evacuation within the JOA.
ASSIGNMENT
Assigned to an MMB or MEDBDE (SPT).
DEPENDENCIES
This unit is dependent upon—
⚫ Appropriate elements within the AOR for religious, FHP, HSS, legal, finance, personnel and
administrative services.
⚫ Communications and communications-security support when not assigned or attached to a higher
medical HQs.
⚫ Vehicle and generator maintenance support when not assigned or attached to the MMB.
⚫ Separately deployed teams are dependent upon a host unit for life support operations and
decontamination support in a CBRN environment.
⚫ Field feeding company, or supported BCT for field feeding support.
EMPLOYMENT
Employed in EAB. It is tactically located where it can best control its assets and execute its patient
evacuation mission.
BASIS OF ALLOCATION
For LSCO, 0.33 per BCT, 0.5 per division HQs and 2 per senior Army HQ.
For stability tasks, 0.33 per BCT, 0.5 per division HQs and 2 per senior Army HQs and add for directed
support to host nation PAR at one company per 42,000 supported population.
For enable civil authority, basis of allocation adjustments will be based on roles of care directed and PAR
supported.
CAPABILITIES
This unit provides—
⚫ Single lift evacuation of 96 litter patients or 192 ambulatory patients, or a combination of both.
⚫ Evacuation of patients from the BSMC and MCAS to supporting hospitals.
⚫ Reinforcement of BSMC evacuation assets.
⚫ Reinforcement of covering force and deep battle operations.
⚫ Movement of patients between hospitals and in route patient staging systems, railheads, or
seaports in brigade and EAB areas.
⚫ Area evacuation support beyond the capability of the MCAS.
⚫ Emergency movement of medical supplies.
⚫ Vehicle refueling support for the MMB, when co-located.
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⚫
The maintenance personnel will augment the maintenance capability of the unit that performs
field maintenance on organic vehicles and power generation equipment.
⚫ Individuals of this organization can assist in the coordinated defense of the unit's area or
installation.
⚫ This unit does not perform field maintenance on any organic equipment including COMSEC
equipment.
⚫ The transportation and handling of human remains is a logistics function and not a medical
function.
FUNCTIONS
Company HQs
Provides mission command, administration, and logistical support for subordinate ambulance platoons.
Ambulance platoon HQs
Provides mission command for the subordinate ambulance squads.
Evacuation section
This section operates ambulances and provides en route medical care for patients in their care.
MOBILITY
The MCGA is 100 percent mobile and is able to transport all of its TOE equipment in a single lift using
organic vehicles.
Figure 3-21. Medical Company (Ground Ambulance) Task Organization
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MEDICAL COMPANY, AIR AMBULANCE (15 AIRCRAFT)
(Revised: 7 November 2019)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08317K000
MED CO AA (15 ACFT)
11
29
69
0
109
MISSION
To provide AE support within the brigade and corps.
ASSIGNMENT
Organic to the general support aviation battalion (GSAB).
DEPENDENCIES
This unit is dependent upon—
⚫ Appropriate elements within the theater AHS support.
⚫ The HHC of the GSAB, for unit religious, legal, finance, and personnel and administrative
services and unit CBRN support.
⚫ The forward support company of the GSAB, for Class III, automotive and generator maintenance,
and field feeding.
⚫ The aviation support company of the GSAB, for aviation unit maintenance of organic aircraft,
including unit level supply support for aircraft Class IX.
⚫ USAF weather team; in the HHC of the aviation brigade, for air weather service support.
EMPLOYMENT
Employed in the theater, corps, division, or echelon above brigade. It is tactically located where it can best
control its assets, and execute its patient evacuation mission.
BASIS OF ALLOCATION
One per GSAB.
CAPABILITIES
This unit provides—
⚫ Fifteen helicopter ambulances to evacuate critically wounded or other patients consistent with
evacuation priorities and operational considerations, from points as far forward as possible, to
Brigade MTFs and hospitals. Total lift capability utilizing all assigned aircraft is 90 litter patients
or 105 ambulatory patients, or some combination thereof.
⚫ One Area Support MEDEVAC platoon (3 aircraft) that will normally locate with the company
HQs. Four forward support MEDEVAC platoons (3 aircraft each) that can be independently or
group deployed.
⚫ Air crash rescue support.
⚫ Expeditious delivery of whole blood, biological, and medical supplies to meet critical
requirements.
⚫ Rapid movement of medical personnel and accompanying equipment/supplies to meet the
requirements for mass casualty, reinforcement/reconstitution, or emergency situations.
⚫ Movement of patients between hospitals, aero-medical staging facilities, hospital ships, casualty
receiving and treatment ships, seaports, and railheads in the brigade AO.
⚫ Individuals of this organization can assist in the coordinated defense of the unit's area or
installation.
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⚫
This unit does not perform field maintenance on any organic equipment to include COMSEC
equipment.
FUNCTIONS
Company HQs/area support MEDEVAC platoon
Provides C2 of all area support and forward support MEDEVAC operations, and provides logistical and
administrative support for the company. Also provides area support AE within the Brigade AO.
Forward support MEDEVAC platoon (X4)
Provides a task-organized means for AE in support of the brigade. Also, provides emergency movement of
medical personnel and emergency delivery of whole blood, biological, and medical supplies and equipment.
MOBILITY
The MCAA is 100 percent mobile and is able to transport all of its TOE equipment in a single lift using
organic vehicles.
The MCAA may be dependent on appropriate elements of the theater, corps, or division, for supplemental
transportation.
Figure 3-22. Medical Company (Air Ambulance) Task Organization
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MEDICAL LOGISTICS MANAGEMENT CENTER
(Approved: 19 March 2021)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08680K000
MED LOG MGMT CTR
21
5
66
0
92
08689KA00
MEDICAL LOGISTICS
MANAGEMENT CENTER (MLMC),
HEADQUARTERS
13
1
22
0
36
08689KB00
MEDICAL LOGISTICS
MANAGEMENT CENTER (MLMC)
SUPPORT SECTION (EE/FO)
8
4
44
0
56
MISSION
To provide centralized tactical to strategic level management of MEDLOG in support of the Army, Unified
Action Partners, and range of military operations in coordination with the TMC and Theater Surgeon.
ASSIGNMENT
Assigned to a TMC.
DEPENDENCIES
⚫
This unit is dependent upon appropriate elements within the theater for religious, legal, AHS
support, finance, and personnel and administrative services.
⚫ Field feeding company, for field feeding support.
⚫ Expeditionary Signal Company to provide automatic switching capabilities for both analog and
digital voice and data traffic, tactical multichannel high capacity transmission systems and
multichannel satellite ground terminals.
EMPLOYMENT
The medical logistics management center (MLMC) maintains operations within CONUS to provide
centralized, strategic-level management of critical Class VIII materiel, patient movement items, optical
fabrication, and medical equipment maintenance for multiple theaters.
BASIS OF ALLOCATION
One unit required in the force. Unit contains a nondeploying HQs base, four MLMC support sections (early
entry/follow on). Each team deploys and supports a theater.
CAPABILITIES
This organization provides the following as shown in their respective TOEs:
⚫ Monitoring of the operation, command, and control of MEDLOG units in all areas of operation
(AO).
⚫ Monitoring of the receipt and processing of Class VIII requisitions from MEDLOG units of all
Services.
⚫ Reviewing and analyzing of demands, and computing theater requirements for Class VIII
supplies, medical equipment, medical equipment maintenance and repair, and optical fabrication.
⚫ Implementation of plans, procedures, and programs for medical materiel management systems.
⚫ Medical materiel management data and reports, as required.
⚫ Single Integrated Medical Logistics Manager information management and distribution
coordination mission to Joint Forces, as directed.
⚫ Management interface with CONUS Class VIII national inventory control point (NICP).
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⚫
Management of critical items and analysis of production capabilities.
Liaison with the materiel distribution manager at brigade/corps and theater levels for distribution
of Class VIII supplies within the AO.
⚫ Deployment of two early entry forward teams, and two follow on MLMC forward teams, as
required into two theaters.
⚫
FUNCTIONS
Headquarters Section
This section provides C2 and administrative support for the MLMC.
Support Division
This division coordinates MEDLOG staff functions. It is responsible for placement and operation of the
four MLMC Early Entry Forward Teams and four MLMC follow on forward teams, and the execution of
operational plans.
Materiel Management Division
This division is responsible for monitoring Class VIII materiel management in CONUS and multiple
Theaters on a daily basis. Monitors requisitions for critical items and analyzes stockage objectives.
Interfaces with national inventory control point and performs special studies and analysis of logistical data.
Receives all theater requisitions for Class VIII materiel for resupply/replenishment actions.
Medical Maintenance Management Division
This division provides the planning, direction, and coordination for medical equipment maintenance
operations. Serves as the medical equipment maintenance consultant for the ASCC Surgeon. Reviews
maintenance status and performance reports and manages the allocation of maintenance personnel assets
and medical stand-by equipment program (MEDSTEP) items.
Detachment Headquarters
This section provides C2 of the MLMC. Personnel of this section will supervise and perform unit and
general supply functions. Maintenance personnel will supplement a collocated unit for daily work
assignments to support the MLMC.
MLMC Support Section (Early Entry and Follow On) (X4)
Early Entry Team
The MLMC has four early entry teams. One forward team will deploy into the theater to provide centralized
management of medical materiel, medical equipment maintenance and repair, MEDLOG contracting
operations, and coordination of the distribution of Class VIII materiel within the AO. The chief logistics of
this team serves as the team commander when deployed. The early entry team may collocate with the
distribution management center of the theater sustainment command (TSC). The team will provide the
information management and distribution coordination portion of the SIMLM mission, when the Army is
designated as the SIMLM by the combatant commander, for joint operations. The team is assigned to the
TMC and collocates with the distribution management center of the TSC/expeditionary sustainment
command. The team is assigned to the medical brigade when there is no TMC in the theater. The early
entry team may collocate with a MEDBDE (SPT), MMB, Corps or division surgeon, the ASCC distribution
operations section, sustainment brigade, or division/corps distribution operations section when the TSC is
not deployed.
Follow On Team
The MLMC has four follow on teams. These teams continue to provide additional centralized management
of medical materiel, medical equipment maintenance, and coordination of the distribution of Class VIII
materiel within the AO. The follow-on team collocates with the distribution management center within the
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TSC. The follow-on team can provide liaison officers (or NCOs) to the division/corps/ASCC surgeon's
location, as required. The team will provide the information management and distribution coordination
portion of the SIMLM mission, when the Army is designated as the SIMLM by the combatant commander,
for joint operations. The team is assigned to the TMC and collocates with the distribution management
center of the TSC/expeditionary sustainment command. The team is assigned to the medical brigade when
there is no TMC in the theater. The follow-on team may collocate with a MEDBDE (SPT), MMB, Corps
or division surgeon, the ASCC distribution operations section, sustainment brigade, or division/corps
distribution operations section when the TSC is not deployed. These follow-on teams are not designed to
operate independently. They will always operate with the MLMC forward team (early entry).
MOBILITY
The MLMC (Headquarters) is only 10 percent mobile and is dependent on appropriate elements of the
theater or corps for supplemental transportation.
The MLMC Support Section (EE/FO) is 100 percent mobile and able to transport all of its TOE equipment
in a single lift using organic vehicles.
NOTES
In FY25 the MLMC will add two (2) additional MLMC forward team (early entry) and two (2) additional
MLMC forward team (follow on). This will double their current task organization.
Figure 3-23. Medical Logistics Management Center Task Organization (FY25)
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MEDICAL LOGISTICS COMPANY
(Approved: 15 February 2017)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08480K000
MEDICAL LOGISTICS COMPANY
2
1
67
0
70
08487KA00
MEDICAL LOGISTICS COMPANY
(BASE)
1
1
43
0
45
08487KB00
MED LOG CO (EARLY ENTRY
TEAM)
1
0
6
0
7
08487KC00
MED LOG CO (CONTACT
REPAIR TEAM)
0
0
9
0
9
08487KD00
MED LOG CO (FORWARD
DISTRIBUTION TEAM)
0
0
9
0
9
MISSION
To provide Class VIII support, optical lens fabrication and repair, and medical equipment maintenance and
repair for the BCT and EAB units, to include augmented support to the field hospital.
ASSIGNMENT
Assigned to a higher-level medical element, usually an MMB.
DEPENDENCIES
⚫
HHD, MMB for appropriate elements of the MEDBDE (SPT) for AHS support, transportation,
power generator maintenance support, religious, legal finance, personnel and administrative
services, automation and technical intelligence for captured medical materiel and
communications maintenance support. The base and early entry team have 30 percent mobility
and are dependent on transportation for movement. The MLC will be dependent on
transportation organization for movement of all equipment and delivery of Class VIII supplies.
⚫ Unit to which assigned or attached for food service support.
⚫ Quartermaster field service company (modular) for shower and laundry support in support for
divisional and nondivisional troops.
EMPLOYMENT
The company will normally be under the mission command of the MMB, forming the MEDLOG company
base for the AOR.
BASIS OF ALLOCATION
One per 13 short tons of Class VIII supplies processed per day.
CAPABILITIES
This unit—
⚫ Provides 220 hours per day of field level medical equipment maintenance and repair.
⚫ Provides Class VIII support, optical lens fabrication and repair, and medical equipment
maintenance and repair support.
⚫ The receive and storage sections, shipping section and the stock control section can process up to
9 short tons of Class VIII supplies per day.
⚫ Coordinates for emergency delivery of Class VIII supplies.
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⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
Provides field and limited sustainment medical equipment maintenance and repair, scheduled
services support, repair parts, and Medical Standby Equipment Program items for medical units
operating within the theater AOR, to include unified action partners, when directed.
Can coordinate for higher priority delivery of Class VIII supplies.
Can build and position preconfigured push-packages, as required, in support of brigade and below
and EAB units.
The optical section can provide single and multi-vision optical lens fabrication and repair to support
a maximum force of 22,000 troops.
Can provide the distribution capability for a theater lead agent for medical materiel when required.
Can provide organic unit maintenance.
Provides one early entry team, three contact repair teams, and three forward distribution teams,
who can process up to 4 short tons Class VIII per day.
Quantities designate the minimum essential wartime requirement for personnel and equipment.
For unit maintenance capability, see the section I of each subordinate TOE.
FUNCTIONS
Company Headquarters
Provides unit-level administration, general supply, arms maintenance, as well as CBRN operations support.
Personnel of this section supervise unit operations, general supply and communications. During the
development of the theater, or during other operations, the MLC can be self-sustaining for short periods of
time (72-hours).
Logistics Support Platoon Headquarters
This section is responsible for ensuring that stocks remain in an issuable condition while in storage. This
includes the prior planning of receipt of supplies, locating stocks in a way that provides for first-in/first-out
handling, utilizing space efficiently and maintaining segregation and disposition of stock as determined by
the accountable officer/platoon leader. The Logistics Support Platoon is composed of a headquarters,
receive/storage section, shipping section and stock control section.
Logistics Support Section
This section can receive and position pre-configured push packages until normal automated requisition flow
is established. This team will have the ability to handle higher priority resupply for specific line item
requisitioning of medical supplies and equipment (as required) out of its authorized stockage list in support
of medical units deployed to the AOR. The team will provide in-transit visibility of Class VIII supplies.
The early entry logistics support personnel will reintegrate with the Receive/Storage Section and the medical
maintenance personnel will reintegrate with the Biomedical Maintenance Section once the base is deployed.
Receive/Storage Section
This section is responsible for preparing and processing receipt documents for incoming shipments. This
section is also responsible for the storage, preservation, location, and accountability for medical supplies
and equipment.
Shipping Section
This section plans for release of materiel to transportation, coordinates for vehicles, stages shipments for
pick-up, and prepares movement documents.
Stock Control Section
This section coordinates all stock control functions. Also maintains accountability for all Class VIII materiel
received, stored and issued in the MLC.
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Optical Section
This section performs optical lens fabrication and repair of single and multi-vision prescription lenses and
military combat eye protection lenses and inserts to support a maximum force of 22,000 troops.
Maintenance Platoon Headquarters
This headquarters is responsible for field and limited sustainment medical equipment maintenance and
repair. This platoon is composed of two elements: the biomedical maintenance section and the
organizational maintenance section. This platoon is responsible for field level maintenance of organization
equipment.
Biomedical Maintenance Section
This section performs field and limited sustainment medical maintenance and repair. It also performs field
maintenance for units in its AO that do not have organic medical equipment maintenance; personnel
assigned.
Biomedical Maintenance Team
This team will establish and track medical equipment density and schedule service information from the
Logistics Information Warehouse for all medical units during theater opening operations. The Biomedical
Maintenance Team will provide limited medical standby equipment utilizing regeneration enablers and field
level repair upon request.
Organizational Maintenance Section
This section is responsible for vehicle maintenance, equipment records and repair parts, fuel distribution,
power generation repair, refrigeration and automation systems repair.
Contact Repair Teams (X3)
These teams can be rapidly deployed to provide medical equipment maintenance and repair. The contact
repair teams can augment any medical organization to include Joint or multinational partners and can
collocate with the BSMC if that medical company is collocated with an FRSD. The contact repair teams
are designed to operate at EAB and go far-forward into the brigade area. This section can deploy three
contact repair teams, which is identified under SRC 08487KC00. The contact repair teams will consist of
three personnel each. These teams will provide field and level maintenance and repair support to all medical
units within their AOR. The contact repair teams will be employed by the MMB based on Mission Enemy
Terrain Troops - Time and Civil considerations data, or by the request of the brigade surgeon to the MMB.
The contact repair teams will deploy to medical units, to include all units within the BCT that have organic
medical equipment. The teams will bring limited repair parts and Medical Standby Equipment Program
capabilities. While these teams are employed forward, they will technically inspect all medical equipment
within their area as proactive maintenance measures.
Forward Distribution Teams (X3)
These teams receive and process supplies at strategic air and sea hubs in theater, facilitating medical materiel
movement.
MOBILITY
The MLC requires 30 percent mobility of its TOE equipment to be transported in a single lift using its
organic vehicles.
Contact Repair and Forward Distribution Teams are 100 percent mobile and are able to transport all of its
TOE equipment in a single lift using organic vehicles.
The MLC may be dependent on appropriate elements of the theater, corps, or division, for supplemental
transportation.
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Figure 3-24. Medical Logistics Company Task Organization
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MEDICAL DETACHMENT, BLOOD SUPPORT
(Revised: 17 April 2018)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08430K000
MEDICAL DETACHMENT, BLOOD
SUPPORT
2
0
19
0
21
08489KA00
HEADQUARTERS, MEDICAL
DETACHMENT, BLOOD
SUPPORT
1
0
5
0
6
08489KB00
COLLECTION, STORAGE &
DISTRIBUTION TEAM
1
0
5
0
6
08489KC00
COLLECTION, MANUFACTURING
& DISTRIBUTION TEAM
0
0
5
0
5
08489KD00
DISTRIBUTION TEAM
0
0
4
0
4
MISSION
Provides collection, manufacturing, storage, and distribution of blood and blood products to BCTs and EAB
medical units and to other services as required.
ASSIGNMENT
Assigned to an MMB.
DEPENDENCIES
This unit is dependent upon the following:
⚫
Appropriate elements within the theater for religious, legal, AHS support, finance, and personnel
and administrative services.
⚫ The medical detachment, blood support (MDBS) is dependent upon higher level medical
elements, usually the HHD, MMB and appropriate elements of the theater MEDBDE (SPT) for
AHS support, supplemental transportation, technical intelligence for captured medical materiel,
power generator maintenance support, communications maintenance support and additional
automotive and utilities maintenance support. Additionally, the Teams when deployed separate
from the base will be dependent upon a host unit for life support operations.
⚫ This unit requires field feeding company, or supported BCT, for field feeding support.
EMPLOYMENT
The MDBS will normally be under the mission command of the HHD, MMB. The detachment has the
capability for 72-hours, limited self-sustainment during initial operations. The detachment can deploy a HQ
and a collection storage and distribution team, and/or a collection manufacturing and distribution team and
or a distribution team. The HQ may forward deploy any of these Teams as required. See the section I of
each subordinate TOE for employment statements.
BASIS OF ALLOCATION
LSCO: 0.035 per field hospital; 0.035 per hospital augmentation detachment (surgical 24-bed); 0.039 per
FRSD; and 0.007 per MCAS/BSMC (First MDBS arrives with the arrival of the first Field Hospital, or
FRSD or MCAS/BSMC).
Army Support to other Services Rule: 1 per JOA.
SOF Rule: 0.039 per FRSD; and 0.007 per MCAS/BSMC (First MDBS arrives with the arrival of the first
FRSD or MCAS/BSMC).
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Stability Tasks Rule: 0.035 per field hospital; 0.035 per hospital augmentation detachment (surgical 24bed); 0.039 per FRSD; and 0.007 per MCAS/BSMC (First MDBS arrives with the arrival of the first Field
Hospital, or FRSD or MCAS/BSMC).
CAPABILITIES
This unit provides—
⚫ Establish the theater blood distribution plan within the JOA, including storage levels and
locations, and the schedule of re-supply.
⚫ Prepare and submit JOA blood reports to the combatant command joint blood program office and
the Armed Services Blood Program Office.
⚫ Implement, monitor, and enforce Armed Services Blood Program Office and joint blood program
office policies and procedures within the JOA.
⚫ Receive and store up to 5,100 refrigerated and/or frozen blood products from CONUS or other
U.S. MTFs, and further distribute these blood products to supported MTFs and medical units.
⚫ Operate in a hub and node distribution manner over a large geographic area.
⚫ Provide consultation with commanders from company to theater level regarding blood support.
⚫ Conduct and coordinate administrative and logistical support to sustain operations.
⚫ Receive and account for blood and blood product shipments from the armed services whole blood
processing laboratory or expeditionary blood trans-shipment centers.
⚫ Maintain theater blood storage depot. Store blood and blood products pending transfer to
distribution & collection sections.
⚫ Distribute blood and blood products to MTFs down to and including level 2 organizations.
⚫ Determine and provide the appropriate blood products and blood types to each facility according
to the facility capabilities and role of care.
⚫ Coordinate movement of blood and blood products and track shipments in transit to ensure proper
delivery.
⚫ Properly screen potential emergency whole blood donors and initiate retrospective viral marker
testing on locally collected whole blood. Collect, process and test whole blood from the available
donor pool when needed for a specific emergent medical condition, such as massive blood loss
coupled with a coagulopathy requiring the transfusion of certain coagulation factors found only
in fresh blood products. Proper processing of blood may include testing and/or treatment of
blood to render potential viruses and bacteria inactive.
⚫ Ensure DOD/Armed Services Blood Program Office policy and procedures are followed with
respect to emergency blood donations and transfusions.
⚫ Properly screen emergency platelet-apheresis donors and initiate retrospective viral marker testing
on locally collected platelet products.
⚫ Collect single-donor platelets by apheresis when needed to address specific medical conditions,
such as uncontrolled bleeding requiring the transfusion of platelets and coagulation factors.
Proper processing of blood may include testing and/or treatment of blood to render potential
viruses and bacteria inactive.
See specific TOE section I for a complete list of capabilities and limitations of this organization.
FUNCTIONS
Medical Detachment Headquarters, Blood Support
This section provides C2 for the Medical Detachment, Blood Support. Personnel of this section supervise
Teams and perform unit plans and operations and general supply support activities. Commander functions
as the Area Joint Blood Program Officer. This headquarters will deploy when any other team of the Medical
Detachment, Blood Support is called into service.
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Collection Storage and Distribution Team
This team receives, inspects, accounts, stores and ships blood products to supported units. Team can store
up to 3,900 units of blood with secondary mission to collect under emergency conditions of up to 100 units
of fresh whole blood and or up to 8 Apheresis platelets per day when not distributing blood products.
Collection Manufacturing and Distribution Team
This team receives, inspects, accounts, stores and ships blood products to supported units. Team can store
up to 900 units of blood with secondary mission to collect under emergency conditions of up to 100 units
of fresh whole blood and or up to 8 Apheresis platelets per day when not distributing blood products.
Distribution Team
This team receives, inspects, accounts, stores and ships blood products to supported units. Team can store
up to 300 units of blood.
MOBILITY
The Medical Detachment Headquarters, Blood Support is 100 percent mobile and is able to transport all of
its TOE equipment in a single lift using organic vehicles.
The Collection Storage and Distribution Team is 50 percent mobile and only able to transport half of its
TOE equipment in a single lift using organic vehicles.
Collection Manufacturing and Distribution Team is 30 percent mobile and only able to transport a third of
its TOE equipment in a single lift using organic vehicles.
Distribution Team is 50 percent mobile and only able to transport half of its TOE equipment in a single lift
using organic vehicles.
The MDBS may be dependent on appropriate elements of the theater, corps, or division, for supplemental
transportation.
Figure 3-25. Medical Detachment, Blood Support Task Organization
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MEDICAL DETACHMENT, OPTOMETRY
(Revised: 10 August 2022)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08567KA00
MEDICAL TEAM, OPTOMETRY
2
0
4
0
6
MISSION
Provides optometry care and optical fabrication to a BCT on an area basis.
ASSIGNMENT
Assigned to a TMC or MEDBDE (SPT) with further attachment to a MMB and may be further attached to
the BSMC of a BCT.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate elements of the (division or corps) for legal, finance, maintenance, personnel and
administrative support, laundry and bath services, and clothing exchange for unit personnel and
communications/information management support, and security of EPWs.
⚫ The unit to which it is attached for water distribution, personnel and administrative services, AHS
support, patient evacuation, medical equipment maintenance and repair, logistic support, and
field maintenance of team vehicles, and communications equipment.
⚫ MMB, for C2 as well as logistic support.
⚫ This unit requires field feeding company, or supported BCT, for field feeding support.
EMPLOYMENT
Medical team, optometry is employed in all intensities of conflict when a BCT is deployed. Task-organized
elements are deployed for brigade-sized offensive, defensive, stability, and defense support of civil
authorities’ tasks METT-TC (I)-dependent. The medical team, optometry supports a BCT in the division
AO and is usually attached to the MMB with further attachment to the BSMC.
BASIS OF ALLOCATION
One per 15,000 population supported in an AO.
CAPABILITIES
This unit provides—
⚫ A medical detachment, optometry consisting of six personnel that can be divided into two teams
(optometry teams A and B). Each team has the capability to provide optometry support limited
to eye examination, optical fabrication, frame assembly, and repair services to brigade and nonbrigade units in the AO as far forward as possible.
⚫ Initial diagnosis and management of eye injuries on the battlefield.
⚫ Examinations to detect, prevent, diagnose, treat, and manage ocular related disorders, injuries,
diseases, and visual dysfunctions.
⚫ Assembly, repair and fabrication of single vision spectacles.
⚫ Individuals of this organization are all medical personnel and cannot assist in the coordinated
defense of the unit's area or installation.
⚫ This unit does not perform field maintenance on any organic equipment.
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FUNCTIONS
Optometry team
This team provides limited optometry services. These include routine eye examinations and refractions and
spectacle frame assembly.
MOBILITY
The Optometry Detachment is 100% mobile and can transport all of its TOE equipment in a single lift
using its organic vehicles.
The Optometry Detachment may be dependent on appropriate elements of the brigade, division, or corps
for supplemental transportation.
Figure 3-26. Medical Detachment, Optometry Task Organization
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Army Health System Unit Synopsis
DENTAL COMPANY (AREA SUPPORT)
(Revised: 6 February 2018)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08473K000
DENTAL COMPANY (AREA SPT)
30
0
58
0
88
MISSION
The mission of the dental company (area support) (DCAS) is to provide on an area basis operational dental
care consisting of emergency and essential dental care, designed to eliminate potential dental emergencies.
ASSIGNMENT
Assigned to a TMC or MEDBDE (SPT).
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate elements within the theater for religious, legal, FHP, finance, personnel and
administrative services.
⚫ The support maintenance company, for all field level maintenance.
⚫ Field feeding company, for field feeding support.
EMPLOYMENT
The DCAS is employed with the TMC or MEDBDE (SPT) within a theater. Dental teams may be employed
in the BCT area to provide forward operational dental care.
BASIS OF ALLOCATION
Based upon the ratio of one dentist in support of 1,175 troops, one DCAS is allocated per 43,000 Army
population supported in the theater.
CAPABILITIES
This unit provides—
⚫ C2 of subordinate dental elements.
⚫ Operational dental care, consisting of emergency dental care and essential dental care.
⚫ Reinforcement and reconstitution of BCT/regiment dental assets.
⚫ Far forward operational dental care to small and forward deployed troop concentrations.
⚫ This section is composed of 3 forward support treatment sections. Each section is composed of
6 treatment teams for a total of 18 forward treatment teams for area support.
⚫ Augmentation of medical assets during mass casualty situations.
⚫ Individuals of this organization can assist in the coordinated defense of the unit’s area or
installation.
This unit does not perform field maintenance on organic equipment (including COMSEC equipment) except
for medical equipment. The medical maintenance personnel will perform limited maintenance on the unit's
organic medical equipment. The remaining maintenance personnel will augment the maintenance capability
of the unit that performs field maintenance on the unit’s organic vehicles and power equipment.
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FUNCTIONS
Company HQs
Provides C2 and daily unit level administration and logistical support for the organization and assigned and
attached elements.
Support section
Provides nonclinical support activities to include wheel vehicle, power generation and medical equipment
maintenance for the organization.
Field dental clinic (area)
Provides operational dental care consisting of emergency dental care and essential dental care. The clinic
is broken down into a specialty section and general dentistry section. The specialty section provides
comprehensive dental care, endodontics, periodontics, and prosthodontics specialty care.
Forward support platoon HQs
Provides C2, and administrative support to the treatment sections.
Forward support treatment section (X3)
Provides operational dental care consisting of emergency dental care and essential dental care throughout
the combat zone and isolated troop concentrations. Each forward support treatment section consists of six
(6) semi-mobile teams made up of a dental officer, dental technician, dental equipment/supplies and mobile
electric power.
MOBILITY
The DCAS is 50% mobile and can transport half of its TOE equipment in a single lift using its organic
vehicles. This unit is capable of transporting 133,700 pounds (11,073.0 cubic feet) of TOE equipment with
organic vehicles.
The DCAS will be dependent on appropriate elements of the theater, corps, or division for supplemental
transportation. The DCAS has 79,758 pounds (6,473.3 cubic feet) of TOE equipment requiring
supplemental transportation.
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Figure 3-27. Dental Company (Area Support) Task Organization
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MEDICAL DETACHMENT
(VETERINARY SERVICES)
(Approved: 23 January 2017)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08300K000
MEDICAL DETACHMENT,
VETERINARY SERVICES
10
1
46
0
57
08516KA00
HEADQUARTERS, MEDICAL
DETACHMENT, VETERINARY
SERVICES
3
1
12
0
16
08516KB00
FOOD PROCUREMENT AND
LABORATORY TEAM
1
0
6
0
7
08516KC00
VETERINARY MEDICAL AND
SURGICAL TEAM
1
0
3
0
4
08516KD00
VET SVC SPT TEAM
1
0
6
0
7
MISSION
The MDVS provides equipment and personnel to provide dispersed veterinary Role 1 and 2 medical and
resuscitative surgical care; veterinary Role 3 comprehensive canine medical/surgical care to military and
DOD contract working dogs; definitive and restorative military working dog dental care to include
endodontic procedures; and evacuation/hospitalization support for military working dogs and
hospitalization support to DOD contract working dogs; endemic zoonotic and foreign animal disease
epidemiology surveillance and control; animal facility and kennel inspections; commercial food source
audits for DOD procurement; food protection, quality, and sanitation inspections; food defense vulnerability
assessments; food and water risk assessments; field confirmatory microbiological and presumptive chemical
laboratory analysis of food and bottled water; and veterinary support to stability tasks and defense support
of civil authorities (DSCA) activities. This unit is normally assigned to a MMB, (MEDBDE (SPT), TMC
or equivalent sister service organization. This unit executes Army veterinary proponent requirements as the
sole provider of veterinary services to the DOD.
ASSIGNMENT
Assigned to a TMC, MEDBDE (SPT), or MMB.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate elements of the AOR for religious, legal, FHP, HSS, field feeding, finance, and
personnel and administrative services.
⚫ Separately deployed teams are dependent upon the host unit for life support operations.
⚫ Communications and communications-security support when not assigned or attached to a higher
medical HQ.
⚫ Vehicle and generator maintenance and vehicle recovery support when not assigned or attached
to the MMB.
⚫ Transportation services when single lift requirements exceed unit capability.
⚫ MLC, for medical equipment maintenance and Class VIII supply support.
⚫ A controlled environment with a stable temperature to minimize contamination of laboratory
samples; to minimize contamination of surgical patients; and ensure proper operation of
equipment.
⚫ Reach back capability for theater validation and definitive levels of microbiological analysis of
food and bottled water; and field confirmatory, theater validation, and definitive levels of
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chemical analysis of food and bottled water and for veterinary Role 4 medical care for military
working dogs (MWDs).
⚫ When attached or assigned to USN, USAF, or USMC units, requirements for support are the same
as above.
EMPLOYMENT
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
The MDVS will be employed in the AO.
The unit deploys the HQ and subordinate teams: The HQs, (HQ, MDVS), the food procurement
and laboratory team, the veterinary medical and surgical team, and five veterinary service support
teams (VSSTs), form the MDVS.
The veterinary teams may be geographically dispersed to align with their primary customers or
those units/activities such as aerial port of debarkation/seaport of debarkation, or corps and
theater level Class I points requiring support.
The unit can be task-organized across team lines or subdivided to meet a variety of functional
scenarios within the stated mission.
The HQs section may be located in the center of operations or near other medical units with
mission command functions.
This unit functions well in conjunction with preventive medicine units.
The MDVS provides one or more VSSTs for early entry capability to provide veterinary
medical/surgical care to military and DOD contract working dogs and to support initial food
inspection requirements.
The MDVS may be aligned with civil military operations centers at BCTs, with CA units, or with
task-organized provincial reconstruction teams when directed for support of stability tasks.
The MDSS supports joint forces in execution of the Army's function of sole provider of veterinary
services to the DOD.
BASIS OF ALLOCATION
For LSCO, maximum of one MDVS per 60,000 personnel supported in all U.S. forces, DOD components
& other units/organizations as directed or one per 300 MWDs & DOD contracted working dogs in support
of all U.S. forces, DOD components & other units/organizations as directed or one per senior Army HQs.
For Army support to other services, add three additional MDVSs.
For special operations forces, one VSST per combined joint special operations task force (offset by
workload).
For stability tasks, same as major combat operations (phase I-III).
For enable civil authority, adjustments will be based on roles of care directed & PAR supported.
CAPABILITIES
This unit provides—
⚫ Early entry capabilities for establishment of initial veterinary Role 1 and Role 2
medical/resuscitative surgical care to military and DOD contract working dogs, and food
inspection support in the AOR.
⚫ Veterinary Role 1 and Role 2 medical/resuscitative surgical care to military and DOD contract
working dogs, and food inspection support in the AOR.
⚫ Veterinary Role 3 advanced canine medical/surgical care and definitive and restorative military
working dog dental care to include endodontic procedures.
⚫ Veterinary Role 3 evacuation/hospitalization support for military working dogs and Veterinary
Role 3 hospitalization for DOD contract working dogs.
⚫ Endemic zoonotic and foreign animal disease epidemiology surveillance and control.
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⚫
⚫
⚫
⚫
⚫
⚫
⚫
Animal facility and kennel inspections.
Commercial food source audits for DOD procurement.
Food safety, quality, and sanitation inspections.
Food defense vulnerability assessments.
Food and water risk assessments.
Field confirmatory microbiological and presumptive chemical food and bottled water laboratory
analysis.
Veterinary support to stability tasks and DSCA activities.
FUNCTIONS
Headquarters, Medical Detachment, Veterinary Services
This headquarters is responsible for C2, unit administration and supply functions, unit movement planning,
Intellectual capital and coordination/liaison experience for stability tasks, foreign humanitarian assistance,
and DSCA activities, and liaison with foreign government officials.
Food Procurement and Laboratory Team
This team is responsible for field confirmatory microbiological and presumptive chemical laboratory
analysis of food and bottled water, food protection audits of commercial food facilities, JBAIDS testing for
CBRN agents in subsistence, and support stability tasks and DSCA activities in areas requiring higher
degrees of expertise in food protection, food diagnostics, and infrastructure reestablishment particularly
with respect to food facilities, distribution, and sanitation.
Veterinary Medical and Surgical Team
This team is responsible for veterinary Role 1-3 medical care to units deployed within the AO,
comprehensive medical and surgical veterinary care, definitive and restorative military working dog dental
care to include endodontic procedures, consultative expertise and referral hospitalization, patient
preparation for evacuation and coordinate evacuation assets, coordination with veterinary Role 4 facility for
evacuation of patients, and support to stability tasks within their AO with a focus on infrastructure rebuilding
of the animal health care and institutional veterinary training programs.
Veterinary Service Support Teams (X5)
This team is responsible for early entry, food protection support, presumptive laboratory analysis of food
and bottled water, food protection audits of commercial food facilities and sanitation inspections of military
food facilities to include assessment of potential military construction sites for food production or storage,
installation food defense vulnerability assessments, food and water risk assessments, surveillance inspection
of CBRN contamination of Class I subsistence as directed, support stability tasks through all phases to
include civil-military and foreign humanitarian assistance operations and special operations force (SOF)
and Role 1 and 2 veterinary treatment teams.
MOBILITY
The Food Procurement and Laboratory Team is 100 percent mobile and able to transport all of its TOE
equipment in a single lift using organic vehicles.
The Veterinary Medical and Surgical Team is 50 percent mobile and only able to transport half of its TOE
equipment in a single lift using organic vehicles.
The Veterinary Service Support Teams are 67 percent mobile and only able to transport two thirds of its
TOE equipment in a single lift using organic vehicles.
The MDVS may be dependent on appropriate elements of the theater, corps, or division, for supplemental
transportation.
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Figure 3-28. Medical Detachment (Veterinary Services) Task Organization
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MEDICAL DETACHMENT,
COMBAT AND OPERATIONAL STRESS CONTROL
(Revised: 30 March 2021 (FDUjr)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08460K000
MEDICAL DETACHMENT COSC
15
0
29
0
44
08463KA00
MED DET COSC MAIN SUPPORT
9
0
17
0
26
08463KB00
MED DET COSC FORWARD
SUPPORT
6
0
12
0
18
MISSION
To provide COSC prevention and treatment services in direct support of BCT, division/corps, and ASCC,
and on an area basis to a joint or combined force as directed in other military operations. The forward
support section provides prevention and limited fitness activity support to maneuver brigades and area
support to units in the brigade support area.
ASSIGNMENT
Assigned to an MMB.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate elements of the theater for religious, legal, FHP, finance, and personnel and
administrative services.
⚫ HHD MMB, or appropriate external elements for medical administration, logistical support,
MEDLOG, medical regulating, evacuation, coordination for return to duty of recovered COSR
soldiers and field maintenance for equipment.
⚫ Field feeding company, or supported BCT for field feeding support.
⚫ Medical Detachment, Minimal Care, for a 40 cot section to support the holding/restoration
mission function.
EMPLOYMENT
This detachment is employed in the theater in supporting tactical division/corps and Theater Army. COSC
detachment provides C2 for the main support section and the forward support section when it deploys as a
complete detachment. The COSC medical detachment has the capability to deploy a forward support section
supporting a division as required. The supported unit provides C2 for the forward support section.
The forward support section performs prevention and limited fitness activity support to maneuver brigades
and area support to units in brigade support areas. COSC detachment provides C2 for the main support
section and the forward support section when it deploys as a complete detachment. The COSC medical
detachment has the capability to deploy a forward support section In support of division/corps as required.
The forward support section will require C2 to be provided by the supported unit.
Both support sections have the capability to break down into six 3-man teams.
BASIS OF ALLOCATION
1 per 39,000 Army population supported in theater. Minimum of one.
CAPABILITIES
This unit provides—
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⚫
⚫
⚫
⚫
⚫
⚫
Consultation, planning support and education to commanders, leaders, chaplains and medical
personnel regarding stressors and interventions in support of troops, mental readiness, morale
and cohesion. Conduct Unit Needs Assessments within supported units.
Neuropsychiatric care, triage and stabilization.
Assistance to nonmedical units with rest category COSR casualties and the return to duty of
recovered COSR Soldiers.
Holding/restoration capability of 40 soldiers for up to 7 days with augmentation from the Medical
Detachment, Minimal Care.
Reconstitution to supported units.
Traumatic Event Management, after action reports, case evaluation and neuropsychiatric triage
and stabilization.
FUNCTIONS
Detachment headquarters
This section provides advice, planning, and coordination for COSC to include employment and coordination
of COSC assets. Also provides unit-level personnel, supply, patient administration, and vehicle
maintenance.
Main support section
This section provides flexible, modular, task organized COSC support in a variety of modularized teams.
The 18-person behavioral health section is comprised of up to six 3-person sub-teams which perform
prevention and limited fitness activity support.
Forward support section
This section provides flexible, modular, task organized COSC support in a variety of modularized teams.
MOBILITY
The Main support section: This unit can transport 50% of its organic personnel and equipment in a single
lift using its authorized organic vehicles.
The Forward support section: This unit can transport 74% of its organic equipment in a single lift using
organic vehicles.
The COSC detachment is dependent on appropriate elements of the theater, corps, or division, for
supplemental transportation.
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Figure 3-29. Combat and Operational Stress Control Task Organization
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MEDICAL DETACHMENT, PREVENTIVE MEDICINE
(Revised: 7 January 2022 [Cyclic Review])
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08429K000
MED DET, PREVENTIVE MED
2
0
11
0
13
MISSION
To provide technical consultation support on preventive medicine issues throughout the TO.
ASSIGNMENT
Assigned to a TMC, MEDBDE (SPT), MMB, MCAS, or a task force medical mission control HQs in the
corps or EAB. The detachment may be attached to a unit in the brigade, corps, or EAB.
DEPENDENCIES
This team is dependent upon appropriate elements within the theater for religious, legal, FHP, finance, and
personnel and administrative services.
EMPLOYMENT
When attached to units in the corps or EAB, the detachment collocates on a temporary basis with the
supported unit until the mission is completed or the mission priority changes. When attached to a BCT, the
detachment collocates with the preventive medicine section of a Role 2 medical company to ensure
coordination of support efforts. When deployed in general support, the detachment collocates with a
medical unit or HQs.
BASIS OF ALLOCATION
One detachment per 17,000 personnel supported at the corps or EAB.
CAPABILITIES
This unit provides—
⚫ Ability to gather information systematically to input into an automated medical surveillance
system to produce real-time tactically significant health threat profiles.
⚫ Guidance to the command concerning PMM by performing a medical assessment of the command
and the potential impact of (DNBI) on military operations.
⚫ Epidemiological investigations to include case-contact interviewing, contact tracing, and outbreak
investigations.
⚫ On-site water quality analysis.
⚫ Monitoring of water and field ice production and distribution.
⚫ Collection of water, soil, and air samples from sources that may pose environmental,
occupational, or industrial hazards to US troops for definitive analysis by EAB/CONUS
laboratories.
⚫ Food service sanitation inspections of field feeding sites.
⚫ Monitoring and guidance on proper field sanitation and waste disposal techniques.
⚫ Guidance on the prevention of climatic injuries (heat, cold, and altitude).
⚫ Direct pest management support including aerial spray missions utilizing aerial spray equipment.
⚫ Direct medical entomology consultation on:
arthropod-borne disease; use of pesticides;
poisonous plants and animals, and measures for control or avoidance of disease vectors of
military significance.
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⚫
Collection of water and ice samples for CBRN surveillance and establishes and maintains a chain
of custody for samples, and forwarding samples to supporting medical laboratories for
identification.
Coordination with the chemical corps CBRN reconnaissance and biological detection units for
collection of air and soil environmental samples for laboratory analysis.
Information on specific PMM to counter health threats.
Training and certification for field sanitation team and food service personnel.
Health promotion education.
Inspection of cargo destined out of theater for plants, arthropods, rodents, soil, and other items as
specified to prevent their introduction into the United States, its territories and possessions, or
other nations.
Assistance in the issuance of vessel clearances for entry into the destination ports, as authorized.
Staff estimates of health threats in the AO.
One wheeled vehicle mechanic (MOS 91B) to augment the maintenance capability of the unit that
performs maintenance on its organic vehicles.
Three teams as necessary to perform missions.
Individuals of this organization can assist in the coordinated defense of the unit's area or
installation.
This unit does not perform field maintenance on any organic equipment including COMSEC
equipment.
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
FUNCTIONS
Headquarters section
This section provides C2 of assigned personnel. Provides coordination with supporting units to ensure the
detachment's administrative, communication, general and medical supplies, and maintenance needs are
being provided while attached to medical or other supporting units.
Preventive medicine team (X3)
These teams are responsible for conducting evaluations within their assigned AO and/or to be task-organized
to provide direct preventive medicine support to designated BCTs, corps, or EAB units, as required. The
preventive medicine teams are 100 percent mobile.
Figure 3-30. Medical Detachment, Preventive Medicine Task Organization
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AREA MEDICAL LABORATORY /
MEDICAL DETACHMENT, GLOBAL MEDICAL FIELD
LABORATORY
(Approved: 19 March 2021)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08660K000
GLOBAL MEDICAL FIELD
LABORATORY
22
0
45
0
67
08668KA00
HEADQUARTERS SECTION
10
0
12
0
22
08668KB00
OCCUPATIONAL AND
ENVIRONMENTAL THREAT
ASSESSMENT SECTION
6
0
9
0
15
08668KC00
BIOLOGICAL THREAT
ASSESSMENT SECTION
3
0
12
0
15
08668KD00
CHEMICAL THREAT
ASSESSMENT SECTION
3
0
12
0
15
MISSION
Identifies and evaluates health hazards in the AO through unique medical laboratory analyses and rapid
health hazard assessments of nuclear, biological, chemical, endemic disease, occupational and
environmental health threats.
ASSIGNMENT
Assigned to a TMC, MEDBDE (SPT), the 20th CBRN Command, and may be further attached to other
deployed medical units as needed.
DEPENDENCIES
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
This unit is dependent upon appropriate elements within the theater for religious, legal, FHP,
finance, and personnel and administrative services.
In the Corps (Echelon above Brigade), MLC for medical maintenance and repair, and reach back
to Original Equipment Manufacturer (OEM).
This unit requires maintenance support on organic equipment, to include Communications
Security (COMSEC) equipment.
Engineer Battalion, for site preparation and minor construction.
Expeditionary Signal Battalion (ESB), for providing Unclassified, Secret, and TS/SCI voice and
data networking and Line of Sight (LOS) and Beyond Line of Sight (BLOS) connectivity.
When deployed OCONUS, elements of the theater for force protection, civilian and military
operations, quartermaster repair, FHP, field feeding, transportation (to include aviation) of
materials under analysis, all field maintenance and recovery, religious, legal, finance, personnel
and administrative services, communications, communications-electronics, reach back support
and Communications Security (COMSEC) support.
When stationed in CONUS, the 20th Support Command (Chemical, Biological, Radiological,
Nuclear and Explosives [CBRNE]) Command, for force protection, civilian and military
operations, quartermaster repair, FHP, field feeding, transportation (to include aviation) of
materials under analysis, all field maintenance and recovery, religious, legal, finance, personnel
and administrative services, communications, communications-electronics, reach back support
and Communications Security (COMSEC) support.
If deployed as part of a multinational or coalition force, joint task force, it is critical that the HSS
planner consider personnel and equipment augmentation in the following areas: command,
control and communications, medical operations planning, power generation, wheeled vehicle
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and generator maintenance, transportation (equipment/cargo and personnel), food service, force
protection, Class VIII (Medical) resupply, medical equipment maintenance and repair, and sick
call (primary care physician).
EMPLOYMENT
This theater asset may be deployed incrementally or as an entire unit. The TMC, or MEDBDE (SPT)
provides C2 and support to forward assigned threat assessment teams of the GMFL or to the entire unit
when deployed. Deployed modular sections or sectional threat assessment teams will normally be deployed
forward in the Corps area where they will interface with preventive medicine teams, veterinary teams,
forward support medical units, Biological Integrated Detection System (BIDS) teams, and chemical
company elements operating in the Corps area.
When operating in a split-base mode, the stay-behind headquarters element remains in CONUS or at EAC
and conducts associated laboratory analysis, consultation, and referral of specimens to non-AML
organizations, as appropriate.
The GMFL integrates its functional capabilities with other Army Medicine and non-Army Medicine assets
to enhance the identification of medical threat agents; provides ac curate field confirmation of suspect
samples/ specimens; and performs health hazard assessments across full spectrum operations.
BASIS OF ALLOCATION
⚫
⚫
AML (Current): One per Theater.
GMFL (FY25): 0.333 per Division HQ.
CAPABILITIES
This unit provides—
A standardized, deployable, networked, modular and scalable FHP theater validation level laboratory
capable of supporting short and extended operations, including the ability to support split based operations.
The theater validation level laboratory will be modular and scalable, with the ability to with the specific
mission to identify and evaluate health hazards in the AO, the following configurations to support single or
split based operations:
Complete Medical Detachment, Global Medical Field Laboratory (GMFL) (SRC 08660K000), consisting
of the following sub-SRCs; Headquarters Section, GMFL (SRC: 08668KA00) (22 personnel); Occupational
and Environmental Threat Assessment Section, (SRC: 08668KB000) (15 personnel); Biological Threat
Assessment Section, (SRC: 08668KC000) (15 personnel) and Chemical Threat Assessment Section, (SRC:
08668KD000) (15 personnel). In this configuration, the GMFL provides the ability to identify and evaluate
health hazards in the AO through unique medical laboratory analyses and rapid health hazard assessments
of nuclear, biological, chemical, endemic disease, occupational and environmental health threats.
Headquarters Section, GMFL (22 personnel)
Plans, coordinates, supervises, and monitors the activities of the GMFL in support of the commander.
Provides C2, supervise and coordinate operations and administrative services, provides security, plans and
operations, deployment, relocation, and redeployment of the GMFL. Coordinates and synchronizes the
execution of the supply management, unit level wheeled vehicle, utilities and tactical generator
maintenance, medical maintenance support, and all other life support requirements. Provides preventive
medicine, environmental science consultation. Provides infectious disease consultation. Consultation on
laboratory analysis results and HRAs to combatant commanders, unified action partners, AHS theater
surgeons, host nation, and medical intelligence operations staff when requested. Provides consultative
support to intra-theater presumptive and field confirmation level assets, such as the Preventive Medicine
Detachment (PM DET) and Veterinary Services Detachment (VET DET) within the AO as required.
Provides veterinary pathology consultation on gross, microscopic, and molecular pathologic assessments of
animal disease.
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Occupational and Environmental Threat Assessment Section (OE-TAS) (15 personnel)
Capable of supporting short and extended operations, including the ability to support split based operations,
consisting of three (3) occupational and environmental threat assessment teams (5 personnel each). In its
smallest configuration, a single occupational and environmental threat assessment team provides rapid,
actionable theater validation level laboratory analysis and health risk assessments (HRAs) for physical and
chemical hazards, media-specific matter, radiological health hazards and contamination, disease
transmitting insects, other medically significant vectors and vector-associated endemic health hazards that
Soldiers may be exposed to in an AO during war, stability operations, or homeland defense operations.
Biological Threat Assessment Section (B-TAS) (15 personnel)
Capable of supporting short and extended operations, including the ability to support split based operations,
consisting of three (3) biological threat assessment teams (TATs) (5 personnel each). In its smallest
configuration, a single biological threat assessment team provides theater validation level laboratory
analysis for the evaluation, detection, analysis, quantification, documentation and transport of endemic
infectious disease microorganisms, identification of microorganisms that are potential biological warfare
agents, diagnosis of zoonotic and significant animal diseases, microbial agent detection and processing and
preparation of specimens that Soldiers may be exposed to in an AO during war, stability operations, or
homeland defense operations.
Chemical Threat Assessment Section (C-TAS) (15 personnel)
Capable of supporting short and extended operations, including the ability to support split based operations,
consisting of three (3) chemical threat assessment teams (5 personnel each). In its smallest configuration, a
single chemical threat assessment team provides the capability to conduct air quality analysis, evaluate
environmental pollutants and toxins, and field confirmatory chemical analysis of environmental samples.
Identifies the chemical composition and physiochemical properties of potential chemical warfare agents,
toxic industrial compounds/materials, or other hazardous materials of operational concern in the AO during
war, stability operations, or homeland defense operations.
FUNCTIONS
Headquarters Section
This section provides command, control, communications, computers, and intelligence to include
coordinating for secure and nonsecure capabilities, automation and computer analysis support requirements
for the laboratory to facilitate split-based operations and administrative and logistical support for the unit.
Occupational and Environmental Threat Assessment Section
This section provides is responsible for evaluation, analysis, quantification, and documentation of physical
(e.g. noise) and chemical (e.g. toxic compounds/materials) hazards, media-specific (air, water, soil),
radiological health hazards and contamination matter and specimen collecting and processing necessary to
identify and assess impact of disease transmitting insects, other medically significant vectors, and vectorassociated endemic health hazards that soldiers may be exposed to in an AO.
Biological Threat Assessment Section
This section is responsible for providing analytical, investigative and consultative microbiology as well as
detection and identification of endemic infectious disease microorganisms from veterinary and
entomological sources, identification of microorganisms that are potential biological warfare agents that
soldiers may be exposed to in an AO during war, stability operations or homeland defense operations.
Chemical Threat Assessment Section
This section provides the capability to conduct air quality analysis, evaluate environmental pollutants and
toxins, and field confirmatory chemical analysis of environmental samples. Identifies the chemical
composition and physiochemical properties of potential chemical warfare agents, toxic industrial
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compounds/materials, or other hazardous materials of operational concern in the AO during war, stability
operations, or homeland defense operations.
MOBILITY
The AML/GMFL is 10% mobile and can transport a tenth of its TOE equipment in a single lift using its
organic vehicles. The AML/GMFL will be dependent on appropriate elements of the theater or corps for
supplemental transportation.
NOTES
The AML will convert to the GMFL in FY25.
Figure 3-31. Area Medical Laboratory Task Organization (Current)
Figure 3-32. Global Medical Field Laboratory Task Organization (FY25)
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BRIGADE SUPPORT MEDICAL COMPANY
(AIRBORNE, ARMOR, INFANTRY, AND STRYKER)
(Revised: IBCT and IBCT [ABN] 2 February 2021 [Cyclic Review]; ABCT: 6
February 2018; SBCT: 8 May 2018)
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
08027K000
MEDICAL COMPANY, BRIGADE
SUPPORT BATTALION
(ARMORED BCT)
15
0
67
0
82
08037K000
MEDICAL COMPANY, BRIGADE
SUPPORT BATTALION
(INFANTRY BCT)
15
0
67
0
82
08047K000
MEDICAL COMPANY, BSB
(AIRBORNE BCT)
15
0
67
0
82
08057K000
MEDICAL COMPANY, BCT
(STRYKER BCT)
16
0
70
0
86
MISSION
To provide Role 2 AHS support to maneuver battalions with organic medical platoons. This company
provides both Role 1 and 2 medical treatment on an area basis to those units without organic medical assets
operating in the BCT AO.
ASSIGNMENT
Organic to the BSB.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate elements within the theater for religious, legal, finance, and personnel and
administrative services.
⚫ The HHC, BSB, for food service support, religious support, and unit administration.
⚫ Field (maintenance) company, BSB, for field maintenance of all organic equipment (less
medical).
⚫ Distribution company, BSB, for supply support.
⚫ FRSD, for surgical augmentation.
⚫ MCAA for AE.
EMPLOYMENT
This company is located in the brigade support area. It provides role 1 and 2 AHS support and has treatment
teams that can operate independently from the company for limited periods of time.
BASIS OF ALLOCATION
One per BCT.
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CAPABILITIES
This unit provides—
⚫ C2 of attached units, which include medical planning and coordination of patient movement
within and outside the brigade.
⚫ Treatment of patients with DNBI, combat operational stress reaction (COSR), triage of mass
casualties, advanced trauma management, initial resuscitation and stabilization, and preparation
for further evacuation of patients’ incapable of returning to duty.
⚫ Ground evacuation for patients from BASs and designated casualty collection points (CCPs) to
the BSMC.
⚫ Operational dental care that consists of emergency and essential dental care designed to
circumvent potential dental emergencies.
⚫ Class VIII supply/resupply to units in the brigade area.
⚫ Unit-level medical equipment maintenance.
⚫ Medical laboratory and radiology services commensurate with Role 2 MTFs.
⚫ Outpatient consultation services for patients referred from Role 1 MTFs.
⚫ Patient holding for up to 20 patients able to return to duty within 72 hours.
⚫ Limited reinforcement and augmentation to supported maneuver battalion medical platoons.
⚫ Regeneration of severely attrited BASs.
⚫ Treatment squads that are capable of operating independently for limited periods of time that
provide advanced trauma management and sick call as required. A treatment squad is capable of
breaking down into two treatment teams, which can also operate independently for limited
periods of time.
⚫ Preventive medicine support.
⚫ Individuals of this organization are provided weapons for personal defense and protection of the
patients under their care.
⚫ This unit performs field maintenance on medical equipment except COMSEC equipment.
FUNCTIONS
Company HQs
Provides C2 of the company and attached medical units. It also provides medical administration, general
and medical supply, CBRN defensive operations, and communications support. The HQs is organized into
command, supply, operations, and communications elements. Within a SBCT, this section provides supply
point distribution of Class VIII push-packages for medical unit’s combat lifesavers operating in the BCT's
AO. Unit medical equipment maintenance is organically provided by one medical maintenance specialist.
Preventive medicine section
This section ensures personnel implement preventive medicine measures (PMM) to protect against food,
water, and vector-borne diseases and environmental injuries.
Mental health section
This section provides advice and assistance in the areas of behavioral health and COSC.
Medical treatment platoon HQs
This is the C2 element of the platoon. It determines and directs the disposition of patients and coordinates
for their further evacuation.
Medical treatment squad
This squad provide emergency and routine sick call treatment to Soldiers assigned to supported units. The
squad can perform their functions while located in the company area, or they can operate independently of
the medical company for up to 48 hours. Each squad has the capability to split and operate as separate
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treatment teams (Teams A and B) for up to 48 hours. While operating in these separate modes, each team
may operate one treatment station. They can be assigned to reinforce or reconstitute similar medical
treatment squads. The equipment for this squad should stay configured and loaded on unit vehicles to be
prepared to execute these types of missions on short notice.
Area support squad
This squad provides emergency dental services, laboratory services, blood support, radiological services,
and physical therapy. This squad is located with and supports the medical treatment squad (area) and
provides services for the treatment squads deployed forward.
Medical treatment squad (area)
This is the base medical treatment element (does not deploy away from the BSMC and is not used to
reinforce or reconstitute other medical units) that provides troop clinic-type services and TCCC within the
brigade support area.
Patient holding squad
This section has 20 cots and provides nursing care for up to 20 patients expected to return to duty within 72
hours. During periods of time when evacuation is delayed (prolonged care), the brigade commander, on the
advice of the brigade surgeon, may extend the patient holding period according to the theater evacuation
policy.
Evacuation platoon HQs
The evacuation platoon HQs provides C2 of the ambulance squads. It also directs the platoon, plans for its
employment, and maintains communications to direct ground ambulance evacuation of patients. The
evacuation platoon HQs performs route reconnaissance (by map; aerial reconnaissance; coordination with
the intelligence staff officer [S-2] and operations staff officer [S-3]; and vehicular route reconnaissance).
The evacuation platoon HQs develops and issues all necessary route and navigational information. The
evacuation platoon headquarters coordinates and establishes an ambulance shuttle system for both air and
ground ambulances as required.
Evacuation squad (forward) (X3)
The forward evacuation squad provides evacuation of patients in a direct support role from the Role 1 BAS
treatment squads/teams of forward maneuver units to the Role 2 BSMC in the Brigade support area. It is
comprised of three evacuation squads. Each evacuation squad consists of two wheeled, Stryker, or tracked
medical evacuation vehicles. Each squad is comprised of one emergency care SGT, two drivers, and, and
three ambulance aides. Each squad can be employed as a separate team/crew with one medical evacuation
vehicle, one TC, one driver, and one ambulance aide.
Evacuation squad (area) (X2)
The area evacuation squad provides evacuation of patients in a general support role within the BCT AO
(normally within the brigade support area) and is comprised of two squads. Each evacuation squad consists
of two HMMWV wheeled ambulances, one trailer, one emergency care SGT, two drivers, and, and three
ambulance aides. Each squad can be employed as a separate team/crew with one ambulance, one TC, one
driver, and one ambulance aide.
Brigade medical supply office
This office is responsible for providing Class VIII supplies and equipment, to include unit-level medical
maintenance and repair, and executes the brigade MEDLOG plans. The BSMC organic to a SBCT does not
have this section. The HQs section is task organized to accomplish this mission.
MOBILITY
This unit is 100 percent mobile and is able to transport all of its TOE equipment in a single lift using organic
vehicles.
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NOTES
There are currently five (5) types of Role 2 BSMC. Depicted here is task organization for the BSMC
assigned to the (IBCT. There are differences between the types of BSMC, the note below explains a few of
the major differences that the SBCT BSMC has. Ensure you review the TOE for your specific type of
BSMC.
Figure 3-33. Brigade Support Medical Company (IBCT) Task Organization
Note: The BSMC assigned to a Stryker BCT does not have a separate BMSO. This capability
and its personnel are rolled up in the BSMC Headquarters Section.
On other noted difference with the BSMC assigned to a Stryker BCT is that is does not have a
Treatment Squad consisting of two treatment teams (eight personnel), It has a Treatment Section
consisting of three Treatment Teams (12 personnel).
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MEDICAL PLATOON
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
17326K100
HHC, COMBINED ARMS
BATTALION (ARMOR) (ABCT)
3
0
32
0
35
07316K100
HHC, COMBINED ARMS
BATTALION (INF) (ABCT)
3
0
32
0
35
07216K000
HHC, INFANTRY BATTALION
(IBCT)
3
0
46
0
49
07216K100
INFANTRY BATTALION
(IBCT)(AIRBORNE)
3
0
46
0
49
07196K000
HHC INF BN (SBCT)
3
0
33
0
36
07816K100
HHC, RANGER BATTALION
4
0
32
0
36
17316K000
HHT, CAVALRY SQUADRON
(ABCT)
3
0
44
0
47
17216K000
HHT, CAVALRY SQUADRON
(IBCT)
3
0
30
0
33
17216K100
HHT, CAVALRY SQUADRON
(IBCT) (AIRBORNE)
3
0
30
0
33
17196K000
HHT, CAVALRY SQUADRON
(SBCT)
3
0
30
0
33
MISSION
To provide medical treatment, MEDEVAC, MEDLOG, and limited FHP for a battalion-sized organization.
ASSIGNMENT
See above table.
DEPENDENCIES
This unit is dependent upon the following:
⚫ Appropriate elements of the brigade support organizations for religious, legal, combat health
support, finance, personnel and administrative services and Communication Security (COMSEC)
equipment maintenance.
⚫ Brigade Support Battalion, for field feeding, Class III/V resupply, supply, transportation, and field
and sustainment maintenance of all equipment.
⚫ Brigade Engineer Battalion, for combat engineer support.
EMPLOYMENT
The Battalion Headquarters deploys a Tactical Operations Center (TOC) to maintain command, control, and
supervision of the infantry battalion and assigned units. Appropriate headquarters staff sections and
elements are employed to support command functions.
Additional headquarters controlled elements provide indirect fire support (mortar platoon), reconnaissance
and security support (scout platoon), sniper support, fires effects support, liaison support, communications
support, aid station, and battalion logistical facilities. These elements are located in various locations in the
battle-area dependent upon the mission and tactical situation.
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The Battalion Combat Trains area is established to provide for most immediate support to the Battalion.
Elements of the sustainment section, medical platoon, unit ministry team, and some ammunition and
petroleum, oil, and lubrication (POL) vehicles (from BSB support) are usually located with the combat
trains.
BASIS OF ALLOCATION
One per each organization in the table above.
CAPABILITIES
See approved TOE.
FUNCTIONS
Medical Platoon Headquarters
⚫
⚫
Coordinates the operations, administration, and logistics of the medical platoon.
Provides oversight of all medical assets conducting FHP (HHC, Ranger Battalion).
Medical Treatment Squad
⚫
Establishes a battalion aid station as far forward as possible, performs triage, and provides medical
treatment within their capabilities.
⚫ Sorts, treats and evacuates the sick and wounded (HHC, Ranger Battalion).
Ambulance Squad
Evacuates casualties from the forward battle area when required.
Ambulance Team
Provides MEDEVAC for the sick and wounded (HHC, Ranger Battalion).
Combat Medic Section
⚫
Provides medical personnel for the two combat platoons in the HHC (Scout and Mortar) and each
infantry rifle company to ensure casualties are properly treated in the forward area. Provides
emergency medical treatment to the rifle platoons/sections.
⚫ Provides oversight of emergency medical treatment to the recon, sniper, and mortar platoons
(HHC Ranger Battalion).
MOBILITY
This unit requires 100 percent mobility of its TOE equipment to be transported in a single lift.
NOTES
Depending on the type of BCT and battalion assignment there are differences in the amount of combat
medics and ground MEDEVAC platforms available to the various types of maneuver battalions. Figure 435 depicts those differences. Ensure you review the TOE for your specific type of medical treatment platoon
for the most current authorized personnel and equipment.
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Figure 3-34. Medical Platoon Task Organization
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MEDICAL SECTIONS/SQUAD
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
03396K000
HHC, CBRN BATTALION
2
0
6
0
8
05316K500
HHC, BRIGADE ENGINEER
BATTALION (ABCT)
1
0
13
0
14
05316K600
HHC, BRIGADE ENGINEER
BATTALION (IBCT)
1
0
13
0
14
05316K700
HHC, BRIGADE ENGINEER
BATTALION (SBCT)
1
0
13
0
14
05316K800
HHC, BRIGADE ENGINEER
BATTALION (IBCT) (ABN)
1
0
13
0
14
06386K000
HHB, FIELD ARTILLERY
BATTALION, 155SP (ABCT)
2
0
19
0
21
06236K100
HHB, FIELD ARTILLERY
BATTALION, COMP (3X6) (IBCT)
2
0
19
0
21
06236K300
HHB, FIELD ARTILLERY
BATTALION, COMP (IBCT) (ABN)
2
0
19
0
21
06326K000
HHB, FIELD ARTILLERY
BATTALION, 155T (SBCT)
2
0
19
0
21
52406K000
HEADQUARTERS AND SUPPORT
COMPANY, HHBn (CORPS)
2
0
6
0
8
MISSION
To provide medical treatment, MEDEVAC, MEDLOG, and limited FHP for a company or battalion-sized
organization.
ASSIGNMENT
See table above.
DEPENDENCIES
See approved TOE.
EMPLOYMENT
See approved TOE.
BASIS OF ALLOCATION
One per each organization in the table above.
CAPABILITIES
See approved TOE.
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FUNCTIONS
Medical Treatment Squad (HHC, CBRN Battalion)
Provides health services support to the Battalion and task organized units as required. Provides physician
directed advanced trauma life support to battlefield casualties and routine sick call service when not engaged
in combat. Provides staff estimates and OPLANs/OPORDs development documents and related required
products as required.
Sustainment/Medical (HHC, Brigade Engineer Battalion)
Provides troop medical care to the soldiers of the battalion and support to any assigned units as required.
Medical Platoon Headquarters (HHB, Field Artillery Battalion)
Provides unit-level combat health support to the battalion. Provides unit level FHP to the battalion.
Medical Treatment Team (HHB, Field Artillery Battalion)
Establishes a battalion aid station as far forward as possible, performs triage, and provides medical treatment
within their capabilities. Provides medical care to personnel of the battalion.
Ambulance Team (HHB, Field Artillery Battalion)
Provides evacuation of casualties from the battalion aid station to the nearest supporting Role 2 medical
company or evacuation point. Provides evacuation of battlefield casualties from the batteries to the battalion
aid station.
Combat Medic Section (HHB, Field Artillery Battalion)
Provides medical support for each firing battery to ensure casualties are properly treated in the forward area;
performs life-saving measures to injured personnel. Provides a combat medic to each firing battery to
perform immediate life saving measures to casualties.
Battalion Medical Treatment Section (HSC, HHBn [Corps])
Plans, coordinates, synchronizes, integrates and provides FHP to the MAIN CP. Coordinates and conducts
combat stress control training for supported population and collects and records social and psychological
data. Provides Emergency Medical Treatment and Advanced Trauma Management, Sick Call Services,
preventive medicine support to the MAIN CP.
MOBILITY
See approved TOE.
Figure 3-35. Notional Medical Section Task Organization
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MEDICAL TEAMS
SRC
TITLE
REQ OFF
REQ WO
REQ ENL
REQ CIV
REQ TOT
01206K000
HHC, ASSAULT BATTALION (UH60)
2
0
3
0
5
01286K000
HHC, ATTACK/RECON
BATTALION (AH-64)
2
0
3
0
5
01226K000
HHC, GENERAL SUPPORT
AVIATION BATTALION
2
0
3
0
5
01302K000
HHC, COMBAT AVIATION
BRIGADE
3
0
5
0
8
03492K000
HHC, CBRN BRIGADE
4
0
5
0
9
07256K000
HHC, SECURITY FORCE
ASSISTANCE BATTALION OR
COMBINED ARMS BATTALION
1
0
2
0
3
17256K000
HHT, SECURITY FORCE
ASSISTANCE SQUADRON
(CALVARY)
1
0
2
0
3
63366K000
HHC, DIVISION SUSTAINMENT
SUPPORT BATTALION (DSSB)
1
0
7
0
8
63312K000
HHC AND STB, DIVISION
SUSTAINMENT BRIGADE
1
0
7
0
8
63302K000
HHC AND STB, SUSTAINMENT
BRIGADE
3
0
9
0
12
87006K400
HEADQUARTERS AND SUPPORT
COMPANY (DIVISION)
1
0
3
0
4
MISSION
To provide medical treatment, MEDEVAC, MEDLOG, and limited FHP for the company or battalion-sized
organization.
ASSIGNMENT
Organic to: See table above.
DEPENDENCIES
This unit is dependent upon the following: See approved TOE.
EMPLOYMENT
See approved TOE
BASIS OF ALLOCATION
One per each organization in the table above.
CAPABILITIES
This unit provides: See approved TOE.
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FUNCTIONS
Medical Treatment Team (HHC, Assault Battalion (UH-60])
Provides FHP for the battalion. Provides physician-directed advanced trauma life support to battlefield
casualties and routine sick call service when not engaged in combat.
Medical Treatment Team (HHC, Attack/Recon Battalion (AH-64])
Provides FHP for the battalion. Provides physician directed advanced trauma life support to battlefield
casualties and routine sick call service when not engaged in combat.
Medical Treatment Team (HHC, General Support Aviation Battalion [GSAB])
Provides FHP for the battalion. Provides physician directed advanced trauma life support to battlefield
casualties and routine sick call service when not engaged in combat.
Medical Treatment Team (HHC, Combat Aviation Brigade [CAB])
Provides FHP for the HHC. Provides physician directed advanced trauma life support to battlefield
casualties and routine sick call service when not engaged in combat.
Medical Treatment Team (HHC, Chemical, Biological, Radiological, and Nuclear [CBRN]
Brigade)
Manages the medical support programs of the Brigade. The Surgeon will issue policy, set priorities, and
develop Brigade-wide strategies to effectively and efficiently perform this function in addition to supporting
emergency planning and special operations. Provides the Service Response Force Surgeon during chemical
accidents/incidents that require the activation of the Service Response Force; coordinates medical response
forces, coordinates patient tracking, and assures adequate resources in the event of a major accident/incident.
Provides staff estimates and related documents and support required in the development of
OPLAN/OPORDs as required.
Behavioral Health Cell (HHC, CBRN Brigade)
Provides recommendations on the positioning and utilization of behavioral health resources within the
brigade. Develops and implements training programs for primary care providers, nonmedical officers, and
noncommissioned officers that focuses on prevention and management of operational stress and other
mental health problems. Provides staff estimates and related documents and support required in the
development of OPLAN/OPORDs as required.
Medical Team (HHC, Security Force Assistance Battalion [Infantry/CAB])
Provides unit level FHP, medical care, and evacuation of to the battalion aid station. Provides advice,
assistance, and training to partnered forces on unit, individual, and leader tasks.
Medical Team (HHT, Security Force Assistance Squadron [Calvary])
Provides unit level FHP, medical care, and evacuation of to the battalion aid station. Provides advice,
assistance, and training to partnered forces on unit, individual, and leader tasks.
Medical Treatment Section (Team) (HHC, Division Sustainment Support Battalion [DSSB])
Provides Role 1 HSS for the DSB HHC and the STBs assigned and attached units.
Medical Evacuation Team (HHC, Division Sustainment Support Battalion [DSSB])
Provides tactical combat casualty care, en route medical care, and ground MEDEVAC from the point of
injury to the medical treatment team for Role 1 care.
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STB Medical Treatment Team (HHC and STB, Division Sustainment Brigade)
Provides Role 1 HSS for the DSB HHC and the STBs assigned and attached units.
STB Medical Evacuation Team (HHC and STB, Division Sustainment Brigade)
Provides tactical combat casualty care, en route medical care, and ground MEDEVAC from the point of
injury to the medical treatment team for Role 1 care.
STB Medical Treatment Team (HHC and STB, Sustainment Brigade)
Provides Role 1 HSS for the Sustainment Brigade HHC and the STBs assigned and attached units. Services
include emergency medical treatment, behavioral health, advanced trauma management and sick call
services.
STB Medical Evacuation Team (HHC and STB, Sustainment Brigade)
Provides tactical combat casualty care, en route medical care, and ground MEDEVAC from the point of
injury to the medical treatment team for Role 1 care.
Battalion Medical Treatment Section (Team) (HSC [Division])
Plans, coordinates, synchronizes, integrates and provides FHP to the Division HQ. Coordinates and
conducts combat stress control training for the supported population and collects and records social and
psychological data; provides Emergency Medical Treatment and Advanced Trauma Management, Sick Call
Services and preventive medicine support to the MCP.
MOBILITY
See approved TOE.
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PART FOUR
The Army Health System in Support of the
Competition Continuum
As the Army’s focus transitions to large-scale ground combat in a multidomain
environment, FM 3-0, Operations, was revised and includes a great deal of discussion
about the Army’s three strategic context—competition below armed conflict, crisis,
and armed conflict.
Joint Doctrine Note 1-19 and FM 3-0 shift Army support to the joint competition
continuum, which includes three broad categories of strategic relationships—
cooperation, competition below armed conflict, and armed conflict. Multidomain
operations are the Army’s contribution to joint operations. Multidomain operations are
the combined arms employment of capabilities from all domains that create and exploit
relative advantages to defeat enemy forces, achieve objectives, and consolidate gains
during competition, crisis, and armed conflict (FM 3-0). Although combatant
commands and theater armies’ campaign across the competition continuum, Army
tactical formations typically conduct operations within a context dominated by one
strategic relationship at a time. Therefore, Army doctrine describes the strategic
situation through three contexts in which Army forces conduct operations:
⚫ Competition below armed conflict.
⚫ Crisis.
⚫ Armed conflict.
Part Four describes the activities and tasks within each of the ten medical functions
specific to each of the Army’s strategic contexts. Naturally, tasks are very dependent
on the operational environment. A TMC would have different tasks in Europe than it
would have in the Pacific region in the competition and crisis contexts. However,
described within this section are many of the generic activities that would be common
and it is then dependent on leaders and command and control planning to scope the
specific tasks that support the goals in each of the strategic contexts.
Adversaries have studied the manner in which U.S. forces deployed and conducted
operations over the past three decades. Several have adapted, modernized, and
developed capabilities to counter U.S. advantages in the air, land, maritime, space, and
cyberspace domains. Military advances by Russia, China, North Korea, and Iran most
clearly portray this changing threat. The AHS must be prepared for this.
While the AHS forces must be manned, equipped, and trained to operate across the
range of military operations, LSCO against a peer threat represents the most significant
readiness requirement. Army Medicine doctrinal publications along with FM 3-0
provides doctrine for how AHS forces do this. FM 3-0 is concerned with operations
using current Army capabilities, formations, and technology in today's OE. It expands
on the material in FM 3-0 by providing tactics describing how theater armies, corps,
divisions, and brigades work together and with unified action partners to successfully
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prosecute operations short of conflict, prevail in LSCO, and consolidate gains to win
enduring strategic outcomes.
The operational frameworks in Part Four begins with an anticipated OE that includes
considerations during the Army strategic contexts (competition below armed conflict,
crisis, and armed conflict) against a peer threat. Within each context, the Army's
operational concept of unified land operations guides how Army forces conduct
operations. In LSCO, Army forces combine offensive, defensive, and stability tasks to
seize, retain, and exploit the initiative. The combined arms approach to operations
during competition, crisis, and armed conflict is foundational to exploiting capabilities
from all domains and their dimensions. The command and control warfighting function
enables commanders and staffs of AHS formations to synchronize and integrate
medical support across multiple domains while medical command and control guides
AHS commanders, staffs, and subordinates in their approach to FHP and HSS
operations. Throughout operations, Army forces maneuver to achieve and exploit
positions of relative advantage across all domains to achieve objectives, defeat the
enemy, and accomplish missions. AHS Commanders, staffs, and subordinates must
understand the operational art depicted in FM 3-0 and be able to overlay and apply the
six AHS principles in order to support the warfighter.
Throughout Part Four of this publication, refer to Table 4-1 for all abbreviations used
in Figures 4-1 through 4-40.
Table 4-1. List of abbreviations for Figures 4-1 through 4-40
1
2
3
4
AFRRI
ASWBPL
AML
AMLC
APOD
APS
AJBPO
ASBPO
ASMP
AXP
BAS
BEB
BMSO
BSMC
CCP
CDC
CLS
CONUS
COSC
CRT
CSSB
DCAM
DCAS
DMC
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Role 1 (BAS)
Role 2 (BSMC or MCAS)
Role 3 (field hospital or hospital center)
Role 4 (CONUS-based hospitals and other safe havens)
Armed Forces Radiobiology Research Institute
Armed Service Whole Blood Processing Laboratory
area medical laboratory
Army Medical Logistics Command
aerial port of debarkation
Army pre-positioned stock
area joint blood program officer
armed services blood program office
area support medical evacuation platoon
ambulance exchange point
battalion aid station
brigade engineer battalion
brigade medical supply office
brigade support medical company
casualty collection point
Centers for Disease Control and Prevention
combat lifesaver
continental United States
combat and operational stress control
contact repair team
combat service support battalion
DMLSS Customer Assistance Module
dental company (area support)
distribution management center
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DMLSS defense medical logistics standard support
DSSB division service support battalion
EBCT Expeditionary Blood Transshipment Center
EE early entry
EECP early entry command post
EE/FO early entry / follow on
ESC expeditionary support command
FDT forward distribution team
FPLT food procurement and lab team
FRSD forward resuscitative surgical detachment
FSMP forward support medical evacuation platoon
FWD forward
GCSS-A global combat support system – Army
GMFL global medical field laboratory
GSAB general support aviation battalion
IFAK individual first aid kit
JBPO joint blood program officer
JDDOC joint deployment and distribution operations center
LNO liaison officer
MAIN main command post
MCAA medical company (air ambulance)
MCAS medical company (area support)
MCGA medical company (ground ambulance)
MDBS medical detachment (blood support)
MDVS medical detachment (veterinary services)
MEDBDE medical brigade (support)
(SPT) medical logistics
MEDLOG
MF multifunctional
MLC medical logistics company
MLMC medical logistics management center
MLST medical logistics support team
MMB medical battalion (multifunctional)
MMC medical materiel center
PM preventive medicine
POI point of injury
SIMLM single integrated medical logistics manager
SPD supply point distribution
SPOD sea port of debarkation
SPT support
surg surgical
TAC tactical command post
TEWLS theater enterprise-wide logistics system
TLAMM theater lead agent for medical materiel
TMC theater medical command
TSC theater support command
USAMRDC United States Army Medical Research and Development Command
USAMRICD United States Army Medical Research Institute of Chemical Defense
USAMRIID United States Army Medical Research Institute of Infectious Diseases
VMST veterinary medical and surgical team
VPLT veterinary procurement and laboratory team
VSST veterinary service support team
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ARMY HEALTH SYSTEM SUPPORT TO THE COMPETITION
CONTINUUM
4-1.
Joint doctrine and FM 3-0 describes the strategic security environment in terms of a competition
continuum. Rather than a world either at peace or at war, the competition continuum describes three broad
categories of strategic relationships—cooperation, competition below armed conflict, and armed conflict. Each
relationship is defined as between the United States and another strategic actor relative to a specific set of policy
aims. (See JP 3-0 and FM 3-0 for more information about the joint competition continuum.)
4-2.
Although combatant commands and theater armies’ campaign across the competition continuum, Army
tactical formations (corps and below) typically conduct operations within a context dominated by one strategic
relationship at a time. Therefore, Army doctrine describes the strategic situation through three contexts in which
Army forces conduct operations:
⚫ Competition below armed conflict, also called competition.
⚫ Crisis.
⚫ Armed conflict.
4-3.
The Army strategic contexts generally correspond to the joint competition continuum. Because
cooperation is generally conducted with an ally or partner to counter an adversary or enemy, Army doctrine
considers it part of competition. Army doctrine adds crisis to account for the unique challenges facing ground
forces that often characterize transition between competition and armed conflict.
4-4.
Operational Medicine forces support the competition continuum by continuous coordinating,
synchronizing, integrating, planning, and executing AHS support at echelon. Key factors include:
⚫ Managing institutional force support to the operational Army.
⚫ Identifying health threats.
⚫ Applying the AHS principles in the AHS support plan.
⚫ Providing medical C2 to synchronize and integrate the nine medical functions (FHP and HSS).
⚫ Providing FHP (operational public health, veterinary services, combat and operational stress
control, dental services, and laboratory services).
⚫ Providing HSS (medical treatment [organic and area support], hospitalization, MEDEVAC [to
include medical regulating], and MEDLOG [to include blood management]).
⚫ Managing health information systems.
⚫ Determining eligibility of care.
⚫ Advising the AHS effects of the law of land warfare and medical ethics.
⚫ Providing Army medical support to other Services and Unified Action Partners.
Figure 4-1. Army strategic contexts and operational categories
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ARMY HEALTH SYSTEM SUPPORT TO THE ARMY STRATEGIC CONTEXT COMPETITION
4-5.
Competition below armed conflict exists when two or more state or non-state adversaries have
incompatible interests, but neither seeks armed conflict. Nation-states compete with each other using all
instruments of national power to gain and maintain advantages that help them achieve their goals. Low levels of
lethal force can be a part of competition below armed conflict. Adversaries often employ cyberspace capabilities
and information warfare to destroy or disrupt infrastructure, interfere with government processes, and conduct
activities in a way that does not cause the United States and its allies to respond with force. Competition provides
military forces time to prepare for armed conflict, opportunities to assure allies and partners of resolve and
commitment, and time and space to set the necessary conditions to prevent crisis or conflict. Examples of
competition include return of forces to Europe (known as REFORGER) exercises conducted during the Cold War,
security assistance provided to Ukraine since 2014, and Pacific Pathways activities to improve readiness in the
Indo-pacific region. (See FM 30, Chapter 4 for a detailed discussion of Army forces during competition.)
4-6.
During operations to competition, medical C2 elements execute the CCDR’s daily AHS support
requirements, begin preparing for deployment, medically set the theater, provide medical area support, plan AHS
support operations against a determined adversary with anti-access/area-denial (A2/AD) capabilities, and conduct
contingency planning for crisis and armed conflict. Operational medicine forces can also assist by improving the
medical capabilities and capacity of our allies and partners through military and global health engagements.
4-7.
This is the time to train and set conditions to win the next conflict by ensuring the readiness (to include
medical readiness) of personnel, equipment, and sufficiency of materiel (operational readiness). Participate in
combined exercises (including unified action partners), and deploy to combat training centers (organic support)
as part of the parent organization. Train and develop personnel in the formation and key leaders. Conduct
contingency planning, to include gathering medical intelligence on the area of interest. Conduct emergency
deployment readiness exercise with combat load.
4-8.
Medical planners should identify other training requirements during mission analysis and plan for the
integration of multi-COMPOs medical units in the fight. Plan for and practice operations security (OPSEC).
Reduce visual, aural, and electromagnetic signatures across the spectrum. Plan for and conduct appropriate
concealment and camouflage techniques when moving and setting.
4-9.
In each of the Army’s three strategic context, Army forces consolidate gains. Operational Medicine
forces consolidate gains most effectively by maintaining a persistent or permanent presence in a theater of
operations and continuing support to the medical forces of allies and partners. Operational Medicine forces
consolidate gains by reinforcing the success of steady-state competition medical activities. Consolidate gains
requires that medical treatment is considered for the support of both stability tasks (restore essential services) as
well as providing required support of the deployed force and potential follow on force. Any shortage of medical
equipment, Class VIII, and personnel should be addressed now. If there is a requirement for follow on forces, a
plan for transfer of authority that addresses any FHP, HSS, host nation, and multinational partner issues.
Interaction with the host nation and populace is key particularly after a fight with new follow on forces flowing
in. The transfer of direct patient care responsibilities is as important for the health of the command and individual
Soldier as conduct of the initial entry operations over the long haul. Postdeployment health assessments, with
preparation of redeployment should address potential behavioral health concerns as well.
4-10.
Medical commanders must plan for and be prepared to transition to crisis and armed conflict. Transitions
are inherently complex and unpredictable because anticipated environmental conditions can quickly change and
alter the perception of strategic leaders who do not have all the information necessary for clear understanding.
Medically, transitions are supported by ensuring a flexible and agile medically ready force and ready medical
force are available to the combatant commander. Forward stationed forces should be prepared to deploy from
garrison to dispersed locations to prepare a defense against an enemy attack. Equally important is ensuring that
forward stationed Operational Medicine forces are prepared to support three courses of action; integrate with
host-nation land component forces as part of a mobile or area defense, assign U.S. Army forces a theater reserve
role, or implement a plan that combines both courses of action.
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Figure 4-2. Army Health System support to the Army strategic context competition
ARMY HEALTH SYSTEM SUPPORT TO THE ARMY STRATEGIC CONTEXT CRISIS
4-11.
A crisis is an emerging incident or situation involving a possible threat to the United States, its citizens,
military forces, or vital interests that develops rapidly and creates a condition of such diplomatic, economic, or
military importance that commitment of military forces and resources is contemplated to achieve national and/or
strategic objectives (JP 3-0). Crisis response operations are characterized by high degrees of volatility and
uncertainty. A crisis may erupt with no warning, or it may be well anticipated. Its duration is unpredictable—it
may end swiftly with a return to competition or an escalation to armed conflict. Regardless of the capabilities
employed, there are generally two broad outcomes from a crisis. Either deterrence is maintained and de-escalation
occurs, or armed conflict begins.
4-12.
The military supports unified action partners during crisis by providing flexible deterrent and response
options. A flexible deterrent option (FDO) is a planning construct intended to facilitate early decision making by
developing a wide range of interrelated responses that begin with deterrent-oriented actions carefully tailored to
create a desired effect. A flexible response option (FRO) is a military capability specifically task-organized for
effective reaction to an enemy threat or attack and adaptable to the existing circumstances of a crisis.
4-13.
FDOs and FROs serve three basic purposes. First, they provide a visible and credible message to
adversaries about the U.S. will and capability to resist aggression. Second, they position U.S. forces in a manner
that facilitates implementation of the operations or contingency plan should armed conflict occur. Third, they
provide options for joint and national senior leaders during crises. Operational Medicine forces support the Army
FDOs and FROs by—
⚫ Operational Medicine forces contribution examples to joint FDOs:
▪ Medical C2 headquarters—establishment of a TMC OCP or deployment of a MEDBDE
(SPT) or MMB.
▪ Additional medical personnel to expand the capability and capacity of the theater-level AHS.
▪ Continued AHS support planning.
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▪
Medical intelligence gathering to support situational understanding, information advantage
activities, and development of the MEDCOP.
▪ Ensure Operational Medicine forces are deployed and aligned according with the application
of the 6 AHS principles.
▪ Continuation of military and global health engagements.
⚫ Operational Medicine forces contribution examples to joint FROs:
▪ Medical support to the airborne or air assault units positioned to conduct joint forcible entry.
▪ Medical support to echelons positioned to conduct a penetration.
▪ Medical support to Army operations in a maritime-dominated environment.
▪ Medical Logistics support to port operations and break down of medical APS for arriving
Operational Medicine forces.
▪ Continuation of military and global health engagements.
4-14.
Medical C2 elements support the theater by ensuring service-specific requirements within the AOR
during a crisis are completed. This may include—
• Medically supporting RSOI operations for arriving forces; and the completion of collective training,
theater orientation, and theater acclimation.
• Providing AHS support and planning within the theater.
• Serving as theater lead agent for veterinary services.
4-15.
Force projection is the ability to project the military instrument of national power from the United States
or another theater, in response to requirements for military operations (JP 3-0). Force projection is particularly
important during crisis, as operational medicine forces have an unknown amount of time to medically support a
developing situation. Army forces achieve persistent presence by deploying forces into a theater to support
forward stationed U.S. forces, or those of allies or partners. During a crisis, ground forces provide more enduring
options than forces primarily concentrated in or transiting other domains. Army forces are capable of occupying
ground indefinitely but they must be medically supported just like other Services. To achieve this, Operational
Medicine force commanders need to—
⚫ Prepare to medically support the response to provocations, indications, or warnings that hostile
activities may commence.
⚫ Execute medical tasks, activities, and operations in support of deterring further malign activity and
set conditions for success should deterrence fail.
⚫ Anticipate an adversary using all available means to contest the deployment of forces, beginning
from home station, during transit, and upon arrival in theater and develop COAs to medically
support each.
⚫ Conduct a final review of deployed Operational Medicine forces, ensuring they are deployed in the
proper sequence according to the 6 AHS principles, and are able to be task-organized effectively
to medically support the anticipated mission.
4-16.
During crisis operations, increased readiness and force projection may result in increased injury; in
addition, these activities provide an opportunity for associated Operational Medicine forces to participate in
individual and collective training opportunities.
4-17.
This is an opportunity during set the theater for units to establish or improve bases. During this activity,
medical treatment access, protection, and inclusion in this activity is utilized. Operational Medicine forces support
setting the theater by performing FHP measures and ensuring access to MTFs.
4-18.
Units are prepared to provide direct and area medical support as needed for units on station without
requisite medical support, or integration of additive medical treatment support arriving on station.
4-19.
During mobilization, training, readiness, and predeployment health assessments and activities take place.
Employment include but are not limited to, entry operations, offensive operations, defensive operations, security
and stability tasks and all those activities imply for the entire AHS.
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4-20.
During and after crisis response, Army forces consolidate gains to deny adversary forces the means to
extend or deepen the crisis. This will often entail maintaining an enhanced force posture in a JOA for a time to
demonstrate U.S. willingness to defend allies and partners.
4-21.
There are two outcomes of a crisis—a de-escalation to competition or an escalation to armed conflict.
Transitions are typically points of friction. Medical commanders emphasize reconsolidating and medically
supplying their units prior to and during transitions. In order to position their forces to medically support the
initiative, medical commanders pay close attention to higher headquarters information collection in order to
maintain a detailed understanding of the threat and continuously assess the situation. Operational Medicine forces
must be prepared to transition to other Army strategic contexts which include:
⚫ Transitioning back to competition by:
▪ During a crisis, partner nation security forces and government institutions may suffer losses
that reduce medical capability and capacity due to the actions of adversary or proxy forces.
▪ Operational Medicine forces may be tasked to engage in global medical engagements to help
restore or maintain partner nation capabilities and capacity as a means to consolidate gains
and maintain popular support.
⚫ Transitioning to armed conflict:
▪ Operational Medicine forces responding to a crisis are prepared for and expect to medically
support the fight. This saves time during the transition and requires an understanding of the
OPLAN or likely concept of operations as early as possible.
▪ Forward positioned Operational Medicine forces reposition into battle positions or tactical
assembly areas and take all available measures to protect themselves from attack in every
domain as they prepare for combat.
▪ When located with allied or partner units, Operational Medicine forces synchronize their
activities to ensure unified action, unity of purpose, and mutual support.
Figure 4-3. Army Health System support to the Army strategic context crisis
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ARMY HEALTH SYSTEM SUPPORT TO THE ARMY STRATEGIC CONTEXT ARMED CONFLICT
4-22.
Armed conflict occurs when a state or non-state actor uses lethal force as the primary means to satisfy
its interests. Armed conflict can range from irregular warfare to conventional warfare and combinations of both.
Entering into and terminating armed conflict is a political decision. Army forces may enter conflict with some
advanced warning during a prolonged crisis or with little warning during competition. How well Army forces are
prepared to enter into an armed conflict ultimately depends upon decisions and preparations made during
competition and crisis. The employment of lethal force is the defining characteristic of armed conflict and is the
primary function of the Army.
4-23.
During armed conflict, operations can reflect combinations of irregular warfare (counterinsurgency and
unconventional) and conventional warfare and vary widely based on the enemy’s capability. Leaders apply the
doctrine of LSCO during limited contingencies that require conventional warfare approaches. Large-scale combat
operations introduce levels of complexity, lethality, ambiguity, and speed to military activities not common in
other operations. Army forces may execute LSCO during defensive and offensive operations in a supporting,
enabling, or advisory role, instead of constituting the bulk of ground maneuver forces.
4-24.
Medical commanders and staff must take into consideration how the enemy approaches armed conflict.
Russia’s approach to armed conflict is centered on creating constraints that prevent U.S campaign success and
their methodologies focus on four key areas:
⚫ Disrupt or prevent understanding of the OE. Russian information warfare (informatsionnaya
voyna- IV) activities manipulate the acquisition, transmission, and presentation of information in
a way that suits Russia’s preferred outcomes.
⚫ Target stability. Russia may foster instability in key areas and among key groups so that regional
security conditions do not support U.S. operational requirements.
⚫ Disaggregate partnerships. Russia would act upon U.S. allies and partners to reduce the ability of
the United States to operate in its preferred combined, joint, and interagency manner.
⚫ Prevent access. Russia employs pre-conflict activities to deny access to U.S. forces, using
nonlethal means initially and transitioning to lethal means if necessary.
4-25.
Meanwhile China considers three aspects in the country’s view of conflict: comprehensive national
power, deception, and the Three Warfares. The three aspects of conflict are:
⚫ Comprehensive national power is made up of hard power and soft power. The two comprehensive
national powers are:
▪ Hard power includes military capability and capacity, defense industry capability, intelligence
capability, and related diplomatic actions such as threats and coercion.
▪ Soft power includes such things as economic power, diplomatic efforts, foreign development,
global image, and international prestige.
⚫ Deception in the People’s Liberation Army planners employ stratagems to achieve their deception
goals. Stratagems describe the enemy’s mindset, focusing on how to achieve the desired
perceptions by the opponent, and then prescribing ways to exploit those perceptions.
⚫ The Three Warfares:
▪ Public opinion warfare is China’s high-level information campaign designed to set the terms
of political discussion.
▪ Psychological warfare is similar to U.S. military information support operations in that it is
intended to influence the behavior of a given audience.
▪ Legal warfare for China is the setting of legal conditions for victory—both domestically and
internationally.
4-26.
Medical commanders and staff anticipate the enemy’s relative, physical, information, and human
advantages and develop an AHS support plan that best supports U.S. forces. As part of the joint force, the
operational medicine force contributes to the joint force by extending AHS support to other Services through a
variety of actions. They include—
⚫ Establish theater medical C2 on land, including task-organizing operational medicine forces for
their purpose.
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⚫
Medically support LSCO, including the AHS support of forward stationed forces in the defense,
offense, enabling operations, Army operations in a maritime-dominated environment, and joint
forcible entry operations.
⚫ Conduct AHS support in rear areas.
⚫ Perform as sole provider of veterinary services for the DOD.
⚫ Medically consolidate gains at every opportunity.
4-27.
Medical commanders must plan to medically support the transition to offense and stability while
conducting defensive operations, and likewise to defense and stability while conducting offensive operations.
Friendly forces may have to reposition forces on defensible terrain and develop a form of defense and scheme of
maneuver based on an assessment of the mission variables. A successful offense can also require a transition to
operations dominated by stability and a strategic environment that transitions to post-conflict competition that
supports political goals.
4-28.
Ultimately U.S forces will transition to post-conflict competition. As hostilities end, stability tasks
dominate operations and have the ultimate goal of transitioning responsibilities to legitimate authorities. Utilizing
medical C2, the medical functions, and, the AHS principles, medical commanders must be prepared to shift
operational medicine forces to put them in the best position to support U.S. forces, host-nation, or other
provisional governments.
Figure 4-4. Army Health System support to the Army strategic context armed conflict
COMPETITION BELOW ARMED CONFLICT
4-29.
Competition activities are continuous within an AOR. The combatant command (command authority)
uses them to improve security within partner nations, enhance international legitimacy, gain multinational
cooperation, and influence adversary decision making. This cooperation includes information exchange and
intelligence sharing, obtaining access for U.S. forces in peacetime and crisis, and mitigating conditions that could
lead to a crisis.
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4-30.
Competition activities are directly tied to authorities provided in various titles of the United States Code
and approved programs, and integrated and synchronized with the Department of State, other government
agencies, country teams, and ambassadors' plans and objectives. The Department of State and the United States
Agency for International Development develop the joint regional strategy to address regional goals, management,
operational considerations, and resources. Each country team develops an individual country plan to address
country context, joint mission goals, and coordinated strategies for development, cooperation, security, and
diplomatic activities. Working with the Department of State and various country teams, the geographic combatant
commander (GCC) and planners develop a theater strategy to influence regional and country conditions to achieve
national objectives. The theater strategy is translated into a theater campaign plan (TCP). The TCP guides the
shaping activities conducted throughout the AOR by joint forces.
4-31.
The ASCC significantly contributes to the planning, execution, and assessment of the GCC’s TCP.
Army forces conduct operations to shape with various unified action partners through careful coordination and
synchronization facilitated by the ASCC through the GCC, and when authorized, directly with the partner nation's
military forces. Army forces provide security cooperation capabilities AOR-wide, including building defense
and security relationships and partner military capacity through exercises and engagements, gaining or
maintaining access to populations, supporting infrastructure through assistance visits, and fulfilling executive
agent responsibilities. Military-to-military contacts and exchanges, joint and combined exercises, various longterm persistent military engagements, and other security cooperation activities provide the foundation of the
GCC’s TCP.
MEDICAL COMMAND AND CONTROL
4-32.
Competition below armed conflict occurs when an adversary’s national interests are incompatible with
U.S. interests, and that adversary is willing to actively pursue them short of open armed conflict. Operations
during competition are intended to deter malign adversary action, set conditions for armed conflict on favorable
terms when deterrence fails, and shape an OE with allies and partners in ways that support U.S. strategic interests
and policy aims. These operations are conducted over time and across broad areas not involving armed conflict.
Army forces contribute to conventional deterrence during competition by preparing for armed conflict, including
LSCO. This includes assisting allies and partners to improve their military capabilities and capacity. Preparation
for combat operations and demonstrating the interoperability of the U.S. joint force with allies and partners
presents the strongest deterrence to adversaries. This may include cooperative training, support to local
institutions, construction projects, and a range of other activities. The graphics depict the scope and scale across
the competition continuum required of medical C2 in coordinating, synchronizing, integrating, and planning AHS
support. In support of competition operations, medical C2 elements are focused on:
⚫ Planning, preparing, executing, and assessing health and medical support.
⚫ Regionally focused medical C2 to promote unity of purpose of all engaged medical assets at
echelon.
⚫ Medical information and communication to identify and mitigate health threats and document
health threat exposures and medical encounters, to report health surveillance data and information
on the health of the command, and to accomplish medical regulating and patient tracking
operations.
⚫ Planning and implementing global health engagements in support of the combatant commander’s
intent.
⚫ Traditional medical training (including joint and multinational) and support to a deployed force
engaged in performing these tasks in support of each strategic context within the competition
continuum.
⚫ Medical expertise and consultation to enhance building partnership capacity in public, private, and
military health sectors of the host nation.
⚫ Development of regional theater security cooperation plans aimed at mitigating or resolving the
underlying causes of health issues prevalent within the region.
4-33.
Consolidation of gains and transitions are conducted within each strategic context. Medical C2 elements
must always keep consolidation of gains and transitions in the forefront. Based off METT-TC (I), in competition,
medical C2 elements should assess and modify AHS contingency or OPLAN in support of crisis and armed
conflict operations. Likewise, in crisis, medical C2 elements should assess and modify AHS contingency or
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OPLANs in support of operations for returning to competition and forward to medically supporting armed
conflict. And in armed conflict medical C2 elements should assess and modify AHS contingency or OPLANs in
support of returning to a state of crisis or competition. For consolidation of gains across the competition
continuum, medical C2 elements are focused on:
⚫ Coordinating, synchronizing, and integrating AHS resources into the interagency efforts. Provide
medical expertise to identify and analyze critical needs emerging within the operational area.
⚫ Managing medical information to facilitate medical regulating of victims to facilities outside of the
operational area and to document medical treatment.
⚫ Assisting affected host nation medical infrastructure in saving lives, reducing long-term disability,
and alleviating human suffering.
⚫ Assisting the local government in conducting rescue operations and providing MEDEVAC of
victims to facilities capable of providing the required care.
⚫ Advising local animal, agricultural, and veterinary industry personnel; assess damage of veterinary
and animal infrastructure; and provide animal medical care to local animals.
⚫ Conducting preventive measures to respond to and resolve emerging health threats caused by
armed conflict
⚫ Conducting health risk assessment and communications.
⚫ Assisting host nation to reestablish its own ability to provide medical services for its population to
a reasonable level it possessed prior to crisis or armed conflict and to support the legitimacy of the
host nation.
⚫ Continuing to assess running estimates and be prepared to provide all facets of AHS support while
either increasing of reducing capacities in support of each strategic context across the competition
continuum, redeployment operations, or downsizing the footprint in theater (i.e.: reducing the
number of ICU and ICW beds).During operations to Shape, plan for deployment and conduct of
operations against a determined adversary with anti-access/anti-denial (A2/AD) capabilities.
Medical assets may participate in building capacity and partnerships through host-nation and
multinational partners.
⚫ This is the time to train and set conditions to win the next conflict by ensuring the readiness of
personnel, equipment, and sufficiency of materiel (operational readiness). Participate in combined
exercises, and deploy to combat training centers (organic support) as part of the parent
organization. Develop personnel in the formation and key leaders. Conduct contingency planning.
Conduct emergency deployment readiness exercise with the combat load.
⚫ Planners should identify other training requirements during mission analysis and plan for
integration of Army special operations forces (ARSOF) and conventional forces in the fight. Plan
for and practice operations security (OPSEC). Reduce visual, aural, and electromagnetic
signatures across the spectrum. Plan for and conduct appropriate concealment and camouflage
techniques when moving and set.
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Figure 4-5. Medical Command and Control in Competition
OPERATIONAL PUBLIC HEALTH
4-34.
The focus of operational public health in competition is to gather information on health threats and
produce real-time tactically significant medical threat profiles. During competition, the only operational public
health assets available to deployed forces will be the BSMC preventive medicine section which consists of a
General Dental Officer and a Dental Specialist for a population at risk of up to 5,000 Soldiers. In competition,
dental readiness is fundamental to maintaining unit readiness and reducing noncombat dental casualties during
deployments. Mobilization and deployment dental processing will create a massive dental workload. Dental
capability may be depleted by deployment of active army dental personnel. Preventive medicine (PVNTMED)
support is designed to prevent patients from DNBI through medical surveillance, OEH surveillance, and health
assessments, PMM of hygiene and sanitation, and personal protective measures. Medical planners, in conjunction
with the TMC or MEDBDE (SPT), must ensure that a thorough analysis of the existing health threat has been
accomplished and of the host nation’s ability to mitigate or reduce the health threat. The health threat analysis is
then used in the development of the mitigation and medical requirements for a given operation.
4-35.
Operations in competition are designed to bring together those activities intended to promote regional
stability and to set the conditions for a favorable outcome in the event of a military confrontation. Army operations
in competition are also conducted to dissuade adversaries from potential military conflict. As part of competition
operations, the Army maintains trained and ready forces to support campaign plans, to serve as a forward presence
to promote U.S. interests, to react to contingencies, and to develop the military capabilities of allied and friendly
nations.
4-36.
During competition, the PVNTMED detachment is more than likely still at home station. Through the
orders process, elements of the PVNTMED detachment may deploy during any strategic context. When deployed
the PVNTMED detachment or teams are assigned to the TMC, MEDBDE (SPT) , MMB, a Role 2 MCAS, or a
task force medical mission control headquarters in the Corps or EAB. The detachment may be attached to a unit
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in the brigade, corps, or EAB. Per its basis of allocation, the PVNTMED detachment is deployed per 17,000
personnel supported at the corps or EAB.
4-37.
Preventive medicine detachments and teams possess the trained personnel and equipment ready to
deploy to a theater and to provide the expertise to counter health threats in support of competition operations.
They are closely involved in Soldier readiness activities for deploying forces and engage in partnerships with
UAPs. Preventive medicine personnel are also deployed with both early-entry and follow-on forces to identify
and address local health threats. Major PVNTMED planning considerations for competition operations consist
of the following: building partner capability and capacity; collecting medical intelligence and identifying health
threats; ensuring supported units have completed pre-deployment PVNTMED related training (that is, field
sanitation team training, basic food and drinking water safety, etc.) and conducting health threat briefings. More
specifically, preventive medicine operations to competition also consist of the following: comprehensive health
surveillance, identification of medical health threats, conduct field sanitation team training, provide food service
training, provide health threat briefings, health promotion education, conduct health threat analysis, develop pest
management plan, and provide information on PMM to counter health threats.
4-38.
Consolidation of gains are the activities designed to make enduring any temporary operational success
and set the conditions for a stable environment allowing for a transition of control to legitimate authorities.
Consolidation Gains will be conducted by Army forces throughout the range of military operations and within
each strategic context. In support of consolidation of gains during competition, preventive medicine units' efforts
may consist mainly in the area of building UAP capabilities and preparing for incoming preventive medicine
detachments. Activities also include transition and reconstitution efforts. In addition, PVNTMED personnel will
be involved in efforts to support units engaged in redeployment. During transition operations, PVNTMED
detachments, teams, and medical planners should assess and modify PVNTMED contingency or OPLANs in
support of crisis and armed conflict operations.
Figure 4-6. Operational Public Health in Competition
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VETERINARY SERVICES
4-39.
Veterinary services are provided to enhance the health of the force through three broad-based
functions—
⚫ Provide veterinary medical care for military/contract working dogs and other government owned
animals.
⚫ Conduct food protection activities to ensure quality, food safety, food defense, and wholesome
food supply for deployed forces.
⚫ Execute veterinary public health activities to mitigate zoonotic disease threats to deployed forces
and mitigate the impact of animal disease to working animals, U.S. agricultural systems, and
partner nations.
4-40.
As the DOD sole provider, the Army provides veterinary service support to the USAF (minus food
inspection support on USAF installations), Army, USN, and USMC forces, as well as other federal agencies, host
nation, and multinational forces, when directed.
4-41.
Veterinary services during competition includes ensuring that military working animals are healthy and
ready to deploy and continuing the food protection mission, which consists of sanitation audit inspections of food
establishments and inspecting operational rations [ready to eat meals and unitized group rations]), as well as
ensuring that military working animals are healthy and ready to deploy. More specifically, veterinary services
during competition may also include—
⚫ Identifying animal diseases of military significance (zoonotic and economic),
⚫ Providing preventive and medical care to government owned animals,
⚫ Conducting sanitation audits of commercial food sources for DOD procurement,
⚫ Conducting inspections for food safety, quality, and sanitation,
⚫ Conducting food defense vulnerability assessments as well as food and water risk assessments,
⚫ Conducting animal facility inspections, and
⚫ Providing veterinary support to stability operations.
4-42.
Veterinary services assets are present across the range of military operations. During competition, the
MDVS is more than likely still at home station. Through the orders process, elements of the MDVS may deploy
during any strategic context. When deployed, the MDVS is assigned to the TMC, MEDBDE (SPT), or MMB.
Per its basis of allocation, one MDVS per 60,000 personnel supported in all U.S. forces, DOD components &
other units/organizations as directed or one per 300 MWD & DOD contracted working dogs in support of all U.S.
forces, DOD components & other units/organizations as directed or one per senior Army HQs (For Army support
to other Services, add three additional MDVSs).
4-43.
During the consolidation of gains, as the DOD sole provider, Army veterinary service personnel continue
in general or direct support of the USMC, USN, and USAF. Army veterinary services personnel may provide
support to other federal agencies, host nations, and multinational forces, as directed. The Army veterinary
services food protection, veterinary medical care, and veterinary public health missions remain unchanged.
Additional global health engagement or stability tasks for veterinary service personnel include advising local
animal, agricultural, and veterinary industry personnel; assessing damage of veterinary and animal infrastructure;
and providing veterinary medical care to local animals. In addition, the transition of veterinary service missions
to host nations, with the main effort being building host-nation veterinary capabilities. During transition
operations, medical planners should assess and modify veterinary services contingency or OPLANs in support of
crisis and armed conflict operations.
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Figure 4-7. Veterinary Services in Competition
COMBAT AND OPERATIONAL STRESS CONTROL
4-44.
The focus of COSC services in competition is on returning Soldiers to duty as far forward as possible.
During competition, the only COSC services available to deployed forces will be the BSMC behavioral health
section that consists of a two behavioral science officers, a behavioral health NCO, and a behavioral health
specialists for a population at risk of up to 5,000 Soldiers. In competition, mobilization and deployment
behavioral health processing will create a massive workload. Behavioral health capabilities may be depleted by
deployment of active army behavioral health personnel.
4-45.
During competition, COSC detachments have the difficult training tasks associated with remaining ready
to deploy to a TO. This may include sending behavioral health teams to combat training centers to be attached to
or in direct support of the maneuver unit. In addition to ensuring they, themselves, are trained and prepared to
deploy, they may support Soldier readiness activities. These activities may include training and education of
Soldiers and leaders on all aspects of remaining mentally healthy during operations. Additionally, COSC
detachments may support ongoing engagements with partner nations to increase those nations’ capacities and
capabilities to provide behavioral health care. While conducting medical engagements, the staff is gaining a great
deal of situational understanding of the medical capabilities and health threats within the operational area, both
will be important if a large-scale deployment occurs in the area.
4-46.
During competition, the COSC is more than likely still at home station. Through the orders process,
elements of the COSC may deploy during any strategic context. When deployed the COSC is assigned to the
MMB and per its basis of allocation of one COSC per 39,000 Army population supported provides COSC services
within the theater, corps, and division echelons. During transition operations, medical planners should assess and
modify COSC services contingency or OPLANs in support of crisis and armed conflict operations.
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Figure 4-8. COSC in Competition
DENTAL SERVICES
4-47.
The focus of dental services in competition is operational dental care. This focuses on returning Soldiers
to duty as far forward as possible. During competition, the only dental services available to deployed forces may
be the BSMC area support squad’s dental team that consists of a General Dental Officer and a Dental Specialist
for a population at risk of up to 5,000 Soldiers. In competition, dental readiness is fundamental to maintaining
unit readiness and reducing noncombat dental casualties during deployments. Mobilization and deployment
dental processing will create a massive dental workload. Dental capability may be depleted by deployment of
active army dental personnel. Lessons learned from previous mobilizations indicate that—
⚫ Little time is available for treatment of dental emergencies during mobilization and deployment
operations.
⚫ High levels of dental readiness and dental preparedness reduce mobilization dental processing and
treatment time.
⚫ Three to five days is the average length of time a Soldier is lost to their unit when they must be
evacuated for dental emergencies.
4-48.
During competition, the DCAS is more than likely still at home station. Through the orders process,
elements of the DCAS may deploy during any strategic context. When deployed the DCAS is assigned to the
MEDBDE (SPT) and per its basis of allocation of one DCAS per 43,000 Army population supported provides
operational dental services within the theater, corps, and division echelons. During transition operations, medical
planners should assess and modify dental services contingency or OPLANs in support of crisis and armed conflict
operations.
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Figure 4-9. Dental Services in Competition
LABORATORY SERVICES
4-49.
During competition, the only medical laboratory services available to deployed forces may be the BSMC
clinical lab personnel assigned to the area support squad which consists of a laboratory specialist capable of
performing basic clinical laboratory for a population at risk of up to 5,000 Soldiers. The Role 2 can provide tests
to support diagnosis and care of Disease and Non-Battle Injuries (DNBI). This set contains a wide range of
laboratory equipment and reagents that will be utilized by a laboratory specialist to perform diagnostic tests. The
cardiac test panel, and its associated support items, has been added to the set. This provides a tool to effectively
guide early and appropriate patient management and therapy decisions, and diagnosis of an acute coronary
syndrome (ACS). At a minimum, the Role 2 can perform the following tests:
⚫ Basic Hematology Studies.
⚫ Basic Microbiology Testing.
⚫ Basic Chemistry Testing.
⚫ Basic Serology Testing.
⚫ Blood Bank.
4-50.
Medical laboratory service is considered one of the ten medical functions under the AHS and its mission
is under the FHP warfighting function. The Area Medical Laboratory (AML) includes capabilities in the
identification and theater validation of suspect CBRN agents, endemic diseases, and OEH hazards. Its focus is
the total health environment of the AO, not individual patient care. The AML is the Army’s specialized theater
laboratory that deploys worldwide as a unit or by task organizing teams to perform surveillance, analytical
laboratory testing, and health hazard assessments of environmental, occupational, endemic, and CBRN threats in
support of Soldier protection and weapons of mass destruction missions. It can perform tests on air, water, soil,
food, waste, and both insect and animal vectors for a broad range of microbiological, radiological, and/or chemical
contaminants under two basic scenarios. First, it provides theater validation level of identification in support of
TO. Second, in contingency operations, it provides immediate hazard identification in high-risk environments
and rapid laboratory analysis and theater validation level of identification to assist commanders in operational
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decision making. The AML is organized into teams: analytical chemistry section; microbiology section; and
OEH surveillance section.
4-51.
During competition, the AML can forward deploy select capabilities while the Headquarters and other
teams remain at home station. Through the orders process, elements of the AML may deploy during any strategic
context. When deployed the AML is assigned/attached to a TMC , a MEDBDE (SPT), the 20th CBRN Command,
and may be further attached to other deployed medical units as needed. The AML basis of allocation is one per
theater. During transition operations, medical planners should begin development of medical laboratory services
contingency or OPLANs in support of crisis or armed conflict operations.
Figure 4-10. Laboratory Services in Competition
MEDICAL TREATMENT (ORGANIC AND AREA SUPPORT)
4-52.
During competition operations, plan for deployment and conduct of operations against a determined
adversary with A2/AD capabilities. Medical treatment assets may participate in building capacity and
partnerships through host-nation, multinational, unified action partners. They continue to train in both clinical
and tactical procedures to standard both individually and collectively. This is the time to train and set conditions
to win the next conflict by ensuring the readiness of personnel, equipment, and sufficiency of materiel (operational
readiness). Participate in combined exercises and deploy to combat training centers (organic support) as part of
the parent organization. Plan for and practice OPSEC. Reduce visual, aural, and electromagnetic signatures across
the spectrum. Plan for and conduct appropriate concealment and camouflage techniques.
4-53.
Medical treatment is normally comprised of organic Role 1 BASs and Role 2 BSMCs within BCTs and
the EAB Role 2 MCAS that operates throughout theater providing medical treatment on an area basis. The medial
treatment assets organic to the BCT will deploy with the brigade. The EAB Role 2 MCAS deploys in accordance
with their basis of allocation which is 1 per 10,000 non-brigade troops supported in the committed
Brigade/Division HQs/Corps HQs and committed ASCC area. During transition operations, medical planners
should begin development of medical treatment contingency or OPLANs in support of crisis and armed conflict
operations.
4-54.
Consolidation of gains requires that medical treatment is considered for the support of both stability
tasks (restore essential services) as well as provided required support of the deployed force and potential followon forces. Any shortage of medical equipment, Class VIII, and personnel should be addressed now.
Postdeployment health assessments, with preparation of redeployment should address potential behavioral health
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concerns as well. If there is a plan for follow on forces, a plan for transfer of authority with any medical treatment
concerns, PVNTMED issues, host-nation matters, multinational and UAP involvement addressed as required.
Figure 4-11. Medical Treatment in Competition
HOSPITALIZATION
4-55.
During competition, the Role 3 hospital has the difficult training tasks associated with remaining ready
to deploy to a TO. Potentially, the two most difficult areas to remain proficient at are the clinical skills of the
health care providers and maintaining the ability to provide medical C2, especially considering elements that may
deploy as a part of a hospital are not organic to the senior mission commander. The hospitals conduct field
training exercises, staff exercises and Role 3 support to combat training centers and require medical providers to
attend these events. A large percentage of the providers work at defense health agency MTFs and remain
proficient in their individual skills. The challenge for the operational hospital is to integrate these providers into
hospital operations utilizing the assigned equipment, procedures, and clinical practice guidelines of the Role 3
hospital, which may be different than the installation MTF they are accustomed to working.
4-56.
Other operations include supporting Soldier readiness activities, assessing prepositioned stocks, and
planning/rehearsing elements of the hospital to provide limited Role 3 early entry support. Additionally, Role 3
hospitals can support ongoing engagements with host and partner nations to increase those nations’ capacities and
capabilities to provide medical care and participate in global health engagements. While conducting health
engagements, the hospital staff is gaining a great deal of situational awareness of the medical capabilities and
health threats within the operational area, both will be important if a large-scale deployment occurs to the area.
4-57.
During competition, the Role 3 hospital is more than likely still at home station. Through the orders
process, elements of the Role 3 hospital may deploy during any strategic context. When deployed the Role 3
hospital is assigned to the MEDBDE (SPT). The hospital center has many augmentation pieces to it. Based on
the orders process and population at risk factors, the HHD hospital center may have combinations of field
hospitals (32 bed), hospital augmentation detachments (surgical 24 bed), hospital augmentation detachments
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(medical 32 bed) , hospital augmentation detachments (intermediate care wards (60 bed), hospital augmentation
teams (head and neck), medical detachments (minimal care 120 bed) , or medial detachments, forward
resuscitative and surgical. The basis of allocation for the HHD hospital center is one per two field hospitals (32
bed) with the HHD deploying with the first field hospital (32 bed). Elements of the Role 3 hospital provide
hospitalization within the theater, corps, and division echelons. During transition operations, Role 3 hospital
planners should assess and modify Role 3 contingency or OPLANs in support of crisis and armed conflict
operations.
Figure 4-12. Hospitalization in Competition
MEDICAL EVACUATION (TO INCLUDE MEDICAL REGULATING)
4-58.
During competition, the organic ground ambulances of the Role 1 BAS and Role 2 BSMC provide the
primary means of MEDEVAC. At the Role 1 BAS this depends on the type of brigade which includes between
4 and 8 ground ambulance platforms of either wheeled or tracked variants. At the Role 2 BSMC there are 10
ground ambulance platforms of either wheeled or tracked variants. Six of these ground ambulances are in forward
ambulance squads and are of the same type as the Role 1 ground ambulances. These forward ground ambulances
are designed to be forward deployed with the maneuver battalions or cavalry squadron. The four remaining
ground ambulances are in two area ambulance squads designed to perform ground MEDEVAC on an area basis.
Maneuver battalion ground ambulances evacuate patients from CCP to the Role 1 BAS. The BSMC forward
ambulance crews are responsible for evacuating from the Role 1 BAS to the AXP. The area support ambulances
are responsible for picking up the patients at the AXP and evacuating them, to the Role 2 BSMC. Depending on
mission variables, the deployed brigade may have a forward support MEDEVAC platoon from the division
combat aviation brigade’s medical company, air ambulance. The FSMP consists of three (3) aircraft that can be
deployed independently or as a group. Total lift capability utilizing all assigned three (3) aircraft is 18 litter
patients or 21 ambulatory patients, or some combination thereof. Additionally, in accordance with the basis of
allocation of the MCGA, a maneuver brigade is authorized 8 ground ambulances from the MCGA. Throughout
the orders process, medical planners should consider this information in conjunction with planning estimates and
the population at risk.
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4-59.
In support of competition operations, MEDEVAC units will continue to train on individual, collective,
mission essential task list (commonly known as METL), conduct clinical training and rotations to sustain medical
skills and certifications, and pursue professional development courses. MEDEVAC units must be proficient not
only to conduct the primary MEDEVAC tasks, but to rapidly disassemble their equipment, move to a new
location, and re-establish themselves to respond to MEDEVAC requests, under all weather conditions. Medical
planners should attend staff courses such as the joint medical planner’s course when available, especially for 67J
and 70H (officer) and 68W (enlisted) occupational specialties on division or corps staff. Key MEDEVAC
activities during competition may include support to military exercises and involve additional requirements such
as support to ship to shore and shore to ship or overwater missions. Associated requirements such as deck landing
qualification, helicopter emergency underwater egress and helicopter emergency egress devise training should be
identified early in order to ensure it is included in training plans. Staff exercises may be held at tactical through
operational levels to train and rehearse the planning and operation of a MEDEVAC system including CCPs,
ambulance exchange points (AXPs), the ambulance shuttle system, evacuation routes, MEDEVAC requests,
synchronization of MTFs, and medical regulating. Units may prepare time-phased and deployment data, update
equipment sets, and prepare containers and vehicles for deployment.
4-60.
Military engagements include interactions with foreign military medical personnel and foreign and
domestic civilian authorities. The MEDEVAC units can support security cooperation and security force
assistance goals through activities such as MEDEVAC training to build partner capacity. MEDEVAC support to
foreign internal defense may be constrained by the number of MEDEVAC vehicles and type and location of
MTFs. In some instances, CASEVAC may be utilized to move a casualty to a MTF or an AXP manned by
MEDEVAC aircraft due to extended distances and limited assets. Humanitarian assistance missions provide
Army MEDEVAC units opportunity to perform its mission while strengthening partnership between the U.S. and
the supported nation.
4-61.
Consolidation of gains in support of competition may include security and stability tasks. It may also
include continued supporting to training events and force projection. MEDEVAC assets should take the time
during competition to learn local road networks and terrain, locations and capabilities of MTFs by Role of care,
and building relationships within their supported areas of operation. Consolidation of gains MEDEVAC support
during competition may be on an area or direct support basis to maneuver forces in corps or division areas of
operation. MEDEVAC operations follows the traditional support provided to combat forces. MEDEVAC support
during consolidation of gains may require a MEDEVAC company to provide direct support to maneuver forces
in one area while supporting stability tasks in another. During transition operations, MEDEVAC assets and
medical planners should assess and modify MEDEVAC support contingency or OPLANs in support of crisis or
armed conflict operations.
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Figure 4-13. Medical Evacuation in Competition
MEDICAL LOGISTICS (TO INCLUDE BLOOD MANAGEMENT)
4-62.
Providing AHS support to set the theater establishes the foundation for planning, sustaining, and
achieving effective medical support to the TCP. During competition operations strategic and theater level medical
organizations work together to set the theater and coordinate with sustainment organizations at echelon for
maintenance, transportation, supply, distribution, and engineering support for the full range of medical operations.
The U.S. Army Medical Logistics Command manages and maintains medical Army Pre-positioned Stock (APS)
assets and provides the Class VIII portion of APS readiness reporting up through the Army Materiel Command.
Under a strategic partnership between Army Medicine and the Defense Logistics Agency, installation medical
supply activities at designated Army installations conduct medical materiel management and supply support
operations using the Defense Working Capital Fund.
4-63.
During competition, the TMC or MEDBDE (SPT) develop the theater medical maintenance strategy to
put in place procedures that ensure lifesaving medical equipment is regularly inspected and that the flow for
repairing non mission capable pieces of medical equipment is developed, rehearsed, and put into OPLANS and
OPORDS. Medical Logistics assets are more than likely still at home station. In competition, the only MEDLOG
assets available to deployed forces may be the organic brigade medical supply office (BMSO) assigned to the
Role 2 BSMC. The BMSO is capable of Class VIII supply and resupply to units in the brigade area and is
responsible for providing Class VIII supplies and equipment, to include unit-level medical maintenance and
repair, and executes the brigade MEDLOG plans. Throughout the order process, medical planners need to take
this into consideration within their planning estimates and population at risk factors regarding MEDLOG.
4-64.
At the theater strategic level, the ASCC surgeon develops the theater MEDLOG plan to meet Army and
joint FHP and HSS requirements that are specific to the region. Efforts would be made where appropriate, to
initiate multinational support agreements for Class VIIIb (blood and blood products) and for medical maintenance
for the joint operations area. The TMC executes and directs theater MEDLOG support through use of modular
MEDLOG units, to include the MLC (with possible use of the MLC early entry team for Class VIIIa and medical
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device maintenance support for early deploying units) and the 6th Medical Logistics Management Center assigned
to the theater force pool and task organized as required to the MEDBDE (SPT) assigned to the TMC or attached
to the ASCC. Coordination through G-4 (S-4) channels for development of medical operational requirements for
medical and nonmedical contracts is also a key activity is support of competition. In competition the MLMC
early entry teams and MLC’s early entry section play a key part in medically setting the theater.
MLMC Forward Team (Early Entry)
4-65.
The early entry teams can deploy as an early entry element to provide centralized, Theater Army and
Division/Corps management of critical Class VIII materiel, Patient Movement Items (PMIs), medical
maintenance, and optical fabrication. A Forward team will deploy into the Theater to provide centralized
management of medical materiel, medical maintenance, MEDLOG contracting operations, and coordination of
the distribution of Class VIII materiel within the AO. The Chief Logistics of this team will serve as the Team
Commander when deployed. The Early Entry Team may collocate with the TSC’s Theater Distribution
Management Center. The Early Entry Team can provide liaison officers (or NCOs) to each deployed MEDLOG
unit of all services and to the Theater Army/Division/Corps surgeon's location, as required. The team will provide
the information management and distribution coordination portion of the SIMLM mission, when the Army is
designated as the SIMLM by the Combatant Commander, for joint operations. The team will be subordinate to
the Theater Army/Division/Corps/TMC or TSC/ESC or Theater Army Sustainment Brigade when there is no
TMC or MEDBDE (SPT) is deployed. The Early Entry team may collocate with the Theater Army distribution
operations section of the Theater Support Brigade (TSB) when the TSC is not deployed. The MLMC early entry
teams provide—
⚫ Monitoring of the operation of MEDLOG units within the AO.
⚫ Monitoring of the receipt and processing of Class VIII requisitions from MEDLOG units of all
services.
⚫ Review and analysis of demands and computes Division/Corps/Theater Army requirements for
Class VIII supplies, medical equipment, medical equipment maintenance, and optical fabrication.
⚫ Monitoring and evaluation of the workload, capabilities, and asset position of the supported
MEDLOG units of all services and directs cross-leveling of workload or resources to achieve
compatibility and maximum efficiency.
⚫ Implementation of plans, procedures, and programs for medical materiel management systems.
⚫ Medical materiel management data and reports, as required.
⚫ Single Integrated Medical Logistics Manager information management and distribution
coordination mission to Joint Forces, as directed.
⚫ Management interface with the MLMC Base for CONUS Class VIII Inventory Support.
⚫ Management of critical items and analysis of production capabilities.
⚫ Liaison with the Materiel Distribution Manager at Division/Corps and Theater Army levels for
distribution of Class VIII supplies within the AO.
MLC Early Entry (EE) Section
4-66.
This section provides Class VIII support, optical lens fabrication and repair and medical device
maintenance and repair for the BCT and EAB units, to include augmented support to the Field Hospital (FH). The
MLC early entry section is broken down into two teams, the Logistics Support Team and the Biomedical
Maintenance Team, each team is responsible for—
Logistics Support Team
4-67.
This team can receive and position pre-configured push packages until normal automated requisition
flow is established. This team will have the ability to handle higher priority resupply for specific line-item
requisitioning of medical supplies and equipment (as required) out of its authorized stockage list in support of
medical units deployed to the AOR. The team will provide in-transit visibility of Class VIII supplies. The EE
logistics support personnel will reintegrate with the Receive/Storage Section and the medical maintenance
personnel will reintegrate with the Biomedical Maintenance Section once (base) is deployed.
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Biomedical Maintenance Team
4-68.
This teams establishes and tracks medical equipment density and service schedule information from the
Army Enterprise Systems Integration Program (AESIP) for all medical units during theater opening operations.
The Biomedical Maintenance Team will provide limited medical standby equipment utilizing regeneration
enablers and field level repair upon request. Overall, the MLC Early Entry Team—
⚫ Provides Class VIII support, optical lens fabrication and repair and medical device maintenance
and repair support.
⚫ Provides field and limited sustainment level medical device maintenance support.
⚫ Field and limited sustainment medical device maintenance and repair, scheduled services support,
repair parts, and Medical Standby Equipment Program items for medical units operating within
the theater AOR, to include Joint multinational forces, and host nations.
⚫ Coordinates for higher priority delivery of Class VIII supplies.
⚫ When deployed separate of the base can process up to 1.95 short tons of Class VIII supplies per
day.
4-69.
During consolidation of gains in competition, enterprise level organizations continue delivering AHS
support to recovering personnel and generating medical combat power in response to contingency requirements.
Theater and operational level elements including the TMC and TSC as well as the MEDBDE (SPT) and
sustainment BDE coordinate for supply and services, facilities, transportation, maintenance, general skills (with
emphasis on interpreter support), distribution of Class VIII, medical maintenance, and engineering support to
medical operations in support of offensive, defensive, and stability tasks. Theater strategic and operational level
medical elements also develop requirements for medical and nonmedical contracting support and shaping
activities are also being conducted for transition back to competition. During transition operations, MEDLOG
assets and medical planners should assess and modify MEDLOG support contingency or OPLANs in support of
crisis or armed conflict operations.
Figure 4-14. Medical Logistics (Class VIIIa) in Competition
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Figure 4-15. Medical Logistics (Class VIIIb) in Competition
Figure 4-16. Medical Maintenance in Competition
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CRISIS
4-70.
The intent of operations in crisis is to deter adversary actions and stop further deterioration of a particular
situation. Competition activities enable the joint force to gain positions of relative advantage prior to future
combat operations. Crisis operations are characterized by actions to protect friendly forces and indicate the intent
to execute subsequent phases of a planned operation. With the shift from competition to crisis, the ASCC shifts
to refining contingency plans and preparing estimates for landpower based on GCC's guidance. The ASCC and
subordinate Army forces perform the following major activities during operations to prevent—
⚫ Execute flexible deterrent options (FDOs) and flexible response options.
⚫ Set the theater.
⚫ Tailor Army forces.
⚫ Project the force
4-71.
Army forces contribute to joint operations, seeking to deter further provocation and compel an adversary
to de-escalate aggression and return to competition under conditions acceptable for the U.S. and its allies or
partners. Through rapid movement and integration with the joint force, Army forces help signal the readiness and
willingness to prevail in combat operations. When authorized, Army forces can inform or influence perceptions
about an operation’s goals and progress to amplify effects on the ground during a crisis; however, commanders
ensure their message aligns with reality and that their narratives are truthful and credible.
4-72.
Army forces help the joint force maintain freedom of action and associated positions of relative
advantage through the activities they conduct and their presence on the ground. They operate in a way that disrupts
adversary risk calculations about the cost of acting contrary to U.S. national interests, compels deescalation, and
fosters a return to competition conditions favorable to the United States. If deterrence fails to end a crisis, Army
forces are better postured for operations during armed conflict. Examples of crisis include the Cuban missile crisis
of 1962, Iraq’s invasion of Kuwait in 1990, North Korean missile and rocket provocations in 2017-2018, and the
Russian attacks into Ukraine in 2014 and 2022. (See FM 3-0, Chapter 5 for a detailed discussion of Army forces
during crisis.)
MEDICAL COMMAND AND CONTROL
4-73.
A crisis may be the result of adversary actions or indicators of imminent action, or it may be the result
of natural or human disasters. During a crisis, opponents are not yet using lethal force as the primary means for
achieving their objectives, but the situation potentially requires a rapid response by forces prepared to fight to
deter further aggression. crisis response operations are characterized by high degrees of volatility and uncertainty.
A crisis may erupt with no warning, or it may be well anticipated. Its duration is unpredictable. Additionally,
adversaries may perceive themselves in a different context or state of conflict than U.S., allied, and partner forces.
What is seen by one side as a crisis might be perceived by the other as armed conflict or competition. Army
leaders must demonstrate flexibility, anticipate changes in an OE, and provide JFCs with credible, effective
options. This requires trained forces agile enough to adapt quickly to new situations and commanders and staff's
adept at linking tactical actions to attaining policy objectives. Regardless of the capabilities employed, there are
generally two broad outcomes from a crisis. Either deterrence is maintained, and de-escalation occurs, or armed
conflict begins. While this requires that Army forces be prepared for either type of transition, forces deploying
during crisis always assume they are deploying to fight. While Army forces prepare for armed conflict, they avoid
sending signals that armed conflict is inevitable, regardless of what the adversary does, to avoid inadvertent
escalation.
4-74.
During operations is support of crisis, increased readiness and show of force operations may result in
increased injury; in addition, these activities provide an opportunity for associated medical units to participate in
individual and collective training opportunities. This is an opportunity during set the theater for units to establish
or improve bases. During crisis, operational medicine forces are prepared to provide direct, and area medical
support as needed for units on station without requisite medical support, or integration of additive medical
treatment support arriving on station. During mobilization, training, readiness, and predeployment health
assessments and activities take place. Employment include but are not limited to, entry operations, offensive
operations, defensive operations, security and stability tasks and all those activities imply for providing AHS
support to the deployed force. During crisis, medical C2 are focused on:
⚫ Planning, preparing, executing, and assessing health and medical support.
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Developing situational awareness and understanding using C2 systems and producing and
publishing a medical common operational picture.
Planning for a scalable and tailorable health and medical infrastructure which ensures the right mix
of health and medical capabilities is available to execute the medical mission.
Executing AHS support to other Services when directed.
Recommending theater evacuation policy adjustments.
Ensuring eligibility of care determination is planned.
Providing theater food protection support.
Coordinating with USTRANSCOM for patient movement plans.
Ensuring interoperability and integration of theater medical capabilities.
Conducting medical preparation of the OE.
Maximizing use of UAP and host-nation medical capabilities.
Continue planning and implementing global health engagements in support of the combatant
commander’s intent.
Continuing unit training (including medical training).
Establishing and executing occupational and environmental health surveillance programs and
countermeasures.
Coordinating with the National Center for Medical Intelligence, Centers for Disease Control and
Prevention, and other strategic partners for identification and mitigation of regional health threats.
Planning for virtual health capabilities with specialty care/telementoring reachback in prolonged
care and austere environments.
Updating medical portions of OPLANS, OPORDS, and running estimates.
Coordinating, synchronizing, integrating, and planning AHS support to—
▪ Noncombatant evacuation operations.
▪ Detainee operations.
▪ RSOI and theater opening.
▪ Large-scale casualty events and prolonged care.
▪ Other Services.
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Figure 4-17. Medical Command and Control in Crisis
OPERATIONAL PUBLIC HEALTH
4-75.
Operations in crisis are designed to deter adversary actions contrary to U.S. interests. Army operations
to prevent are typically conducted in response to activities that threaten unified action partners and require the
development or repositioning of credible forces in a theater to demonstrate the willingness to fight if deterrence
fails. These operations are tailored in scope and scale to achieve a theater strategic or operational level objective.
4-76.
Major PVNTMED planning considerations for crisis operations consist of the following: conducting
OEH surveillance and base camp assessments; environmental sampling; entomological and epidemiological
assessments; and tracking DNBI statistics. Increased readiness and show of force operations may result in
increased injury; in addition, these activities provide an opportunity for associated medical units to participate in
individual and collective training opportunities. More specifically, PVNTMED operations in crisis also consist
of the following: conduct similar operations to competition, increase partner capacity and capabilities, provide
guidance to the command concerning PMM, epidemiological investigations, on-site water quality analysis,
monitoring of water and field ice production and distribution, collection of samples (water, soil, air), food service
sanitation inspections of field feeding sites, monitoring and training on proper field sanitation and waste disposal
techniques, pest management support, entomologic consultation, and base camp assessments.
4-77.
During crisis, elements of the PVNTMED detachment may still be at home station while others are
forward deployed. Through the orders process, elements of the PVNTMED detachment may deploy during any
strategic context. When deployed the PVNTMED detachment is assigned to the TMC MEDBDE (SPT), MMV,
Role 2 MCAS, or medical task force and per its basis of allocation provides operational public health within the
theater, corps, and division echelons. During transition operations, PVNTMED detachments, teams, and medical
planners should assess and modify PVNTMED contingency or OPLANs for returning to competition and forward
to armed conflict.
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Figure 4-18. Operational Public Health in Crisis
VETERINARY SERVICES
4-78.
Veterinary services activities for crisis includes continuing the food protection mission, conducting
sanitary audit inspections of food establishments, and inspecting operational rations (ready to eat meals and
unitized group rations) as well as ensuring that military working animals are healthy and ready to deploy. More
specifically, veterinary services to the crisis strategic context also includes Veterinary Role 1 and Role 2
medical/resuscitative surgical care to military and DOD contract working dogs, and food inspection support in
the AO, complete preventive and medical care to government owned animals, medically prepare MWDs for
deployment, food defense vulnerability assessments, and endemic zoonotic and transboundary animal disease
epidemiology surveillance and control.
4-79.
During crisis, elements of the MDVS may still be at home station while others are forward deployed,
however, through the orders process, elements of the MDVS may deploy during any strategic context. When
deployed, the MDVS and teams is assigned to the TMC, MEDBDE (SPT), or MMB. Its structure is such that it
can deploy subordinate teams based on mission requirements. Per its basis of allocation, the MDVS provides
veterinary services within the theater, corps, and division echelons. During crisis, veterinary support for
consolidation of gains also continues. During transition operations, veterinary services detachments, teams, and
medical planners should assess and modify veterinary services contingency or OPLANs for returning to
competition or forward with armed conflict.
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Figure 4-19. Veterinary Services in Crisis
COMBAT AND OPERATIONAL STRESS CONTROL
4-80.
During crisis, organic behavioral health sections continue to provide COSC services within their
brigades. COSC detachments continue training all aspects of their required capabilities. Through the MMB,
COSC leadership is engaged in mission analysis and coordination to ensure all aspects of deployment and
employment are adequate. As with competition, COSC units may be significantly involved with the predeployment preparation and Soldier readiness activities of operational units. COSC detachments may still be
supporting ongoing engagements with partner nations to increase those nations’ capacities and capabilities.
4-81.
During crisis, elements of the COSC may still be at home station while others are forward deployed.
When deployed the COSC is assigned to the MMB and per its basis of allocation of one COSC per 39,000 Army
population supported provides COSC services within the theater, corps, and division echelons. Through the orders
process, elements of the COSC may deploy during any strategic context. COSC Forward Support Sections may
deploy prior to the COSC in support of crisis operations. This section performs prevention and limited fitness
activity support to Corps, Divisions, and Brigades on an area support basis to units in support areas. The Forward
Support Section has the capability to break down into six 3-man teams. Each team consists of a behavioral health
officer, an NCO team chief, and a behavioral health SPC.
4-77.
While conducting consolidation of gains, organic behavioral health sections and COSC detachments
may again be involved with stability activities in order to increase the partner nation’s ability to care for its own
population. In addition to their own redeployment efforts, and as units prepare to redeploy, COSC capabilities
may be employed to support the health assessments of individual Soldiers. During transition operations, medical
planners should assess and modify COSC services contingency or OPLANs for returning to competition or
forward with armed conflict.
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Figure 4-20. COSC in Crisis
DENTAL SERVICES
4-78.
Dental services in crisis provided to deployed Soldiers in theater is referred to as operational dental care.
Operational dental care consists of emergency dental care and essential dental care. Because of their size and
mobility, the dental assets can conduct expeditionary and joint operations and once deployed are better able to
quickly respond to ever-changing mission requirements.
4-79.
During crisis, the organic dental team assigned the BSMC continues to provide operational dental care
to personnel assigned to the BCT. The DCAS is employed and assigned to the TMC or the MEDBDE (SPT)
within a theater based on their basis of allocation of one Dental Company (Area Support) per 43,000 Army
population supported in the Theater and based upon the ratio of one dentist in support of 1,175 troops). Forward
dental treatment sections may deploy prior to the DCAS in support of crisis operations. These sections provide
area dental support and far forward operational dental care to small and forward deployed troop concentrations.
This platoon is composed of 3 Forward Support Treatment Sections. Each section is composed of 6 treatment
teams for a total of 18 forward treatment teams for area support. Each section consists of six (6) semi-mobile
teams made up of a Dental Officer, Dental Technician, dental equipment/supplies, and mobile electric power.
These dental teams may be employed in the BCT area to augment the organic dental team in providing forward
emergency and preventive dental care. As the population at risk increases the amount of MCASs will increase
which mean there are additional dental teams available to provide operational dental care support on an area basis.
4-80.
During crisis, elements of the DCAS may still be at home station while others are forward deployed.
Through the orders process, elements of the DCAS may deploy during any strategic context. When deployed the
DCAS is assigned to the MEDBDE (SPT) and per its basis of allocation provides operational dental services
within the theater, corps, and division echelons. During transition operations, medical planners should assess and
modify dental services contingency or OPLANs for returning to competition or forward with armed conflict.
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Figure 4-21. Dental Services in Crisis
LABORATORY SERVICES
4-81.
During crisis, organic medical laboratory personnel continue to provide clinical laboratory services
within their brigades. The AML continue training all aspects of their required capabilities and may receive
samples from theater to test prior to deployment. The AML leadership, through their assigned higher
headquarters, are engaged in mission analysis and coordination to ensure all aspects of deployment and
employment are adequate. The AML may still be supporting ongoing engagements with partner nations to
increase those nations’ capacities and capabilities.
4-82.
In crisis, the OE is growing which in turn elevates the population at risk. As the OE mature, Role 3
hospital medical laboratory assets may be deployed. The laboratory section of the Role 3 expands on the Role 2
medical laboratory capabilities and has the necessary supplies and equipment to provide clinical laboratory testing
to support diagnosis and care of battlefield and disease and DNBI. This set contains a wide range of laboratory
equipment and reagents to perform diagnostic tests, and at a minimum will allow the following tests to be
performed:
⚫ All testing performed at Role 2.
⚫ Biochemistry (blood, serum, and/or plasma based) testing.
⚫ Hematology/Urinalysis testing.
⚫ Microbiology/Serology testing.
4-83.
Elements of the AML may still be at home station while others are forward deployed. In support of
crisis operations, the AML and its teams are assigned/attached to a TMC , a MEDBDE (SPT), the 20th CBRN
Command, or may be further attached to other deployed medical units as needed.
4-84.
While conducting consolidation of gains, organic clinical laboratory personnel may be involved with
stability activities in order to increase the partner nation’s ability to care for its own population. In consolidation
of gains, the AML may continue to conduct operations for Theater Validation of CBRN materials, to include
transmitting analytical information to national laboratories for Definitive Identification. During transition
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operations, medical planners should begin development of medical laboratory services contingency or OPLANs
for going back to a state of competition and forward with armed conflict.
Figure 4-22. Laboratory Services in Crisis
MEDICAL TREATMENT (ORGANIC AND AREA SUPPORT)
4-85.
Operations in support of crisis are designed to deter adversary actions contrary to U.S. interests. Army
operations to crisis are typically conducted in response to activities that threaten unified action partners and
require the development of credible forces in theater by an increase in partner training and integration with U.S.
forces activities and concurrent planning for current and future operations. Synchronization, partner integration
(medical treatment and supporting activities), tailored for the OE, AO, and adversary intentions and capabilities
are key to success. This is an opportunity during set the theater for medical units to establish or improve bases.
Medical units are prepared to provide area and organic medical support as needed for units that are on station.
During mobilization, training, and readiness, predeployment health assessments and activities also take place. As
the OE grows and matures, the Role 1 BAS and Role 2 BSMC/MCAS will incrementally have a larger population
at risk. With more patients comes medical waste, each role of care must establish waste management procedures
and ensure the proper disposal of medical waste throughout the competition continuum.
4-86.
During crisis, the OE is increasing. Through the orders process, medical treatment assets may deploy
during any strategic context. Elements of medical treatment assets may still be at home station while others are
forward deployed. Medical treatment assets come into the operational areas based on the order process, planning
estimates, and population at risk factors. These medical treatment assets are strategically placed with the
operational area to provide organic and area support medical treatment. When deployed the organic medical
treatment assets are assigned to their units. EAB medical treatment assets are assigned to the MMB and per their
basis of allocation provide medical treatment on an area support basis at echelon. During transition operations,
medical planners should assess and modify medical treatment contingency or OPLANs for returning to
competition or forward with armed conflict.
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Figure 4-23. Medical Treatment in Crisis
HOSPITALIZATION
4-87.
During crisis, Role 3 hospitals continue training all aspects of their required capabilities. Hospital staffs
are engaged in mission analysis and coordination with the MEDBDE (SPT) to ensure all aspects of deployment
and employment are adequate. Especially key for the hospital is coordinating Army prepositioned stock draws,
if applicable, support during reception, staging, onward movement, and integration activities (to include early
entry Role 3), and ensuring the right capabilities are available if a transition to armed conflict occurs. As the OE
grows and matures, the Role 3 will incrementally have a larger population at risk. With more patients comes
medical waste, the Role 3 hospital must establish waste management procedures and ensure the proper disposal
of medical waste throughout the competition continuum.
4-88.
Role 3 hospitals may still be supporting ongoing engagements with host and partner nations to increase
those nations’ capacities and capabilities to provide hospital care. While conducting health engagements, the
hospital staff continues to gain a great deal of situational awareness of the medical capabilities and health threats
within the operational area, both will be important if a large-scale deployment occurs in the area. Based on the
OE, elements of the Role 3 deploy into the AO. Once deployed the Role 3 can provide—
⚫ Information to commanders and their staff on the health of their command and on health aspects
affecting the unit's mission(s) or AHS.
⚫ Indefinite split-base capability.
⚫ Emergency treatment to receive, triage, and resuscitate casualties to include not only military
personnel, but DOD civilian employees and contractors, local nationals, detainees, enemy
prisoners of war (EPWs)/retained/detained personnel as required.
⚫ Hospitalization for up to 240 patients consisting of:
▪ One (1) ward providing intensive nursing care for up to twelve (12) patients (Field Hospital
[32 Bed]) (Multiple this by two [2] if assigned two Field Hospitals [32 Bed]).
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One (1) ward providing intermediate nursing care for up to twenty (20) patients. (Field
Hospital [32 Bed]) (Multiple this by two [2] if assigned two Field Hospitals [32 Bed]).
▪ Two (2) wards providing intensive nursing care for up to twenty-four (24) patients (Hospital
Augmentation Detachment [Surgical 24 Bed]).
▪ One (1) ward providing intensive nursing care for up to twelve (12) patients (Hospital
Augmentation Detachment [Medical 32 Bed]).
▪ One (1) ward providing intermediate nursing care for up to twenty (20) patients. (Hospital
Augmentation Detachment [Medical 32 Bed]).
▪ Three (3) wards providing intermediate nursing care for up to twenty (20) patients each.
(Hospital Augmentation Detachment [Intermediate Care Ward 60 [Bed]) (Multiple this by
two [2] if assigned two Hospital Augmentation Detachments [Intermediate Care Ward 60
[Bed]).
Surgical capability, including general, thoracic, orthopedic, oral maxillofacial, and obstetricsgynecological based on—
▪ Two operating room tables capable of providing 36 operating room hours per day (Field
Hospital (32 Bed). (Multiple this by two [2] if assigned two Field Hospitals [32 Bed]).
▪ Two operating room tables capable of providing 36 operating room hours per day (Hospital
Augmentation Detachment [Surgical 24 Bed]).
Operational dental care consisting of emergency dental care and essential dental care designed to
circumvent potential dental emergencies, along with limited preventive dentistry through use of
assigned dental hygiene personnel.
Psychiatry, public health nursing, and physical therapy services.
Pharmacy, clinical laboratory, blood banking, radiology/computed tomography microbiology, and
nutrition care service for patients and organic staff.
Coordination with the United States Air Force (USAF) Theater Patient Movement Requirements
Center (TPMRC) for medical regulating and movement of patients from the theater.
Consultation and outpatient clinic services for patients referred from other MTFs.
Technical advice and consultation on medical automated information systems and programs such
as the Theater Medical Information Program (TMIP) and medical communications for combat
casualty care (MC4).
Personnel administration, patient administration, unit maintenance, medical and non-MEDLOG,
laundry services for direct patient-related linen and shower facilities for ambulatory patients and
direct patient care providers.
Field medical maintenance support to all elements of the hospital, and all attached and assigned
units.
All work areas and assemblages deploy with three days of supply (DOS) on hand within identified
Medical Materiel Set(s).
4-89.
During crisis, elements of the Role 3 hospital may still be at home station while others are forward
deployed. Through the orders process, elements of the Role 3 hospital may deploy during any strategic context.
Deployment of elements of Role 3 hospitalization weigh heavily on the basis of allocation (which is very detailed
for hospitalization and requires medical planners to be well versed in the computations). They are also based on
planning estimates and population at risk factors. When deployed, the Role 3 hospital is assigned to the MEDBDE
(SPT) and per its various basis of allocations provides Role 3 hospitalization within the theater, corps, and division
echelons. During transition operations, Role 3 hospital planners should assess and modify Role 3 contingency or
OPLANs for returning to competition and forward to armed conflict.
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Figure 4-24. Hospitalization in Crisis
MEDICAL EVACUATION (TO INCLUDE MEDICAL REGULATING)
4-90.
At the theater strategic level, the ASCC plans and coordinates Army capabilities to set the theater.
Medical planners assess available intelligence to identify health threats, foreign medical capabilities and
infrastructure, population at risk, viable routes for evacuation and locations for MTFs and units. Medical planners
may also develop contingency or OPLANs. During operations in crisis, a corps HQs may deploy into an
operational area as a tactical HQs with subordinate divisions and brigades as a show of force or may deploy an
early entry command post to provide control over arriving forces. Medical planners within the corps surgeon
section should begin planning early, develop an understanding of the mix of forces and how to best support them
with the available MEDEVAC assets which may include units and capabilities from other services and
CASEVAC augmentation.
4-91.
Units and personnel who are part of a readiness force or who have been designated for specific operation
should have completed clinical rotations and training events and be available for immediate recall and
deployment. Supporting operations in crisis, MEDEVAC units could be part of a tailored force in support of
force projection. Force projection is the ability to project the military instrument of national power from the
United States or another theater in response to requirements for military operations (JP 3-0). MEDEVAC units
may provide area MEDEVAC support during reception, staging, onward movement and integration, at ports of
embarkation, debarkation, and along movement routes. Medical planners may coordinate with U.S. or host and
partner nation organizations for some aspects of support. Additionally, in accordance with the basis of allocation
of the MCGA, a division headquarters is authorized 12 ground ambulances from the MCGA. When directed to
support host nation population at risk the basis of allocation is one MCGA per 42,000 supported population.
Throughout the order process, medical planners need to take this into consideration within their planning estimates
and population at risk factors.
4-92.
Consolidation of gains in support of crisis becomes more difficult as MEDEVAC assets build capacity
within the OE as they continue to support training, force projection, security, and stability tasks. MEDEVAC
assets in support of crisis should refine their knowledge of local road networks and terrain, locations of MTFs by
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Role of care, and building relationships within their supported AO. MEDEVAC assets support may be on an
area or direct support basis to maneuver forces conducting C consolidation of gains within corps or division rear
operations. MEDEVAC operations follows the traditional support provided to combat forces. MEDEVAC
support during operations to consolidate gains may require a MEDEVAC company to provide direct support to
maneuver forces in one area while supporting stability tasks in another. During transition operations, MEDEVAC
assets and medical planners should assess and modify MEDEVAC support contingency or OPLANs in support
of operations for returning to competition or forward to armed conflict.
Figure 4-25. Medical Evacuation in Crisis
MEDICAL LOGISTICS (TO INCLUDE BLOOD MANAGEMENT)
4-93.
Army operations to crisis are an extension of competition operations and are designed to prevent
adversary opportunities to further exploit positions of relative advantage. Key AHS activities during crisis include
the provision of medical support to flexible deterrence and flexible response options and setting the theater for
possible escalation. During operations to crisis, strategic and theater level medical organizations coordinate with
sustainment units at echelon for maintenance, supply and services, facilities, transportation, general skills (with
emphasis on interpreter support), distribution of Class VIII, medical maintenance, and engineering support to
medical operations in support of flexible deterrence/response options and possible expansion should escalation
occur. The Office of The Surgeon General (OTSG) releases medical APS assets as required. The U.S. Army
Medical Logistics Command coordinates with AMC for release of medical APS to identified rotational medical
units and deploys a MEDLOG Support Teams to interface with APS and issue medical stocks. The TMC
leverages the 6th Medical Logistics Management Center to interface with the TSC/ESC DMC for coordination
and establishment of the Class VIII distribution chain.
4-94.
During crisis, the OE is expanding. Organic BCT MEDLOG assets continue providing MEDLOG to
their brigades. Elements of EAB MEDLOG assets (which include blood support, medical maintenance, and
optometry) may still be at home station while others are forward deployed. Through the orders process, elements
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of the EAB MEDLOG assets may deploy during any strategic context. Deployment of EAB MEDLOG assets
weigh heavily on their basis of allocation. For the MLMC that is one (1) unit required for the force and assigned
to the TMC. For the MLC it is one per 13 Short Tons of Class VIII supplies processed per day and assigned to a
higher-level medical element, usually the MMB. For the medical detachment, blood support the basis of
allocation is very detailed and requires medical planners to be well versed in the computations. During crisis,
the TMC, MEDBDE (SPT), and MMB continue to evolve the medical maintenance strategy to fit the OE and
continue to train, rehearse, and refine OPLANS and OPORDS. This is all based on planning estimates and
population at risk factors. When deployed, MEDLOG assets provide all aspects of MEDLOG at echelon.
Deploying MEDLOG assets in support of crisis are—
MLMC Forward Team (Follow On)
4-95.
This team deploys as a follow on element to provide additional centralized Theater Army and
Brigade/Corps management of critical Class VIII materiel, PMIs, medical maintenance, and optical fabrication.
These teams are not meant to deploy independently of the MLMC Forward Team (EE). It has the same
capabilities as the MLMC Forward Team (EE).
Medical Logistics Company
4-96.
This company provides Class VIII support, optical lens fabrication and repair, and medical device
maintenance and repair for the BCT and EAB units, to include augmented support to the field hospital (FH). The
MLC—
⚫ Provides 220 hours per day of field level medical device maintenance and repair.
⚫ Provides Class VIII support, optical lens fabrication and repair, and medical device maintenance
and repair support.
⚫ The Receive and Storage Sections, Shipping Section and the Stock Control Section can process up
to 9 short tons of Class VIII supplies per day.
⚫ Coordinates for emergency delivery of Class VIII supplies.
⚫ Can build and position preconfigured push-packages, as required, in support of units in the theater.
⚫ The Optical Section can provide single and multi-vision optical lens fabrication and repair to
support a maximum force of 22,000 troops.
⚫ Can provide the distribution capability for a theater lead agent for medical materiel (TLAMM)
when required.
⚫ Provides one early entry team, three contact repair teams, and three forward distribution teams,
who can process up to 4 short tons class VIII per day.
Elements of the Medical Detachment, Blood Support (MDBS)
4-97.
This detachment provides collection, manufacturing, storage, and distribution of blood and blood
products to BCTs, Corps, and Echelons above Corps (EAC) medical units and to other services as required. The
MDBS will normally be under the mission command of the MMB. The detachment has the capability for 72hours, limited self-sustainment during initial operations. The detachment can deploy a HQ and a Collection
Storage and Distribution Team (Refrigerated storage for 3,900 units of packed red blood cells), and/or a Collection
Manufacturing and Distribution Team (Refrigerated storage for 900 units of packed red blood cells) and or a
Distribution Team (Refrigerated storage for 300 units of packed red blood cells). Per their capabilities, these
teams may forward deployed as required. The MDBS—
⚫ Establish the theater blood distribution plan within the Joint Operations Area (JOA), including
storage levels and locations, and the schedule of re-supply.
⚫ Prepare and submit JOA Blood Reports to the Combatant Command JBPO and ASBPD.
⚫ Implement, monitor, and enforce ASBPD and JBPO policies and procedures within the JOA.
⚫ Receive and store up to 5,100 refrigerated and/or frozen blood products from CONUS or other
U.S. (MTFs, and further distribute these blood products to supported MTFs and medical units.
⚫ Operate in a hub and node distribution manner over a large geographic area.
⚫ Provide consultation with commanders from company to theater level regarding blood support.
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Conduct and coordinate administrative and logistical support to sustain operations.
Receive and account for blood and blood product shipments from the ASWBPL or EBTCs.
Maintain theater blood storage depot. Store blood and blood products pending transfer to
Distribution & Collection Sections.
Distribute blood and blood products to MTFs down to and including Level 2 organizations.
Determine and provide the appropriate blood products and blood types to each facility according
to the facility capabilities and level of care.
Coordinate movement of blood and blood products and track shipments in transit to ensure proper
delivery.
Properly screen potential emergency whole blood donors and initiate retrospective viral marker
testing on locally collected whole blood. Collect, process and test whole blood from the available
donor pool when needed for a specific emergent medical condition, such as massive blood loss
coupled with a coagulopathy requiring the transfusion of certain coagulation factors found only in
fresh blood products. Proper processing of blood may include testing and/or treatment of blood to
render potential viruses and bacteria inactive.
Ensure DOD/ASBPD policy and procedures are followed with respect to emergency blood
donations and transfusions.
Properly screen emergency platelet-Apheresis donors and initiate retrospective viral marker testing
on locally collected platelet products.
Collect single-donor platelets by Apheresis when needed to address specific medical conditions,
such as uncontrolled bleeding requiring the transfusion of platelets and coagulation factors. Proper
processing of blood may include testing and/or treatment of blood to render potential viruses and
bacteria inactive.
Optometry Detachment
4-98.
Provides optometry care and optical fabrication on an area support basis. This detachment is employed
in all intensities of conflict and is usually attached to the MMB. The detachment consisting of six personnel that
can be divided into two teams (Optometry Teams A and B). Each team has the capability to provide optometry
support limited to eye examination, spectacle fabrication, frame assembly and repair services to brigade and nonbrigade units in the AO as far forward as possible. The detachment—
⚫ Provides initial diagnosis and management of eye injuries on the battlefield.
⚫ Provides examinations to detect, prevent, diagnose, treat, and manage ocular related disorders,
injuries, diseases, and visual dysfunctions.
⚫ Provides assembly, repair and fabrication of single vision spectacles.
⚫ Planning considerations for Class VIIIb support during crisis include coordinating with the Armed
Services Blood Program Office, (ASBPD), appointment of a Joint Blood Program Officer (JBPO),
Area Joint Blood Program Officer (AJBPO), Armed Service Whole Blood Processing Laboratory
(ASWBPL), and Expeditionary Blood Transshipment Center (EBTC) to establish a theater blood
distribution plan within the joint operations area, including storage levels, locations, and the
schedule of re-supply.
4-99.
During consolidation of gains in support of crisis, enterprise level organizations continue delivering AHS
support to recovering personnel and generating medical combat power in response to contingency requirements.
Theater and operational level elements including the TMC and TSC as well as the MEDBDE (SPT) and
sustainment BDE to continue coordination of sustainment (to include distribution of Class VIII and engineering
support to medical operations) in support of operations. Theater and operational level medical elements also
develop requirements for medical and nonmedical contracting support and crisis activities are also being
conducted for transition back to competition. During transition operations, MEDLOG assets and medical planners
should assess and modify MEDLOG support contingency or OPLANs in support of returning to competition or
forward to armed conflict.
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Figure 4-26. Medical Logistics (Class VIIIa) in Crisis
Figure 4-27. Medical Logistics (Class VIIIb) in Crisis
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Figure 4-28. Medical Maintenance in Crisis
ARMED CONFLICT
4-100. During armed conflict, Army forces defeat the enemy. Defeat of enemy forces in close-combat
operations (defensive and offensive tasks) is normally required to achieve campaign objectives and national
strategic goals after the commencement of hostilities. Planning for sequels to consolidate gains at higher levels
should be informed by combat operations and vice versa. However, the demands of LSCO consume all available
staff capability at the tactical level.
4-101. Armed conflict against a peer threat, commanders conduct decisive action to seize, retain, and exploit
the initiative. This involves the orchestration of many simultaneous unit actions in the most demanding of OEs.
Large-scale combat operations introduce levels of complexity, lethality, ambiguity, and speed to military
activities not common in other operations. Armed conflict require the execution of multiple tasks synchronized
and converged across multiple domains to create opportunities to destroy, dislocate, disintegrate, and isolate
enemy forces.
4-102. Army forces defeat enemy organizations, control terrain, protect populations, and preserve joint force
and unified action partner freedom of movement and action in the land and other domains. Corps and division
commanders are directly concerned with those enemy forces and capabilities that can affect their current and
future operations. Accordingly, joint interdiction efforts with a near-term effect on land maneuver normally
support land maneuver. Successful corps and division operations may depend on successful joint interdiction
operations, including those operations to isolate the battle or weaken the enemy force before battle is fully joined.
4-103. During armed conflict, Army forces enable joint force freedom of action by denying the enemy the
ability to operate uncontested in multiple domains. Army leaders synchronize the efforts of multiple unified
action partners to ensure unity of effort. Army forces adapt continuously to seize, retain, and exploit the initiative.
Army forces use mobility, protection, and firepower to strike the enemy unexpectedly from multiple directions,
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denying the enemy freedom to maneuver and creating multiple dilemmas that the enemy commander cannot
effectively address.
4-104. During armed conflict, Army forces generally constitute the preponderance of land combat forces and
are tactically organized into corps and divisions. Army forces seize the initiative, gain and exploit positions of
relative advantage in multiple domains to dominate an enemy force, and consolidate gains. Corps and divisions
execute decisive action tasks, where offensive and defensive tasks make up the preponderance of activities.
Commanders must explicitly understand the lethality of modern armed conflict to preserve their combat power
and manage risk. Commanders leverage cyberspace operations, space capabilities, and information-related
capabilities in a deliberate fashion to support ground maneuver. Commanders also use ground maneuver and other
land-based capabilities to enable maneuver in the other domains.
4-105. The BCTs and subordinate echelons concentrate on performing offensive and defensive tasks and
necessary tactical enabling tasks. During armed conflict they perform only those minimal essential stability tasks
necessary to comply with the laws of land warfare. They do not conduct operationally significant consolidate
gains activities unless assigned that mission while conducting rear operations. BCT commanders orchestrate rapid
maneuver to operate inside an enemy's decision cycle and create an increasing cascade of hard choices for the
enemy commander.
4-106. It is imperative that AHS commanders, staffs, surgeons, and subordinates maintain an operational
understanding how to generate and apply combat power, the foundations and fundamentals of operations, and the
operations conducted within the Army strategic contexts set forth in FM 3-0. Full understanding and application
of the operational art depicted in FM 3-0 will ensure the AHS principles and medical functions are applied through
medical C2 and are intertwined within the application of FM 3-0, ensuring the seamless delivery of FHP and HSS
to the warfighter. (See FM 3-0, Chapter 6 for a detailed discussion of Army forces conducting operations during
armed conflict. See FM 3-0, Chapter 7 for a discussion of Army forces in large-scale combat in maritime
environments.)
MEDICAL COMMAND AND CONTROL
4-107. Armed conflict encompasses the conditions of a strategic relationship in which opponents use lethal
force as the primary means for achieving objectives and imposing their will on the other. The employment of
lethal force is the defining characteristic of armed conflict, and it is the primary function of the Army. During
armed conflict, operations usually reflect combinations of conventional and irregular warfare approaches. Leaders
apply doctrine for LSCO during limited contingencies that require conventional warfare approaches. Irregular
warfare includes counterinsurgency and unconventional warfare, which other publications specifically address.
The initial actions of LSCO will likely overlap with actions initiated during competition and crisis. For example,
while some units are engaged in offensive or defensive operations, other units may be completing non-combat
evacuations while in contact with enemy forces. Large-scale combat operations are extensive joint combat
operations in terms of scope and size of forces committed, conducted as campaigns aimed at achieving operational
and strategic objectives through the application of force. Large-scale combat on land occurs within the framework
of a larger joint campaign, usually with an Army headquarters forming the base of a joint force headquarters.
These operations typically entail high tempo, high resource consumption, and high casualty rates. Large-scale
combat introduces levels of complexity, lethality, ambiguity, and speed to military activities not common in other
operations. Large-scale combat operations occur in circumstances usually associated with state-on-state conflict,
and they encompass divisions and corps employing joint and Army capabilities from multiple domains in a
combined arms manner. Irregular warfare activities often complement LSCO, with conventional, irregular, and
special operations forces conducting operations close to each other. This proximity requires cooperation between
friendly forces of all types to ensure success. To succeed in armed conflict, the U.S. joint force must create its
own relative advantages, preserve combat power, and rapidly exploit what opportunities it creates. Commanders
must assume risk to create opportunity and sequence their operations because they cannot defeat enemy forces in
a single decisive battle.
4-108. Seizing the initiative during armed conflict results in higher rates of casualties with rapid and fluid phase
lines of attack. Dwell time is limited, communication, delays in evacuation, potential for conducting prolonged
care with limited Class VIII may be possible. Peer threats are brutal with elements that do not practice discipline
in concealment, camouflage, emplacement and displacement and OPSEC. Enemy indirect and direct fires
coupled with enhanced situational awareness, punishes combatant elements as well as medical elements. There
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are no safe havens to conduct medical treatment in organic support or area support in any deployed role of care.
In armed conflict, evacuation lines will become extended as maneuver forces achieve success requiring increased
synchronization between MEDEVAC units and MTFs to validate AXP, the ambulance shuttle system, and unit
locations and status. MTFs must be emptied of patients in order to be capable of moving to sustain proximity
with the supported unit(s). This places great demands upon MEDEVAC elements as well as the area support
elements in the AO. Though Role 1 units are not designed or manned to hold patients, the combat situation may
require it, consideration of this possibility requires that thought be given this potential event. During armed
conflict, medical C2 is responsible for coordinating, synchronizing, integrating and planning AHS support. This
includes but is not limited to:
⚫ Supporting and facilitating the execution of the combatant commander’s plan.
⚫ Coordinating, synchronizing, integrating, planning, preparing, executing, and assessing FHP and
HSS.
⚫ At echelon, cultivating medical professional contacts between Services and within a nation or
group of nations.
⚫ At echelon, actively monitor existing health threats to deployed forces, develop strategies to
mitigate these threats, enhance the host-nation government’s legitimacy with the affected
population, and reduce human suffering.
⚫ Maintaining situational awareness and understanding using C2 systems and developing and
publishing the medical common operational picture.
⚫ Synchronizing and integrating the FHP and HSS functions into the operations plan and operations
order.
⚫ Ensuring execution of health and medical support plans that supports the combatant commander’s
decisions and intent.
⚫ Facilitating and enhancing a seamless continuum of health care from the point of injury or
wounding to definitive care in the CONUS-support base, if required.
⚫ Providing a scalable and tailorable health and medical infrastructure which ensures the right mix
of health and medical capabilities is deployed to execute the medical mission.
⚫ Analyzing, evaluating, and interpreting medical reports and medical statistical data.
⚫ Managing, consulting, and providing situational awareness of virtual health capabilities in
prolonged care and austere environments.
⚫ Ensuring health and medical standards are established, implemented, and monitored throughout
the operational area.
⚫ Providing clinical, health, medical, and technical consultation, and support to subordinate medical
units/elements.
⚫ Providing reach back capability to CONUS-support base in the areas of various health and medical
disciplines and specialties.
⚫ Providing oversight over medical care to Servicemembers, civilians, and detainees.
⚫ At the tactical level, management of organic Role 1 medical treatment (including CBRN treatment,
en route care, and prolonged care). At the operational and theater strategic level, maintain
situational awareness.
⚫ At the tactical level, management of organic Role 2 medical treatment (including CBRN treatment,
en route care, and prolonged care) on an area basis and Role 1 (for units without organic medical
assets). At the operational and theater strategic level, maintain situational awareness.
⚫ At echelon, managing, consulting, and providing situational awareness of Role 3 hospitalization.
⚫ At echelon, managing, consulting, and providing of forward resuscitative surgical assets to
stabilize nontransportable patients for evacuation out of theater.
⚫ At echelon, managing, consulting, and providing situational awareness of MEDEVAC and/or
CASEVAC from point of injury through the continuum of care.
⚫ At echelon, coordination of intra/intertheater patient movement (through the continuum of care)
(to include emergency movement of Class VIII [including blood], medical personnel, and medical
equipment).
⚫ At echelon, managing, consulting, and providing situational awareness of medical regulating.
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At echelon, managing, consulting, and providing situational awareness of MEDLOG (including
blood management.(this also includes medical maintenance and optical fabrication).
Management of patient movement items.
At echelon, managing, consulting, and providing situational awareness of operational public health
(includes conducting medical, occupational , and environmental health surveillance, and
conducting health risk assessments and communications).
At echelon, managing, consulting, and providing situational awareness of combat and operational
stress control services.
At echelon, managing, consulting, and providing situational awareness dental services.
At echelon, managing, consulting, and providing situational awareness of veterinary services (food
protection, medical treatment for MWDs, and veterinary public health).
Coordinating AHS support operations to force rotation (reception, staging, onward movement, and
integration).
Sustainment of AHS support operations (possible nontraditional sources of support from other
Services, UAP, multinational forces, or host nation without habitual support relationships).
Oversight of unit reconstitution using the modular medical concept.
Managing, consulting, and providing situational awareness of care provided to enemy prisoners of
war and detainees (increased requirements for operational public health, primary care, care of
chronic diseases/conditions).
4-109. Consolidation of gains requires that medical treatment and evacuation are considered for the support of
both stability tasks (restore essential services) as well as provided required support of the deployed force and
potential follow-on force. Any combat losses of authorized equipment, shortage of medical equipment, Class
VIII, and personnel should be addressed now. Postdeployment health assessments, with preparation of
redeployment should address potential behavioral health concerns as well. If there is a plan for follow-on forces,
a plan for transfer of authority with addressing of any medical treatment, PVNTMED, host nation, and
multinational partners is addressed. Interaction with the host nation and populace is key particularly after a fight
with new follow-on forces flowing in. The transfer of medical treatment responsibilities is as important for the
health of the command and individual Soldier as conduct of the initial entry operations over the long haul.
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Figure 4-29. Medical Command and Control in Armed Conflict
OPERATIONAL PUBLIC HEALTH
4-110. In support of armed conflict operations, PVNTMED planning considerations consist of providing disease
prevention and control services; field PVNTMED services; environmental health; and health surveillance and
epidemiology. More specifically, operational public health operations to support armed conflict also consist of
the following: activities listed for competition and crisis, plan for and execute surging capabilities in direct
support of main effort units, maintain a location best able to provide support without encumbering maneuver
forces, provide Level III PVNTMED support to detainee operations, and to begin planning for transition of
support to consolidate gains.
4-111. During armed conflict and METT-TC (I) dependent, PVNTMED detachments are deployed and located
within the operational area based on the order process, planning estimates, and population at risk factors. When
deployed, PVNTMED detachments and teams are assigned to a TMC, MEDBDE (SPT), MMB, Role 2 MCAS,
or a medical mission task force HQs in the division, corps, or EAB and per its basis of allocation provides
operational public health services within the theater, corps, and division echelons.
4-112. Consolidation of gains is support of armed conflict requires that medical treatment is considered for the
support of both stability tasks (restore essential services), as well as required support to the deployed force and
potential follow-on force. Shortages of medical equipment, Class VIII supplies, and personnel issues should be
addressed in this strategic role. In support of consolidate gains activities, PVNTMED detachments will be
involved in working with UAPs to assist their efforts to perform stability tasks for their populations. PVNTMED
detachments and teams will also continue to be involved with similar responsibilities and tasks found in
competition and crisis roles. PVNTMED detachments, teams, and medical planners should assess and modify
PVNTMED contingency or OPLANs in support of operations for returning to a state of crisis or competition.
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Figure 4-30. Operational Public Health in Armed Conflict
VETERINARY SERVICES
4-113. As the sole provider of DOD veterinary services, In armed conflict, Army veterinary services personnel
will be in direct support of the USMC, USN, USAF, as well as other federal agencies, host nations, and
multinational forces, as directed. Veterinary services during armed conflict includes tasks and activities
performed in competition and crisis. Other tasks may include:
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Veterinary Roles 1 and 2 as well as Veterinary Role 3 advanced canine medical/surgical care and
definitive and restorative military working dog dental care to include endodontic procedures.
Veterinary Role 3 evacuation/ hospitalization support for military working dogs.
Veterinary Role 3 hospitalization for DOD contract working dogs.
Continuation of the food and water mission including sanitary audit inspections of local food
establishments and inspecting operational rations (ready to eat meals and unitized group rations).
Food defense vulnerability assessments.
Veterinary public health (prevention and mitigation of the effects of foodborne disease and the
prevention of zoonotic diseases transmissible to man).
Endemic zoonotic and foreign animal disease epidemiology surveillance and control.
Animal facility and kennel inspections.
Commercial food source audits for DOD procurement.
Maintaining the health and treating military working animals.
Coordinating evacuation of military working dogs and DOD contract working dogs.
4-114. During armed conflict and METT-TC (I) dependent, the full complement of veterinary services assets
are deployed and located within the operational area based on the order process, planning estimates, and
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population at risk. When deployed the MDVS is assigned to the TMC, MEDBDE (SPT), or MMB and per its
basis of allocation continues to provide veterinary services within the theater, corps, and division echelons.
4-115. Many types of ongoing veterinary services mission support requirements are conducted while
consolidating gains. While some maneuver units may still be engaged in combat operations, others may have
transitioned to stability tasks. The MDVS must maintain situational awareness in order to remain flexible and
conform to the operational commander’s requirements. This will require the MDVS to continue to assess running
estimates and be prepared to provide all aspects of veterinary services while reducing capacities in support of
forward movement is support of armed conflict operations, redeployment operations and downsizing the footprint
in theater. Additionally, many of the veterinary global health engagement activities or stability tasks that occurred
in competition and crisis still require support in consolidation of gains. During transition operations, MDVSs,
veterinary teams, and medical planners should assess and modify veterinary services contingency or OPLANs in
support of returning to a state of crisis or competition.
Figure 4-31. Veterinary Services in Armed Conflict
COMBAT AND OPERATIONAL STRESS CONTROL
4-116. In armed conflict, organic behavioral health section provide COSC services at the brigade and COSC
detachment provides behavioral health support to a division/corps. In support of armed conflict COSC
detachments must remain as flexible as possible. The COSC detachment can deploy small teams to forward
maneuver units to provide direct support or augment the unit’s organic behavioral health capabilities. In addition
to behavioral health triage, care and stabilization the unit provides planning and staff advice to operational HQs
regarding the stressors affecting the Soldiers, mental readiness, morale, and cohesion. Behavioral health sections
and COSC personnel continue to provide education and training for leaders, chaplains, and medical personnel as
well as preventive consultation.
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4-117. During armed conflict and METT-TC (I) dependent, COSCs are deployed and strategically located
within the operational area based on the order process, planning estimates, and population at risk factors. When
deployed the COSC is assigned to the MMB and per its basis of allocation provides COSC services within the
theater, corps, and division echelons.
4-118. The ability to evacuate patients during large-scale ground combat will likely be limited and may only
occur during short periods when the operational situation is permissive enough. Therefore, behavioral health
sections and COSCs need to be prepared to provide care for patients for prolonged periods of time, which might
be longer than they are comfortable with or longer than the theater evacuation policy normally allows for. Class
VIII stocks, bed management, medical regulating, and maximizing RTDs are just a few key considerations in a
prolonged care situation.
4-119. During consolidation of gains, behavioral health sections and COSC detachment support reconstitution
by maximizing the return to duty rate within the limits of the theater MEDEVAC policy and patient status, as
close to the supported unit as possible. During transition operations, medical planners should assess and modify
COSC services contingency or OPLANs in support of returning to a state of crisis or competition.
Figure 4-32. COSC in Armed Conflict
DENTAL SERVICES
4-120. Dental personnel in armed conflict have the additional wartime role of augmenting medical personnel
during mass casualty situations. Under these circumstances, dental officers may be called upon to augment and
assist the medical staff of these facilities in treating the sick and injured. Dental teams may be employed
throughout the AOR dependent on METT-TC (I). With the inclusion of the entire DCAS we add the capability
of the Field Dental Clinic (Area). This clinic provides operational dental care consisting of emergency dental
care and essential dental care. The clinic is broken down into a specialty section and general dentistry section.
The specialty section provides comprehensive dental care, endodontics, periodontics, and prosthodontics
specialty care.
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4-121. During armed conflict and METT-TC (I) dependent, DCASs are deployed and located within the
operational area based on the order process, planning estimates, and population at risk factors. When deployed
the DCAS is assigned to the TMC or MEDBDE (SPT) and per its basis of allocation provides operational dental
services within the theater, corps, and division echelons.
4-122. Numerous categories of personnel seek care in U.S. facilities during consolidation of gains in support of
armed conflict where host-nation civilian dental infrastructure is nonexistent or is not capable of providing
adequate care. Conducting a dental assessment does not obligate the U.S. military to provide the full spectrum
of dental care. Although it does obligate the MTF or DCAS to provide immediate stabilization for life-, limb-,
and eyesight-threatening dental conditions and to prepare the patient for evacuation to the appropriate civilian or
national contingent MTF when the patient’s dental condition permits. During transition operations, medical
planners should assess and modify dental services contingency or OPLANs in support of returning to a state of
crisis or competition.
Figure 4-33. Dental Services in Armed Conflict
LABORATORY SERVICES
4-123. In armed conflict, organic clinical laboratory personnel continue providing medical laboratory services
at the brigade and the AML continues to identify and evaluate health hazards in the AO through unique medical
laboratory analyses and rapid health hazard assessments of nuclear, biological, chemical, endemic disease,
occupational and environmental health threats.
4-124. During armed conflict and METT-TC (I) dependent, the full complement of medical laboratory assets
are deployed and located within the operational area based on the order process, planning estimates, and
population at risk factors. When deployed the AML is assigned/attached to a TMC , a MEDBDE (SPT), the 20th
CBRN Command, and may be further attached to other deployed medical units as needed. When deployed in
support of armed conflict, the AML The AML can operate in a split-base mode with the stay-behind headquarters
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element remains in CONUS or at EAC and conducts associated laboratory analysis, consultation, and referral of
specimens to non-AML organizations, as appropriate. The AML integrates its functional capabilities with other
AMEDD and non-AMEDD assets to enhance the identification of medical threat agents; provides accurate field
confirmation of suspect samples/ specimens; and performs health hazard assessments across full spectrum
operations. The deployed AML sections can provide—
⚫ Analytical, investigative and consultative capabilities to identify nuclear, biological and chemical
threat agents in biomedical specimens and other samples from the AO.
⚫ Analytical, investigative and consultative capabilities to assist in the identification of occupational
and environmental health hazards and endemic diseases.
⚫ Special environmental control and containment to evaluate biomedical specimens for the presence
of highly infectious or hazardous agents of operational concern.
⚫ Data and data analysis to support medical analysis and operational decisions.
⚫ Medical laboratory analysis to support the diagnosis of zoonotic and significant animal diseases
that impact on military operations.
⚫ Tailorable force projections to support war and other operations.
⚫ Deployed modular sections or sectional teams will normally be deployed forward in the Corps area
where they will interface with preventive medicine teams, veterinary teams, forward support
medical units, Biological Integrated Detection System (BIDS) teams, and chemical company
elements operating in the Corps area
4-125. While conducting consolidation of gains it may include many kinds of ongoing medical laboratory
mission support requirements. Medical laboratory assets must maintain situational awareness in order to remain
flexible and conform to the operational commander’s requirements. This will require the medical C2 headquarters
to continue to assess running estimates and be prepared to provide all aspects of medical laboratory services while
reducing capacities in support of forward movement is support of armed conflict operations, redeployment
operations and downsizing the footprint in theater. Additionally, many of the UAP engagement activities that
occurred in competition and crisis will require support in consolidation of gains. During transition operations,
medical planners should begin development of medical laboratory services contingency or OPLANs for going
back to a state of crisis or competition.
Figure 4-34. Laboratory Services in Armed Conflict
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MEDICAL TREATMENT (ORGANIC AND AREA SUPPORT)
4-126. Conducting armed conflict tasks and seizing the initiative during LSCO results in higher rates of
casualties (ill and injured) with rapid and fluid offensive and defensive maneuvers by the combatants. Movement
and maneuver is frequent, dwell time is limited, communication, synchronization, rapid evacuation (if possible),
combined with necessity for planning and conducting prolonged care with limited Class VIII is possible. Enemy
indirect and direct fires coupled with their enhanced situational awareness, punishes combatant elements as well
as medical elements. Large-scale combat operations with a peer/near-peer who can challenge the United States
military in all domains will produce casualty (ill and injured) rates not seen since World War 2. In this OE there
are no safe havens to conduct medical treatment in organic support, or area support at any deployed role of care.
4-127. In large-scale combat, evacuation lines will become extended as maneuver forces achieve success
requiring increased synchronization between MEDEVAC units and Role 1 and Role 2 units to validate AXPs, the
ambulance shuttle system, unit locations, and status. In large-scale combat operation ground MEDEVAC will be
the primary means of MEDEVAC. Ground ambulance crews may have to perform en route care for extended
periods of time and distance when the OE precludes AE. Role 1 units are not designed or manned to hold patients;
Despite this, the combat situation may require the Role 1 and Role 2 to execute prolonged care operations.
Consideration of this possibility requires that thought be given this potential event. The Role 1 BASs must plan
to address clearing the BAS of patients in order to facilitate movement in support of assigned maneuver units.
Role 2 medical companies must be emptied of patients in order to be capable of moving to sustain proximity with
the supported unit(s). This places great demands upon medical treatment and MEDEVAC elements performing
en route care as well as the area support elements in the AO. Additionally, the Role 1 BAS and Role 2
BSMC/MCAS should be prepared to conduct walking blood banks to collect and utilize whole blood as the
resuscitative fluid of choice.
4-128. During armed conflict, the full complement of medical treatment assets are deployed within the
operational area. METT-TC (I) dependent, these medical treatment assets are placed within the operational area
to provide organic and area support medical treatment. During transition operations, medical planners should
assess and modify medical treatment contingency or OPLANs for returning to a state of crisis or competition.
4-129. While conducting consolidation of gains it may include many kinds of ongoing medical treatment
mission support requirements. While some maneuver units may still be engaged in combat operations, others
may have transitioned to stability tasks. Operational medicine formations performing medical treatment must
maintain situational awareness in order to remain flexible and conform to the operational commander’s
requirements. This will require the medical C2 headquarters to continue to assess running estimates and be
prepared to provide all aspects of medical treatment while reducing capacities in support of forward movement is
support of armed conflict operations, redeployment operations and downsizing the footprint in theater.
Additionally, many of the UAP engagement activities that occurred in competition and crisis will require support
in consolidation of gains.
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Figure 4-35. Medical Treatment in Armed Conflict
HOSPITALIZATION
4-130. The Role 3 hospital provides hospitalization to corps and divisions, per their basis of allocation. Role 3
hospitals must remain as flexible as possible. While the hospital center was designed to be modular, it is still a
significant effort to relocate any part or all the hospital. Commanders and staffs must plan for and maintain
situational awareness of possible requirements to relocate Role 3 capabilities. This may include task organizing
limited amounts of Role 3 capabilities (that is, damage control resuscitation, damage control surgery, ICU) and
employing it in direct support of a maneuver unit engaged in heavy combat operations. The Role 3 should be
prepared to conduct walking blood banks to collect and utilize whole blood as the resuscitative fluid of choice.
In addition, support may include providing hospitalization to detainees. This will require a significant amount of
coordination with the MEDBDE(SPT) and other enabling capabilities within the AO (such as, military police and
sustainment units).
4-131. While conducting offensive operations, a Role 3 hospital must be prepared to move forward to stay in
proximity of supported forces. Due to the time it takes to de-complex a Role 3 hospital and METT-TC (I)
dependent, the Role 3 hospital may only setup 208 of its 240 beds. This leaves one 32-bed field hospital packed
up and on order is ready to move to a new location. Once setup and FOC the 208-bed hospital can de-complex,
pack up, and move to the new location and re-complex. At the new location, the 32-bed hospital that just arrived
will remain packed up and ready to jump to a new location when directed. Medical commander’s do assume risk
with not setting up the full 240-bed Role 3. Commander's need to weigh their options when supporting the
operational commander's intent while conducting operations in armed conflict.
4-132. The ability to evacuate patients during large-scale ground combat operations with a peer/near peer will
likely be limited and may only occur during short periods when the OE is permissive enough. Therefore, Role 3
hospitals need to clear beds regularly and be prepared to provide care for patients for prolonged periods of time,
which might be longer than they are comfortable with or longer than the theater evacuation policy normally allows
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for. When conducting prolonged care operations at a Role 3 hospital, the hospital commander must be prepared
to clear beds at a moment’s notice during windows of opportunity. Class VIII stocks, bed management, medical
regulating, and maximizing RTDs are just a few key considerations in a prolonged care situation. The Role 3
hospital supports reconstitution by maximizing the return to duty rate within the limits of the theater evacuation
policy and patient status, as close to the supported unit as possible.
4-133. During armed conflict and METT-TC (I) dependent, Role 3 hospitals are deployed and located within
the operational area based on the orders process, planning estimates, and population at risk factors. When
deployed the Role 3 hospital is assigned to the MEDBDE (SPT) and per its various basis of allocations provides
Role 3 hospitalization within the theater, corps, and division echelons. In addition to the various Role 3
augmentation detachments designed around the hospital center there are several other capabilities that can be
employed at the Role 3. Through the orders process the Role 3 may have the following units attached:
Medical Detachment, Forward Resuscitative and Surgical
4-134. This detachment is a Role 3 capability that METT-TC (I) dependent, can be utilized at Role 2. When
not forward deployed with a Role 2 the FRSD is attached to the Role 3 to augment their surgical capability. The
FRSD personnel insert themselves into the surgery schedules of the Role 3 but keep their equipment packed and
ready to forward deploy. The FRSD provides forward damage control resuscitation (DCR) and damage control
surgery (DCS) for short and extended military HSS operations. See pages 118-112 The FRSD is capable of —
⚫ Deploying as a complete FRSD, consisting of the following components: administration/supply,
two surgical and two resuscitative elements (20 personnel). In this configuration the FRSD
provides emergency treatment to receive, triage, and prepare 30 incoming casualties for surgery
over a 72 hour period; provides the required surgery and continued postoperative care for critically
wounded/injured patients with organic medical equipment sets (MES). Postoperative care can
manage 8 patients over 6 hours post-surgery.
⚫ Deploying as two resuscitative and surgical elements, capable of supporting split based operations,
each consisting of administration/supply, surgical and resuscitative sections (10 personnel). In this
configuration the FRSD provides emergency treatment to receive, triage, and prepare 12 incoming
casualties for surgery over a 72 hour period; provides the required surgery and continued
postoperative care for critically wounded/injured patients with organic MES. Postoperative care
can manage 4 patients over 6 hours post-surgery.
⚫ Deploying two surgical elements, capable of supporting very short duration (24 hours) operations,
consisting of only a surgical element (6 personnel). In its smallest configuration, the single surgical
element provides emergency treatment to receive, triage, and prepare 4 incoming casualties for
surgery; provides the required surgery and limited continued post-operative care for those
critically wounded/injured patients over a period of 24 hours with its organic MES.
⚫ Providing urgent initial surgery for otherwise non-transportable patients, primarily when attached
to a Role 2 MTF to maximize health system synergies (e.g., access to x-ray, ancillary support,
patient holding, proximity to evacuation modalities), or when co-located with another organization
capable of meeting its support requirements.
⚫ Providing postoperative acute nursing care for up to 8 patients simultaneously for up to 6 hours
prior to further patient evacuation.
⚫ Technical advice and assistance to the supported unit surgeon and the surgeon section/medical
operations center for the surgical services portion of the supported unit plans and policies.
Hospital Augmentation Team, Head and Neck
4-135. This teams provides ear, nose and throat surgery, neurosurgery and eye surgery augmentation in support
of theater hospitals and consultative services as required. See pages 116-117. This team can provide—
⚫ Initial and secondary ear, nose, and throat surgery and consultation services in support of theater
hospitals.
⚫ Initial and secondary neurosurgery and consultation services in support of theater hospitals.
⚫ Initial and secondary eye surgery and consultation services in support of theater hospitals.
⚫ Augmentation to the hospital operating room surgical and nursing services.
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⚫
A medical materiel set (MMS) radiology, computerized tomography which enables the hospital to
perform computerized tomography examinations.
⚫ Three days of supply for use upon deployment and during routine operations.
Medical Detachment, Minimal Care (120 Cot)
4-136. This detachment provides minimal care/convalescent care, hospitalization, nursing, and rehabilitative
services in support of theater hospitals. See pages 113-115. This detachment can provide—
⚫ Augmentation of the hospital to which attached to provide hospitalization and minimal nursing
care for up to 120 ambulatory patients and for reconditioning and rehabilitation for those patients
who can return to duty within the theater evacuation policy or who are awaiting further
MEDEVAC.
⚫ Physical therapy and occupational therapy services for patients.
⚫ Augmentation for the emergency nursing capabilities of the hospital to which attached during mass
casualty situations.
⚫ Augmentation to the nutrition care capabilities of the hospital to which attached to support patient
feeding of this detachment.
⚫ Augmentation to the Patient Admin Section of the hospital to which attached to support patient
records.
⚫ Three days of supply level for all organic elements upon deployment and during routine operations.
4-137. While conducting consolidation of gains it may include many kinds of ongoing mission support
requirements. While some maneuver units may still be engaged in combat operations, others may have
transitioned to stability tasks. The Role 3 hospital must maintain situational awareness in order to remain flexible
and conform to the operational commander’s requirements. This will require the hospital to continue to assess
running estimates and be prepared to provide all aspects of Role 3 care while reducing capacities in support of
forward movement is support of armed conflict operations, redeployment operations and downsizing the footprint
in theater (such as, reducing the number of ICU and ICW beds). Additionally, many of the UAP engagement
activities that occurred in competition and crisis will require support in consolidation of gains. Key to the
successful consolidation of gains will be for the host nation to restore essential services, which includes a hospital
system that is self-sufficient.
4-138. During transition operations, coordination between the outgoing and incoming commands is vital to
ensure a smooth hand off and continuity of operations. Coordination should be made between the outgoing and
incoming commands to determine if medical assets (personnel, equipment, and supplies) are required to be left
behind including planning for disposal of equipment and supplies that cannot be redeployed. Role 3 hospital
planners should assess and modify Role 3 contingency or OPLANs in support of operations for returning to state
of crisis or competition.
Medical Detachment (Prolonged Care Augmentation Detachment)
4-139.
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This detachment will be active in FY25. See pages 123-125.
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Figure 4-36. Hospitalization in Armed Conflict
MEDICAL EVACUATION (TO INCLUDE MEDICAL REGULATING)
4-140. In support of armed conflict, ground and air MEDEVAC units provide direct and area support to units
operating in the theater, corps, division, and BCT AO. These MEDEVAC assets provide continuum of care as
patients are evacuated, higher from lower, from POI or company CCPs to Role 1, from Role 1 to the BSMC Role
2, and from Role 2 to Role 3. Patients may bypass the next higher role of care in order to obtain specialty care if
needed but in LSCO this is highly unlikely. In the corps and division support areas, MEDEVAC support is
provided on an area basis by EAB MCAS and MCGA companies as well as organic division MCAA or attached
MCAAs in the corps. Additionally, in accordance with the basis of allocation of the MCGA each deployed senior
Army headquarters is authorized 2 MCGA.
4-141. During armed conflict and METT-TC (I) dependent, the full complement of MEDEVAC assets are
deployed and located within the operational area based on the order process, location of MTFs, planning
estimates, and population at risk factors. When supporting LSCO, in a peer/near peer OE, MEDEVAC may only
be able to be conducted during windows of opportunity. This limits the use of AE and places ground MEDEVAC
as the primary means of clearing the battlefield of patients to maximize freedom of maneuver and movement for
operational commanders. Medical planners must include this variable in their running estimates and within the
planning process. When deployed, maneuver ground MEDEVAC assets are organic to the BCT, EAB ground
MEDEVAC assets are assigned to the MMB, and AE assets are assigned to the combat aviation brigade. Per
their various basis of allocations, each provide MEDEVAC support at echelon. Once deployed, EAB MEDEVAC
assets can provide—
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The Medical Company (Ground Ambulance)
4-142. The MCGA provide ground evacuation within and assigned AO. The MCGA is employed at EAB and
within the BCT and is tactically located where it can best control its assets and execute its patient evacuation
mission. The MCGA can provide—
⚫ Single lift evacuation of 96 litter patients or 192 ambulatory patients, or a combination of both.
⚫ Evacuation of patients from the Role 2 BSMC and MCAS to supporting hospitals.
⚫ Reinforcement of BSMC evacuation assets.
⚫ Reinforcement of covering force and deep operations.
⚫ Movement of patients between hospitals and in route patient staging systems, railheads, or seaports
in brigade and EAB areas.
⚫ Area evacuation support beyond the capability of the MCAS.
⚫ Emergency movement of medical supplies and personnel.
⚫ Vehicle refueling support for the MMB, when co-located or ambulance shuttle system operations.
The Medical Company (Air Ambulance)
4-143. The MCAA provides AE support to the BCT, division, and corps and is employed within the theater,
corps, and division. It is tactically located where it can best control its assets and execute its patient evacuation
mission. The MCAA can provide—
⚫ Fifteen helicopter ambulances to evacuate critically wounded or other patients consistent with
evacuation priorities and operational considerations, from points as far forward as possible, to
Brigade MTFs and hospitals. Total lift capability utilizing all assigned aircraft is 90 litter patients
or 105 ambulatory patients, or some combination thereof.
⚫ One Area Support MEDEVAC Platoon (3 aircraft) that will normally locate with the Company
Headquarters.
⚫ Four Forward Support MEDEVAC Platoons (3 aircraft each) that can be independently or group
deployed.
⚫ Air crash rescue support.
⚫ Expeditious delivery of whole blood, biological, and medical supplies to meet critical
requirements.
⚫ Rapid movement of medical personnel and accompanying equipment/supplies to meet the
requirements for mass casualty, reinforcement/reconstitution, or emergency situations.
⚫ Movement of patients between hospitals, aero-medical staging facilities, hospital ships, casualty
receiving and treatment ships, seaports, and railheads in the Theater, Division, and Brigade AO.
4-144. During LSCO against a peer/near peer enemy, units will simultaneously conduct actions to seize, retain,
and exploit the initiative. The complexity and lethality of the environment will require MEDEVAC units to
operate across multiple domains (air, land, cyber), in a synchronized effort with the MTFs to clear the battlefield
thereby sustaining the initiative of the maneuver commander. A key aspect of LSCO is its joint nature. Medical
planners and commanders can mitigate problems by providing a plan that synchronizes CASEVAC, MEDEVAC,
en route care, and treatment capabilities, addresses constraints and limitations, and standardizes terms and
procedures. Other Service representatives should be included into planning efforts when feasible and integrated
into battle rhythm events pertaining to MEDEVAC and MTFs.
4-145. Consolidation of gains in support of armed conflict sees MEDEVAC assets at their highest capacity and
may include combat against remnant or bypassed enemy forces. This presents a threat to MEDEVAC units and
teams utilizing evacuation routes or manning AXPs/ALPs and should be mitigated by accompanying security
assets, if available. MEDEVAC support during consolidation of gains may be on an area or direct support basis
to maneuver forces in corps or division areas of operation. MEDEVAC operations continue to follow the
traditional support provided to maneuver forces. MEDEVAC support may require elements to provide direct
support to maneuver forces in one area while supporting stability tasks in another. A key factor for MEDEVAC
support will be for the host nation to reestablish its own ability to provide medical services for its population to a
reasonable level it possessed prior to hostilities and to support the legitimacy of the host nation. During transition
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operations, MEDEVAC assets and medical planners should assess and modify MEDEVAC support contingency
or OPLANs in support of operations for returning to a state of crisis or competition.
Figure 4-37. Medical Evacuation in Armed Conflict
MEDICAL LOGISTICS (TO INCLUDE BLOOD MANAGEMENT)
4-146. At the strategic level, the OTSG also coordinates with the Defense Health Agency and the national health
system for increased requirements for medical services and the Armed Services Blood Program for surge of Class
VIIIb (blood and blood products). The TMC maintains theater level coordination with the theater sustainment
command/expeditionary sustainment command for maintenance, supply and field services, facilities,
transportation, general skills (with continued emphasis on interpreter support), distribution of Class VIII, and
engineering support to medical operations in support of armed conflict. The TMC leverages regional medical
agreements and provides medical enterprise reach-back to mitigate theater-level FHP and HSS shortfalls in
support of armed conflict. Measures are also being taken to resource, coordinate, sustain, and synchronize large
scale casualty events. The TMC and MEDBDE (SPT) interface and integrate into the transportation network to
monitor movement of incoming personnel and equipment and extend the medical materiel chain, as necessary.
Medical logistics elements conduct resupply of class VIIIa by push package in coordination with sustainment
elements and by lifts of opportunity. Class VIIIb blood and blood products are distributed to Role 1-3 MTFs.
Walking blood banks may also be established. The TMC, MEDBDE (SPT), and MMB continue to manage the
theater medical maintenance strategy to ensure lifesaving medical equipment is regularly inspected and that the
plan for repairing non mission capable pieces of medical equipment is being executed by medical maintenance
assets throughout the theater.
4-147. When preparing for AHS support to armed conflict, the OTSG releases APS Army War Reserve Stocks
as required. The U.S. Army Medical Materiel Agency coordinates through Army Medical Logistics Command
and Army Materiel Command for release of medical Army War Reserve Stocks to identified medical units.
Strategic MEDLOG organizations work through AMLC to coordinate with—
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⚫
DLA to leverage the strategic acquisition framework, which links operational forces with nationallevel industry partners for increased Class VIIIa surge capacity.
⚫ The national medical enterprise for increased medical device maintenance and repair support.
⚫ Financial management personnel for anticipated international enterprise or host nation outsourcing
for projected and emerging Class VIIIa shortfalls in operations plans.
4-148. During armed conflict and METT-TC (I) dependent, the full complement of MEDLOG assets are
deployed and located within the operational area based on the orders process, planning estimates, and population
at risk factors. When deployed the MEDLOG assets are assigned to various headquarters per their table of
organizations and equipment section 1 and basis of allocations and provide all facets of MEDLOG support (Class
VIIIa, Class VIIIb, medical maintenance, and optical) at echelon.
4-149. During consolidation of gains in support of armed conflict, enterprise level organizations continue
delivering AHS support to recovering personnel and generating medical combat power in response to contingency
requirements. Theater and operational level elements including the TMC and TSC as well as the MEDBDE
(SPT), MMB, and sustainment BDE coordinate for sustainment (including distribution of Class VIII, engineering
support to medical support operations, and medical maintenance operations) in support of cooperations. Theater
and operational level medical elements also develop requirements for medical and nonmedical contracting support
and shaping activities are also being conducted for transition back to competition. During transition operations,
MEDLOG assets and medical planners should assess and modify MEDLOG support contingency or OPLANs in
support of retuning to a state of crisis or competition.
Figure 4-38. Medical Logistics (Class VIIIa) in Armed Conflict
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Figure 4-39. Medical Logistics (Class VIIIb) in Armed Conflict
Figure 4-40. Medical Maintenance in Armed Conflict
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Army Health System Terms
Appendix A
Army Health System Terms
The AHS terms listed below are a synopsis of medical terminology located in the DOD
Dictionary of Military and Associated Terms and FM 1-02.1, Operational Terms.
aeromedical evacuation
The movement of patients under medical supervision to and between medical treatment facilities by air
transportation. Also called AE. (JP 4-02)
ambulance control point
A manned traffic regulating, often stationed at a crossroad or road junction, where ambulances are
directed to one of two or more directions to reach loading points and medical treatment facilities. (ATP
4-02.2)
ambulance exchange point
A location where a patient is transferred from one ambulance to another en route to a medical
treatment facility. Also called AXP. (ATP 4-02.2)
ambulance loading point
This is the point in the shuttle system where one or more ambulances are stationed ready to receive
patients for evacuation. (ATP 4-02.2)
ambulance relay point
A point in the shuttle system where one or more empty ambulances are stationed to advance to a
loading point or to the next relay post to replace departed ambulances. (ATP 4-02.2)
ambulance shuttle system
A system consisting of one or more ambulance loading points, relay points, and when necessary,
ambulance control points, all echeloned forward from the principal group of ambulances, the company
location, or basic relay points as tactically required. (ATP 4-02.2)
amnesia
A lack of memory. Amnesia related to trauma, such as concussion, can be either antegrade or
retrograde. Antegrade amnesia is the inability to form new memories following the traumatic event
(typically not permanent). (ATP 4-02.5)
area of operations
An operational area defined by the joint force commander for land and maritime forces that should be
large enough to accomplish their missions and protect their forces. Also called AO. (JP 3-0)
area support
A method of logistics, medical support, and personnel services in which support relationships are
determined by the location of the units requiring support. Sustainment units provide support to units
located in or passing through their assigned areas. (ATP 4-90).
Army Health System
A component of the Military Health System that is responsible for operational management of the HSS
and force health protection missions for training, predeployment, deployment, and postdeployment
operations. Army Health System includes all mission support services performed, provided, or
arranged by the Army Medicine to support HSS and force health protection mission requirements for
the Army and as directed, for joint, intergovernmental agencies, coalition, and multinational forces.
Also called AHS.
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battalion aid station
The forward-most medically staffed treatment location organic to a maneuver battalion. (ATP 4-02.3)
battle injury
Damage or harm sustained by personnel during or as a result of battle conditions. Also called BI. (JP
4-02)
casualty
Any person who is lost to the organization by having been declared dead, duty status— whereabouts
unknown, missing, ill, or injured. (JP 4-02)
casualty collection point
A location that may or may not be staffed, where casualties are assembled for evacuation to a medical
treatment facility. (Currently the proponent is FM 4-02 but will be moved to ATP 4-02.2 when
revised.)
casualty evacuation
The movement of casualties aboard nonmedical vehicles or aircraft without en route medical care.
Also called CASEVAC. (Currently the proponent is FM 4-02 but will be moved to ATP 4-25.13 when
revised.)
choking agent
A chemical warfare agent which produces irritation to the eyes and upper respiratory tract and damage
to the lungs, primarily causing pulmonary edema. Also known as lung-damaging agent. (ATP 4-02.85)
combat and operational stress control
A coordinated program of actions taken by military leadership to prevent, identify, and manage
reactions to traumatic events that may affect exposed organizations and individuals during unified land
operations. Also called COSC. (Currently the proponent is FM 4-02 but will be moved to ATP 4-02.51
when published.)
combat and operational stress reaction
Describes the wide range of anticipated, maladaptive psychological and physical symptoms, generally
transient, of any severity and nature which occur in individuals without any apparent mental disorder
in response to combat and operational stress exposure, and which usually subside within hours or days.
(ATP 4-02.5)
combat lifesaver
A nonmedical Soldier of a unit trained to provide enhanced first aid as a secondary mission. (Currently
the proponent is FM 4-02 but will be moved to ATP 4-02.11 when published.)
continuity of care
Attempt to maintain the role of care during movement between roles at least equal to the role of care at
the preceding facility. (FM 4-02)
definitive care
Care or treatment which returns an ill or injured Soldier achieving maximum medical improvement.
(FM 4-02)
definitive treatment
The final role of comprehensive care provided to return the patient to the highest degree of mental and
physical health possible. It is not associated with a specific role or location in the continuum of care; it
may occur in different roles depending upon the nature of the injury or illness. (FM 4-02)
dental care
The preventive and restorative treatments of the hard and soft oral structures, which is comprised of
operational dental care and comprehensive dental care. (Currently the proponent is ATP 4-02.5, but
will be in ATP 4-02.19 when revised.)
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Army Health System Terms
direct support
(Army) a support relationship requiring a force to support another specific force and authorizing it to
answer directly to the supported force’s request for assistance. (FM 3-0)
disease and nonbattle injury
All illnesses and injuries not resulting from enemy or terrorist action or caused by conflict. Also called
DNBI. (JP 4-02).
emergency medical treatment
The immediate application of medical procedures to the wounded, injured, or sick by specially trained
medical personnel. (FM 4-02)
en route care
The care required to maintain the phased treatment initiated prior to evacuation and the sustainment of
the patient’s medical condition during evacuation. (Currently the proponent is FM 4-02 but will be
moved to ATP 4-02.2 when revised.)
essential care
The absolutely necessary initial, en route, resuscitative, and surgical care provided to save, stabilize,
and return as many Soldiers to duty as quickly as possible. (FM 4-02)
first aid (self-aid/buddy aid)
Urgent and immediate lifesaving and other measures which can be performed for casualties (or
performed by the victim himself) by nonmedical personnel when medical personnel are not
immediately available. (Currently the proponent is FM 4-02 but will be moved to ATP
4-02.11 when published.)
5 R’s
Actions used for combat and operational stress reaction control that include—Reassure of normality;
Rest (respite from combat or break from the work); Replenish bodily needs (such as thermal comfort,
water, food, hygiene, and sleep); Restore confidence with purposeful activities and contact with his
unit; Return to duty and reunite Soldier with his unit. (ATP 4-02.5)
force health protection
(Army) Force health protection are measures that promote, improve, or conserve the behavioral and
physical well-being of Soldiers comprised of preventive and treatment aspects of medical functions
that include: combat and operational stress control, dental services, veterinary services, preventive
medicine, and laboratory services. Enabling a healthy and fit force, prevent injury and illness, and
protect the force from health hazards. (FM 4-02).
forward resuscitative surgery
Urgent initial surgery required to render a patient transportable for further evacuation to a medical
treatment facility staffed and equipped to provide for the patient’s care. (Currently the proponent is FM
4-02 but will be moved to ATP 4-02.25 when published.)
health service support
(Army) Health service support is support and services performed, provided, and arranged by the Army
Medicine to promote, improve, conserve, or restore the behavioral and physical well-being of
personnel by providing direct patient care that include medical treatment (organic and area support)
and hospitalization, medical evacuation to include medical regulating, and medical logistics to include
blood management. (FM 4-02)
hospital
A medical treatment facility capable of providing inpatient care. It is appropriately staffed and
equipped to provide diagnostic and therapeutic services, as well as the necessary supporting services
required to perform its assigned mission and functions. A hospital may, in addition, discharge the
functions of a clinic. (Currently the proponent is FM 4-02 but will be moved to ATP 4-02.10 when
published.)
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Appendix A
hostile casualty
A person who is the victim of a terrorist activity or who becomes a casualty “in action.” “In action”
characterizes the casualty as having been the direct result of hostile action, sustained in combat or
relating thereto, or sustained going to or returning from a combat mission provided that the occurrence
was directly related to hostile action. Included are persons killed or wounded mistakenly or
accidentally by friendly fire directed at a hostile force or what is thought to be a hostile force.
However, not to be considered as sustained in action and not to be interpreted as hostile casualties are
injuries or death due to the elements, self-inflicted wounds, combat and operational stress reaction, and
except in unusual cases, wounds or death inflicted by a friendly force while the individual is AWOL,
deserter, or dropped-from-rolls status or is voluntarily absent from a place of duty. (AR 638-8)
inpatient
A person admitted to and treated within a Role 3 and 4 hospital and who cannot be returned to duty
within the same calendar day. (Currently the proponent is FM 4-02 but will be moved to ATP 4-02.10
when published.)
lines of patient drift
Natural routes along which wounded Soldiers may be expected to go back for medical care from a
combat position. (Currently the proponent is FM 4-02 but will be moved to ATP 4-02.2 when
published.)
mass casualty
Any number of human casualties produced across a period of time that exceeds available medical
support capabilities. Also called MASCAL. (JP 4-02)
medical evacuation
The timely and effective movement of the wounded, injured, or ill to and between medical treatment
facilities on dedicated and properly marked medical platforms with en-route care provided by medical
personnel. Also called MEDEVAC. (Currently the proponent is FM 4-02 but will be moved to ATP 402.2 when published.)
medical evaluation or assessment
A meeting between a Soldier and a person with medical training (combat medic, physician assistant,
physician, or other health care provider) to ensure the health and well-being of the Soldier.
Components of this evaluation include reviewing a history (events surrounding injury, review of
symptoms, and the like), a physical examination, and a review of the treatment plan with the Soldier.
(ATP 4-02.5)
medical regulating
The actions and coordination necessary to arrange for the movement of patients through the roles of
care and to match patients with a medical treatment facility that has the necessary health service
support capabilities, and available bed space. (JP 4-02)
medical treatment facility
(Army) Medical treatment facility refers to any facility established for the purpose of providing
medical treatment. This includes battalion aid stations, Role 2 facilities, dispensaries, clinics, and
hospitals. (FM 4-02)
mild traumatic brain injury/concussion
The diagnosis of concussion is made when two conditions are met. In the absence of documentation,
both conditions are based on self-report information. An injury event must have occurred. The
individual must have experienced one of the following: Alteration of consciousness lasting less than 24
hours. Loss of consciousness, if any, lasting for less than 30 minutes. Memory loss after the event,
called posttraumatic amnesia, that lasts for less than 24 hours. Normal structural neuroimaging. (ATP
4-02.5)
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Army Health System Terms
military acute concussion evaluation
A three-part medical screening tool developed by the Defense and Veterans Brain Injury Center to
assist clinical providers with the evaluation of concussion. This tool is available to medical personnel
by e-mailing: info@DVBIC.org. Also referred to as MACE. (ATP 4-02.5)
neuroimaging
A radiographic imaging study to evaluate the brain, to include computerized tomography scan or a
magnetic resonance imaging. (ATP 4-02.5)
nontransportable patient
A patient whose medical condition is such that he could not survive further evacuation to the rear
without surgical intervention to stabilize his medical condition. (Currently the proponent is FM 4-02
but will be moved to ATP 4-02.2 when revised.)
outpatient
A person receiving medical/dental examination and/or treatment from medical personnel and in a
status other than being admitted to a hospital. Included in this category is the person who is treated
and retained (held) in a medical treatment facility (such as a Role 2 facility) other than a hospital.
(Currently the proponent is FM 4-02 but will be moved to ATP 4-02.10 when published.)
patient
A sick, injured or wounded Soldier who receives medical care or treatment from medically trained
personnel. (FM 4-02)
patient decontamination
The removal and/or the neutralization of hazardous levels of chemical, biological, radiological, and
nuclear contamination from patients before admission into a medical treatment facility under the
supervision of medical personnel to prevent further injury to the patient during the decontamination
process. (ATP 4-02.7)
patient estimates
Estimates derived from the casualty estimate prepared by the personnel staff officer/assistant chief of
staff, personnel. The patient medical workload is determined by the Army Health System support
planner. Patient estimate only encompasses medical casualty. (Currently the proponent is FM 4-02 but
will be moved to ATP 4-02.55 when published.)
patient movement
The act of moving a sick, injured, wounded, or other person to obtain medical and/or dental treatment.
(Currently the proponent is FM 4-02 but will be moved to ATP 4-02.2 when revised.)
posttraumatic amnesia
Period of amnesia following a traumatic brain injury. (ATP 4-02.5)
preventive medicine
The anticipation, prediction, identification, prevention, and control of communicable diseases
(including vector-, food-, and waterborne diseases), illnesses, injuries, and diseases due to exposure to
occupational and environmental health threats, including nonbattle injury threats, combat and
operational stress reactions, and other threats to the health and readiness of military personnel and
military units. (Currently the proponent is FM 4-02 but will be moved to ATP 4-02.17 when
published.)
reconditioning program
An intensive 4- to 7-day program (may be extended by exception to theater evacuation policy) of
replenishment, physical activity, therapy, and military retraining for combat and operational stress
control casualties and neuropsychiatric cases (including alcohol and drug abuse) who require
successful completion for return to duty or is evacuated for further neuropsychiatric evaluation. (ATP
4-02.5)
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Appendix A
resuscitative care
Advanced trauma management care and surgery limited to the minimum required to stabilize a patient
for transportation to a higher role of care. (Currently the proponent is FM 4-02 but will be moved to
ATP 4-02.25 when published.)
return to duty
A patient disposition which, after medical evaluation and treatment when necessary, returns a Soldier
for duty in his unit. (FM 4-02)
soldier restoration
A 24- to 72-hour (1- to 3-day) program in which Soldiers with combat and operational stress reactions
receive treatment. (ATP 4-02.5)
stabilized patient
(Joint) A patient whose airway is secured, hemorrhage is controlled, shock treated, and fractures are
immobilized. (JP 4-02)
tailgate medical support
An economy of force device employed primarily to retain maximum mobility during movement halts
or to avoid the time and effort required to set up a formal, operational treatment facility (for example,
during rapid advance and retrograde operations). (ATP 4-02.4).
theater evacuation policy
A command decision indicating the length in days of the maximum period of noneffectiveness that
patients may be held within the command for treatment, and the medical determination of patients that
cannot return to duty status within the period prescribed requiring evacuation by the first available
means, provided the travel involved will not aggravate their disabilities or medical condition.
(Currently the proponent is FM 4-02 but will be moved to ATP 4-02.2 when revised).
triage
The process of sorting casualties based on need for treatment, evacuation, and available resources. (FM
4-02)
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Army Health System Symbology
Appendix B
Army Health System Symbology
The AHS symbology listed below are a synopsis of medical symbols located in MILSTD-2525D, Joint Military Symbology and FM 1-02.2, Military Symbols. They
provide the detailed requirements for composing and constructing symbols. The rules
for building a set of military symbols allow enough flexibility for users to create any
symbol to meet their operational needs. This also includes control measure symbols.
Readers can find defined terms used for symbology in FM 1-02.1, including crossreferences to publications that discuss usage of control measure symbols. All control
measure symbols found in FM 1-02.2 are linked to doctrine.
Medical Main Icons
Function
Icon
Example
Note. The icon has been
enlarged for better visibility
and is not proportional to the
orientation or example
.
Hospital (medical treatment
facility)
Any facility established for the
purpose of providing medical
treatment. This includes
battalion aid stations, Role 2
facilities, dispensaries, clinics,
and Role 3 hospitals/MTFs.
(FM 4-02)
Medical
Promotes, improves,
conserves, or restores the
behavioral and physical wellbeing of personnel in the Army,
and as directed in other
Services, agencies, and
organizations. (See FM 4-02 for
more information on medical.)
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242
Army Health System Symbology
Medical Sector 1 modifiers
Note. Modifiers for medical units are offset to the right to avoid overlapping with the main icon
Function
Icon Note. The icon has
Example
been enlarged for better
visibility and is not proportional
to the orientation or example
Medical Role 1 – Unit-level
medical care capability
provided by the combat medic
or medical treatment provided
by the battalion aid station.
(see FM 4-02)
1
Medical Role 2 – capability to
provide care by area support
squads or medical treatment
platoons of medical companies
with greater medical
capabilities available than Role
1. (see FM 4-02)
2
Medical Role 3 – Capability to
provide hospitals that are
staffed and equipped to
provide care for all categories
of patients, including
resuscitation, initial wound
surgery, damage control
surgery, and postoperative
care. (see FM 4-02)
3
Medical Role 4 – Hospital/
Medical care capability found
at installation level DHA
CONUS-based MTFs and
other safe havens (to include
robust overseas MTFs). (see
FM 4-02)
4
.
Medical evacuation
The timely and effective
movement of the wounded,
injured, or ill to and between
medical treatment facilities on
dedicated and properly marked
ground and air medical
platforms with en route care
provided by medical personnel.
Also called MEDEVAC. (ATP
4-02.2)
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243
Appendix B
Medical Sector 2 modifiers
Note. Modifiers for medical units are offset to the right to avoid overlapping with the main icon.
Function
Icon Note. The icon has been
Example
enlarged for better visibility and
is not proportional to the
orientation or example
Blood – A capability to
receive, account, store, and
distribute blood and blood
products. (see ATP 4-02.1)
COSC – A capability that
provides behavioral health
services such as consultation
and combat and operational
stress control. (see FM 4-02)
Dental services – A capability
to provide consultation, early
treatment of severe oral and
maxillofacial injuries; and to
augment medical personnel (as
necessary)
during
mass
casualty operations. (See FM 402)
Intensive care - depicts
intensive care beds located
within a Role 3 hospital.
Medical bed – A capability to
identify and locate available
bed assets for current and
anticipated needs. (see FM 402, ATP 4-02.5, ATP 4-02.55)
Medical laboratory – A place
equipped for experimental
study in a science or for testing
and analysis. (FM 4-02)
Optometry – A capability to
provide optometry care, optical
fabrication, and repair support
(see FM 4-02)
Patient evacuation
coordination – A NATO term
that may be used in a Joint
environment to integrate
operational, clinical, and
medical regulating
considerations to inform patient
movement activities throughout
the joint operations area.
244
.
IC
LAB
.
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Army Health System Symbology
Preventive medicine – A
capability that provides
consultation and conducts
medical surveillance which
also includes, health risk
communication, education,
field sanitation, pest and vector
control, disease risk
assessment, environmental
and occupational monitoring
and health surveillance,
preventive medicine
measures, health threat
controls for waste (human,
hazardous, and medical)
disposal, food safety
inspection, and potable water
surveillance. (see FM 4-02)
Surgical – A capability to
provide life, limb, or eyesight
saving operative treatment
using specialized instruments
to repair or stabilize a patient.
(see FM 4-02)
Veterinary services – A
capability that provides
consultation, animal care, food
protection, and veterinary
public health services. (See
FM 4-02)
V
Medical main icons for activities
Function
Icon
Example
Note. The icon has been
enlarged for better visibility
and is not proportional to the
orientation or example
Emergency medical
operations
.
.
EMT Station Location
Health Department Facility
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245
Appendix B
Medical main icons for activities (continued)
Medical Facilities Outpatient
Pharmacy
.
POI
Point of injury
Triage
Medical sector 1 modifiers for activities
Function
Icon
Emergency collection
evacuation point
Example
ECEP
Medical CBRN control measures
Control Measure
Template
Example
Wounded personnel
decontamination site
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Army Health System Symbology
Medical control measures
Control Measure
Main Icon (Field A)
Construct example and
symbol translation
Ambulance exchange point
A location where a patient is
transferred from one ambulance to
another en route to a medical
treatment facility.
AXP
Ambulance control point
A point where ambulances may
take one of two or more directions
to reach loading points.
ACP
Ambulance load point
A point where one or more
ambulances are stationed ready to
receive patients for evacuation.
ALP
Ambulance relay point
A point where one or more empty
ambulances are stationed.
ARP
Casualty collection point
A
specific
location
where
casualties are assembled to be
transported to a medical treatment
facility, for example, a company aid
post.
CCP
Medical evacuation pickup
point
U.S. Class VIII
A sustainment distribution point
control measures symbol for
medical supply
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247
Appendix B
AHS unit or element symbols
Title
Symbol
Amplifier Definition
++
xxxx
Theater Medical Command
18TMC
USARPAC
18th Theater Medical
Command; United States Army
Pacific Command
X
++
Medical Brigade (Support)
1MEDBDE (SPT)
68TMC
1st Medical Brigade (Support);
68th Theater Medical
Command
II
Medical Battalion
(Multifunctional)
261MMB
MF
44MEDBDE (SPT)
261st Medical Battalion,
Multifunctional; 44th Medical
Brigade (Support)
II
3
Hospital Center
(240-bed)
9HOSP CTR
1MEDBDE(SPT)
240-BED
I
Field Hospital
(32-bed)
3
586FLD HOSP
531HOSP CTR
32-BED
Hospital Augmentation
Detachment
(Surgical, 24-bed)
3
534SURGICAL
627HOSP CTR
24-BED
Hospital Augmentation
Detachment
(Medical, 32-bed)
248
3
32-BED
433MEDICAL
32HOSP CTR
AHS Doctrine Smart Book
9th Hospital Center; 1st
Medical Brigade (Support) w/
240-Bed Capability
32-Bed, 586th Field Hospital;
531st Hospital Center, w/ 32Bed Capability
24-Bed, 534th Hospital
Augmentation Detachment,
Surgical; 627th Hospital
Center, w/ 24-Bed Capability
32-Bed, 433rd Hospital
Augmentation Detachment,
Medical; 32nd Hospital Center,
w/ 32-Bed Capability
16 March 2023
Army Health System Symbology
AHS unit or element symbols (continued)
Hospital Augmentation
Detachment
(ICW, 60-bed)
60-Bed, 431st Hospital
Augmentation Detachment,
ICW; 16th Hospital Center, w/
16HOSP CTR
60-Bed Capability
3
431ICW
60-BED
Forward Resuscitative and
Surgical Detachment (FRSD)
250FRSD
250th FRSD; 62nd Medical
Brigade (Support)
62MEDBDE (SPT)
319th Medical Detachment,
319MINIMAL CARE Minimal Care; 531st Hospital
Center, w/ 120-Cot Capability
531HOSP CTR
Medical Detachment
(Minimal Care, 120-cot)
120-COT
3
Hospital Augmentation Team
(Head and Neck)
499HEAD NECK
1MEDBDE (SPT)
I
2
Medical Company
(Area Support)
575MCAS
56MMB
40-COT
I
Brigade Support Medical
Company
(Airborne)
2
505ABB
82ABD
20-COT
I
Brigade Support Medical
Company
(Air Assault)
2
426BSB
327AAB
101AAD
20-COT
I
Brigade Support Medical
Company
(Armor)
2
47BSB
2BDE
1AD
20-COT
I
Brigade Support Medical
Company
(Infantry)
2
101BSB
1BDE
20-COT
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82BSB
SPT
1ID
AHS Doctrine Smart Book
499th Medical Team, Head &
Neck; 1st Medical Brigade
(Support)
575th Medical Company, Area
Support; 56th Medical
Battalion, Multifunctional, w/
40-Cot capability
C Company, 82nd Brigade
Support Battalion; 505th
Parachute Infantry Regiment;
82nd Airborne Division, w/ 20Cot Capability
C Company, 426th Brigade
Support Battalion; 1st Brigade
Combat Team; 101st Airborne
Division (Air Assault), w/ 20Cot Capability
C Company, 47th Brigade
Support Battalion; 2nd Brigade
Combat Team; 1st Armored
Division, w/ 20-Cot Capability
C Company, 101st Brigade
Support Battalion; 2nd Brigade
Combat Team; 1st Infantry
Division, w/ 20-Cot Capability
249
Appendix B
AHS unit or element symbols (continued)
I
Brigade Support Medical
Company
2
296BSB
1SBCT
(Stryker)
7ID
20-COT
I
6 GSAB
Medical Company
(Air Ambulance)
101CAB
101AAD
15 HH60M
I
Medical Company
(Ground Ambulance)
560MCGA
168MMB
24 M997
I
464DCAS
Dental Company
(Area Support)
421MMB
30MEDBDE (SPT)
I
582MLC
61MMB
Medical Logistics Company
1MEDBDE (SPT)
Medical Detachment
(Veterinary Services)
Medical Detachment
(Combat and Operational
Stress Control)
Medical Detachment
(Preventive Medicine)
72MDVS
261MMB
V
44MEDBDE (SPT)
85COSC
61MMB
255PM
56MMB
Medical Detachment
(Blood Support)
95BLOOD
168MMB
65MEDBDE (SPT)
250
AHS Doctrine Smart Book
C Company, 296th Brigade
Support Battalion; 1st Stryker
Brigade Combat Team; 7th
Infantry Division, w/ 20-Cot
Capability
C Company, 6th General
Support Aviation Battalion;
101st Combat Aviation Brigade;
101st Airborne Division (Air
Assault)
560th Medical Company,
Ground Ambulance; 168th
Medical Battalion,
Multifunctional, w/ 24 M997
Capability
464th Dental Company, Area
Support; 421st Medical
Battalion, Multifunctional; 30th
Medical Brigade (Support)
582nd Medical Logistics
Company; 61st Medical
Battalion, Multifunctional; 1st
Medical Brigade (Support)
72D Medical Detachment,
Veterinary Services; 261st
Medical Battalion,
Multifunctional; 44th Medical
Brigade (Support)
85th Medical Detachment,
Combat and Operational Stress
Control; 61st Medical Battalion,
Multifunctional
255th Medical Detachment,
Preventive Medicine; 56th
Medical Battalion,
Multifunctional
95th Medical Detachment,
Blood Support; 168th Medical
Battalion, Multifunctional; 65th
Medical Brigade (Support)
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Army Health System Symbology
AHS unit or element symbols (continued)
++
Medical Logistics Management
Center
6MLMC
3TMC
++
Area Medical Laboratory
LAB
Medical Detachment
(Optometry)
1AML
807TMC
24OPTO
6th Medical Logistics
Management Center; 3rd
Theater Medical Command
1st Area Medical Laboratory;
807th Theater Medical
Command
24th Medical Detachment,
Optometry; 261st Medical
Battalion, Multifunctional
261MMB
AHS vehicle symbols
1
Wheeled Vehicle
Ambulance (M997)
(High Mobility (Cross Country)
M997 4-LITTER
GRND AMB MES
2/327 101AAD
(1) 4-Litter, M997; Equipped with
a ground ambulance Medical
Equipment Set (MES); Assigned
to 2nd Battalion, 327th Infantry
Battalion, 101st Airborne
Division (Air Assault)
1
Wheeled Vehicle
Ambulance
(Limited Cross Country)
Armored Personnel Carrier
Ambulance (M113)
TYPE I 1-LITTER
PARAMEDIC
1
FWD
M113 4-LITTER
GRND AMB MES
Armored Multi-Purpose Vehicle
(Medical Evacuation)
C/115 BSB/1BCT/1CD
1
Armored Wheeled
Ambulance (M1133)
(High Mobility (Cross Country)
M1133 4-LITTER
GRND AMB MES
1/17SBCT 7ID
(1) 1-Litter, Wheeled Vehicle
Ambulance (Civilian); Paramedic
on board
(1) 4-Litter, M113; Equipped with
a ground ambulance MES;
Assigned to Ambulance Squad
(Forward), Charlie Company,
115th BSB, 1BCT, 1st Cavalry
Division
(1) 4-Litter, M1133; Equipped
with a ground ambulance MES;
Assigned to 1st Battalion 17th
Stryker Infantry Battalion; 2nd
Stryker Brigade Combat Team;
7th Infantry Division
AHS vehicle symbols (continued)
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251
Appendix B
1
FIELD SURGEON
Mobile Emergency Physician
TCMC MES
2/327 101AAD
1
HH-60M 4-LITTER
Rotary wing, in flight
AIR AMB MES
3/25GSAB
1
HH-60M 2-LITTER
Rotary wing, on ground
AIR AMB MES
2/227GSAB
1
C130 74-LITTER
Fixed wing, in flight
AEROMED EVAC EQUIP
USAF
1
C17 36L / 54A
Fixed wing, on ground
AEROMED EVAC EQUIP
USAF
(1) 62B Field Surgeon;
Equipped with a tactical combat
medic care (TCMC) MES;
Assigned to 2nd Battalion,
327th Infantry Battalion, 101st
Airborne Division (Air Assault)
(1) 4-Litter, HH-60M MEDEVAC
helicopter; Equipped with an air
ambulance MES; Assigned to
3rd General Support Aviation
Battalion (GSAB), 25th Combat
Aviation Brigade (CAB)
(1) 2-Litter, HH-60M MEDEVAC
helicopter; Equipped with an air
ambulance MES; Assigned to
2nd GSAB, 227th CAB
(1) 73-Litter, C-130; Equipped
with an aeromedical evacuation
equipment kit; Assigned to
USAF
(1) 36-Litter, 54 ambulatory,
C-17; Equipped with an
aeromedical evacuation
equipment kit; Assigned to
USAF
1
USS COMFORT
500-BED
Military Noncombatant
(Hospital Vessel)
USN
(1) 500-Bed, USN Hospital Ship
(USS Comfort); Assigned to the
USN
1
USS MERCY
AH
500-BED
USN
(1) 500-Bed, USN Hospital Ship
(USS Mercy); Assigned to the
USN
1
Civilian/Merchant (Hospital
Ship)
MERCY SHIP
80-BED
(1) 80-Bed, Civilian operated
hospital ship
CIVILIAN
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Surgeon at Echelon
Appendix C
The Surgeon and Surgeon Section at Echelon
Organizations from battalion through ASCC level are authorized a surgeon. Army Medicine
leverages the technical chain of surgeon's cells (staff channels) and C2 channels (TMC,
MEDBDE (SPT), and [MMB]) to form medical C2 which provides overall AHS support to
the deployed force. Integration of these two channels and other warfighting function
elements occur at command headquarters (HQs) at different echelons (see figure C-1
below).
The surgeon is a member of the commander’s personal and special staff. Through the
medical C2 function, the surgeon coordinates and synchronizes the nine remaining medical
functions within the protection and sustainment warfighting functions and serves as a link
between these varied commands and staffs (see figure C-2 on page 232).
Surgeons at the ASCC/theater, corps, division, and brigade level are authorized a surgeon
staff. The surgeon’s staff is considered special staff and executes the actions required of the
surgeon.
The surgeon and the surgeon sections at each echelon work with their commands and staffs
to conduct planning, coordination, synchronization, and integration of AHS support. This
ensures the consideration of all ten medical functions is included in the command’s running
estimates, OPLANs, and OPORDs.
Figure C-1. Surgeon link to medical and warfighting functions
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Appendix C
Figure C-2. Medical function alignment to Army warfighting functions
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Surgeon at Echelon
SURGEON
C-1. The surgeon is a Medical Corps officer and member of the commander’s personal and special staff. The
surgeon normally work under the staff supervision of the chief of staff/executive officer. The surgeon is responsible
for coordinating health assets and operations within the command. This officer provides and oversees medical care
to Soldiers, civilians, and detainees. The surgeon prepares Appendix 9 (FHP) of Annex E (Protection) and
Appendix 3 (HSS) of Annex F (Sustainment) to the OPORD or OPLAN. If operating in a joint headquarters
(Theater/Corps), they have the responsibility of writing Annex Q (Medical Services) to the joint OPORD or
OPLAN (Refer to JP 4-02, Joint Health Services). The surgeon advises the commander and their staff on all
medical or medical related issues.
SURGEON SECTION
C-2. The surgeon section works with many personal, special, and coordinating staffs. At different echelons, they
work closely with two functional cells, protection and sustainment. At the theater, corps, and division level, there
are chiefs of protection and sustainment. At the brigade and battalion level, the S-3 is responsible for protection
and the S-4 is responsible for sustainment. Force health protection falls within the chief of protection/S-3’s
functional area. Health service support falls within the chief of sustainment’s/S-4 functional area. The
responsibility of the entire AHS support structure, which includes both FHP and HSS medical functions, rests with
the surgeon. Figure C-3 on page 233 depicts the coordination and synchronization relationship shared between the
surgeon, their staffs, and the chief of the protection/S-3 and chief of sustainment/S-4 cells.
STAFF COORDINATION
C-3. Listed below in figure C-3 and in table C-1 on page 234 is a compiled list pulled from various doctrinal
publication from across the force (to include FMs 3-94 and 6-0 and ATPs 3-91, 3-92, and 3-94) that reference the
surgeon. This table is also referenced in appendix C of FM 4-02. The surgeon and their sections are responsible
for coordinating with many personal, special, and coordinating staffs in order to fully accomplish their medical C2
responsibilities. This list is not limited to Table C-1 or in any of the provided lists in this appendix or appendix C
of FM 4-02. Surgeons are recommended to refer to their unit tactical standard operational procedure for more unit
specific detail or to ensure inclusion of any task that was not included in FM 4-02. Table C-2 depicts a list of
reports found in FM 6-99 that the surgeon and surgeon section needs to be aware of. If a surgeon has questions
regarding staff coordination, please email the MEDCoE doctrine division at usarmy.jbsa.medicalcoe.mbx.ameddcs-medical-doctrine@army.mil for assistance. For more information, please feel free to research
any of the mentioned doctrinal publications.
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Appendix C
Figure C-3. Surgeon and protection/sustainment cell coordination and synchronization matrix
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Surgeon at Echelon
Table C-1. Coordination between surgeon/surgeon section and staff elements
Coordinating Staff
Surgeon Functions / Tasks
Commander/Staff Judge
Advocate
As part of a joint HQs, coordinates with the staff judge advocate and chain of
command to determine eligibility for medical care in a military MTF.
Commander/Staff Judge
Advocate
Member of the battle update briefing and the commander's update briefing and
provides the FHP portion for protection update and the HSS portion of the sustainment
update.
TMC / MEDBDE (SPT)
Ensure that the division current and future operations and plans are coordinated with
the TMC and the supporting MEDBDE (SPT).
Assistant Chief of Staff,
G-1 (S-1), Personnel
Coordinates and assists with all casualty and DNBI estimates and reporting related
issues (casualty operations).
Assistant Chief of Staff,
G-2 (S-2], Intelligence
Coordinates on all medical information of a potential intelligence value or medical
intelligence related issues.
Assistant Chief of Staff,
G-3 (S-3), Operations
Member of the operations synchronization meeting.
Assistant Chief of Staff,
G-3 (S-3), Operations
Member of the protection working group providing a FHP protection task update.
Assistant Chief of Staff,
G-3 (S-3)
Coordinates to establish environmental vulnerability protection levels.
Assistant Chief of Staff,
G-3 (S-3), Operations
Coordinates for medical support requests.
Assistant Chief of Staff,
G-3 (S-3]
Coordinates for the task organization of corps support medical elements. (
Assistant Chief of Staff,
G-3 (S-3), Operations
Coordinates for medical contingency operations
Assistant Chief of Staff,
G-3 (S-3), Operations
Coordinates in regard to ground MEDEVAC within the command.
Assistant Chief of Staff,
G-3 (S-3), Operations
Develops and publishes the medical reporting schedule for Force XXI Battle
Command Brigade and Below in accordance with FM 6-99 and the commander’s
guidance. Initiates other reports as necessary
Assistant Chief of Staff,
G-3 (S-3), Operations
Determines AHS training requirements and provides health education and training.
G-3 (S-3) Air
Coordinates in regard to aeromedical and nonstandard air platform evacuation within
the command.
Assistant Chief of Staff, J3, Operations
As part of a joint HQs, develops Annex Q (Medical Services)
Assistant Chief of Staff,
G-4 (S-4), Logistics [Chief
of Sustainment]
Member of the sustainment working group providing a HSS task update.
Assistant Chief of Staff,
G-4 (S-4), Logistics [Chief
of Sustainment]
Member of the sustainment board providing the HSS update.
Assistant Chief of Staff,
G-4 (S-4), Logistics [Chief
of Sustainment]
Participates in the sustainment cell-working group.
Provides the chief of sustainment with HSS input for Annex F (Sustainment) Appendix
3 (HSS).
Assistant Chief of Staff,
G-4 (S-4), Logistics (Chief
of Sustainment)
Provides forecasts of the division’s MEDLOG requirements during the defense.
Assistant Chief of Staff,
G-4 (S-4), Logistics [Chief
of Sustainment]
Refer to ATP 3-91, para 5-80 for list of medical coordination’s required for a mobile
defense.
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Appendix C
Table C-1. Coordination between surgeon/surgeon section and staff elements (continued)
Coordinating Staff
Surgeon Functions / Tasks
Assistant Chief of
Staff, G-4 (S-4),
Logistics (Chief of
Sustainment)
Coordinates for food and water inspections
Assistant Chief of
Staff, G-9 (S-9), Civil
Affairs Operations
Provides a member to the civil affairs operations working group.
Coordinates on the military use of civilian MTFs, medical materiels, and supplies.
Chief of Protection
Participates in the protection cell working group.
Provides the chief of protection with FHP input for Annex E (Protection), Appendix 9
(FHP).
CBRN Officer
Coordinates AHS support requirements for CBRN operations. (Annex E (Protection,
Appendix 10).
Chaplain
Coordinates the employment of COSC teams with the chaplain to best meet the needs of
division Soldiers for stress control.
Detainee operations
Provides a member to the detention operations staff battle drill.
Senior, adjacent, and
subordinate command
surgeons
Provides the current AHS support plan/MEDCOP to the surgeons/medical operations
staffs of senior, adjacent, and subordinate HQs to maintain medical situational
awareness.
MTF Liaison
As part of a division staff, establishes a division liaison with the MTFs through which sick,
injured, or wounded Soldiers move as they are evacuated outside the division AO.
Host nation local
authorities
(Host nation local authorities) Coordinates with local authorities concerning environmental
and health concerns.
Unified action partners
Works with civil affairs staff and other unified action partners to obtain up to date medical
intelligence for a projected area of operations.
Higher Headquarters
Submits to higher HQs those recommendations on professional medical problems that
require research and development.
LEGEND:
AO – Area of Operations
ATP – Army Technique Publication
CBRN – Chemical, Biological, Radiological, Nuclear
COSC - Combat and Operational Stress Control
DNBI – Disease Nonbattle Injury
FHP – Force Health Protection
HQ – Headquarters
HSS – Health Service Support
MEDBDE (SPT) – Medical Brigade (Support)
MEDCOM – Medical Command
MEDEVAC – Medical Evacuation
MEDLOG – Medical Logistics
MTF – Medical Treatment Facility
SPT – Support
Table C-2. Medical reports
Report Title
Report Acronym
Bed Availability and Element Status
BEDAVAIL
Bed Designations
BEDDESIG
Bed Request
BEDREQ
Blood Shipment Report
BLDSHIPREP
Casualty Report
CASREP
Daily Blood Report
DBLDREP
Medical Evacuation Request
MEDEVAC
Medical Situation Report
MEDSITREP
Medical Spot Report
MEDSPTREP
Medical Status Report
MEDSTAT
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FIELD SURGEON (BATTALION SURGEON)
C-4. The field surgeon (commonly referred to as battalion surgeon)/medical officer/senior assigned medical
provider is a member of the commander’s personal and special staff. The battalion surgeon also serve as the medical
advisor to the battalion commander and the staff. In this role, the battalion surgeon advises the battalion commander
on the employment of the medical platoon and on the health of the battalion. The battalion surgeon are also the
supervising physician (medical officer/field surgeon) of the medical platoon’s treatment squad. This officer is
responsible for all AHS support provided by the platoon. The BSMC company commander, with consultation by
the senior physician, performs many related responsibilities mentioned below within the brigade support battalion.
Units not assigned a battalion surgeon will utilize their assigned senior medical Service member in order to
accomplish the below listed responsibilities. Responsibilities include, but are not limited to:
⚫ Advises the commander on the health of the battalion.
⚫ Provides current information on the battalion AHS support plan/MEDCOP to surgeons/medical
operations staffs of the next higher and adjacent HQs to maintain medical situational awareness.
⚫ Advises the battalion commander and their staff on AHS support operations and the health threat.
⚫ Advises the commander on the effects of the Geneva Conventions on AHS support.
⚫ Plans and directs Role 1 AHS support for the battalion or within the brigade support area.
⚫ Supervises the health, welfare, organizational training, administration, discipline, and maintenance of
equipment, supply functions, and employment of medical platoon or company personnel.
⚫ Supervises and oversees all medical treatment provided by platoon or company personnel.
⚫ Examines, diagnoses, treats, and prescribes courses of treatment for patients, to include DNBI, TCCC,
and trauma management.
⚫ Supervises the battalion COSC program to include training troop leaders in the preventive aspect of
stress on Soldiers.
⚫ Supports humanitarian assistance programs, when directed.
⚫ Provides operational public health support for the battalion.
⚫ Requests operational public health support from the brigade for requirements beyond their (battalion
surgeon) capabilities.
⚫ Plans and oversees public health training for battalion personnel.
⚫ Monitors the command operational public health program to include health risk assessment and medical
surveillance.
⚫ Oversees the Army warrior task training, continuing medical education, and clinical training of
subordinate medical personnel.
⚫ Oversees the training of combat lifesavers.
⚫ Oversees the training of unit field sanitation teams.
⚫ Ensures that field health records are maintained.
⚫ Coordinates and monitors patient decontamination operations to include:
▪ Use of nonmedical Soldiers to perform patient decontamination procedures under medical
supervision.
▪ Training of nonmedical personnel for patient decontamination teams.
▪ Layout and establishment of patient decontamination site.
▪ Use of collective protection.
▪ Use of nonmedical Soldiers to perform patient decontamination procedures under medical
supervision.
C-5. Only when a battalion surgeon is assigned does the overall responsibility for the medical platoon belong to
someone other than the medical services corps officer. However, due to the battalion surgeon’s roles as both
personal and special staff to the battalion commander, based upon command discretion, the medical operations
officer is normally designated as the medical platoon leader. The medical operations officer works with both the
battalion surgeon and physician assistant to ensure medical treatment and AHS support requirements are met for
the battalion. This officer is the primary leader for medical platoon operations, administration, logistics and
principal assistant to the battalion surgeon.
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Appendix C
Note. In the absence of a battalion surgeon, the physician assistant is the principal advisor to the battalion
commander and their staff in the area of health and medical readiness.
BRIGADE SURGEON
C-6. The brigade surgeon is a member of the commander’s personal and special staff. The brigade surgeon is
assigned to the headquarters and Headquarters Company of a brigade, and normally work under the staff
supervision of the brigade executive officer. The brigade surgeon plans and coordinates the brigade AHS support
activities with the brigade’s personal, special, and coordinating staffs. The brigade surgeon is responsible for the
technical control of all medical activities in the command. The brigade surgeon oversees and coordinates AHS
support activities through the brigade surgeon section and the brigade S-3. The brigade surgeon keeps the brigade
commander informed on the status of AHS support for brigade operations and the health of the command. The
brigade surgeon provides input and obtains information to facilitate medical planning. The brigade surgeon’s
specific duties in this area include, but are not limited to:
⚫ Ensures implementation of the AHS support section of the brigade TSOP.
⚫ Participates in the S-4’s sustainment cell working group to integrate and synchronize HSS tasks. Prepares
a portion of Annex F (Sustainment) to the OPORDs and plans.
⚫ Participates in the S-3’s protection cell working group to integrate and synchronize FHP tasks and
systems for each phase or transition of an operation or major activity. Prepares a portion of Annex E
(Protection) to the OPORDs and plans.
⚫ Determines the allocation of medical resources within the brigade.
⚫ Supervises technical training of medical personnel and the combat lifesaver program within the brigade.
⚫ Determines procedures, techniques, and limitations in the conduct of routine medical care, emergency
medical treatment, and trauma management.
⚫ Monitors aeromedical and ground ambulance evacuation.
⚫ Monitors the implementation of automated medical systems.
⚫ Informs the division surgeon on the brigade’s AHS support situation.
⚫ Monitors the health of the command and advises the commander on measures to counter disease and
injury threats.
⚫ Exercises technical supervision of subordinate battalion surgeons and physician assistants.
⚫ Provides consultation and mentoring for subordinate battalion surgeons, physicians, and physician
assistants.
⚫ Provides the medical estimate and health threat for inclusion in the commander’s estimate.
C-7. Through the C2 system the brigade surgeon utilizes medical C2 to coordinate, synchronize, and integrate
the nine remaining medical functions split between the protection and sustainment warfighting functions and serves
as a link between these varied commands and staffs.
C-8. As a member of the staff, the brigade surgeon section participates in the planning and orders production
process that provides the tasks, purpose, and guidance to the assigned, attached, and supporting medical
organizations (only medical control for the surgeon). The surgeon section liaisons with these organizations during
the planning process to optimally coordinate, synchronize, integrate, and plan AHS support, but does not encroach
on the command authority of those organizations.
SURGEON SECTION
C-9. The brigade surgeon section is assigned to the headquarters and Headquarters Company of the brigade and
operates out of the brigade tactical operations center. This section is an integral part of the brigade’s main CP and
the staff of the brigade surgeon is intimately involved with the S-3 and their staff in the planning process. The
section, in coordination with the brigade S-4, the BSMC company commander, and battalion surgeons, is
responsible for the development of the medical portion of the brigade OPLAN/OPORD and takes part in the
brigade operations process. This section is responsible to the brigade commander for staff supervision of AHS
support within the brigade. The brigade surgeon section is also responsible for coordinating GS and DS
relationships of organic medical units and medical units/elements whether OPCON or attached to the brigade. This
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Surgeon at Echelon
section updates the brigade commander as required on the status of AHS support in the brigade. The staff of the
brigade surgeon section assists the brigade surgeon in planning and conducting brigade AHS support operations.
Specific functions include, but are not limited to:
⚫ Provides current information on the brigade AHS support plan/MEDCOP to surgeons/medical
operations staffs of the next higher, adjacent, and subordinate HQs to maintain medical situational
awareness.
⚫ Plans and ensures the timely and efficient establishment of Roles 1 and 2 AHS support for the brigade.
⚫ Plans and coordinates AHS support operations for brigade medical assets, attached, or OPCON EAB
assets. This includes reinforcement and reconstitution.
⚫ Coordinates with the division surgeon section for prioritizing the reallocation of organic and corps
medical augmentation assets as required by the tactical situation.
⚫ Ensures that the medical annex of the brigade TSOPs, plans, policies, and procedures for AHS support,
prescribed by the brigade surgeon, are prepared and executed.
⚫ Oversees medical training and provides information to the brigade surgeon and brigade commander.
⚫ Coordinates and prioritizes MEDLOG and blood management requirements for the brigade.
⚫ Collects health threat information and coordinates medical intelligence requirements with the brigade S2.
⚫ Coordinates and directs patient evacuation from forward areas to supporting MTFs.
⚫ Coordinates the MEDEVAC of all detainee casualties from the brigade AO.
⚫ Coordinates the disposition of captured medical materiel.
⚫ Coordinates, plans, and prioritizes operational public health missions.
⚫ Coordinates with the supporting veterinary element for subsistence and animal disease surveillance.
⚫ Coordinates and monitors patient decontamination operations to include:
▪ Use of nonmedical Soldiers to perform patient decontamination procedures under medical
supervision.
▪ Training of nonmedical personnel for patient decontamination teams.
▪ Layout and establishment of patient decontamination site.
▪ Use of collective protection.
STAFFING
C-10. The brigade surgeon section varies from command to command. Tables C-3 through C-14 depicts the
staffing of various brigade surgeon section.
Table C-3. Brigade combat team surgeon section
HHC, BRIGADE COMBAT TEAM (ABCT, IBCT , IBCT [ABN], AND SBCT)
Paragraph title
Sustainment–S-4/Medical
AOC/ MOS
Grade
Title
Branch
Quantity
62B00
O4
Field Surgeon
MC
1
70H67
O3
Medical Operations Officer
MS
1
68W4O2S
E7
Health Care NCO
NC
1
Table C-4. Combat aviation brigade surgeon section
HHC, COMBAT AVIATION BRIGADE
Paragraph title
Brigade Surgeon Section
16 March 2023
AOC/ MOS
Grade
Title
Branch
Quantity
61N00
O4
Flight Surgeon
MC
1
70H67
O3
Medical Operations Officer
MS
1
68W5O2S
E8
Operations NCO
NC
1
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Appendix C
Table C-5. Division sustainment brigade surgeon section
HHC AND STB, DIVISION SUSTAINMENT BRIGADE
Paragraph title
Surgeon Section
AOC/MOS
Grade
Title
Branch
Quantity
60A00
O5
Surgeon
MC
1
70H67
O3
Medical Operations Officer
MS
1
70K67
O3
Medical Logistics Officer
MS
1
67D00
O3
Behavioral Science Officer
MS
2
68W4O
E7
Operations NCO
NC
1
68X2O
E5
Behavioral Health NCO
NC
1
68X1O
E4
Behavioral Health SPC
1
Table C-6. Security forces assistance brigade surgeon section
HHC, SECURITY FORCES ASSISTANCE BRIGADE
Paragraph title
Sustainment–S-4/Medical
AOC/ MOS
Grade
Title
Branch
Quantity
62B00S8
O4
Field Surgeon
MC
1
70H67S9
O3
Medical Operations Officer
MS
1
68W5OS8
E8
Senior Health Care NCO
NC
1
Table C-7. Field artillery brigade surgeon section
HHB, FIELD ARTILLERY BRIGADE
Paragraph title
Medical Platoon
Headquarters
AOC/ MOS
Grade
Title
Branch
Quantity
62B00
O4
Field Surgeon
MC
1
70H67
O3
Medical Operations Officer
MS
1
68W4O
E7
Operations SGT
NC
1
Table C-8. Engineer brigade surgeon section
HHC, ENGINEER BRIGADE
Paragraph title
Sustainment/ Brigade
Surgeon
AOC/ MOS
Grade
Title
Branch
Quantity
62B00
O4
Field Surgeon
MC
1
67D00
O3
Behavioral Science Officer
MS
2
70H67
O3
Medical Operations Officer
MS
1
68W5O
E8
Senior Health Care NCO
NC
1
68X2O
E5
Behavioral Health NCO
NC
1
68X1O
E4
Behavioral Health SPC
1
Table C-9. Military police brigade surgeon section
HHC, MILITARY POLICE BRIGADE
Paragraph title
Brigade Surgeon Section
262
AOC/ MOS
Grade
Title
Branch
Quantity
62B00
O4
Brigade Surgeon
MC
1
67D00
O3
Behavioral Science Officer
MS
2
70H67
O3
Medical Operations Officer
MS
1
68W4O
E7
Health Care NCO
NC
1
68X2O
E5
Behavioral Health NCO
NC
1
68X1O
E4
Behavioral Health SPC
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Surgeon at Echelon
Table C-10. Signal brigade surgeon section
HHC, SIGNAL BRIGADE (CORPS)
Paragraph title
Surgeon Section
Behavioral Health
AOC/MOS
Grade
Title
Branch
Quantity
62B00
O4
Field Surgeon
MC
1
67D00
O3
Behavioral Science Officer
MS
2
70H67
O3
Medical Operations Officer
MS
1
68W4O
E7
Health Care NCO
NC
1
68X2O
E5
Behavioral Health NCO
NC
1
68X1O
E4
Behavioral Health SPC
1
Table C-11. Sustainment brigade surgeon section
HHC AND SPECIAL TROOPS BATTALION, SUSTAINMENT BRIGADE
Paragraph title
AOC/MOS
Grade
Title
Surgeon Section
Branch
Quantity
60A00
O5
Surgeon
MC
1
70H67
O3
Medical Operations Officer
MS
1
70KI67
O3
Medical Logistics Officer
MS
1
68W4O
E7
Operations NCO
NC
1
Table C-12. Maneuver enhancement brigade surgeon section
HSC, MANEUVER ENHANCEMENT BRIGADE
Paragraph title
Medical Section
AOC/MOS
Grade
Title
Branch
Quantity
62B00
O4
Brigade Surgeon
MC
1
65D00
O3
Physician Assistant
SP
1
67D00
O3
Behavioral Science Officer
MS
2
70H67
O3
Medical Operations Officer
MS
1
68W4O2S
E7
Health Care NCO
NC
1
68X2O
E5
Behavioral Health NCO
NC
1
68X1O
E4
Behavioral Health SPC
1
68W1O
E3
Health Care SPC/Driver
1
68W1O
E3
Health Care SPC/Driver
1
Table C-13. Military intelligence expeditionary brigade surgeon section
HHC, MILITARY INTELLIGENCE EXPEDITIONARY BRIGADE
Paragraph title
Brigade Surgeon Section
Behavioral Health
16 March 2023
AOC/MOS
Grade
Title
Branch
Quantity
62B00
O4
Brigade Surgeon
MC
1
67D00
O3
Behavioral Science Officer
MS
2
70H67
O3
Medical Operations Officer
MS
1
68W4S
E7
Medical Plans NCO
NC
1
68X2O
E5
Behavioral Health NCO
NC
1
68X1O
E4
Behavioral Health SPC
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Appendix C
Table C-14. Medical brigade clinical operations section
HHC, MEDICAL SUPPORT BRIGADE
Paragraph title
Clinical Operations
Section (Early Entry
Module)
Clinical Operations
Section (Expansion
Module)
Clinical Operations
Section (Campaign
Module)
AOC/ MOS
Grade
Title
Branch
Quantity
60A00
60C00
67D00
68X2O
66N00
60W00
63R00
64B00
68Z6O6S
68K4O
68X4O
68W1O
65C00
72D67
640AO
68S4O
O6
O5
O3
E5
O6
O5
O5
O5
E9
E7
E7
E3
O4
O4
W2
E7
Chief Professional Services
Preventive Medicine Officer
Behavioral Science Officer
Behavioral Health NCO
Chief Nurse
Psychiatrist
Chief Dental Officer
Veterinary Preventive Medicine Officer
Chief Medical NCO
Senior Medical Laboratory NCO
Behavioral Health NCO
Health Care Specialist
Dietician
Environmental Science Officer
Food Safety Officer
Preventive Medicine NCO
MC
MC
MS
NC
AN
MC
DC
VC
NC
NC
NC
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
MS
MS
WO
NC
SPECIAL OPERATIONS BRIGADE SURGEON STAFFING
C-11. The special operations brigade sized surgeon section varies from command to command. Tables C-15
through C-19 depicts the staffing of various special operations brigade surgeon section.
Table C-15. Special Forces group surgeon section
HHC, SPECIAL FORCES GROUP
Paragraph title
AOC/MOS
Surgeon Section
264
Grade
Title
Branch
Quantity
61N00
O5
Flight Surgeon
MC
1
65D00
73B67
63B00
O4
O4
O3
Physician Assistant
Clinical Psychologist
Comprehensive Dental Officer
SP
MC
DC
1
1
1
64A00
O3
Field Veterinary Service Officer
VC
1
65B00
70H67
70K67
72D67
18Z5O
68S4S
18D3O
68G3S
68J3S
68A2S
68F2S
68J2S
O3
O3
O3
O3
E8
E7
E6
E6
E6
E5
E5
E5
Physical Therapist
Medical Operations Officer
Health Service Materiel Officer
Environmental Science Officer
Medical Operations SGT
Preventive Medicine NCO
Medical SGT
Patient ADMIN NCO
MEDLOG SGT
Biomedical Equipment Repair SGT
Physical Therapy SGT
MEDLOG SGT
MS
MS
MS
MS
NC
NC
NC
NC
NC
NC
NC
NC
1
1
1
1
1
1
1
1
1
1
1
1
68T2S
68W2S
68X2S
68E1S
E5
E5
E5
E4
Animal Care SGT
Health Care SGT
Behavioral Health NCO
Dental SPC
NC
NC
NC
1
2
1
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Surgeon at Echelon
Table C-16. Ranger regiment surgeon section
HEADQUARTERS, RANGER REGIMENT
AOC/MOS
Paragraph title
Medical Section
Mental Health Section
Grade
Title
Branch
Quantity
61N005SM7
65D005S
70H675S
O5
O4
O4
Flight Surgeon
Senior Physician Assistant
Medical Operations Officer
MC
SP
MS
1
1
1
64A005S
O3
Field Veterinary Service Officer
VS
1
68W5U
E8
Senior Health Care NCO
NC
1
68J5U
E7
Medical Logistics Sergeant
NC
1
68W4UW1
E7
Operations Sergeant
NC
2
68W4UW1
68T3U
E7
E6
Plans Sergeant
Animal Care NCO
NC
NC
1
1
74B67M6N7
O4
Clinical Psychologist
MS
1
E6
E6
E5
Behavioral Health NCO
Preventive Medicine NCO
Preventive Medicine NCO
NC
NC
NC
1
1
1
68X3U
68S3U
Medical Support Section
68S2U
Table C-17. Aviation regiment (special operations) surgeon section
HEADQUARTERS, AVIATION REGIMENT (SPECIAL OPERATIONS)
Paragraph title
AOC/MOS
Grade
Title
SOA Medical
Treatment
Mental Health Section
Branch
Quantity
61N005SM7
O5
Flight Surgeon
MC
1
61N005SM7
O4
Flight Surgeon
MC
1
65B00
65D005S
68W5S
68W5S
68W4SW1
68W4SW1
68F3S
68J3S
68W3SW1
68G2S
68W2S
74B675PM6N7
68X3O
O3
O3
E8
E8
E7
E7
E6
E6
E6
E5
E5
O4
E6
Physical Therapist
Physician Assistant
Senior Advisor
Senior Health Care Sergeant
Emergency Care NCO
Operations Sergeant
Physical Therapy NCO
Medical Logistics Sergeant
Flight Paramedic NCO
Patient Services NCO
Flight paramedic
Clinical Psychologist
Behavioral Health NCO
MS
SP
NC
NC
NC
NC
NC
NC
NC
NC
NC
MS
NC
1
1
1
1
1
1
1
1
4
1
2
1
1
Branch
Quantity
Table C-18. Civil affairs brigade surgeon section
HEADQUARTERS, CIVIL AFFAIRS BRIGADE (SO) (AIRBORNE)
AOC/MOS
Grade
Title
Paragraph title
Medical Section
Medical Training and
Operations Section
16 March 2023
62B00
O4
Field Surgeon
MC
1
64B005P
72D675P
63A005P
66B005P
74B675PN7
38B5PW4
68S3S
68J3S
70K67
68W5P
68S3S
O4
O4
O3
O3
O3
E8
E7
E6
O3
E8
E7
Field Veterinary Service Officer
Environmental Science Officer
Chief Dental Officer
Public Health Nurse
Clinical Psychologist
CA Medical Operations Sergeant
Preventive Medicine NCO
Medical Logistics Sergeant
Medical Logistics Officer
CA Medical Operations Sergeant
Preventive Medicine NCO
VS
MS
DC
AN
MS
NC
NC
NC
MS
NC
NC
1
1
1
1
1
1
1
1
1
1
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Table C-19. Psychological operations group surgeon section
HEADQUARTERS, PSYCHOLOGICAL OPERATIONS GROUP (SO)(ABN)
Paragraph title
AOC/MOS
Grade
Title
Branch
Quantity
Medical Section
62B005P
65D005PM3
68W4S
68W3S
68W2S
68W1S
68W3S
O3
O3
E7
E6
E5
E4
E3
Field Surgeon
Physician Assistant
Medical Plans NCO
Health Care Sergeant
Health Care Sergeant
Health Care Specialist
Health Care Specialist
MC
SP
NC
NC
NC
NC
NC
1
1
1
2
2
2
2
ARMY HEALTH SYSTEM RELATIONSHIPS AND FLOW OF INFORMATION WITHIN THE BCT
C-12. Paragraphs C-12 through C-19 are from ATP 4-02.6. The AHS relationships and flow of information within
the BCT consists of the BSS, the SPO-MED, the Role 1, and the Role 2. The AHS relationship follows the same
pattern as the logistics relationships of the forward support company, the support operations officer, and the brigade
S-4. The technical channel this relationship creates should focus on the synchronization and employment of AHS
support assets from the forward line of own troops to the brigade rear boundary, which is accomplished through
medical C2. The SPO-MED, Role 2 commander, and Role 1 platoon leader will then use C2 to employ those
capabilities through the orders process. Figure C-4 depicts the execution (Role 1 and Role 2), synchronization
(SPO-MED), and the coordination (BSS) relationship.
Figure C-4. BCT AHS coordination, synchronization, and execution relationships
C-13. The AHS relationship is further broken down into coordination, synchronization, and execution. The
coordinators concentrate on up and out. This entails working with the division surgeon, other brigade surgeons,
coordinating for EAB medical assets per the orders process, and planning AHS support operations at the brigade
level. Synchronizers take the FHP and HSS portions of OPORD and EAB assets received from the coordinator
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and synchronize AHS support across the BCT. Synchronizers normally concentrate on down and in. Executers
receive the additional EAB medical assets from the division and are responsible for executing the FHP and HSS
plan per the OPORD.
Coordination
C-14. Within the BCT the AHS coordinator is the BSS that works within the brigade main and tactical CPs. The
BSS with the BCT consists of three personnel: the field surgeon (brigade surgeon), a medical operations officer,
and a health care NCO. The main duties and responsibilities of the BSS are the coordination and planning of FHP
and HSS within the BCT.
Synchronization
C-15. The SPO-MED is a team assigned to the support operations section of the BSB. The SPO-MED is staffed
with three to four personnel: a medical operations officer, a MEDLOG officer, and one or two 68Woperations
NCOs. The main duties and responsibilities of the SPO-MED are the synchronization of FHP and HSS within the
BCT.
Execution
C-16. The Role 1 MTFs and Role 2 MTFs within the BCT are the executors of the AHS support plan and integrate
additional EAB AHS assets within their units. The Role 2 MTF is responsible for providing Role2 AHS support
to supported maneuver battalions with organic medical platoons and providing both Role 1and Role 2 medical
treatment on an area basis to those units without organic medical assets operating in the BCT AO. The Role 1 MTF
is responsible for establishing the BAS as far forward as possible, performing triage, and providing medical
treatment within their capabilities. The Role 1 ambulance squad is responsible for evacuating patients from the
forward battle area when required. The combat medic section of the Role 1provides medical personnel for the two
combat platoons in the headquarters company (scout and mortar) and each infantry rifle company to ensure patients
are properly treated in the forward area
ARMY HEALTH SYSTEM INFORMATION FLOW
C-17. . Within the BCT, information flow may be challenging due to limited communications platforms as there
is disparity between the personnel, equipment assigned, and the physical location of the sections. The BSS is
staffed with three personnel, does not have dedicated communication equipment, and must rely on those platforms
located in the BCT main CP or the BCT administrative logistics operations center. The SPO-MED is staffed with
three to four personnel, is collocated with the SPO, and has additional communications platforms available. The
Role 2 has numerous personnel in the company headquarters, has several communications platforms to maintain
situation awareness, and should be in contact with the DS ambulances that are attached with the Role 1 MTFs.
C-18. Information should flow from the executors (Role 1 and Role 2) to the SPO-MED who collects and
synchronizes the AHS support for the BCT to the BSS for coordination with division. Medical reports, support
requests, and location of the MTFs, AXPs, and HLZs are sent from the executors to the SPO-MED who then
consolidates that information and creates the BCT MEDCOP. The consolidated medical reports, support requests,
and BCT MEDCOP are then sent to the BSS for coordination. The BSS sends the consolidated medical reports,
EAB support requests, and BCT MEDCOP to the division headquarters for action. The BSS disseminates the
division MEDCOP and EAB enabler support to the subordinated organizations through the orders process.
C-19. The Role 2 should receive each MEDEVAC request from Role 1 MTFs or units without organic medical
support in the BCT AO according to a published communication plan that is included in the BCT and Role 2
tactical SOP. Due to the increased communication platforms and personnel, the Role 2 is better postured to process
and action a MEDEVAC request within the BCT. The Role 2 commander should be granted mission authority to
process the MEDEVAC request. If the determination is made that the MEDEVAC request is a ground mission, the
Role 2 commander should have launch authority for the ground platforms as they are organic to the Role 2. If the
determination is made that the MEDEVAC request is an AE mission, the Role 2 commander should relay the
mission to the FSMP first up aircraft who will process the mission to obtain launch authority according to the
FSMP tactical SOP. Evacuation request from the Role 2 MTF to the Role 3 MTF should be processed through the
BSS for coordination with EAB MEDEVAC organizations.
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DIVISION SURGEON
C-20. The division surgeon is a division level officer and member of the commander’s personal and special staff.
The division surgeon normally work under the staff supervision of the division chief of staff. The division surgeon
is the principal advisor to the commander on the health status of the division and advise the division commander
and their staffs on all medical or medical-related issues. The division surgeon operating from within the section
coordinates EAB medical support and ensures information is integrated into the commander’s ground tactical plan.
As the chief of the division surgeon section, the division surgeon is able to contribute to the division’s warfighting
capability by providing timely and effective AHS support planning (to include developing patient estimates) for
inclusion in the division planning process and the conduct of conducting LSCO. They are also responsible for the
technical oversight of all medical activities in the command. The division surgeon ensure that the division’s current
and future operations and plans are coordinated with the TMC and the supporting MEDBDE (SPT).
C-21. Through the C2 system the division surgeon utilizes medical C2 to coordinate, synchronize, and integrate
the nine remaining medical functions split between the protection and sustainment warfighting functions and serves
as a link between these varied commands and staffs.
C-22. As a member of the staff, the division surgeon section participates in the planning and orders production
process that provides the tasks, purpose, and guidance to the assigned, attached, and supporting medical
organizations (only medical control for the surgeon). The surgeon section liaisons with these organizations during
the planning process to optimally coordinate, synchronize, integrate, and plan AHS support, but does not encroach
on the command authority of those organizations.
PARAGRAPH 54, MCP/SUS/SURGEON SECTION.
C-23. Principal advisor to the Commander on the health status of the Division. Monitors and coordinates Combat
Health Services Operations. Provides recommendations on allocation and redistribution of medical personnel and
Class VIII items. Oversees all Combat Health and Logistics for the command. Provides patient disposition and
reports. Monitors and coordinates Preventive Medicine Operations. Provides technical advice to the Division
Commander for occupational, environmental health, and medical surveillances, sanitary inspections, and potential
CBRN contamination.
Surgeon Element
C-24. The division surgeon position is in the tactical command post surgeon element. They oversee and coordinate
AHS support activities through the division surgeon section. This element is responsible for, but not limited to:
⚫ Advises the commander on the health of the command.
⚫ Oversees, monitors, and coordinates divisional AHS support operations to include both FHP and HSS
activities.
⚫ Ensure that the division current and future operations and plans are coordinated with the TMC and the
supporting MEDBDE (SPT).
⚫ Oversees, monitors, and coordinates medical treatment (to include CBRN) provided to personnel in the
division AO.
⚫ Provides status of the wounded.
⚫ Coordinate MEDEVAC including Army dedicated MEDEVAC platforms (air and ground).
⚫ Provides recommendations on allocation and redistribution of medical personnel and Class VIII items.
⚫ Oversees all MEDLOG for the command.
⚫ Monitors and coordinates dental services within the division.
⚫ Monitors and coordinates COSC.
⚫ Monitors and coordinates veterinary services within the division.
⚫ Provides patient disposition and reports.
⚫ Monitors and coordinates public health operations.
⚫ Oversees medical civil-military operations.
⚫ Provides technical advice to the Division Commander for OEH surveillance, health threat analysis,
medical surveillance, facility sanitation inspections, and potential CBRN contamination.
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⚫
⚫
⚫
⚫
⚫
⚫
Participates in the sustainment cell working group to integrate and synchronize HSS tasks. Prepares a
portion of Annex F (Sustainment) to the OPORD or OPLAN.
Participates in the protection cell working group to integrate and synchronize FHP tasks and systems for
each phase or transition of an operation or major activity. Prepares a portion of annex E (Protection) to
the OPORD or OPLAN.
Refines the division’s FHP medical support plan during the preparatory phase of defensive tasks.
Identifies additional medical resources needed to support additional divisional attachments received in
the joint operations area and those elements of the civilian population whose needs are not meet by
civilian medical assets.
Coordinates for Role 4 CONUS-support based MTF support.
Oversees medical training for division medical personnel.
Surgeon Section
C-25. The division surgeon section resides in the MCP. Its mission is to plan, coordinate, and synchronize the
division’s AHS support under the supervision of the division surgeon. The division AHS support planning also
involves the division's staff and the division’s projected supporting MEDBDE (SPT) and next higher echelon Army
or joint surgeon's staff section. This coordination focuses on how the medical command’s plans impact the
provision of AHS support within the division. A series of planning, in-progress reviews, coordination meetings,
and rehearsals are required to tailor an AHS support plan to sustain the division's anticipated operations. This
section is responsible for, but not limited to:
⚫ Provides reachback capability for the forward deployed surgeon in the tactical command post.
⚫ Reviews all division OPLANs and contingency plans to identify potential health threats associated with
geographical locations and climatic conditions.
⚫ Oversees division TSOPs, plans, policies, and procedures for AHS support as prescribed by the division
surgeon.
⚫ Assists tactical command post in monitoring and coordinating AHS support operations.
⚫ Provides current information on the division AHS support plan/MEDCOP to surgeons/medical
operations staffs of the next higher, adjacent, and subordinate HQs to maintain medical situational
awareness.
⚫ Plans and ensures Roles 1 and 2 AHS support for the division is provided in a timely and efficient
manner.
⚫ Establishes links from the medical brigade supporting the division to the medical platoons and teams in
its brigades as each brigade completes its deployment. Division medical support includes both air and
ground ambulance platforms and embedded forward surgical, COSC, and preventive medicine
detachments and teams.
⚫ Utilizes casualty and DNBI estimates and forecasts evacuation, treatment, and Class VIII requirements.
Commanders pre-position medical treatment and evacuation capabilities forward to efficiently evacuate
casualties to where they can receive the appropriate medical care. When developing the AHS support
plan, the surgeon section planner considers many factors (Refer to ATP 4-02.55). The forms of
maneuver, as well as the threat’s capabilities, influence the character of the patient workload and its
time and space distribution. The analysis of this workload determines the allocation of medical resources
and the location or relocation of MTFs.
⚫ Establishes links to the theater MEDLOG infrastructure to begin the Class VIII resupply process once
deployed. The division surgeon section anticipates customer Class VIII unit requisitions. They identify
and store adequate Class VIII stocks in medical brigade Role 3 MTFs supporting the division to reduce
the resupply turnaround times for forward surgical detachments in the brigades.
⚫ Determines situationally appropriate medication resupply protocols for cold packages, birth control, and
sexually transmitted diseases.
⚫ Tracks the expenditures of prophylaxis means, such as anthrax and smallpox vaccinations.
⚫ Coordinates relationships of organic medical units and medical units/elements under OPCON or attached
to the division for GS or direct support (DS).
⚫ Coordinates for both air and ground ambulance support beyond the capabilities of BCT medical
companies with the division’s supporting medical unit(s) and combat aviation brigade.
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Appendix C
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
Coordinates the prompt evacuation of casualties from the division’s Role 1 and 2 MTFs to supporting
Role 3 MTFs provided by the division’s supporting medical unit.
Coordinates with G-1/S-1 casualty operation personnel to ensure patient tracking is performed.
Ensures medical supplies are available to division medical personnel.
Develops and maintains the medical troop basis, revising as required, to ensure task organization for
mission accomplishment.
Plans and coordinates AHS support operations for division and attached/OPCON corps medical assets.
This includes reinforcement and reconstitution.
Prepares and presents, as directed by the division surgeon, routine AHS support portion of the division
briefings.
Coordinates with the G-3 for prioritizing the reallocation of organic and corps medical augmentation
assets as required by the tactical situation.
Works with the protection cell to provide staff supervision of the implementation of FHP actions by the
division’s subordinate units. Medical personnel monitor the division’s AO for disease; conducts
preventive services such as: immunizations and prophylaxes; and help when Soldiers are exposed to
hazards. Medical personnel establish medical, occupational, and environmental health screening as
required. Through field sanitation team training and water assessments, medical personnel educate
Soldiers and noncombatants on disease and nonbattle injury prevention.
Coordinates for prophylactic medical treatment for the division’s projected AO and with projected
supporting medical organizations to ensure they can support the division’s projected operations and
resupply divisional medical units and combat lifesavers with Class VIII (medical materiel).
Works with the theater army surgeon, civil affairs staff, and other unified action partners to obtain upto-date health threat analysis on the division’s projected AO. Pre-deployment behavioral health surveys
should be conducted as part of deployment processing.
STAFFING
C-26. Table C-20 depicts the staffing of the division surgeon section.
Table C-20. Division surgeon section and support area command post
SIGNAL, INTELLIGENCE, AND SUSTAINMENT COMPANY (DIVISION)
Paragraph title
MCP/SUS/
Surgeon Section
Support Area
Command Post
/SUS/SUS EL
AOC/MOS
Grade
Title
Branch
Quantity
60A00
70H67
60W00
65D00
O5
O5
O4
O4
Surgeon
Medical Operations Officer
Psychiatrist
Physician Assistant
MC
MS
MC
SP
1
1
1
1
67J00
O4
Aeromedical Evacuation Officer
MS
1
70E67
70H67
72D67
68Z6O6S
68W5O
70K67
O4
O4
O3
E9
E8
O4
Patient ADMIN Officer
Medical Plans Officer
Environmental Science Officer
Chief Medical NCO
Operation NCO
Health Service Materiel Officer
MS
MS
MS
NC
NC
MS
1
1
1
1
1
1
68W4O
E7
Operations NCO
NC
1
CORPS SURGEON
C-27. The corps surgeon is a corps level officer and member of the commander’s personal and special staff. They
normally work under the staff supervision of the corps chief of staff. The corps surgeon is charged with leading
the planning and coordination of the AHS support mission within the corps. However, as personal staff, the corps
surgeon is the principal advisor to the commander on the health status of the corps and has direct access to the
corps commander on all AHS support or medical-related issues. The corps surgeon is responsible for the technical
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oversight of all medical activities in the command. The corps surgeon oversee and coordinate AHS support
activities through the corps surgeon section. The corps surgeon also monitors, prioritizes, synchronizes, and
assesses AHS support; serves as medical contract officer for the corps; and provides an analysis of the health threat.
C-28. Through the C2 system, the corps surgeon utilizes medical C2 to coordinate, synchronize, and integrate the
nine remaining medical functions split between the protection and sustainment warfighting functions and serves
as a link between these varied commands and staffs.
C-29. As a member of the staff, the corps surgeon section participates in the planning and orders production process
that provides the tasks, purpose, and guidance to the assigned, attached, and supporting medical organizations
(only medical control for the surgeon). The surgeon section liaisons with these organizations during the planning
process to optimally coordinate, synchronize, integrate, and plan AHS support, but does not encroach on the
command authority of those organizations.
PARAGRAPH 48, MCP/SUS/SURGEON SECTION.
C-30. Principal advisor to the Commander on the health status of the corps. Monitors and coordinates AHS support
operations for the corps. Provides recommendations on allocation and redistribution of medical personnel and
Class VIII items. Oversees all Army MEDLOG for the command. Provides patient disposition and reports.
Monitors and coordinates operational public health operations. Provides technical advice to the corps commander
for occupational, environmental health, and medical surveillances, sanitary inspections, and potential CBRN
contamination. The corps surgeon resides in the main command post within the surgeon section.
C-31. The surgeon section is normally functionally organized under the sustainment warfighting function, but may
report directly to the corps chief of staff depending on the desires of the corps commander. This section is
responsible for, but not limited to:
⚫ Provides reachback capability for the forward deployed surgeon element in the tactical command post.
⚫ Assists the tactical command post in monitoring and coordinating AHS support operations.
⚫ When operating as a joint headquarters, coordinates with the staff judge advocate and chain of command
to determine eligibility for medical care in an MTF.
⚫ As a member of a joint staff, provides Annex Q (Medical Services) to all OPLANs and orders.
⚫ When operating as a joint headquarters, recommends theater policy for medically evacuating
contaminated patients.
⚫ Participates in the sustainment cell working group to integrate and synchronize HSS tasks. Prepares a
portion of Annex F (Sustainment) to the OPORDs and plans.
⚫ Participates in the protection cell working group to integrate and synchronize FHP tasks and systems for
each phase or transition of an operation or major activity. Prepares a portion of Annex E (Protection) to
the OPORDs and plans.
⚫ Reviews all Corps OPLANs and contingency plans to identify potential health threats associated with
geographical locations and climatic conditions.
⚫ Provides current information on the corps AHS support plan/medical common operating picture
(MEDCOP) to surgeons/medical operations staffs of the next higher, adjacent, and subordinate HQs to
maintain medical situational awareness.
⚫ Ensures AHS support is provided across the conflict continuum. Various types of mission support
(traditional support to a deployed force, operations predominantly characterized by stability tasks, and
defense support of civil authorities) are provided simultaneously in various locations throughout the
corps AO. AHS planners anticipate the types of support required and develop flexible plans that are
rapidly adjusted to changes in the level of violence and tempo, as well as to transition from one type of
task to the next.
⚫ Coordinates access to intelligence of medical interest with the Assistant Chief of Staff, G-2, Intelligence
and ensures that the health threat, medical intelligence, and intelligence of medical interest are integrated
into AHS OPLANS and OPORDS.
⚫ Coordinates HSS, including the treatment and MEDEVAC of patients from the battlefield and the
required Class VIII supplies, equipment, and services necessary to sustain these operations.
⚫ Coordinates and monitors FHP operations to include, operational public health, veterinary services,
AML services and support, dental services, and COSC.
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⚫
Develops, in conjunction with higher headquarters, corps evacuation policy.
Develops health consultation services within the corps.
⚫ Provides technical advice to the Corps Commander for occupational, environmental health, and medical
surveillances, sanitary inspections, and potential CBRN contamination.
⚫ Initiate operational public health programs (to include medical surveillance, and OEH surveillance)
within the corps.
⚫ Determines corps AHS training policies and programs as required.
⚫
PARAGRAPH 71, TAC/SUS/SURGEON ELEMENT.
C-32. The primary role of the tactical command post (TAC) is as the alternate command post of the corps. The
TAC/SUS/surgeon element serves as the corps surgeon’s eyes and ears for the forward deployed TAC. Reviews
all Corps OPLANs and contingency plans to identify potential medical hazards associated with geographical
locations and climatic conditions. Assists TAC in monitoring and coordinating Army Health System support
operations. This element is responsible for, but not limited to:
⚫ Oversees, monitors, and coordinates AHS support operations for the TAC and communicates back to
the MCP/SUS/Surgeon Section.
⚫ In coordination with the MCP/SUS/Surgeon Section, oversees MEDLOG for the TAC.
⚫ Provides patient disposition and reports for the TAC and forwards to the MCP/SUS/Surgeon Section.
⚫ Evaluates and interprets AHS statistical data within the TAC and forwards information back to the
MCP/SUS/Surgeon Section.
PARAGRAPH 77, REAR COMMAND POST (RCP)/SUS/SURGEON ELEMENT.
C-33. The corps commander may establish a Rear CP (RCP) that can co-locate with the maneuver enhancement
brigade (MEB) or other brigade HQs to provide command authority and general officer oversight of the Corps
Support Area (CSA) operations and sustainment, medical and other CSA activities. The RCP may also be activated
in support of defeating threats, coordinating and synchronizing protection, enabling stability operations, and
enabling transitions. When established, the RCP surgeon element personnel move from the MCP/SUS/Surgeon
Section to the RCP/SUS/Surgeon Element. This element is responsible for, but not limited to:
⚫ Monitors and coordinates AHS support operations for the corps surgeon.
⚫ Provides current information on the corps AHS support plan/medical common operating picture
(MEDCOP) to surgeons/medical operations staffs within the corps support area to maintain medical
situational awareness.
⚫ Provides recommendations on allocation and redistribution of medical personnel and Class VIII items
to the corps surgeon.
⚫ With guidance from the corps surgeon, coordinates with the supporting MEDBDE (SPT) and liaisons
with the Rear Command Post (RCP)/SUS/LOG/G4 Supply and Service Element in planning for the
allocation of MEDLOG support and assists in oversight of MEDLOG for the command.
⚫ Provides patient disposition and reports for the corps surgeon.
⚫ Evaluates and interprets AHS statistical data for the corps surgeon.
⚫ Monitors and coordinates FHP operations for the RCP and corps surgeon.
⚫ Monitors and coordinates operational public health operations (to include medical surveillance, and OEH
surveillance) within the RCP.
STAFFING
C-34. Table C-21 depicts the staffing of the corps surgeon section.
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Table C-21. Corps surgeon section
SIGNAL, INTELLIGENCE, AND SUSTAINMENT COMPANY, HHB (CORPS)
Paragraph title
MCP/SUS/ Surgeon
Section
TAC/SUS/ Surgeon
Element
Rear Command Post/SUS/
Surgeon Element
Grade
O6
O5
O5
O5
O5
E9
E7
O6
O5
O5
E8
O4
E6
AOC/MOS
60A00
60C00
70H677J
67J00
70K67
68Z6O7S
68G4O
70H67
65D00
72D67
68W5O
70H67
68W3O
Title
Surgeon
Preventive Medicine Officer
Medical Operations Officer
Aeromedical Evacuation Officer
Health Service Materiel Officer
Chief Medical NCO
Patient ADMIN NCO
Medical Operations Officer
Corps Physician Assistant
Environmental Science Officer
Operation NCO
Medical Operations Officer
Medical NCO
Branch
MC
MS
MS
MS
MS
NC
NC
MS
SP
MS
NC
MS
NC
Quantity
1
1
1
1
1
1
1
1
1
1
1
1
1
INDEPENDENT SUPPORT COMMAND SURGEON STAFFING
C-35. The independent support command surgeon section varies from command to command. Tables C-22 through
C-25 depicts the staffing of varies independent support command surgeon sections.
Table C-22. Theater medical command clinical services and force health protection section
HHC, THEATER MEDICAL COMMAND
Paragraph title
Clinical Services
Force Health
Protection Section
AOC/MOS
60A00
61J00
66N00
66N00
72A67
68Z6O
68C5O
60C00
60W00
63R00
64Z00
64B00
72B67
72D67
72D67
73A67
68Z6O
68R5O
68S5O
Grade
O6
O6
O6
O5
O5
E9
E8
O6
O6
O6
O6
O5
O5
O5
O5
O5
E9
E8
E8
Title
Medical Consultant
Surgical Consultant
Nursing Consultant
Chief Nursing Services
Nuclear Medicine Science Officer
Chief Medical NCO
Senior Practical Nurse NCO
Preventive Medicine Officer
Psychiatrist
Dental Surgeon
Senior Veterinarian
Veterinary Preventive Medicine Officer
Entomologist
Environmental Science Officer
Environmental Engineer
Social Worker
Chief Medical NCO
Senior Veterinary NCO
Preventive Medicine NCO
Branch
MC
MC
AN
AN
MS
NC
NC
MS
MC
DC
VC
VC
MS
MS
MS
MS
NC
NC
NC
Quantity
1
1
1
1
1
1
1
1
1
1
1
1
1
2
1
1
2
2
1
Table C-23. Theater sustainment command surgeon section
HQ AND STB, THEATER SUSTAINMENT COMMAND
Paragraph title
AOC/MOS
Grade
Title
Branch
Quantity
Surgeon Section
60A00
70H67
72D67
68W5O
O6
O4
O3
E8
Surgeon
Medical Operations Officer
Environmental Science Officer
Senior Health Care NCO
MC
MS
MS
NC
1
1
1
1
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Appendix C
Table C-24. Expeditionary sustainment command surgeon section
Headquarters, SUSTAINMENT COMMAND (Expeditionary)
Paragraph title
AOC/MOS
Grade
Title
Branch
Quantity
Surgeon Section
60A00
70H67
68W4O
O4
O4
E7
Surgeon
Medical Operations Officer
Health Care NCO
MC
MS
NC
1
1
1
Table C-25. Chemical biological, radiological, and nuclear command surgeon section
HHC, CBRNE COMMAND
Paragraph title
Surgeon Section
AOC/MOS
60D00
70H67
72A00
72A67
68W5O
Grade
O5
O4
O4
O4
E8
Title
Occupational Medicine Officer
Medical Operations Officer
Microbiologist
Nuclear Medicine Science Officer
Health Service Materiel Officer
Branch
MC
MS
MS
MS
NC
Quantity
1
1
1
1
1
ARMY SERVICE COMPONENT COMMAND SURGEON (THEATER
SURGEON)
C-36. The ASCC surgeon is a theater level officer and member of the commander’s personal and special staff. The
ASCC surgeon is charged with leading the planning and coordination of the AHS support mission within the
theater. The ASCC surgeon is the theater army staff proponent responsible for (in coordination with the TMC
commander) the provision of AHS support within the AOR. The ASCC surgeon has staff responsibility for medical
planning, coordination, and policy development for AHS support to deployed forces.
C-37. Through the C2 system the theater army surgeon utilizes medical C2 to coordinate, synchronize, and
integrate the nine remaining medical functions split between the protection and sustainment warfighting functions
and serves as a link between these varied commands and staffs.
PARAGRAPH 94, SURGEON HQ SECTION.
C-38. Maintains situational understanding by coordinating for current AHS information with medical operation
staffs of the next higher, adjacent, and subordinate HQs. Coordinates with USAMEDCOM for AHS information
and resources. Provides for health services in the AOR. Monitors execution of AHS to ensure it supports the
combatant commander's decisions and intent. Synchronizes AOR medical resources to ensure effective and
consistent treatment of wounded, injured, or sick personnel as to return to full duty or evacuate from the AOR. Staff
responsibility for all AHS functional areas. Advises the Theater Army commander on the health of the
command. Coordinates AHS (including, but not limited to, preventive medicine, inpatient/outpatient care, ancillary
support, MEDLOG, patient evacuation, hospitalization, dental support, return to duty, and veterinary services) in
preparing and sustaining theater forces. Develops and manages programs to identify health threats, apply risk
management, and abate such risks. Specific functions of the surgeon HQs section include, but are not limited to:
⚫ Advises the theater army commander on the health of the command and the occupied or friendly territory
within the theater AO.
⚫ Determines the health threat and provides advice concerning the medical effects of the environment and
of CBRN weapons and personnel, military and contract working dogs, rations, and water. Develops and
manages programs to identify health threats, apply risk management, and mitigate such risks.
⚫ Maintains situational understanding by coordinating for current AHS information with the medical
operations staffs of subordinate HQs.
⚫ As a member of a joint staff, provides Annex Q (Medical Services) to all OPLANs and orders.
⚫ Participates in the sustainment cell working group to integrate and synchronize HSS tasks. Prepares a
portion of Annex F (Sustainment) to the OPORDs and plans.
⚫ Participates in the protection cell-working group to integrate and synchronize FHP tasks and systems for
each phase or transition of an operation or major activity. Prepares a portion of Annex E (Protection) to
the OPORDs and plans.
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Surgeon at Echelon
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
Coordinates with the surgeon general for AHS information and resources.
Provides for health services in the AOR.
Monitors execution of AHS support to ensure it supports the CCDR's decisions and intent.
Synchronizes AOR medical resources to ensure effective and consistent treatment of wounded, injured,
or sick personnel as to return to full duty or evacuate from the AOR.
Provides staff oversight for all ten AHS medical functions.
Coordinates AHS support (including, but not limited to, operational public health, inpatient/outpatient
care, ancillary support, MEDLOG, patient evacuation, hospitalization, dental support, return to duty,
and veterinary services) in preparing and sustaining theater forces.
Coordinates with the staff judge advocate and chain of command to determine eligibility for medical
care in an MTF.
Determines the policy for the requisition, procurement, storage, maintenance, distribution management,
and documentation of Class VIII material, blood and blood products, and special designation of a
TLAMM and the assignment of missions for the single integrated MEDLOG manager (SIMLM)
Recommends changes to the theater evacuation policy and provides input and personnel to the theater
patient movement requirements center, as required.
Recommends theater policy for medically evacuating contaminated patients.
PARAGRAPH 95, SURGEON MEDICAL OPERATIONS ELEMENT.
C-39. Coordinates patient evacuation from theater. Manages movement of patients within and from
Theater. Manages flow of casualties within the AOR. Monitors the flow of patients to medical facilities within the
combatant command AOR or for inter-theater evacuation. Communicates with the Patient Movement Requirement
Centers (Theater and global). Develops mass casualty plans, and determines the medical workload requirements
based upon the casualty estimate. Recommends MEDEVAC policies and procedures, changes to the theater
evacuation policy and provides input to the Patient Movement Requirement Center. Monitors medical regulating
and patient tracking operations. Specific functions of the surgeon medical operations element include, but are not
limited to:
⚫ Coordinates patient evacuation from theater.
⚫ Manages movement of patients within and from theater.
⚫ Manages flow of casualties within the AOR.
⚫ Monitors the flow of patients to MTFs within the combatant command AOR or for inter-theater
evacuation.
⚫ Communicates with the theater patient movement requirements center and the global patient movement
requirement center.
⚫ Develops mass casualty plans and determines the medical workload requirements based upon the
casualty estimate.
⚫ Recommends MEDEVAC policies and procedures, changes to the theater evacuation policy, and
provides input to the theater patient movement requirements
PARAGRAPH 96, SURGEON SUPPORT OPERATIONS ELEMENT.
C-40. Manages health services resources in the AO to provide effective and consistent treatment of wounded,
injured, or sick personnel as to return to full duty or evacuate from the Theater. Monitors policies, protocols, and
procedures pertaining to the medical and dental treatment of sick, injured and wounded personnel. Determines
requirements and priorities for MEDLOG. Evaluates and interprets medical statistical data. Specific functions of
the surgeon support operations element include, but are not limited to:
⚫ Manages health services resources in the AO to provide effective and consistent treatment of wounded,
injured, or sick personnel as to return to full duty or evacuate from the theater.
⚫ Monitors policies, protocols, and procedures pertaining to the medical and dental treatment of sick,
injured and wounded personnel.
⚫ Determines requirements and priorities for MEDLOG.
⚫ Evaluates and interprets medical statistical data.
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Appendix C
STAFFING
C-41. Army service component command surgeon section varies from command to command. Tables C-26
through C-32 depicts the staffing of each ASCC surgeon section. Since there are 7 variants of ASCC surgeon
sections, ensure you check FMSWeb to ensure you are viewing your command.
Table C-26. Army Surgeon Section, Variant 1
INTELLIGENCE AND SUSTAINMENT COMPANY, HHB
Paragraph title
MCP Surgeon Division
OCP Surgeon Division
AOC/MOS
60A00
72D67
67J00
70E67
70K67
68Z6O7S
70H67
70H67
70H67
70H67
68W5O
Grade
O6
O5
O4
O4
O4
E9
O6
O5
O4
O3
E8
Title
Surgeon
Environmental Science Officer
Aeromedical Evacuation Officer
Patient ADMIN Officer
Health Service Materiel Officer
Chief Medical NCO
Medical Operations Officer
Medical Operations Officer
Health Services Officer
Medical Operations Officer
Operations NCO
Branch
MC
MS
MS
MS
MS
NC
MS
MS
MS
MS
NC
Quantity
1
1
1
1
1
1
1
1
1
1
1
Table C-27. Army Surgeon Section, Variant 2
MCP HQ
Paragraph title
Surgeon
Headquarters
Section
Surgeon Medical
Operations Element
Surgeon Support
Operations Element
276
AOC/MOS
Grade
Title
Branch
Quantity
00B00
70H67
68Z6O7S
67J00
O7
O6
E9
O5
Surgeon
Medical Operations Officer
Chief Medical NCO
Aeromedical Evacuation Officer
GO
MS
NC
MS
1
1
1
1
70H67
70E67
70H67
68W5O2S
60A00
66N00
70K67
64B00
70F67
72D67
70K67
O5
O4
O4
E8
O6
O6
O6
O5
O5
O5
O6
Medical Operations Officer
Patient ADMIN Officer
Medical Plans Officer
Operations NCO
Deputy ACOFS Health Service
Chief Nursing Services
Health Service Materiel Officer
Veterinary Preventive Medicine Officer
Health Services Personnel Manager
Environmental Science Officer
Health Service Materiel Officer
MS
MS
MS
NC
MC
AN
MS
VS
MS
MS
MS
1
1
1
1
1
1
1
1
1
1
1
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Surgeon at Echelon
Table C-28. Army Surgeon Section, Variant 3
MCP HQ
Paragraph title
AOC/MOS
Grade
Title
Branch
Quantity
Surgeon
Headquarters Section
70H67
O6
Medical Operations Officer
MS
1
70H67
O5
Medical Plans/ Operations Officer
MS
1
70H67
O5
Senior Medical Operations Officer/ Deputy
MS
1
68W4O2S
E7
Medical Plans NCO
NC
1
60D00
O5
Occupational Medicine Officer
MC
1
64B00
O5
Veterinary Preventive Medicine Officer
VS
1
70K67
O5
Health Service Materiel Officer
MS
1
72D67
O5
Environmental Science Officer
MS
1
70K67
O3
Medical Logistics Officer
MS
1
Surgeon Medical
Operations Element
Surgeon Support
Operations Element
Table C-29. Army Surgeon Section, Variant 4
MCP HQ
Paragraph title
AOC/MOS
Grade
Title
Branch
Quantity
Surgeon
Headquarters Section
60A00
O6
Surgeon
GO
1
68Z6O7S
E9
Chief Medical NCO
NC
1
70H67
O4
Medical Plans Officer
MS
1
64B00
O5
Veterinary Preventive Medicine Officer
VS
1
70K67
O5
Health Service Materiel Officer
MS
1
72D67
O5
Environmental Science Officer
MS
1
65D00
O4
Physician Assistant
SP
1
Surgeon Medical
Operations Element
Surgeon Support
Operations Element
Table C-30. Army Surgeon Section, Variant 5
MCP HQ
Paragraph title
AOC/MOS
Grade
Title
Branch
Quantity
Surgeon
Headquarters Section
00B00
O7
Surgeon
GO
1
68Z6O7S
E9
Chief Medical NCO
NC
1
70H67
O6
Medical Operations Officer
MS
1
70H67
O4
Medical Plans Officer
MS
1
68W5O2S
E8
Operations NCO
NC
1
60A00
O6
Deputy ACOFS Health Service
MC
1
64B00
O5
Veterinary Preventive Medicine Officer
VS
1
70K67
O5
Health Service Materiel Officer
MS
1
72D67
O5
Environmental Science Officer
MS
1
Surgeon Medical
Operations Element
Surgeon Support
Operations Element
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Appendix C
Table C-31. Army Surgeon Section, Variant 6
MCP HQ
Paragraph title
Surgeon
Headquarters
Section
Surgeon Medical
Operations
Element
Surgeon Support
Operations
Element
AOC/MOS
Grade
Title
Branch
Quantity
00B00
O7
Surgeon
GO
1
60A00
O6
Deputy Surgeon
MC
1
70H67
O6
Medical Operations Officer
MS
1
68Z6O7S
E9
Chief Medical NCO
NC
1
67J00
O5
Aeromedical Evacuation Officer
MS
1
70H67
O5
Chief Medical Operations
MS
1
70E67
O4
Patient ADMIN Officer
MS
1
68W5O2S
E8
Plans NCO
NC
1
64B00
O5
Veterinary Preventive Medicine Officer
VS
1
65D00
O5
Physician Assistant
SP
1
70F67
O5
Health Service Personnel Manager
MS
1
72D67
O5
Environmental Science Officer
MS
1
70K67
O4
Health Service Materiel Officer
MS
1
Table C-32. Army Surgeon Section, Variant 7
MCP HQ
Paragraph title
Surgeon
Headquarters
Section
Surgeon Medical
Operations
Element
Surgeon Support
Operations
Element
278
AOC/MOS
Grade
Title
Branch
Quantity
60A00
O6
Surgeon
MC
1
70H67
O5
Medical Operations Officer
MS
1
68Z6O7S
E9
Chief Medical NCO
NC
1
70H67
O5
Chief Medical Operations
MS
1
70H67
O4
Medical Plans Officer
MS
1
68W5O2S
E8
Operations NCO
NC
1
64B00
O5
Veterinary Preventive Medicine Officer
VS
1
70K67
O5
Health Service Materiel Officer
MS
1
72D67
O5
Environmental Science Officer
MS
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Joint Medical Capabilities
Appendix D
Joint Medical Capabilities
United States military operations are joint in nature. Army medical planners often become
involved in planning efforts for operations or are in providing Army medical support to
organizations and medical capabilities from other Services. This appendix provides basic
information of medical capabilities and capacities of other Services. The purpose is to
provide information to assist medical planners to efficiently plan for the use of medical
capabilities when other Service assets are available for support.
REFERENCES
D-1. The following Joint and Service medical publications were used to compile this appendix:
⚫ JP 4-02, Joint Health Services.
⚫ FM 4-02, Army Health System.
⚫ ATP 4-02.2, Medical Evacuation.
⚫ ATP 4-02.4, Medical Platoon.
⚫ ATP 4-02.6, The Medical Company (Role 2).
⚫ ATP 4-02.10, Theater Hospitalization.
⚫ ATP 4-02.55, Army Health System Support Planning.
⚫ NWP 4-02, Naval Expeditionary Health Service Support Afloat and Ashore.
⚫ NTTP 4-02.4, Expeditionary Medical Facilities.
⚫ NTTP 4-02.6, Hospital Ships.
⚫ NTTP 4-02.2M, Patient Movement.
⚫ MCRP 4-11.1E, Health Service Support Field Reference Guide.
⚫ MCTP 3-40A, Health Service Support Operations.
⚫ AFTTP 3-42.71, Expeditionary Medical Support (EMEDS) and Air Force Theater Hospital (AFTH).
⚫ DAFI 48-107v1, En Route Care and Aeromedical Evacuation Medical Operations.
UNITED STATES ARMED FORCES ROLES OF CARE COMPARISION
D-2. In order to plan efficient and synchronized medical support in a joint environment, Army medical planners
should understand the organizations other Services use to provide medical care. Figure D-1 provides a comparison
of roles of care using Army capabilities as the point of reference. Understanding the equivalent of Army capabilities
will enable medical staff and commanders to utilize available forces more effectively in support of an operation as
well as identify capability strengths and gaps. The Roles of Care are coupled with the following capabilities:
⚫ Casualty Response. Casualty care rendered at point of injury/illness to self or others (TCCC Tiers 1 and
2)
⚫ Role 1 (Unit-Level Medical Care). Medical care rendered at point of injury/illness to self or others
(TCCC Tiers 3 and 4).
⚫ Role 2 (Trauma Management and Emergency Medical Treatment. Forward advanced emergency
medical treatment performed close to the point of injury/illness (TCCC Tiers 3 and 4).
⚫ Role 3 (Hospitalization). Modular hospitals with medical and surgical capabilities.
⚫ Role 4 (Definitive Care). Full range of acute, convalescent, restorative, and rehabilitative care.
⚫ En Route Care. The care required to maintain the phased treatment initiated prior to evacuation and the
sustainment of the patient’s medical condition during evacuation.
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Appendix D
Figure D-1. United States Military Roles of Care Service Comparison
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Joint Medical Capabilities
ROLE 1 CARE
D-3. Role 1 is point of injury care. It is split between casualty response and
⚫ First responder care: first aid and immediate lifesaving measures provided by self-aid and buddy aid
(TCCC Tier 1), or a combat lifesaver (nonmedical team/squad member trained in enhanced first-aid)
(TCCC Tier 2).
⚫ Care by the combat medic, corpsman , or medical technician trained in TCCC Tier 3. Additional
battlefield providers, with various levels of training, include the Special Forces medical sergeant, special
operations combat medic, SEAL (Sea, Air, Land) independent duty corpsman, special boat corpsman,
pararescueman, and special operations medical technician.
Role 1 care is provided by the following:
U.S .Army (Battalion Aid Station)
⚫
Includes triage, treatment, and evacuation.
Care is provided by the physician, physician assistant, and/or medic.
⚫ Goals are to return to duty or to stabilize and evacuate to the next higher role MTF.
⚫ No surgical or patient holding capability.
⚫
U.S. Marine Corps (Battalion Aid Station)
⚫
Includes triage, treatment, and evacuation.
Care is provided by the physician, physician assistant, and/or corpsman.
⚫ Goals are to return to duty or to stabilize and evacuate to the higher taxonomy of care.
⚫ No surgical or patient holding capability.
⚫
U.S. Marine Corps (Shock Trauma Platoon)
⚫
⚫
⚫
⚫
⚫
Small emergency medical unit that supports the Marine Expeditionary Force.
Includes stabilization and evacuation sections.
Staff consists of two emergency medicine physicians and supporting staff (total staff of 25 personnel).
No surgical capability.
Patient holding time limited to 48 hours.
U.S. Navy (En Route Care System [ERCS)
⚫
Two-person team consisting of a critical care or emergency medicine registered nurse and a corpsman.
⚫ Provides transport of two critically injured or ill, but stabilized, patients for up to 8-hour transit via
ground, surface, or air.
⚫ Has own equipment package.
⚫ Dependent on opportune lift.
U.S. Navy (Expeditionary Resuscitative Surgical System [ERSS])
⚫
Advanced, modular, mission-specific medical capability close to POI.
7-9-person team.
⚫ Can handle up to 5 damage-control surgical cases and hold patients up to 4 hours.
⚫ Can operate at sea or on shore.
⚫ Has own equipment package.
⚫
U.S. Navy (Expeditionary Medical Unit [EMU])
⚫
Damage control surgery and damage control resuscitation capability.
Advanced, modular, mission-specific medical capability close to POI.
⚫ 30-37-person team.
⚫ Organic shelter system.
⚫ Can handle 15 admissions and 13 surgical procedures per 24-hour period.
⚫
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Appendix D
⚫
⚫
Requires host facilities.
Able to deploy afloat or ashore.
ROLE 2 CARE
D-4. Role 2 care includes basic primary care. May also include optometry; combat and operational stress control
and behavioral health; dental, laboratory, radiographic, and surgical capabilities (when augmented). It may also
include:
⚫ Increased medical capability over Role 1, but limited inpatient cot space.
⚫ 100% mobility.
⚫ Preventive medicine.
⚫ Physical therapy.
⚫ Each service has slightly different units at this role.
U.S. Army (Medical Company–Brigade Support Battalion), assigned to the brigade combat team
and provides organic Role 2 and Role 1 care to units without medical asset operating in the brigade
AO and,
U.S. Army (Medical Company–Area Support), which provides general or direct AHS support on an
area basis to echelons above brigade units operating within the the corps or division AO.
⚫
⚫
⚫
⚫
⚫
⚫
Role 2 medical treatment facilities are located in the treatment platoons of medical companies/troops.
Includes basic/emergency treatment (trauma management).
Has capability to deliver packed red blood cells (liquid).
Limited X-ray, clinical laboratory, dental support, combat and operational stress control, and operational
public health (preventive medicine) (BSMC only).
Patient hold for those who can return to duty within 72 hours (BSMC [20 cots] / MCAS [40 cots]).
Resuscitative surgery capability only when an FRSD is collocated.
U.S. Marine Corps (Surgical Company)
⚫
⚫
⚫
⚫
⚫
⚫
Provides surgical care for the Marine Expeditionary Force. Basis of allocation is one per infantry
regiment.
Provides stabilizing surgical procedures (damage control surgery).
Doctrinally consists of 4 forward resuscitative surgical systems, 4 shock trauma platoons, and 4 en route
care teams.
Has 20-bed capability.
Portable digital X-ray and minimal laboratory and blood banking capabilities.
Patient holding capability up to 72 hours.
U.S. Marine Corps (Forward Resuscitative Surgical System [FRSS])
⚫
⚫
⚫
⚫
⚫
⚫
⚫
Basic surgical capability module.
Rapid assembly, highly mobile.
Can provide resuscitative surgery for 18 patients within 48 hours without resupply.
The 8-person team includes 2 surgeons, 1 anesthesiologist, 1 critical care nurse, 2 OR technicians, and
2 corpsmen.
Holding capability of 4 hours.
No intrinsic evacuation capability.
Not a stand-alone organization.
U.S. Marine Corps (En route Care Team)
⚫
⚫
282
Two-person team consisting of a critical care registered nurse and a corpsman.
Provides transport of two critically injured or ill, but stabilized, postoperative casualties.
AHS Doctrine Smart Book
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Joint Medical Capabilities
⚫
Has own equipment package.
Capable of transporting two patients, one ventilated.
⚫ Dependent on opportune lift.
⚫
U.S. Navy (Casualty Receiving and Treatment Ship [CRTS])
CRTSs are part of an Amphibious Ready Group (ARG) and are usually comprised of one Marine amphibious assault
ship (Tarawa class) or landing helicopter deck Wasp-class ship, whose primary mission is the transport and deployment
of Marines and whose secondary mission is to function as a casualty-receiving platform. An ARG typically comprises
three ships, with surgical capability only on the CRTS.
⚫ Ships have 45 ward beds, 4 ORs (with augmented staff; see below), and 17 ICU beds.
⚫ A 176-person Fleet Surgical Team consists of 1 surgeon, 1 certified registered nurse anesthetist, 1 critical
care nurse, 1 OR nurse, 1 general medical officer, and 12 support staff.
⚫ A CRTS and the Fleet Surgical Team can be augmented with 84 additional personnel to increase
capability from one OR to four, as well as provide the following specialties: 2 orthopedic surgeons and
1 oral and maxillofacial surgeon.
⚫ Ships have laboratory, X-ray, and frozen blood capabilities.
⚫ Designed for receipt and flow of casualties from helicopter flight deck and landing craft well deck.
⚫ Have triage areas for 50 casualties.
⚫ Doctrinal holding capability is limited to 3 days.
U.S. Navy (Aircraft Carrier Battle Group)
⚫
Includes 1 OR, 52 ward beds, and 3 intensive care beds.
Staff includes 1 surgeon and 5 additional medical officers.
⚫ Medical assets aboard aircraft carriers are intended for use by the aircraft carrier and its task force.
Aircraft carriers are not casualty-receiving ships and are not included in medical assets for support to
ground forces.
⚫
U.S Air Force (Expeditionary Medical Support [EMEDS] Health Response Team [HRT])
D-5. The EMEDS HRT is the first increment of EMEDS capability. The EMEDS HRT is designed to support the
early phases of military operations and requires reinforcement of personnel and equipment for operations longer
than 10 days. It includes specialized personnel and equipment UTCs that can be tailored in or out, depending on
the mission. It is designed for rapid mobility and efficient setup. Its primary goal is to stabilize patients and prepare
them for movement to the next level of care. The EMED HRT accomplishes this by:
⚫ Deploying within 24 hours of notification.
⚫ Establishing emergency room (ER) capability within 2 hours.
⚫ Establishing operating room capability within 4 hours.
⚫ Establishing critical care capability within 6 hours.
⚫ Reaching full operational capability (FOC) within 12 hours of arrival.
⚫ Stabilizing and holding four patients (three of which can be critical) for 24 hours.
⚫ Evacuating patients within 24 hours.
U.S. Air Force (EMEDS +10)
D-6. The EMEDS+10 is the second increment of EMEDS capability and builds on EMEDS HRT. This combined
capability has a total of 10 medical/surgical beds and can support a PAR of 3,000-5,000. EMEDS+10 provides
medical/surgical and critical care augmentation. Laboratory service is added, as well as additional BE, public
health, administration, and MEDLOG support. EMEDS+10 can reach FOC within 36 hours of arrival. Note: For
HA/DR and stability operations, if the anticipated patient throughput exceeds the capabilities included with
EMEDS HRT, additional specialty UTCs, such as pediatrics (FFPED/FFPE1) and OB/GYN (FFGYN/FFGY1),
can be added to the EMEDS+10 configuration.
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Appendix D
ROLE 3 CARE
D-7. At Role 3, the patient is treated in a MTF staffed and equipped to provide care to all categories of patients,
including resuscitation, initial wound surgery, damage control surgery, and postoperative treatment. This role of
care expands the support provided at Role 2. Patients who are unable to tolerate and survive movement over long
distances receive surgical care in a hospital as close to the supported unit as the tactical situation allows. This role
includes provisions for:
⚫ Evacuating patients from supported units.
⚫ Providing care for all categories of patients in a MTF with the proper staff and equipment.
⚫ Providing support on an area basis to units without organic medical assets.
U.S. Army (Hospital Center)
D-8. The hospital center provides essential care within the theater evacuation policy to either return the patient to
duty or stabilize the patient for evacuation to a Role 4 MTF outside the AO. The hospital center’s assigned medical
personnel, facilities, equipment, and materials provide the requisite capabilities to render significant preventive
and curative health care. These highly robust services encompass primary inpatient and outpatient care; emergency
care; and enhanced medical, surgical, psychiatric, and ancillary capabilities. The modular design of the hospital
provides the capability to tailor and deploy capabilities as modules or multiple individual capabilities that provide
incrementally increased medical services.
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
284
Command and control of organic elements to include AHS support, planning, policies, and support
operations within the hospital's AO and is capable of operating up to 72 hours with its initial basic load
of supply on hand within identified medical materiel set(s).
Information to commanders and their staff on the health of their command and on health aspects affecting
the unit's mission(s) or AHS.
Initial deployments consists of the hospital center headquarters and headquarters detachment (HHD) and
one (1) field hospital (32-bed).
Indefinite split-base capability when a field hospital (32-bed) is deployed with the HHD hospital center.
Subsequent modularity provides an additional field hospital (32-bed), a surgical (24-bed) detachment, a
medical (32-bed) detachment, and up to two intermediate care ward (60-bed) detachments.
At full capacity provides hospitalization for up to 240 patients consisting of five (5) 12-bed wards
providing intensive nursing care for up to sixty (60) patients and nine (9) wards providing intermediate
nursing care for up to one-hundred and eighty (180) patients.
Surgical capability, including general, orthopedic, and obstetrics-gynecological based on two operating
room tables capable of providing 108 operating room hours per day.
Emergency treatment to receive, triage, and resuscitate casualties to include not only military personnel,
but DOD civilian employees and contractors, local nationals, detainees, enemy prisoners of war
(EPWs)/retained/detained personnel as required.
Provides Role 1 and 2 care on an area support basis.
Pharmacy, clinical laboratory, blood banking, radiology/computed tomography and nutrition care
service for patients and organic staff.
Psychiatry, public health nursing, and physical therapy services.
Operational dental care consisting of emergency dental care and essential dental care designed to
circumvent potential dental emergencies.
Personnel administration, patient administration, unit maintenance, medical and non-MEDLOG, laundry
services for direct patient-related linen and shower facilities for ambulatory patients and direct patient
care providers.
Technical advice and consultation on medical automated information systems and programs such as the
Theater Medical Information Program (TMIP) and medical communications for combat casualty care
(MC4).
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U.S. Army Hospital Center Augmentation Companies, Detachments, and Teams
D-9. The HHD, Hospital Center deploys with the first Filed Hospital (32-Bed). Through the orders process and
using the basis is of allocation, population at risk, and METT-TC (I) dependent this expeditionary Role 3 capability
may be augmented by one or more field hospitals, medical detachments, hospital augmentation teams, or medical
teams. These may include:
⚫ Field hospital (32-bed). Provides hospitalization and outpatient services for all classes of patients within
the theater for up to 32 patients consisting of one (1) ward providing intensive nursing care for up to
twelve (12) patients and one (1) ward providing intermediate nursing care for up to twenty (20) patients
and provides 36 operating room hours per day.
⚫ Hospital augmentation detachment (surgical 24 bed). Augments the capabilities of the field hospital (32
bed) with thoracic, urology, oral maxillofacial surgical capabilities, 24 additional ICU beds, outpatient
services, microbiology and provides 36 operating room hours per day and provides 36 operating room
hours per day.
⚫ Hospital augmentation detachment (medical 32 bed). Augments the field hospital (32 bed) with
operational dental care, one additional ICU ward, one ICW ward, additional microbiology capabilities
and outpatient services for all classes of patients within the Theater.
⚫ Hospital augmentation detachment (intermediate care ward (ICW), 60 bed). Augments the capabilities
of the field hospital as required with three additional 20-bed ICWs providing intermediate nursing care
and additional personnel to support nutrition and patient administration capabilities.
⚫ Medical detachment (forward resuscitative and surgical). Provides forward damage control resuscitation
(DCR) and damage control surgery (DCS) in support of unified land operations, either independently,
or as part of a future unified action partner coalition, for short and extended HSS operations.
⚫ Medical detachment, minimal care (120 cot). Provides 120 cots for ambulatory patients receiving
minimal/convalescent care, nursing, and rehabilitative services in support of theater hospitals.
⚫ Hospital augmentation team, head and neck. Provides special surgical care for ear-nose-throat surgery,
neurosurgery, and eye surgery to support the theater hospitals plus specialty consultative services. The
hospital team (head and neck) is the only organization authorized a CT scanner.
⚫ Forward Resuscitative Surgical Detachment (FRSD). A Role 3 capability utilized at Role 2. Provide
forward damage control resuscitation (DCR) and damage control surgery (DCS) in support of unified
land operations, either independently, or as part of a future unified action partner coalition, for short and
extended military HSS operations.
▪ Provides rapidly deployable, forward damage control resuscitation (DCR) damage control surgery
(DCS) within the BCT AO.
▪ 20 Personnel, able to operate for up to 72 hours, or more w/out resupply (1 field medical assistant,
1 detachment sergeant, 2 general surgeons, 2 orthopedic surgeon, 2 critical care Nurses, 1 OR NCO,
2 Practical Nurse, 1 OR Sergeant, 2 Anesthesia Providers, 2 Emergency Medical Physicians, 2
Emergency Nurses, 2 Health Care Specialists).
▪ 2 operating tables, approx. 30 patients in 72 hours (15 cases per team)
▪ Post operative nursing – 8 Patients simultaneously, up to 6 Hrs.
▪ Can split into 2 teams (10 personnel per team)
▪ Limitation on logistic support therefore – 12 cases/72 hrs. per team
▪ Can split/deploy only surgical team (6 personnel per team)
▪ 24 hours OPS only – 4 cases per team
▪ Attached to the field hospital (32-bed) when not forward deployed with a Role 2 medical company.
▪ Basic surgical capability module.
▪ Rapid assembly, highly mobile.
▪ No intrinsic evacuation capability.
▪ Not a stand-alone organization.
Note: The Role 2 definition used by NATO (North Atlantic Treaty Organization) forces (Allied Joint Publication4.10(A)) includes terms and descriptions not used by U.S. Army forces. U.S. Army forces subscribe to the basic
definition of a Role 2 MTF providing greater resuscitative capability than is available at Role 1. Surgical capability is
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not mandatory at Role 2 according to U.S. Army doctrine. The NATO description of Role 2 care, however, includes
damage control surgery. There is no such thing as a Role 1 or Role 2 (Enhanced).
U.S. Navy (Expeditionary Medical Facility)
D-10. The EMF provides standardized, modular, flexible combat service support and medical/dental capabilities
to an advanced base environment throughout the full range of military operations. It is able to support the theater
unified commander, joint task force commanders, Marine air-ground task forces, the naval expeditionary group,
and forward elements of the United States Navy, United States Army, and United States Air Force units deployed
ashore. The EMF mission is also to provide HSS and civil support care for US government agencies involved in
foreign humanitarian assistance and peacetime operations with manning, medical materiel, equipment, and
provisions tailored according to individual missions.
⚫ Provide resuscitative medical care to support combat care management across the full range of military
operations.
⚫ Provide a deployable HSS asset to support deployed forces and combat operations globally.
⚫ Provide hospital beds required for medical facility augmentations, bed totals come in 10, 81, 111, 273,
and 504 configurations.
▪ The 10-bed EMF configuration consists of 1 OR table, 4 intensive care beds, and 6 acute care beds.
▪ The 81-bed EMF configuration consists of 2 OR tables, 21 intensive care beds, 6and 0 acute care
beds.
▪ The 111-bed EMF configuration consists of 2 OR tables, 21 intensive care beds, and 90 acute care
beds.
▪ The 273-bed EMF configuration consists of 4 OR tables, 63 intensive care beds, and 210 acute care
beds.
▪ The 504-bed EMF configuration consists of 6 OR tables, 84 intensive care beds, and 420 acute care
beds.
⚫ Provides emergency treatment to receive, triage, and prepare incoming patients for surgery.
⚫ Has surgical capability, including general, orthopedic, thoracic, urological, gynecological, and oral and
maxillofacial, between based on one to six OR tables staffed for between 24 (1-bed) and 144 (6-bed)
operating table hours per day.
⚫ Provides emergency treatment to receive, triage, and prepare incoming patients for surgery.
⚫ Consultation services for inpatients and outpatients include area support for units without organic
medical services.
⚫ Provides pharmacy, psychiatry, public health nursing, physical therapy, clinical laboratory, blood
banking, radiology, and nutrition care services.
⚫ Provides stand-alone, full ancillary services.
⚫ Provides complete base operating support available with a large holding capability.
⚫ Includes class VIII support until theater is “mature” or approximately 60 days after operations
commence.
Note: Based on the experiences of a decade of evolutionary operations, Navy Expeditionary HSS is considering a
dramatic change to the structure of expeditionary medical facilities. Determinations will be made regarding scalability,
modularity, mobility, and deployable capability to improve and enhance Navy Medicine’s flexibility in providing
medical support across the full range of military operations.
U.S Navy Hospital Ships (Currently the USNS Mercy and USNS Comfort)
D-11. Hospital ships (T-AHs) are afloat trauma hospitals designed to deliver theater hospitalization capability
(THC) in support of major combat operations (MCOs), humanitarian assistance (HA) operations—both afloat and
ashore. The T-AH provides a mobile, flexible, and responsive afloat medical and surgical care capability providing
health services in support of designated combatant command missions across the full range of military operations,
including the support of medical stability operations and diplomatic efforts. The secondary missions are to provide
Defense Support of Civil Authorities (DSCA), foreign humanitarian assistance/disaster relief, theater security
cooperation including civil-military operations, and humanitarian and civic assistance. The Second Geneva
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Convention contains specific provisions relating to the unique HSS mission of T-AHs under the laws of armed
conflict. The ships are immune from attack or capture, must be used for humanitarian duties, and shall refrain from
all interference in military operations.
⚫ Each ship has 999 beds consisting of 88 intensive care beds (68 general intensive care beds and 20
postsurgical recovery beds). All 88 beds are equipped with piped in oxygen and suction, and cardiac
monitoring capability. One ward is configured with 11 respiratory isolation beds.
⚫ Inpatient ward capability includes 460 intermediate care and 440 minimal care/convalescence beds. The
440 minimal care beds are upper bunks, unsuitable for injury patterns related to fractures. Most upper
bunks are typically used by escorts and patients ready to return to full duty.
⚫ Each ship has support services for up to 12 fully equipped operating rooms (ORs).
⚫ Each ship has 1,215 medical staff (272 officers, 50 chief petty officers, and 893 enlisted).
⚫ Extensive laboratory and X-ray capabilities, including CT scan.
⚫ Large blood bank with frozen blood capability.
⚫ Patients are allowed a 5-day average stay in accordance with a baseline 7-day evacuation policy.
⚫ Designed for sustained operations from 30 days without major resupply to 60 days or longer with
resupply.
⚫ Can used as MEDLOG hubs for resupply of surrounding Role 2 capable ships.
U.S. Air Force (EMEDS + 25)
D-12. Provides forward stabilization, resuscitative care, primary care, dental services, and FHP and prepare
casualties for evacuation to the next level of care. EMEDS capabilities are grouped into distinct medical support
packages that provide an incremental buildup of capability: EMEDS HRT, EMEDS+10, and EMEDS+25.
⚫ Has 84 personnel and 2 OR tables.
⚫ EMEDS+25 is the third increment of EMEDS capability and builds on EMEDS+10 and EMEDS HRT.
⚫ Combined capability has a total of 25 medical/surgical beds and can support a PAR of 5,000-6,500.
⚫ Can provide 20 operations in 48 hours.
⚫ Additional specialty modules can be added, including vascular/cardiothoracic, neurosurgery, obstetrics/
gynecology, ear-nose-throat, and ophthalmology teams; each comes with its own personnel and
equipment modules.
⚫ Provides expanded medical/surgical care, emergency/trauma care, dental care, and ancillary services,
as well as additional medical C2, logistics, and patient administration support.
⚫ Adds basic physical therapy and enhanced dietary services.
US Air Force (Air Force Theater Hospital)
⚫
⚫
⚫
⚫
⚫
⚫
⚫
⚫
Provide dedicated in-theater and en-route support to a PAR of 6,500 and above.
Structures and staffing are capabilities-based and modular.
Represents the largest Air Force critical care and surgically capable MTF in the theater of operations.
Minimum of 58 beds (12 critical care beds and 46 medical/surgical beds), six operating room tables, and
approximately 260 personnel.
Medical/surgical specialties include otorhinolaryngology (ENT), infectious disease control, mental
health triage and combat stress management, neurosurgery, OB/GYN, ophthalmology, oral and
maxillofacial surgery, pediatrics, thoracic/vascular surgery, and urology.
Additional ancillary services include a blood support center, computed tomography (CT), diagnostic
radiology, and optometry.
The AFTH expansion packages are modular and can be added in multiple sets.
They are usually located at an air hub to facilitate patient movement to definitive care facilities in the
CONUS and designated facilities outside the continental United States (OCONUS).
ROLE 4 CARE
D-13. Role 4 medical care is found in CONUS-based hospitals and other safe havens. Mobilization requires
expansion of military hospital capacities and the inclusion of the Department of Veterans Affairs and civilian
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Appendix D
hospital beds in the National Disaster Medical System to meet the increased demands created by the evacuation of
patients from the AO.
EN ROUTE CARE
D-14. En route care is the care required to maintain the phased treatment initiated prior to evacuation and the
sustainment of the patient’s medical condition during evacuation. The purpose of an ERC capability is the
continuation of care during movement (evacuation) without clinically compromising the patient’s condition. ERC
normally involves transitory medical care, patient holding, and staging capabilities during transport from the POI
or onset of disease, through successive roles of care, to an MTF that can meet the needs of the patient. Each Service
component has organic vehicles that can be used for PM from POI to initial treatment at an MTF.
D-15. (2) ERC capability can take three forms. Casualty evacuation involves the unregulated movement of
casualties aboard ships, land vehicles, or aircraft. Medical evacuation is the timely, efficient movement and ERC
by medical personnel of the wounded, injured, or ill persons from the battlefield and/or other locations to and
between MTFs. MEDEVAC is conducted with dedicated ground and air ambulances, properly marked and
employed in accordance with the Geneva Conventions and the law of war. Medical evacuation involves the
movement of both unregulated and regulated patients. Aeromedical evacuation refers to the movement of patients
under medical supervision to and between MTFs by air transportation. The United States Air Force (USAF) AE
system provides for the time-sensitive ERC of patients, to and between MTFs, using organic and/or contracted
aircraft with medical aircrew explicitly trained for the mission. More detailed guidance on CASEVAC is provided
in Army Techniques Publication (ATP) 4-02.13, Casualty Evacuation; Air Force Tactics, Techniques, and
Procedures (AFTTP) 3-42.5, Aeromedical Evacuation (AE); and Navy Tactics, Techniques, and Procedures
(NTTP) 4-02.2M/Marine Corps Reference Publication (MCRP) 3-40A.7, Patient Movement.
D-16. En route care is provided on all Army MEDEVAC platforms when a medical attendant is on board with
access to the patient. This care is essential for minimizing mortality, enhancing survival rates, and reducing
disability of wounded, injured, or ill Soldiers.
D-17. En route care is provided by trained medical professionals who provide the timely, efficient movement and
en route care of the wounded, injured, or ill persons from the battlefield or other locations to MTFs. The provision
of en route care on medically equipped vehicles or aircraft greatly enhances the patient’s potential for recovery
and may reduce long-term disability by maintaining the patient’s medical condition in a more stable manner.
D-18. The appropriate level of care must be maintained throughout the continuum of care. A patient who has
received complex care requires continuous maintenance of the critical care support that was initiated at a forward
MTF. Depending on the level of care, the medical personnel providing en route care may be critical care flight
paramedics, en route critical care nurses, or other properly trained medical specialists. When possible, this en route
care should be used as far forward as the METT-TC (I) allows.
JOINT EVACUATION CAPABILITIES
D-19. This portion of the appendix provides medical and CASEVAC capabilities to assist planners in determining
capacity based on the number and type of vehicles available. Tables D-1 through D-4 depict the varies CASEVAC
and MEDEVAC capabilities each service currently utilizes. For more information on overall Joint medical
capabilities, refer to the references listed above.
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Table D-1. United States Army medical and casualty evacuation capabilities
Army Medical Evacuation (ground)
Type
Litter
Ambulatory
M997 wheeled ambulance
4
6
M113A3 tracked ambulance
4
6-8
M1254 Stryker MEV
4
6
M1284 (AMPV) medical evacuation vehicle
4
6
M1266A1 LWB MRAP ambulance
2
4
Army Medical Evacuation (rotary wing)
HH-60M Blackhawk
6
7
UH-72 Lakota
2
3
Army Casualty Evacuation (ground)
M998 series (HMMWV) wheeled vehicle
3
5
M1081 LMTV
7
12
M1093 MTV
8
14
M977A4 HEMTT
9
M871 22 1/2 ton cargo trailer
16
Army Casualty Evacuation (rotary wing)
0
31
4
25
8
19
CH-47 Chinook (multiple evacuation
configurations with litter support kit
12
16
installed)
16
10
20
4
24
1
Army Casualty Evacuation (fixed wing)
C-12 Huron
18
0
C-23 Sherpa
0
20
Combination
2 Litter/3 ambulatory
2 Litter/3-4 ambulatory
2 Litter/2-4 ambulatory
2 Litter/3 ambulatory
1 Litter/2 ambulatory
varies
varies
varies with configuration
varies with configuration
varies with configuration
Table D-2. United States Navy and Marine Corps casualty evacuation capabilities
United States Navy/Marine Corps casualty evacuation capabilities (ground)
Type
Litter
Ambulatory
Combination
MRAP CAT II ISS
2
4
LAV 25
0
4
LAV-L
4
7
MK 23 (7-ton truck)
10
20
United States Navy/Marine Corps casualty evacuation capabilities (rotary wing)
UH-1Y Huey
6
10
CH-46 Sea Knight
15
22
CH-53 Sea Stallion
24
37
V-22 Osprey
12
24
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Appendix D
Table D-3. United States Navy ship capabilities and staffing
CV/CVN Capability
Operating Rooms
Intensive Care Unit Beds
Ward Beds
Ancillary
LHD/LHA Capability
Operating Rooms
Intensive Care Unit Beds
Ward Beds
Ancillary
Aircraft Carrier (CVN) Capabilities
Nimitz Class
1
3
48
Ford Class
1
3
32
Laboratory, x-ray, pharmacy, preventive medicine, biomedical
repair, aviation physical examinations, radiation health,
spectacle fabrication, psychology, and physical therapy
Amphibious Assault Ship (LHA) Capabilities
Ship/FST
1
3
12
SHIP/FST/HSAP
4
15
45
Laboratory, blood bank, x-ray, pharmacy, preventive medicine,
biomedical repair, and aviation physical examinations.
Amphibious Transport Dock (LPD) Capabilities
LPD Capability
Austin Class
San Antonio Class
Operating Rooms
0
1
Ward Beds
17*
24*
Ancillary
Laboratory and x-ray
Landing Ship Dock (LSD) Capabilities
Ward Beds (2 isolation beds)
8*
Ancillary
Laboratory and x-ray
Submarine Tender (AS) Capabilities
Operating Rooms
2
Ward Beds
12
Ancillary
Laboratory, x-ray, and pharmacy
Hospital Ship (T-AH) Capabilities
Operating Rooms
12
88 (includes 20 post-surgical recovery beds and 11 isolation
Intensive Care Unit Beds
beds with critical care capability
Intermediate Care Beds
400
Minimal Care Beds
500
Laboratory, blood bank, x-ray (includes CAT scan and
Ancillary
angiography suite), pharmacy
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Table D-4. United States Air Force aircraft capacities
USAF floor loading capacities (fixed wing aircraft))
Type
C-130
C-17
KC-46A
Litter
15/21 (J Model)
48 (12 litter patients can be placed on the ramp to maximize utilization of the aircraft)
24 (plus 30 ambulatory)
KC-135
8
C-130H/J
C-17
KC-135
C-12J
C-21
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USAF MEDEVAC capacities (fixed wing aircraft)
AE Configuration
AE-1
AE-2
AE-3
AE-4
72/92
Litter Spaces
30
20
50/6- (J-30)
(J-30)
46/62
6/10
44/62
30/62
Total Seats*
(J-30)
(J-30)
(J-30)
(J-30)
AE Configuration
AE-1
AE-2
AE-3
AE-4
Litter Spaces
9
36
9
6
Total Seats
54
54
90
49
AE Configuration
AE-1
AE-2
AE-3
Litter Spaces
6
9
15
Total Seats
31
28
20
AE Configuration
AE-1
Litter Spaces
1
Total Seats
10
Litter Spaces
1
Total Seats
5
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10
31/45
(J-30)
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Health Information Systems
Appendix E
Health Information Systems
The purpose of this appendix is to provide a list of medical information and communication
system and their capabilities. Operational medicine Roles 1 through 3 will require
information and communication platforms that are employed in dynamic contiguous and
noncontiguous AO. Specifically, health information and battle command systems enable
effective planning, preparing, decision-making, and execution of mission objectives. For
more information, refer to ATP 4-02.6, Chapter 10 and ATP 4-02.10, Appendix C.
Table E-1. Theater Medical Information Program-Joint (TMIPS-J) Applications
System
Description
Medical Common
Operating Picture
(MedCOP)
(Replacing MSAT)
MedCOP is the Joint Health Services’ mission command platform, providing real-time
visibility of unit health, equipment and supplies to enable informed decisions. The web-based
capability, managed by the Joint Operational Medicine Information Systems (JOMIS)
program office, facilitates real-time operational medicine information sharing and
collaboration inside and outside the medical community. MedCOP consolidates data from
multiple disparate data sources and supports data synchronization across multiple network
domains to provide a universally accessible, situationally relevant and globally integrated
medical common operating picture. MedCOP is deployed to combatant command and
service medical command, control, communications, computers, and intelligence users at
multiple echelons.
Medical Situational
Awareness in the
Theater (MSAT)
(Being replaced by
MedCOP)
The MSAT application is a secure web-based portal that combines information from multiple
communities to provide a joint medical common operational picture and clinical decision
support. The MSAT system links together medical intelligence and information that
encompasses aggregated patient encounter data, patient tracking, chemical and biological
warfare agent threats, environmental and occupational health hazards, command and control
data, human resources, unit locations, and weather. MSAT provides a dashboard that
provides critical medical capability statuses of equipment, supplies, personnel and available
beds. MSAT also provides a medical situation report tool that enables medical command and
control.
Armed Forces
Health Longitudinal
Technology
Application—
Theater (AHLTA-T)
The AHLTA-T application resides on a laptop computer configured as a standalone server or
on a large server with several laptop clients. This application allows deployed medical
staff/clinicians to document encounters. It enables clinicians to document the diagnosis,
update provided care, and track illnesses at deployed locations in a standardized format.
Medical staff are enabled to document the same information noted above, with the exception
of making and recording a diagnosis. It also handles the recording and reporting of individual
and mass immunizations in the operational environment. Completed encounters, are stored
locally, sent to TMDS, imported into MSAT and forwarded to the Military Health System Data
Repository where the patient’s longitudinal electronic medical record is stored. Regardless of
network or internet connectivity, AHLTA-T supports the documentation of care with its store
and forward capability.
Theater Medical
Information
Program-Joint
(TMIP-J)
Composite Health
Care System (TC2)
TC2 provides documentation for inpatient health care and computer based provider orderentry including ancillary services order-entry and result-reporting in the deployed
environment. This delivers an effective, interoperable health care system to support the
deployed medical business practice. Once documented, data is viewable in the electronic
health record through the Theater Medical Data Store (TMDS).
Deployed TeleRadiological
System (DTRS)
The DTRS is a theater image repository that provides in-theater users with deployed imaging
capability that manages, transfers, and stores theater medical images. This capability
improves the quality, timeliness, and availability of stored images to medical treatment
decision makers and facilities when patients require follow-up treatment.
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Appendix E
Table E-1. Theater Medical Information Program-Joint (TMIPS-J) Applications (continued)
Theater Medical
Data Store (TMDS)
TMDS is the repository of all medical data coming out of deployed locations. The TMDS
application is a web-based portal that offers healthcare providers the ability to view individual
patient encounters, history, notes, discharge summaries, allergy, drug, and radiological
history. Providers can view captured medical data regardless of where it was completed in an
operational area or fixed facility. Patient encounters in the operational area are entered
through MCC, AHLTA-T or TC2 and viewable in TMDS and MSAT. TMDS stores, filters and
compartmentalizes the patient encounter data of other non- Department of Defense (DOD)
beneficiaries entered in the operational area. The records are also captured as a part of the
Soldier’s lifelong medical records. TMDS provides access to the JLV portal, patient tracking
and is the theater blood inventory management system (including pre-screening results,
inventory, donor, and transfusion tracking).
Department of
Defense Trauma
Registry (DoDTR)
The DoDTR is a web-based data collection tool which supports US military performance
improvement initiatives with global collection and aggregation of combat casualty care
epidemiology, treatments and outcomes. The trauma data registry captures and documents,
in electronic format, information about the demographics, injury-producing incident, diagnosis
and treatment, and outcome of injuries sustained by US/Non-US military and US/Non-US
civilian personnel in wartime and peacetime from the point of injury (POI) to final disposition.
An adjunct to the DoDTR is the Store-and-Forward version that is rapidly deployed into
austere environments with little to no internet connectivity.
Table E-2. Other system applications
System
Defense Medical
Logistics Standard
Support (DMLSS)
Defense Medical
Logistics Standard
Support Customer
Assistance Module
(DCAM)
Transportation
Command
Regulating and
Command and
Control Evacuation
System
(TRAC2ES)
Travel Vaccination
Application
(Travax)
Medical Protection
System
(MEDPROS)
294
Description
DMLSS delivers an automated and integrated information system with a comprehensive
range of medical logistics management functions. It is a local server-based application that
supports medical logistics functions internal to a military hospital or clinic, deployed military
hospitals and clinics and war reserve management sites. DMLSS supports all local medical
logistics business practices to include the following: catalog research and purchase
decisions, customer inventory management, medical inventory management, biomedical
equipment maintenance, property management, facility management, assemblage
management and distribution and transportation functions.
DCAM is a medical logistics ordering application that runs on the desktop allowing users to
view their supplier’s catalog and generate electronic orders. DCAM automates the Class VIII
supply process at the lower levels of care, and enables logisticians and non-logisticians to
electronically exchange catalog, order, and status information with their supply activity. The
desktops are within enclaves for each of the Services.
The TRAC2ES application is a web-based portal that provides patient transportation
information and in-transit visibility to the defense transportation community and medical
support information to medical facilities. TRAC2ES combines transportation, logistics, and
clinical decision elements that enable prioritized requirements, resource allocation, and
supports tactical and strategic operations.
This application is a web-based portal that is provides medical professionals access to
medical information to prepare Soldiers and travelers for health threats and other concerns
related to international travel. It supplements Department of Defense (DOD) medical
information with data integrated from international and regional health organizations plus
additional information and analysis developed collaboratively through a network of trusted
medical advisors. This information is also integrated in medical situational awareness in the
theater (MSAT).
The Medical Protection System (MEDPROS) was developed by Army Medicine to track all
immunization, medical readiness, and deployability data for all active and reserve
components of the Army as well as Civilians, contractors and others. It is a powerful tool
allowing the chain of command to determine the medical and dental readiness of individuals,
units, and task forces. Commander’s and medical leaders at various echelons are
responsible for the use and implementation of MEDPROS to measure their unit/individual
medical readiness status. The electronic post-deployment health assessment is a suite of
software used by deployed medical providers to document a Soldier’s current physical and
psychological health status on DD Form 2796, (Post-Deployment Health Assessment) prior
to the Soldier’s return from deployment. The Website link will be on the MC4 laptop and
accessible from standard computers.
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Table E-2. Other system applications (continued)
Corporate Dental
Application (CDA)
a web-based application of the Corporate Dental System (CDS) that is used to collect,
process, present, and archive all dental workload, readiness, and patient scheduling for all
active duty service members treated at Army and Air Force Dental Treatment Facilities. The
CDS acquires workload and readiness data from input through the CDA and data interfaces
with other MHS systems. CDS workload and readiness data will be sent to the MDR for
incorporation into the Tri-Service MDR dental files.
Patient Movement
Item Tracking
System (PMITS)
The PMITS application tracks the storage of patient movement items during peacetime and
their movement during contingency and wartime operations. This application directly
supports the sustainment mission by ensuring critical patient movement equipment is
available to evacuate critically injured Soldiers. Commanders use PMITS to manage and
redistribute patient movement item assets in order to avoid shortages during patient
evacuations. The PMITS application has the ability to show location and status of patient
movement item assets to assist in eliminating shortages and overages of essential patient
evacuation equipment.
Global Combat
Support System Army (GCSSArmy)
GCSS-Army will be one single system that contains the functionality associated with the
business areas of supply, maintenance, property, and tactical finance. GCSS-Army is an
integrated system where users with access and permissions can login and perform their
business area missions regardless of their position in the modular structure or location
throughout the world. Class VIII is in the process of integrating into GCCS-Army.
Table E-3. Sample health information system training strategy
Focus
Tasks
Complete MC4 system
administrative training
Set up the MC4 for
operation
System
Administration
Prepare the MC4 for
operation
Employ the MC4
Individual Tasks
Clinical Operations
Integration
MC4 Workflow
Validation
Create shared
understanding of MC4
applications
Functional user
training
Develop hospital
technology layout plan
Develop training
casualty scenarios
Order sets and
templates
Communications
exercise
Collective Tasks
Rehearsal
Certification
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Exercise operations
under degraded
conditions
Establish and utilize
MC4 network
AHS Doctrine Smart Book
Purpose
S-6 section trained as MC4 system
administrators
Update server and client images.
Computer names and passwords
standardized
AHLTA-T, TC2, DCAM, TMDS, and
MSAT accounts prepared
Test network with organic two-way
satellites and peripherals; connect to
TMDS/MSAT servers
Clinical and operational staff reviews
health information system overview and
develop user role/accounts
Complete all health information systems
functional training as it pertains to
respective clinical role
S-6 staff and Clinical Operations create
health information systems topology and
layout for respective MTF setup
Coordinate with internal and external
resources to ensure casualty scenarios
are prepared and meet respective
AHLTA-T/ TC2 application parameters
Coordinate with clinical operations staff
for initial order set review and validation
Conduct communication exercise in order
to test entire system connectivity and
verify user accounts
Establish manual notification procedures
Successfully incorporate and validate
entire health information systems scope of
operations in support of medical
command and control
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GLOSSARY
SECTION I – ACRONYMS AND ABBREVIATIONS
A2
ABCT
AD
ADCON
anti-access
armored brigade combat team
anti-denial
administrative control
ADP
Army doctrine publication
AHS
Army Health System
AMEV
AML
armored medical evacuation vehicle
area medical laboratory
AO
area of operations
AOR
area of responsibility
APS
Army Pre-positioned Stock
ARSOF
Army special operations forces
ASCC
Army Service component command (also referred to as theater Army)
ASMC
area support medical company
ATP
Army techniques publication
AXP
ambulance exchange point
BAS
battalion aid station
BCT
brigade combat team
BSA
brigade support battalion
BSMC
brigade support medical company
BW
biological warfare
C2
command and control
CA
civil affairs
CASEVAC
casualty evacuation
CBRN
chemical, biological, radiological, and nuclear
CCDR
combatant commander
CCP
casualty collection point
CE
communications-electronics
CM
campaign module
CMS
central materiel services
COMSEC
communications security
CONUS
continental United States
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COSC
combat and operational stress control
COSR
combat and operational stress reaction
DCAS
dental company (area support)
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Glossary
DNBI
disease and nonbattle injury
DOD
Department of Defense
DSCA
defense support of civil authorities
EAB
echelons above brigade
EEM
early entry module
EM
expansion module
EMT
emergency medical treatment
EPW
enemy prisoners of war
FHP
force health protection
FM
field manual
FRSD
forward resuscitative surgical detachment
GCC
geographic combatant commander
GSAB
general support aviation battalion
HHC
headquarters and headquarters company
HHD
headquarters and headquarters detachment
HQ
headquarters
HSS
health service support
ICU
intensive care unit
IBCT
infantry brigade combat team
JOA
joint operations area
JP
LSCO
large-scale combat operations
MAP
modified table of organization and equipment (MTOE) assigned personnel
MASCAL
MC4
mass casualty
medical communications for combat casualty care
MCAA
medical company (air ambulance)
MCAS
medical company (area support)
MCGA
medical company (ground ambulance)
MDBS
medical detachment (blood support)
MDO
multi-domain operations
MDVS
medical detachment (veterinary services)
MEDBDE (SPT)
medical brigade (support)
MEDCOE
Medical Center of Excellence
MEDEVAC
medical evacuation
MEDLOG
medical logistics
MES
METT-TC (I)
medical equipment sets
mission, enemy, terrain and weather, troops and support available, time
available, and civil considerations (informational considerations)
MEV
medical evacution vehicle
MHS
military health system
MLC
medical logistics company
MLMC
298
joint publication
medical logistics management center
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Glossary
MMB
medical battalion (multifunctional)
MMS
medical materiel set
MOS
military occupational specialty
MSR
main supply route
MTF
medical treatment facility
MWD
military working dog
NATO
North Atlantic Treaty Organization
OE
OEH
operational environment
occupational and environmental health
OPCON
operational control
OPLAN
operational plan
OPORD
operation order
OPSEC
operations security
OR
OTSG
operating room
Office of The Surgeon General
PAR
population at risk
POI
point of injury
PPM
preventive medicine measures
PREOP
PVNTMED
preoperation
preventive medicine
RTD
return to duty
SBCT
Stryker brigade combat team
SFAB
security forces assistance brigade
SIMLM
SOF
TACON
TCCC
single integrated medical logistics manager
special operations forces
tactical control
tactical combat casualty care
TCP
theater campaign plan
TMC
theater medical command
TOE
table of organization and equipment
TPMRC
theater patient movement requirements center
TSC
theater sustainment command
UMT
unit ministry team
U.S.
United States
USAF
United States Air Force
USMC
United States Marine Corps
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USN
United States Navy
WIA
wounded in action
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Glossary
300
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