1
TASK FORCE
COMBAT HEALTH SUPPORT
GUIDE
TABLE OF CONTENTS
PAGE
Chapter 1
TACTICAL DECISION MAKING, MISSION ANALYSIS,
& TROOP LEADING PROCEDURES
4
Chapter 2
TASK FORCE TACTICAL OPERATIONS
35
Chapter 3
COMBAT HEALTH SUPPORT IN A MANEUVER TASK FORCE
75
Chapter 4
MEDICAL EVACUATION
87
Chapter 5
MEDICAL PLATOON EXECUTION CHECKLIST
100
Chapter 6
MISCELLANOUS MEDICAL AND GENERAL INFORMATION
157
3
Chapter 1
TACTICAL DECISION MAKING,
MISSION ANALYSIS & TROOP LEADING PROCEDURES
TASKS
PAGE
Troop Leading Procedures “Step by Step Process”
6
Combat Health Support Mission Analysis
10
Combat Health Support Staff Estimate
11
OCOKA
12
METT-TC
13
Medical Platoon Warning Order (WARNO)
15
Medical Platoon Time Management Example/Timeline
17
Information required in a Task Force Operations
Order, Paragraph 4
19
Task Force Medical Platoon Operations Order (OPORD)
20
Task Force Medical Platoon Execution Matrix
23
Fragmentary Order (FRAGO)
24
Backbrief and Briefback Format
26
Rehearsal Checklist
27
Medical Platoon Pre-Combat Checklist
28
4
Chapter 1
TROOP-LEADING
PROCEDURES
1. RECEIVE AND
ANALYZE THE MISSION
2. ISSUE A
WARNING ORDER
TACTICAL DECISION MAKING
AND MISSION ANALYSIS
“Steps and Procedures”
Reference ARTEP 7-94-MTP
MILITARY
DECISION-MAKING PROCESS
MISSION ANALYSIS (METT-TC)
• MISSION
• ENEMY
• TERRAIN AND WEATHER
• TROOPS
• TIME AVAILABLE
• CIVILIAN CONSIDERATIONS
BATTLEFIELD
VISUALIZATION
“See the terrain”
3. MAKE A TENTATIVE
PLAN
DEVELOPMENT OF
COURSES OF ACTION
ANALYSIS OF
COURSES OF ACTION
“See the enemy”
COA COMPARISON
4. INITIATE MOVEMENT
5. CONDUCT
RECONNAISSANCE
6. COMPLETE THE PLAN
SELECTION OF COA
7. ISSUE THE ORDER
8. SUPERVISE & REFINE
REFINEMENT OF PLAN,
INTEGRATION OF CS AND CSS,
AND DEVELOPMENT OF
BRANCH PLANS
“See yourself”
Chapter 1
TACTICAL DECISION MAKING
AND MISSION ANALYSIS
“Steps and Procedures”
Reference ARTEP 7-94-MTP
1. Platoon leader receives the mission (Step 1, TLPs).
• Clarifies any questions.
• Coordinates with personnel as needed.
2. Platoon leader analyzes mission to identify the following• Mission and intent of the commander two levels up.
• Mission and intent of the immediate commander.
• Specified, implied, and mission-essential tasks.
• Constraints and limitations.
• Purpose.
3. Platoon leader produces• A restated mission that contains the unit’s mission-essential tasks and the
purpose for which they were assigned.
• A tentative time schedule (Reference Medical Platoon Timeline, page 17).
4. Platoon leader issues a warning order (reference WARNO Format, page 15)
to the platoon sergeant and section leaders (Step 2, TLPs).
• Includes enough information for subordinate elements to prepare for the
mission.
• Gives warning order immediately after being alerted.
• Includes movement instructions if movement is to be initiated before
OPORD issuance.
• Addresses the items not covered in the unit TACSOP.
5. Platoon members concurrently perform readiness, maintenance, and
functional checks under the supervision of their leader (reference precombat
checks, page 28-34). They check• Weapons & Night Vision Goggles.
• Vehicles.
• Medical equipment sets (MESs).
• Communications equipment.
• NBC equipment.
• Any special equipment.
6. Platoon members combat-load vehicles IAW the TACSOP or warning order.
7. All personnel test-fire weapons, if the situation permits.
6
Chapter 1
TACTICAL DECISION MAKING
AND MISSION ANALYSIS
“Steps and Procedures”
Reference ARTEP 7-94-MTP
8. Platoon leader makes a tentative plan (Step 3, TLPs). Platoon leader at a
minimum• Uses the estimate of the situation to analyze METT-TC information.
• Develops courses of action.
– Includes significant mission specific factors which any course of
action must satisfy.
– Identifies assumptions about the situation on which the analysis
is based.
– Produces at least two general courses of action that can
accomplish the mission but that are different enough to allow
useful analysis.
• Makes a reconnaissance plan that– Compares the advantages, disadvantages and risk of each
course of action.
– Identifies the key leaders in each course of action.
– Identifies the critical events.
– Identifies the most dangerous contingencies.
9. Platoon initiates movement (Step 4, TLPs), as required, for the quartering
party, selected elements, or the entire platoon• Follows instructions for movement given in the warning order.
• Moves to the assembly area or linkup point NLT the time specified in the
warning order.
10. Platoon reconnoiters (Step 5, TLPs).
• Determines the unit locations.
• Obtains supported information about the terrain (OCOKA).
• Request other information from higher.
11. Platoon leader completes the plan (Step 6, TLPs) based on METT-TC
considerations, intelligence from the reconnaissance, and other sources. Plan
should include• Clear expression of the platoon leader’s or battalion commander’s intent,
which addresses the unit’s mission-essential tasks and the purpose of
those tasks.
• Scheme of maneuver.
• Concept of medical support.
• Task organization of task force and platoon.
• Control measures.
7
Chapter 1
TACTICAL DECISION MAKING
AND MISSION ANALYSIS
“Steps and Procedures”
Reference ARTEP 7-94-MTP
12. Platoon leader issues an order to subordinate leaders (Step 7,
TLPs)(reference Medical Platoon OPORD, page 20).
• Provides ample subordinate leader planning and preparation time by the
1/3 to 2/3 guide.
• Clarifies any questions.
13. Platoon leader coordinates for the mission.
• Platoon leader request CS assets (MPs/Engineers) to aid the mission.
• Platoon leader or representative coordinates plans and actions with
higher, adjacent, and supported units.
– Scheme of maneuver.
– Current intelligence/Medical threat.
– Control measures/Graphics.
– Communications and signals.
– Time schedules.
– Additional support requirements.
• Platoon leader (or platoon sergeant/section leader) receives attachments,
as time permits, briefed on– Platoon mission and intent.
– Specified tasks.
– Platoon SOPs.
– Overall plan.
– Recent platoon activities.
– Recent enemy activities.
• Platoon leader or platoon sergeant checks the attachments for mission
readiness.
• Platoon leader or platoon sergeant links up with the individuals who will be
their point on contact within the platoon.
14. Platoon leader supervises mission preparation (reference rehearsals,
backbriefs, briefbacks, page 26-27).
• Subordinate leaders conduct briefbacks of their plan to the platoon leader
to ensure the intent is understood.
• Platoon rehearses key platoon actions as the situation permits.
• Elements prepare all field-expedient equipment needs for their tasks.
• Key leaders– Supervise.
– Inspect.
– Conduct briefbacks.
– Rehearse.
– Continue coordination.
8
Chapter 1
TACTICAL DECISION MAKING
AND MISSION ANALYSIS
“Steps and Procedures”
Reference ARTEP 7-94-MTP
15. Platoon leader plans sustainment of combat health support operations.
• Platoon sergeant determines anticipated medical supplies and equipment
general supplies and ammunition requirements.
• Platoon leader establishes and carries out a rest plan for all platoon
members (particularly key personnel and leaders) based on the unit SOP,
mission analysis, and current orders.
• Platoon sergeant coordinates with CTCP for supplies to support CHS
plan.
16. Platoon monitors actions of higher, adjacent, and supporting units.
• Enemy & friendly locations or actions.
• Orders from higher headquarters to other units.
17. Platoon leader issues order or modifies the original plan. Order or change
must be explained in terms of • Current platoon mission.
• Higher commander’s mission.
• Enemy & friendly situation.
• Terrain.
• Troops available.
18. Platoon issues FRAGO (reference medical platoon FRAGO, page 24) to the
platoon and attached elements.
• Contains situation, mission, and element tasks.
• All subordinates must receive and acknowledge.
9
Chapter 1
COMBAT HEALTH SUPPORT PLANNING
“Mission Analysis”
Reference FM 8-55, FM 71-123
1. Arrive at the Tactical Decision Making Process (TDMP) with current status of
assets:
• Personnel.
• Vehicles.
• Critical Class VIII Deficiencies.
2. Then read the Brigade CSS Annex:
• Identify higher/adjacent CHS elements (location of treatment
teams/AXPs/Patient Collection Points)
• Identify available evacuation resources (Ground/Air)
• Identify area of operation (See terrain)
3. Analyze the Mission. To ensure effective support, CHS operators and planners
must understand the commander's tactical plans and intent. They must know-• What each of the supported elements are doing.
• When they are doing it.
• How they are doing it.
After analyzing the concept of operations, CHS planners must be able to accurately
predict support requirements. They must determine-• What are the number of patients and where are they expected.
• What type of medical support is required.
• The priority of medical support, by type and unit.
Using the support requirements of the tactical plan as a base, the support capabilities of
the task force are assessed by-• What CHS resources are available (organic, lateral, and higher
headquarter).
• Where the CHS resources are.
• When can the CHS resources be made available to the maneuver units.
• How can they be made available.
Based on this information, CHS plans are developed by applying resources against
requirements.
4. Your Mission Analysis Summary:
• Know current status of medical platoon assets (Cross LD/NLT Defend)
• Know support available from Brigade.
• Identify internal nonstandard resources available.
• METT-TC
• Commander’s Intent and guidance.
10
Chapter 1
COMBAT HEALTH SUPPORT
STAFF ESTIMATE
Reference FM 8-55
1. MISSION. Restated mission resulting from the mission analysis.
2. SITUATION AND CONSIDERATIONS.
a. Characteristics of area of operations.
(1) Weather. How will different military aspects of weather affect specific staff
area of concern and resources?
(2) Terrain. How will aspects of the terrain affect specific staff areas of
concern and resources.
(3) Other Key Facts. Analyses of political, economic, sociological,
psychological, cultural and environmental infrastructure, as they relate to the area.
b. Enemy Forces. Enemy dispositions, composition, strength, capabilities, and
COAs as they affect specific staff area of concern.
c. Friendly Forces.
(1) Friendly courses of action.
(2) Current status of resources within staff area of responsibility.
(3) Current status of other resources that affect staff area of responsibility.
(4) Comparison of requirements versus capabilities and recommended
solutions.
(5) Key considerations (evaluation criteria) for COA supportability.
d. Assumptions.
3. COMBAT HEALTH SUPPORT ANALYSIS. Analyze each COA using key
considerations (evaluation criteria) to determine advantages and disadvantages.
a. Patient Estimates (where, when, & how many).
b. Support Requirements.
c. Resources Available.
d. Courses of Action (supporting the commander’s course of action)
4. EVALUATION AND COMPARISON. Compare COAs using key considerations
(evaluation criteria). Rank order of COAs by supportability. Comparison should be
visually supported by a decision matrix.
5. RECOMMENDATIONS AND CONCLUSIONS.
a. Recommended COA based on the comparison (most supportable from specific
staff perspective).
b. Issues, deficiencies, and risks with recommendations to reduce their impacts.
11
Chapter 1
OCOKA
Reference FM 71-2, FM 71-2
1. Observation and fields of fire. Consider the ground that’s allows observation of
the enemy throughout the area of operation. Consider fields of fire in terms of the
characteristics of the weapons available to the unit: e.g. maximum effective range,
requirement for grazing fire, arming range and time of flight for anti-armor weapons.
2. Cover and concealment. Look for terrain that will protect unit from direct and
indirect fires (cover) and from aerial and ground observation (concealment).
3. Obstacles. In the attack, consider the effect of restrictive terrain on the unit’s
ability to maneuver. In the defense, consider the advantage of tying obstacles to the
terrain to disrupt, turn, fix, or block an enemy force and protect your unit from enemy
assault.
4. Key terrain. Key terrain is any locality or area whose seizure or retention affords
a marked advantage to either combatant. Consider key terrain in your selection of
objectives, support positions, and routes in the offense, and on the positioning of your
unit in the defense.
5. Avenues of approach. An air or ground route of an attacking force or a given
size leading to its’ objective or key terrain in its’ path. In the offense, identify the
avenue of approach that affords the greatest protection and place the unit at the
enemy’s most vulnerable spot. In the defense, position key weapons along the
avenue of approach most likely to be used by the enemy.
12
Chapter 1
METT-TC
(Mission, Enemy, Terrain, Troops, Time Available, and Civilians)
Reference FM 71-1, FM 71-2
1. Mission. Analyze the platoon mission within the frame work of the battalion
commander’s intent (two levels up).
a. What role will the platoon play during different phases of the battalion
operation?
b. What platoon tasks are essential to the success of the battalion and platoon
missions?
2. Enemy. Analyze the enemy force, capabilities, and the platoon vulnerabilities.
a. What type of force, tactics and weapons system is the enemy likely to employ
against the platoon?
b. What weaknesses in the platoon could an enemy exploit?
c. During the mission, when will the platoon have the greatest exposure to enemy
action, and what is that action likely to be?
3. Terrain. Analyze the positive and negative effects of terrain upon the platoon
mission using the acronym OCOKA.
a. What effect will the terrain have upon the platoon mission in the terms of tasks
that the platoon will have to accomplish because of the terrain?
b. Where (location) and when (phase of the operation) will the terrain benefit the
enemy?
c. Where (location) and when (phase of the operation) will the terrain benefit the
platoon?
4. Troops Available. What are the strengths and capabilities of:
a. The soldiers in the platoon plus attachments?
b. The vehicles and equipment in the platoon?
c. What additional support can be used to enhance the platoon capabilities?
13
Chapter 1
METT-TC
(Mission, Enemy, Terrain, Troops, Time Available, and Civilians)
Reference FM 71-1, 71-2
5. Time Available. Allot time based on the tentative plan and any changes to the
situation.
a. Time for planning by leaders (1/3 of available time).
b. Time for soldier preparation tasks and rehearsals (2/3 of time available).
c. Backward plan from “mount up,” not “move out.” e.g.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
1600
1545
1520
1500
1400
1300
1130
1015
0915
0800
- cross LD.
- convoy to staging area.
- mount up and line up.
- break.
- final PCI.
- platoon rehearsal and final AAR.
- squad PCI, rehearsals and AARs
- platoon order.
- warning order, squad preparation activities.
- receive mission.
6. Civilians. Identify any civilian considerations that may affect the mission. These
factors may include refugees, humanitarian assistance requirements, or specific
considerations related to the applicable ROE and or ROI.
14
Chapter 1
MEDICAL PLATOON LEADER’S
WARNING ORDER (WARNO)
WARNING ORDER (Short Format)
1. What ____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
(Situation + Mission Tasks)
2. Who ____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
(Specific Tasks to Subordinates)
3. How ____________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
(Tentative Execution Plan)
4. When ___________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
(Pre-Execution Time Schedule)
5. Where __________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
(Time + Location of OPORD +Rehearsal)
15
Chapter 1
MEDICAL PLATOON LEADER’S
WARNING ORDER (WARNO)
1. Situation:
a. Brief description of enemy situation if changed.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
b. Brief description of friendly situation if changed.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
2. Mission: Short, concise statement of task and purpose.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
3. Execution: Tentative concept of the operation including:
a. Time schedule for OPORD + all pre-execution tasks.
____________________________________________________________________
____________________________________________________________________
b. Mission tasks to subordinates
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
c. Rehearsal tasks and location.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
4. Service Support: If different from TACSOP.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
5. Command and Signal:
a. Location of CP.
____________________________________________________________________
b. SOI in effect.
____________________________________________________________________
c. Signal/code words.
____________________________________________________________________
16
Chapter 1
MEDICAL PLATOON
TIMELINE/TIME MANAGEMENT EXAMPLE
Defend NLT
BMNT 030600
MOPP2NLT
030430
Total time available:
(Daylight
16 hours)
(Limited Light 20 hours)
36 hours
Minus
Total available time:
15 hours
21 hours
022200
Medical Platoon Reconnaissance Complete (Task Force)
022000
021900
021800
EENT
Medical Coordination Complete (C Med, Adj Unit, & TF)
BDE CSS Rehearsal
021600
Platoon Rehearsals Complete
021500
TF CSS Rehearsal
021430
Platoon PCCs/PCIs Complete
021300
TF Maneuver Rehearsal
MINUS:
* Receipt of order
2.5 hours
* Task Force troop 12.5 hours
leading procedures
15 hours
Platoon Conducts Priorities of Work
Platoon Conducts Movement
020700
Platoon Leader Issues his OPORD
020600
BMNT / TF OPORD Issued
= Limited Visibility
Med PL Completes Medical Platoon OPORD
Med PL Finalizes CSS/Medical Annex
Med PL Conducts Wargaming at TF TOC
Med PL Issues WARNO3 to Platoon
Med PL Develops Medical COA and Analyzes it with the TF COAs
Med PL Issues WARNO2 to Platoon
Med PL Conducts Mission Analysis/Medical Estimates
012000
EENT
Med PL Issues WARNO1 to Platoon
011900
Med PL at TF TDMP
17
Chapter 1
TIME
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MEDICAL PLATOON TIMELINE
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18
= LIMITED VISIBILITY
Chapter 1
TASK FORCE OPERATIONS ORDER
PARAGRAPH 4 - SERVICE SUPPORT
“Medical Evacuation & Hospitalization”
Medical evacuation & hospitalization.
 Location of casualty collection points (in each phase of the operation).
 Location of task force aid station(s) during the battle (in each phase of the operation).
 Primary/alternate and dirty/clean evacuation routes.
 Method of marking vehicles with wounded.
 Plan for non-standard evacuation.
 Procedures for evacuation of wounded.
 AXP locations.
 FSMC or unit level II medical care.
 Patient decontamination operations and locations.
 Air MEDEVAC frequency and LZ Operations.
Example Figure 1-1, Example of Combat Health Support
Overlay at a Maneuver Task Force
19
Chapter 1
MEDICAL PLATOON LEADER’S
OPERATIONS ORDER FORMAT
Task Organization - changes in normal unit organization for this mission.
1. Situation.
a. Enemy Forces (and battlefield conditions).
(1) Weather and light data.
 Precipitation.
 Temperature.
 Other weather conditions (wind, dust, or fog).
 Light data:
BMNT: __________
Sunset: __________
Moonrise: __________
Percent illumination: __________
(2) Terrain (Factors of OCOKA)
 Observation and fields of fire.
 Cover and concealment.
 Obstacles.
 Key terrain.
 Avenues of approach.
(3) Enemy Forces.
 Location
 Activity
 Composition/order of battle.
 Strength
Sunrise: __________
EENT:
__________
Moonset: __________
b. Friendly Forces.
(1) Mission of next higher unit
(2) Higher commander’s concept of the operation.
(3) Location and planned action of units on left, right, front, and rear.
c. Attachments and Detachments. (To the platoon.)
2. Mission. (Who, what, when where and why.) (Picture of Success/End State.)
3. Execution. (How)
a. Concept of Medical Support for the Task Force.
(1) Scheme of maneuver
 Passage of lines
 Routes
 Movement formations.
 Movement techniques.
 Actions on contact, at obstacles, during consolidation and
reorganization.
20
Chapter 1
MEDICAL PLATOON LEADER’S
OPERATIONS ORDER FORMAT
3. Execution (Cont.)
a. Concept of Medical Support for the Task Force.
(2) Mission Essential Platoon Task(s).
 Patient decontamination locations & operations.
 Decontamination points.
 Dirty and clean evacuation routes.
 AXP locations.
 FSMC or echelon II locations.
 Plan for non-standard evacuation.
 Air MEDEVAC frequency and LZ operations.
 Location of casualty collection points (in each phase of the operations).
 Method of marking wounded on the battlefield.
 Procedure for evacuating wounded.
(4) Engineer Support.
(5) Military Police Support
b. Tasks to subordinate units.
(Squads/Teams/Key Individuals.)
c. Coordinating Instructions.
(1) Specified tasks to more than one element.
(2) Rules of engagement/actions on contact.
(3) MOPP Status.
(4) Coordination with friendly units.
(5) PIR and other reporting requirements (phase lines, check points).
(6) Essential times not covered.
(7) Inspections.
(8) Rehearsals.
4. Service Support.
a. Concept of Support.
(1) Location of task force combat and field trains.
(2) Location of task force UMCP.
(3) Current and future MSRs.
b. Material and Services.
(1) Supply.
(2) Transportation (schedule of delivery).
(3) Services (type, location & schedule).
(4) Maintenance (type & location not included in TACSOP).
(5) Medical evacuation & additional treatment locations.
21
Chapter 1
MEDICAL PLATOON LEADER’S
OPERATIONS ORDER FORMAT
4. Service Support (Cont.).
c. Personnel.
(1) EPW collection point.
(2) Individual replacements.
(3) Uniform and equipment.
5. Command and Signal.
a. Command.
(1) Chain of command.
(2) Location of platoon/squad leader in formation and at the objective.
(3) Succession of command if not IAW SOP.
b. Signal.
(1) SOI index in effect.
(2) Listening silence, if applicable.
(3) Methods of communication in priority.
(4) Emergency signals, visual signals.
(5) Code words.
22
PHASES/H-HOUR
AID STATION MARKING
DAY ______________________________________________________________________
NIGHT______________________________________________________________________
PAT DECON STATIION MARKING SYSTEM
DAY ______________________________________________________________________
NIGHT______________________________________________________________________
TASK FORCE CASUALTY MARKING SYSTEM:
URGENTS __________________________________________________________________
PRIORITY __________________________________________________________________
ROUTINE __________________________________________________________________
AIR MEDEVAC PLATFORMS AVAIL.
AIR MEDEVAC FREQUENCY
ADA
ENGINEERS
MORTARS
SCOUTS
SPECIALTY PLTS/ATTACH MENTS COMBAT HEALTH SUPPORT PLAN
# OF KIA
# OF ROUTINE
# OF PRIORITY
# OF URGENT
CASUALTY/CHEM CAS ESTIMATE
DIRTY/CLEAN ROUTES
NON-STANDARD EVAC
PATIENT DECON SITES
AXP LOCATIONS
FSMC LOCATIONS
TRMT TM B LOCATIONS
TRMT TM A LOCATIONS
TRIGGERS FOR BAS
FSMC FREQUENCY:
NOTES/REMARKS:
FSMC CALL SIGNS:
Chapter 1
TASK FORCE MEDICAL PLATOON
“EXECUTION MATRIX”
Chapter 1
FRAGMENTARY ORDER (FRAGO)
Task Organization
1. Situation:
a. Enemy
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
b. Friendly
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
2. Mission:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
3. Execution:
a. Concept - Operation
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
b. Tasks to Subordinates
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
c. Coordinating Instructions
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
24
Chapter 1
FRAGMENTARY ORDER (FRAGO)
4. Service Support (other than SOP):
a. Company Trains
______________________________________________________________________
______________________________________________________________________
b. Material and Services
______________________________________________________________________
______________________________________________________________________
c. Personnel
______________________________________________________________________
______________________________________________________________________
d. Medical
______________________________________________________________________
______________________________________________________________________
5. Command & Signal (other than SOP):
a. Command
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
b. Signal
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
25
Chapter 1
BRIEF BACK & BACKBRIEF FORMATS
Once the OPORD is issued, the platoon leader may be required to brief the
commander on what he understands the OPORD requirements to be. This ensures
that the platoon leader understands what is expected of him and what the support
requirements are and, provides the commander the opportunity to provide additional
guidance, if required. (This procedure is sometimes referred to as a brief back.) The
information consists of the—
 Task organization.
 Enemy situation.
 Mission analysis.
 Specified tasks.
 Implied tasks.
 Restrictions / constraints.
 Key coordinating instructions.
 Questions or assumptions required for planning.
Once the platoon leader determines how he will support the plan and prior to issuing
that guidance to the platoon (platoon order), the platoon leader will brief the
commander on what the platoon order will contain. (This process may be referred to
as a backbrief.)
 Task organization.
 Enemy situation.
 Mission analysis.
 Specified tasks.
 Implied tasks.
 Restrictions / constraints.
 Restated mission.
 Concept (by phase).
 Combat health support plan.
 Key coordinating instructions.
26
Chapter 1
REHEARSAL CHECKLIST
1. Before the Rehearsal. Consider time available.
 Know specific mission essential tasks (PLT/SQD/IND) plus critical
personnel & equipment requirements.
 Know the teaching order of the tasks (time available).
_ All tasks in chronological order.
_ Critical tasks in chronological order.
 Teach leaders their individual and collective tasks.
_ Sand table or easel drawing.
_ Platoon, squad & critical leader tasks step by step.
_ Decision & synchronization points.
_ Picture of success for each sub element.
_ Standard(s) for sub element rehearsals, equipment and
personnel inspections.
2. During the Rehearsal - Consider time available.







Sub leaders teach the plan. Talk thru crawl-walk-run.
Sand table discussion (talk thru).
Tasks for each element in chronological order.
Decision & synchronization points.
Picture of success/execution standards for each element and task.
Ensure leaders inspect the plan-consider time available.
Hands on serviceability for each critical item of equipment.
(See it - touch it - see it work).
 Personnel readiness. Ask meaningful, specific questions during brief
back.
 Ensure leaders work the plan.
 Step by step rehearsal of each phase. Crawl, walk, run.
 Meaningful AARs - coordinate & change what doesn't work to standard
- repeat the task.
3. After the Rehearsal - consider time available.
 Validate the plan with leaders to ensure each element achieves
standard or picture of success with minimum exposure to error.
 Change what doesn't work & rehearse the changes.
27
Chapter 1
PRECOMBAT CHECKLIST FOR CLASS VIII
 Authorized number of days of supply are on hand.
 Medications, reagents, and other time-sensitive supplies are current.
 Accountability of controlled substances is maintained.
 Oxygen on hand.
 Medical equipment is on hand and calibrated, as required.
 Medical maintenance/repair support is coordinated.
 Push package from FSB coordinated.
 Estimated expenditures forwarded to FSB.
 Re-supply method confirmed with the FSB.
PRECOMBAT CHECKLIST FOR PREVENTIVE
MEDICINE SUPPORT
 All authorized equipment on hand and serviceable.
 Individual PVNTMED supplies (such as insect repellent) issued to soldiers.
 Individuals trained in the application of PVNTMED measures.
 Unit field sanitation team trained.
 Unit field sanitation team supplies are on hand.
 Provisions for the use of chemical toilets have been coordinated, if appropriate.
 Waste disposal procedures and facilities have been established.
28
Chapter 1
PRECOMBAT CHECKLIST FOR GROUND AMBULANCES
 Authorized MES are on hand.
 Medical equipment is complete and serviceable.
 Authorized medical gases (oxygen) are on hand and serviceable.
 Authorized medications are on hand and current.
 Packing list is available.
 Strip maps and/or road maps with overlays are available.
 On vehicle equipment (OVM) is on hand.
 Log book is present and current.
 All drivers are licensed.
 Situational awareness equipment (GPS) is on hand and serviceable.
 Communications equipment is on hand, serviceable, and set to the correct
frequency.
 Medical unit identification markers (in accordance with the Geneva Conventions)
are displayed. (Markers are red on a white background only; camouflaged or
subdued markers are not authorized.)
PRECOMBAT CHECKLIST FOR MISCELLANEOUS
EQUIPMENT
 Inspect binoculars.
 Inspect camouflage nets and support systems.
 Inspect night vision devices and ensure batteries are on hand.
 Inspect mine detectors.
 Inspect tentage.
 Inspect global positioning systems (if available).
29
Chapter 1







PRECOMBAT CHECKLIST FOR THE MEDICAL
TREATMENT FACILITY
All authorized shelters are on hand and serviceable.
All authorized collective protective equipment is on hand and serviceable.
Procedures for management of medical waste are established.
Provisions for water supply are coordinated.
Patient protection measures are instituted.
Ambulance turnaround is planned for and established.
Area for patient decontamination operations is planned for and established, when
required.
 Camouflage materiel is available if authorized for use.
 Medical unit identification markers (in accordance with the Geneva Conventions)
are on hand.
 Triage and evacuation signs for day/night operations are on hand.
 LZ marking kit with pegs/stakes on hand.
 Litters and litter stands on hand.
 Treatment, sickcall, patient decon/treatment MESs are on hand.
 All special medial equipment tested and serviceable.
 Oxygen on hand.
 Communication equipment on hand and serviceable.
30
Chapter 1
PRECOMBAT CHECK ON NUCLEAR, BIOLOGICAL,
AND CHEMICAL EQUIPMENT
 Individual protective equipment (CPOG and MOPP) is on hand and serviceable.
(One set is issued and the extra set remains in supply.)
 Protective masks are issued and serviceable.
 Nerve agent antidote is available and distributed (as required).
 Convulsant antidote for nerve agent (CANA) is available and distributed (as
required).
 Decontamination apparatus is complete and serviceable.
 Basic load of decontamination supplies is on hand:
_ M291 Skin DECON Kits
_ M295 IEDK
_ DS2
_ Super Tropical Bleach [STB]





Chemical agent alarms are on hand and serviceable.







Patient protective wraps are on hand, if authorized.
M256A1 detector kits issued.
NBC contamination marking kits are distributed.
NBC teams are trained and briefed on the current threat and contingency plan.
Coordination for patient decontamination team support (non-medical) is
completed.
Chemical agent monitors are on hand and serviceable.
M8 and M9 detector paper is on hand.
M272 detector kits are issued.
Replacement filters for protective masks are on hand.
Nerve agent pretreatment packets (NAPP) are available.
Biological agent prophylaxis/immunizations have been accomplished, if
appropriate.
 Radiac sets (AN/PDR 27, AN/PDR 77, or AN/VDR 2) are on hand.
 Chemical agent patient treatment MES are on hand or available.
 Chemical agent patient decontamination MES are on hand or available.
 Biological sample collection equipment/supplies are available.
31
Chapter 1
PRECOMBAT CHECKLIST OF PERSONNEL
 Ensure soldiers are in the correct uniform.
 Ask questions to ensure that soldiers have been briefed on mission and situation.
 Implement appropriate MOPP level.
 Check for drivers license.
 Brief soldiers on operations safety and environmental injuries.
 Individual equipment is on hand and stowed properly.
 Soldier fed and briefed on future meal consumption.
 Identification (ID) tags, ID card, Geneva Convention Card, multifunctional
automated record card (MARC) are on hand and serviceable.
 Camouflage self and equipment.
 Work/rest plan implemented.
 Water discipline plan implemented, if appropriate.
 MEDEVAC request on hand.
PRECOMBAT CHECKLIST FOR INDIVIDUAL WEAPONS
 Clean and functional.
 Cleaning tools/kits, bolts, and ruptured cartridge extractors are present.
 Range cards are on hand.
 Ammunition is issued, accounted for, and secured.
 Magazines issued.
 Blank adapter installed (if appropriate).
 Function check has been performed.
 Test fire (with permission from Bn/Co).
32
Chapter 1
PRECOMBAT CHECKLIST ON COMMUNICATIONS
EQUIPMENT
 Radios are operational (communications check conducted).
 Telemedicine equipment is available and operational, if available.
 Speech security equipment functional.
 Radios filled with one extra battery on hand.
 Frequencies are set.
 Matching units are operational.
 Antennas tied down properly.
 Connectors clean and serviceable.
 TA-312 on hand and serviceable, batteries are on hand.
 WD-1 on hand and serviceable.
 Manpack sets are complete, batteries are on hand.
 Switchboard on hand and serviceable.
 Antennas and remotes are present, batteries are on hand.
 SOI is available and secured; call signs and frequencies have been
disseminated.
 Perform communications check again.
33
Chapter 1
PRECOMBAT CHECKS FOR VEHICLES
 Loads are according to load plan; load plan posted in the vehicle.
 Hazardous cargo properly identified and stored toward rear of vehicle for easy
access and inspection.
 Ammunition issued and properly stored.
 Vehicle fuel tank topped off.
 Package POL products and small arms lubricant present.
 Water cans full.
 MREs issued and stowed.
 First aid kits present and complete.
 Operators' manuals and lubrication orders are present for the vehicle, radios, and
associated equipment.
 Critical toll and basic issue items (BII) are present.
 Vehicle dispatch is complete; DA Form 2404 is complete; no deadline deficiencies
exist.
 Before operation PMCS has been completed.
 Wheeled vehicles hardened with sandbags.
 M11/M13 Decon apparatus present.
 Fire extinguisher present.
 Fire evacuation and vehicle rollover drills complete.
 Chem-lights/other signal equipment present.
 MEDEVAC request on hand and posted in the medical platoons vehicles.
34
Chapter 2
TASK FORCE TACTICAL OPERATIONS
Reference FM 71-1, FM 71-2, FM 71-3, FM 7-90
TOPIC/INFORMATION
Combat Operations In The Offense.
Purpose of Offensive Operations.
Characteristics of Offensive Operations.
Sequence of Attack.
Forms of Maneuver.
Movement Techniques and Formations.
How the Threat Defends.
Conducting Attacks.
PAGE
36
36
36
37
41
44
45
Combat Operations In the Defense.
Purpose of Defensive Operations.
Characteristics of Defensive Operations.
Framework of the Defense.
How the Threat Attacks.
Sequence of the Defense.
Types of Defensive Operations.
53
53
54
56
56
58
Combat Operations in the Reserve.
Counterattack.
Spoiling Attack.
Block, Fix, or Contain.
Reinforce.
Rear Operations.
65
65
66
66
66
Combat Operations in Other Tactical Operations.
Retrograde Operations.
Delay.
Withdrawal/Retirement.
Passage of Lines.
Relief.
Breakout from Encirclement.
Linkup.
Guard.
67
69
70
70
71
72
73
73
35
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Offensive Operations”
Reference FM 7-10, 7-20, 71-1, 71-2
1.
A.
B.
C.
D.
E.
F.
G.
PURPOSE OF OFFENSIVE OPERATIONS:
Defeat enemy forces.
Secure key or decisive terrain.
Deprive the enemy of resources.
Gain information.
Deceive and divert the enemy.
Hold the enemy in position.
Disrupt an enemy attack.
2. CHARACTERISTICS OF OFFENSIVE OPERATIONS:
A. SURPRISE: Achieved when the enemy cannot react effectively to the task force
commander’s scheme of maneuver, achieved by thorough recon and surveillance,
striking at an unexpected direction at unexpected time or using deception efforts.
B. CONCENTRATION: The massing and synchronization of over whelming combat
power against an enemy weakness.
C. SPEED: The task force quickly moves to take advantage of enemy weaknesses.
Speed in execution is key to denying the enemy time to reposition or reorient to meet
an attack.
D. FLEXIBILITY: The ability to divert from the plan and exploit success by
maintaining freedom of maneuver. Flexibility in planning results from wargaming.
E. AUDACITY: The willingness to risk bold action to win. The commander is quick
and decisive, and willing to take prudent risks based on sound tactical judgement,
personnel observation of the terrain, and first-hand knowledge of the battle.
3. SEQENCE OF AN ATTACK.
A. RECONNAISSANCE. Begins as soon as possible after the task force receives its
mission. Gathers information on avenues of approach, obstacles, and the enemy
positions in order to plan the attack. Continues throughout the attack.
B. MOVEMENT TO A LINE OF DEPARTURE. When attacking form positions not in
contact, tasks forces often stage in rear assembly areas, road march to attack
positions behind friendly unit in contact with the enemy, conduct a passage of lines,
and begin the attack.
36
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Offensive Operations”
Reference FM 7-10, 7-20, 71-1, 71-2
C. MANEUVER. The task force maneuvers to a position of advantage.
D. DEPLOYMENT. The task force deploys to attack or to fix the enemy if bypassing.
E. ATTACK. The enemy position is attacked by fire, assaulted, or bypassed.
F. CONSOLIDATION AND REORGANIZATION OR CONTINUATION. The task
force eliminates resistance and prepares for or conducts further operations.
4. FORMS OF MANEUVER.
A. ENVELOPMENT. The preferred form of maneuver. The attacker strikes the
enemy’s flank or rear. The envelopment caused the enemy to fight in a direction from
which he is less prepared. Requires an assailable flank, flank found by aggressive
reconnaissance.
• One or more companies or teams make
supporting attacks to fix the enemy.
• Other companies of the task force
maneuver against the enemy’s flank or
rear.
• May be conducted mounted or
dismounted, but must have mobility and
combat power to achieve its purpose.
• Variations of the envelopment include
double envelopment and encirclement.
B. TURNING MOVEMENT. Is a variant
of the envelopment which the attack
seeks to pass around the enemy,
avoiding his main forces, to secure an
objective deep in the rear. The task
force normally conducts a turning
movement as part of a larger unit’s
operation.
Figure 2-1, Envelopment.
C. PENETRATION. Task Force concentrates its forces to rupture the defense on a
narrow front, normally a platoon. The gap created is then widened and used to pass
forces through to defeat the enemy in detail and to seize objectives in depth. A
successful penetration depends on surprise and the attacker’s ability to suppress
enemy weapons, to concentrate forces at the point of attack and to quickly pass
sufficient force through the gap to destroy the enemy’s defense. Normally attempted
when enemy flanks are unassailable, or when the enemy has a weak or unguarded
gap in his defense.
37
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Offensive Operations”
Reference FM 7-10, 7-20, 71-1, 71-2
PENETRATION IS PLANNED IN THREE PHASES
Step 1 - The isolation of the site selected for penetration.
(Step #1) - Figure 2-2.
Step 2 - Initial penetration of the enemy position. Dismounted infantry company
teams breach the close-in obstacles and seize enemy positions behind these
obstacles. These teams widen and hold the shoulders of the initial penetration. This
penetration is overwatched and supported by other elements of the task force.
(Step #2) - Figure 2-3.
38
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Offensive Operations”
Reference FM 7-10, 7-20, 71-1, 71-2
Step 3 - Exploitation of the penetration. Other companies complete the destruction of
the enemy position and move to deeper objectives.
(Step #3) - Figure 2-4.
D. FRONTAL ATTACK. The frontal attack is the least preferred form of maneuver.
In the frontal attack, the task force uses the most direct routes to strike the enemy
along his front. This attack is normally employed when the mission is to fix the enemy
in position or deceive him. Although the frontal attack strikes the enemy’s front within
the zone of the attacking force, it does not require that the attacker do so on line or
that all subordinate unit attacks be frontal. Frontal attacks, unless in overwhelming
strength, are seldom decisive.
E. INFILTRATION. The purpose of an infiltration is to move by stealth to place a
maneuver force in a more favorable position to accomplish the mission. This is a
preferred form of infantry maneuver, because it permits a smaller force to use stealth
and surprise to attack a larger or fortified force. Infiltration helps avoid detection and
engagement. Movement is usually by foot or air but can be by vehicle or watercraft.
Along with other units, an infiltrating force can attack the rear and flanks of enemy
forward positions to accomplish its mission and as a means to facilitate a penetration
of a larger force. It can also attack lines of communication, administrative rear
installations, headquarters, CPs, and CS or CSS activities and facilities. Infiltrating
units can seize key terrain, destroy critical communications nodes, and interfere with
the resupply and reinforcement of enemy positions.
39
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Offensive Operations”
Reference FM 7-10, 7-20, 71-1, 71-2
E. INFILTRATION (Cont.)
(a) Types.
(1) Land. Infiltration by foot is most common but infiltration by vehicle is also
possible. It is most feasible in areas with large gaps between forces or where flanks
might be impossible to secure. Many infiltrations have been conducted by vehicle,
especially when force-to-space ratios were small.
(2) Water. Forces can infiltrate by sea or inland waterway.
(b) Advantages. Infiltration can be used when enemy firepower discourages the
use of another form of maneuver or when a light force is employed against a
mechanized or motorized force. Infiltration can panic and disorganize an enemy
oriented physically and mentally to fight to the front. This can sometimes cause the
enemy to withdraw even if he is too strong to be driven out by other means.
(c) Disadvantages. The main disadvantage of an infiltration is that small infiltrating
elements can be destroyed piecemeal if the defending force detects them. Infiltration
requires time and for small-unit leaders to have excellent navigational skills. For an
infiltration to be successful, all forces must link up as planned behind enemy lines.
(d) Conditions. The commander's knowledge of enemy dispositions and the
battalion's ability to conceal plans and movements allows infiltration over rough
terrain, heavily wooded terrain against a widely dispersed enemy or in a front with
fluid positions.
(1) A rough, almost inaccessible location is best for an infiltration.
(2) Darkness and bad weather reduce the chance that the enemy will detect the
infiltration.
(3) Infiltration should be conducted through areas not occupied or covered by
enemy surveillance and fire.
(4) The local population should be avoided unless known to be friendly.
Civilians positively confirmed as friendly can help with the infiltration and can be used
as guides.
40
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Offensive Operations”
Reference FM 71-1, 71-2, 71-3
5. MOVEMENT TECHNIQUES AND FORMATIONS.
A. MOVEMENT TECHNIQUES. The three movement techniques are traveling,
traveling overwatch, and bounding overwatch. Usually, the task force does not move
as a unit using one movement technique. Rather, the task force commander
designates the movement technique to be used by the lead unit(s). Movement
techniques end upon enemy contact. The unit begins its actions on contact and the
overwatching force begins its suppressive fire.
B. FORMATIONS. The tack force may move in any of six basic formations:
Column, wedge, V, echelon, line, and box or diamond. The task force may use
more than one formation in a given movement; especially true when the terrain
changes during movement. Other factors are distances of the move and enemy
disposition.
(1) Column formation.
The task force moves in column formation
when early contact is not expected, and
the objective is far away. Normally the lead
element uses traveling overwatch while
the following units are traveling.
Considerations are as follows:
• Speed of movement, easy to control, useful
in defiles or dense woods.
• Provides for quick transition.
• Requires flank security.
• Provides majority of firepower to tanks.
Figure 2-5, Column.
(2) Wedge Formation. The wedge formation best positions the battalion to attack an
enemy appearing to the front and flanks. It is used when enemy contact is possible
or expected, but the location and disposition of the enemy is vague. When enemy
contact is not expected, it may be used to rapidly cross open terrain.
Considerations are as follows:
• Facilitates control and transition to the assault.
• Provides for maximum firepower forward and good firepower to the flanks.
• In forested areas or during poor visibility, is difficult to control.
• Requires sufficient space to disperse companies laterally and in depth.
41
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Offensive Operations”
Reference FM 71-1, 71-2, 71-3
(3) V Formation. The V formation
disposes the task force with two
companies abreast and one trailing.
This arrangement is most suitable to
advance against a threat know to be
to the front of the task force. It may
be used when enemy contact is
expected and the location and
disposition of the enemy is know.
Considerations are as follows:
• Hard to reorient: control is difficult in
heavily wooded areas.
• Provides for good firepower forward and
to the flanks.
Figure 2-6 (V Formation).
(4) Echelon Formation. The echelon formation arranges the task force with the
company teams in column formation in the direction of the echelon (right or left). It is
commonly used when the task force provides security to a larger moving force.
Considerations are as follows:
• Provides for firepower forward and in
the direction of echelon.
• Facilitates control in open areas; more
difficult in heavily wooded areas.
Figure 2-7 (Echelon Right)
42
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Offensive Operations”
Reference FM 71-1, 71-2, 71-3
(5) Line formation. The line formation
arranges the task force with the company
teams abreast. Since it does not dispose
company teams in depth, the line provides
less flexibility of maneuver than other
formations. It is used when continuous
movement with maximum firepower to the
front is required.
Considerations are as follows:
• Permits maximum firepower to the front.
• Difficult to control.
• Facilitates the use of speed and shock
in closing with the enemy.
Figure 2-8, Line Formation
(6) Box formation. The box formation arranges the task force with two company
teams forward and two company teams trailing. It is the most flexible of all formations
because it can easily be changed to any other formation.
Considerations are as follows:
• Provides firepower to the front and flanks.
• Facilitates speed of movement because
it is easy to control.
(6) Diamond formation. The diamond
formation is a variation of the box
formation. In the diamond formation,
one company team leads, one company
team is positioned on each flank, and
the remaining company team is to the
rear.
Figure 2-9, Box Formation
43
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“How The Threat Defends”
Reference FM 71-1 and 71-2
1. The threat normally uses motorized rifle units to defend and used tank forces in
the counterattack. Other key notes in how the threat defends are as follows:
• Perceives the hasty defense as the most probable form of defense, as it allows for
a rapid transition to offensive operations.
• It is most vulnerable to an attack.
• When halted for more than a few hours, makes the transition from a hasty defense
to a prepared defense organized in successive belts and echelons to provide depth.
• The threat consists of a security zone and a main defense belt.
• The attacker is faced with a series of mutually supporting platoon and company
battle positions or strongpoints in depth.
• Obstacles are prepared forward to canalize him into “fire sacks” or to expose them
to counterattacks by tank-heavy reserves.
• Security zones try to halt or delay the attacker by forcing him to deploy before
reaching the main defense belt.
2. The following are strengths of the threat
defense.
• Mechanized and armored formation fight
as a combined arms team.
• Heavy attack helicopters are used against
close targets; fixed-wing aircraft attack
artillery unit, nuclear delivery systems, and
other deep targets.
• Massive amounts of field artillery can be
brought to bear.
• Counterfire and close support missions
are fired simultaneously.
• The defense is antitank and strongpoint
oriented with tank-heavy mobile reserves.
Figure 2-10, Threat Defense
3. Vulnerabilities and weaknesses of the defense are as follows.
• Communications are excellent; at platoon level, primary command and control is
with visual signals.
• Artillery command observation posts (COP) are the heart of the fire support
system.
44
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Conducting Attacks”
Reference FM 71-1, 71-2, 71-123
1. Movement to Contact. The task force conducts a movement to contact to make or
regain contact with the enemy and to develop the situation. Task forces conduct
movement to contact independently or as part of a larger force. The task force will
normally be given a movement to contact mission as the lead element of a brigade
attack, or as a counterattack element of a brigade or division. It terminates with the
occupation of an assigned objective or when enemy resistance requires the battalion to
deploy and conduct an attack to continue forward movement.
a. Key planning considerations for the
movement to contact are:
(1) Movement. Task force
movement is oriented on the objective
and along any assigned axis advance.
The task force moves consistent with the
following factors:
• Speed required by brigade.
• Available avenues of approach.
• Requirements to maintain mutual support
between maneuver units, security, and
fire support to the security force.
• Making contact with the smallest element
possible.
• Reacting to contact faster than the enemy.
Figure 2-11, Movement to Contact
(2) Task Organization. The task force is organized with a security force,
advance guard, main body, and flank and rear guards.
• Security Force. Provides adequate warning and sufficient space for the task force to
move.
• Advance Guard. This is the task force commander’s initial main effort, usually a
company team. The mission to provide security for the main body and facilitate its
uninterrupted advance. It’s composition is METT-TC dependent. In open terrain, a tankheavy team is preferred. At night, a mech infantry heavy team is preferred. Engineers
will follow or are attached to the lead elements.
• Main Body. Remains 1 to 2 kilometers behind advance guard lead element. Contains
the bulk of the combat elements. The Tactical CP follows the advance guard. Main CP
moves behind the lead element of the main body.
• Flank and rear guards. Normally a platoon size element from one or more of the
companies. Provides flank guard under company control. Trailing company provides
rear security.
45
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Conducting Attacks”
Reference FM 71-1, 71-2, 71-3
2. Hasty Attack. The hasty attack differs from the deliberate attack only in the amount
of time allowed for planning and preparation. The hasty attack is conducted either as a
result of a meeting engagement or when bypass has not been authorized and the
enemy force is in a vulnerable position. Hasty attacks are initiated and controlled by
FRAGOs. Two categories of hasty attack depending on the disposition of the enemy:
• An attack against a moving enemy force.
• An attack against a stationary enemy force.
a. Attack Against a Moving Force.
(1) When two opposing forces converge,
the side that wins is normally the one
that acts fastest and maneuvers to
positions of advantage against the
opponent’s flank. The advance guard
attacks or defends, depending on
the size and disposition of the enemy
force.
(1) The task force commander will
maneuver trailing or adjacent teams
against the enemy’s flank or rear,
while attacking by fire and interdicting
enemy units attempting to do the same
(see Figure 2-12).
(2) Tanks normally lead the attack;
BFVs will overwatch and support the
maneuvering tanks by fire.
Figure 2-12, Hasty Attack (Moving Enemy)
(3) FASCAM, smoke, and other supporting fires maybe used to disrupt enemy
maneuver and cover that of the task force.
(4) The scouts and advance guard provide initial information on the enemy force and
develop the situation.
(5) The lead company teams defends from hasty positions to fix the enemy element.
(6) A company team seizes high ground to provide overwatch and flank security.
(7) The trail team(s) counterattacks the enemy flanks supported by field artillery and
CAS.
46
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Conducting Attacks”
Reference FM 71-1, 71-2, 71-3
b. Attack Against a Stationary Force.
(1) A hasty attack against a stationary force is initiated after scouts or lead company
teams reconnoiter the enemy’s positions to find flanks or gaps that can be exploited.
(2) The task force commander coordinates the actions of his subordinates through
FRAGOs and previously issued contingency plans and control measures.
(3) Dismounted infantry assaults supported by direct and indirect fires may be
necessary to defeat the enemy. Tanks support by fire and begin their assault timed
to arrive on the enemy position at the same time as the dismounted infantry.
3. Deliberate Attack.
a. Task force deliberate attacks differ from the hasty attack in that they are
characterized by precise planning based on detailed information, thorough
preparation, and rehearsals.
b. The tank or mechanized infantry battalion will normally conduct deliberate attack a
delibrate attack as the main or supporting effort of a brigade attack, or as the brigade
reserve.
c. A deliberate attack requires time for collecting and evaluating enemy information,
reconnoitering, planning, and coordinating. The commander will designate support,
breaching, and assault forces and position them in the attack formation for anticipated
breaching operations.
4. Attack Of A Strongpoint.
During offensive operations, enemy strongpoints may be encountered. The four
steps in the process of destroying an enemy strongpoint are:
• Reconnoiter and task-organize to take advantage of enemy weaknesses.
• Isolate the point of initial penetration with smoke and fires.
• Breach or find bypass routes around obstacles and gain a foothold into the position.
• Exploit this penetration to complete the destruction of the strongpoint.
47
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Conducting Attacks”
Reference FM 71-1, 71-2, 71-3
a. Reconnoiter and Task-organize.
(1) Reconnaissance of the strongpoint is conducted in the same manner as
reconnaissance for a deliberate attack.
(2) The task force organizes into a breaching force, a support force, and an
assault force. A company size reserve is retained or part of the support force is
designated as reserve.
(a) The breach force is usually formed around a mechanized infantry company.
Engineers, if available, are part of the breach force. The breach force makes the
initial breach and passes the assault force through it.
(b) The support force is organized to provide supporting direct (and indirect)
fires to the breach force initially, then to the assault force. The support force may
consist of tank companies or tank-heavy company teams.
(c) The assault force is usually a mechanized-infantry-heavy company team.
The assault force may be required to breach enemy close-in obstacles and should,
therefore, include infantry and engineers. The assault force attacks through the
breach and destroys the enemy position.
b. Isolate the Point of Penetration.
The decisive point is the site on which
the initial breach of the enemy position
will occur. This position is isolated by
intense direct and indirect fires and
smoke to destroy enemy positions and
to prevent lateral movement to reinforce
this platoon.
c. Breach and Penetrate. The breach
of the enemy strongpoint is the task force
initial main effort (see figure 2-13). The
breach force breaches the enemy’s
protective obstacles, gains a foothold in
the trench line, and creates a gap in the
strongpoint large enough to pass through
the assault force.
48
Figure 2-13, Attack of a Strongpoint the breach.
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Conducting Attacks”
Reference FM 71-1, 71-2, 71-3
d. Exploit the penetration. After the
successful breach, the assault force
becomes the task force main effort (see
figure 2-14). The assault force passes
rapidly through the breach, supported by
the fires of the support force and the
breach force. The assault objective is an
isolated enemy platoon position.
(1) The assault force will be organized
into support, breach, and assault elements.
As subsequent platoon positions are
encountered, the breaching process may
have to be repeated.
(2) The task force commander may
commit the reserve to complete the
destruction of the strongpoint and prepare
for a counterattack or continue the attack.
Figure 2-14, Attack of a
Strongpoint - the assault.
5. Exploitation.
a. The exploitation is conduct to take advantage of success in battle. It prevents the
enemy form reconstituting an organized defense or conducting an orderly withdrawal.
It may follow any successful attack. The task force normally participates in the
exploitation as part of a larger force. The keys to successful exploitation are speed in
execution and maintaining direct pressure on the enemy.
b. Exploiting force missions include • Securing objectives deep in the enemy rear.
• Cutting lines of communication.
• Surrounding and destroying enemy units.
• Denying escape routes to an encircled force.
• Destroying enemy reserves, CS, and CSS units and assets.
c. The task force conducting an exploitation moves rapidly to the enemy’s rear area
using movement to contact techniques, avoiding or bypassing enemy combat units,
and destroying lightly defended and undefended enemy installations and activities.
49
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Other Offensive Operations”
Reference FM 71-1, 71-2, 71-3
5. Exploitation (Cont.)
d. The exploitation continues day and night for as long as the opportunity permits.
The momentum of the exploitation must not be slowed because of lack of support.
6. Pursuit.
a. The pursuit normally follows a successful exploitation. It differs from an
exploitation in that a pursuit is oriented primarily on the enemy force rather than on
terrain objectives. While a terrain objective maybe designated, the enemy force is the
primary objective. The purpose of the pursuit is to run the enemy down and destroy
him. The pursuit is conducted using a direct-pressure force, an encircling force, and a
follow-and-support force.
• The direct-pressure force denies the enemy units the opportunity to rest, regroup,
or resupply by repeated hasty attacks to force them to defend without support or to
stay on the move. The direct-pressure force envelops, cuts off, destroys, and
harasses enemy elements.
• The encircling force moves with all possible speed to get in the enemy rear, block
his escape, and with the direct-pressure force, destroy him. The enveloping force
advances along routes parallel to the enemy’s line of retreat to establish positions
ahead of the enemy main force.
• The follow-and-support force is organized to destroy bypassed enemy units, relieve
units under direct pressure, secure lines of communication, secure key terrain, or
guard prisoners or key installations.
7. Raid.
a. A raid (see Figure 2-15) is an attack into enemy territory to accomplish a specific
purpose and with no intention of gaining or holding terrain. Raids may be conducted
to •
•
•
•
Capture prisoners.
Capture or destroy specific enemy materiel.
Destroy logistical installations.
Obtain information concerning enemy locations,
dispositions, strength, intentions, or methods of operation.
• Disrupt enemy plans.
50
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Other Offensive Operations”
Reference FM 71-1, 71-2, 71-3
7. Raid (Cont.)
b. Battalion task force may conduct, or
may direct subordinate elements to
conduct, a raid.
c. May be conducted mounted or
dismounted and may be accomplished
through infiltration or air assault.
Mounted raids normally are conducted
as an exploitation with a limit of advance,
or as an attack with a limited-depth
objective. Dismounted raids are
conducted as a combat patrol.
d. Raids may be conducted during day
or night.
e. Raiding force security is vital,
because the raiding party is vulnerable
to attack from all directions.
Figure 2-15, Raid
f. Raids are timed so that raiding force arrives a the objective area at dawn, twilight,
or other times of low visibility.
g. During daylight, the raid force used covered routes or approach. During reduced
visibility, when surprise through stealth is possible, advance and flank security
detachments precede the raiding force.
h. The withdrawal is usually make over a different route from the one used to
approach the objective.
i. Logistically, the raiding force carries everything required to sustain itself during the
operations. Resupply of the raiding force, if required, is by aircraft.
8. Feint. A feint is a supporting offensive operations to draw the enemy’s attention
away form the area of the main attack and induce him to move his reserves or shift
his fire support. Feints must appear real. Contact with the enemy is required.
51
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Other Offensive Operations”
Reference FM 71-1, 71-2, 71-3
9. Demonstration. The demonstration is an operation to deceive the enemy about
the main attack. Its purpose is similar to a feint; however, no contact with the
enemy is made.
52
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
1. PURPOSE OF DEFENSE
The purpose of defense is to defeat the enemy’s attack and gain the initiative of
offensive operations. Defense is a temporary measure conducted to identify or create
enemy weaknesses that allow for the early opportunity to change over to the offense.
Achieve one or more of the following:
•
•
•
•
•
•
•
Destroy the enemy.
Weaken enemy forces as a prelude to the offense.
Cause an enemy attack to fail.
Gain time.
Concentrate forces elsewhere.
Control key or decisive terrain.
Retain terrain.
2. CHARACTERISTICS OF DEFENSIVE OPERATIONS.
a. Preparation.
(1) Operational security is the defender’s first requirement to defeat an attack.
Unit must maintain operations security, avoid patterns, and practice deception to hide
the defender’s position. Enemy reconnaissance efforts and probing attacks must be
defeated without disclosing the scheme of defense. The winner of the
reconnaissance battle is usually the winner of the final battle.
(2) An enemy attack is preceded and accompanied by masses supporting
fires. To survey, units must use defilade, reverse slope, and hide positions; use
supporting and suppressive fires; and avoid easily targeted locations. The defender
must use all available time to prepare fighting positions and obstacles, to rehears
counterattacks, and to plan supporting fires and combat service support in detail.
b. Disruption. The defender must slow or fix the attack, disrupt the attacker’s
mass, and break up the mutual support between the attacker’s combat and combat
support elements. A general aim is to force the attacker to fight a nonlinear battle to
make the attacker fight in more than one direction.
c. Concentration. The defender should be able to rapidly concentrate forces,
thereby massing combat power to defeat an attacking force, then disperse and be
prepared to concentrate again.
53
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
2. CHARACTERISTICS OF DEFENSIVE OPERATIONS (Cont.)
d. Flexibility. Commanders designate reserves and deploy forces and logistic
resources in depth to ensure continuous operations and to provide options for the
defender if forward positions are penetrated.
Figure 2-16, Defensive Framework
3. FRAMEWORK OF THE DEFENSE
The task force normally defends as part of a larger force. The defensive framework
which the corps and divisions organize and fight are organized into five elements (see
Figure 2-16).
•
•
•
•
•
Deep operations forward of the forward line of own troops (FLOT).
Security force operations forward of and to the flanks of the defending force.
Main battle area (MBA) operations.
Reserve operations in support of the main defensive effort.
Rear operations to retain freedom of action in the rear area.
54
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
a. Deep Operations.
(1) Deep operations are actions against those enemy forces not yet in direct
contact with the FLOT. Deep operations are conducted using indirect fires, EW, air
force and army aviation, deception, and maneuver forces.
(2) Task forces have no deep operations capabilities, although they maybe part
of a deep maneuver operation.
b. Close Operations.
(1) Security area operations.
(a) The forward security force normally established by corps is called a
covering force. It fights against the attacker’s leading echelons in the covering force
area (CFA). Covering force actions weaken the enemy; allows repositioning of
forces; deceives the enemy as to the size, location, and strength of the defense.
(b) A battalion task force may fight as a part of a covering force operation.
When it disengages the enemy, it becomes part of the MBA forces or reserve.
(2) Main battle area operations.
(a) Based on the estimate of the situation and intent the brigade
commander assigns sectors or battle positions to task forces. He will identify the
main effort and give assets required to the force responsible for the most dangerous
avenue of approach into the MBA.
(b) Task force commanders structure their defenses by deploying units in
depth within the MBA. A mounted reserve of one-quarter to one-half of the task force
strength provides additional depth.
(3) Reserve Operations.
(a) The commitment of reserve forces at the decisive point and time is
key to the success of a defense. When the task force is designated as a reserve
force, it can expect to receive one or more of the following missions: counterattack,
spoiling attack, block, fix or contain, reinforce, or rear operations.
c. Rear Operations. The battalion task force does not have a rear operations
fight within its assigned sector. However, a maneuver battalion assigned a rear
mission by a higher headquarters may conduct offensive operations against enemy
conventional or unconventional forces in the rear area.
55
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
4. HOW THE THREAT ATTACKS.
The threat strives to sustain continuous operations with overwhelming numbers
through momentum, mass, and echelonment. The threat uses combined arms
formations of massed tanks, motorized (mechanized) infantry, and other armored
vehicles supported by massed fires. (See Figure 2-17 for an example threat
motorized rifle regiment attack.)
Figure 2-17, The Offensive Threat
5. SEQUENCE OF THE DEFENSE.
a. Occupation. During this phase, the scouts are usually the first to clear the
proposed defensive position. Leaders then reconnoiter and prepare their assigned
areas. Security is established forward of the defense area to allow occupation of
positions and preparation of obstacles without compromise.
b. Covering Force Fight. The covering forces makes initial contact with the
approaching enemy. Depending on the mission, organization, and size of the
covering force, it may do anything from provide early warning to defeat of the enemy’s
lead echelons. The counter reconnaissance fight begins here.
56
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
5. SEQUENCE OF THE DEFENSE (Cont.)
b. Passage of the Covering Force. The task force establishes contact with, and
assists the disengagement and passage of the covering force or other security
elements.
c. Defeat of Enemy Reconnaissance, Infiltration, and Preparatory Fires.
Consistent with security requirements, task force elements remain in defilade, hide,
and prepared positions to avoid the casualties and shock associated with indirect
fires. The enemy will attempt to discover the defensive scheme by reconnaissance
and probing attack of the advance guard.
d. Approach of the Enemy Main Attack. Task force security elements observe and
report enemy approach movement. The task force commander repositions or
reorients his forces to mass against the enemy’s main effort. Enemy formations are
engaged at maximum range by supporting fires and close air support to slow,
disorganize or to impair his communications. Obstacles are closed, direct fire
weapons are repositioned as required. The task force may withhold fires to allow the
enemy to enter the engagement area.
e. Enemy Assault. As the enemy deploys, he becomes increasingly vulnerable to
obstacles. The task force uses obstacles, blocking positions, and fires to break up
the assaulting formation. Continued maneuver to enemy flanks and rear is used to
destroy him.
f. Counterattack. As the enemy
assault is slowed or stopped, the task
force commander will launch his counter
attack (by fire or by maneuver) to
complete the destruction of the enemy
forces.
g. Reorganization and Consolidation.
The task force must quickly reorganize
to continue the defense. Casualties
are evacuated, ammunition and other
critical items are cross-leveled and
resupplied. Security and obstacles are
reestablished and reports are submitted.
57
Figure 2-18,
Reorganization and Consolidation
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
6. TYPES OF DEFENSE
a. Defense of a Sector.
(1) A defensive sector is an area designated by boundaries that define where a
unit operates and the terrain for which it is responsible. Defense in sector is the most
common defense mission for the task force.
(2) Sectors maybe used in the MBA
and CFA. Task force sectors are
oriented on regimental avenues of
approach and are used when the brigade
commander wishes to allow maximum
freedom of action to his task forces. A
commander defending a sector is
expected to defeat enemy forces within
his sector, and maintain his flank
security.
(3) Defend in sector is the least
restrictive mission. It allows the task
force commander to plan and execute
his defense using whatever technique is
necessary to accomplish the mission
He may use sectors, battle positions,
strongpoints, or a combination of
measures to accomplish his mission.
Figure 2-19, Three Company Teams
in Sector
(4) If the commander cannot concentrate fires, he distributes his forces
and fires using company sectors. For example, in Figure 2-19, the commander
used three companies in sector because multiple avenues of approach promoted
decentralization. The reserve is positioned near where it probably will be
used, and the reserve force commander prepares and reconnoiters routes to
on-order counterattack positions.
(a) To control his forces, the task force commander establishes coordinating
points, phase lines, on-order battle positions, and contact points.
(b) In Figure 2-20 , the commander has established coordinating points for
control along the FEBA. His intent is to destroy the enemy force forward in the MBA.
He establishes a security force consisting of a reinforced mech infantry company to
provide early warning, conduct counterreconnaissance, and assist the rearward
passage and battle handover of the covering force.
58
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
(c) As the battle develops, the security force identifies the main effort against the
middle company sector. The enemy’s attack is initially blunted by the defending
company. The left flank team commander sees an opportunity to conunterattack from
the flank to destroy the enemy force (see figure 2 - 21).
Figure 2-20, Company team sectors with control and coordination measures.
Figure 2-21, Task Force Counterattack.
(d) The commander may compensate for changes in the battle by moving the reserve
positioned in depth forward to assume responsibility for the vacant sector. Following
the counterattack, he may then direct the counterattack force to conduct a rearward
passage and occupy positions in depth to become the reserve.
59
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
Figure 2-22, Company battle positions.
(f) As depicted in figure 2-22, the commander may choose to employ companies in
battle positions. This technique restricts maneuver and complicates flank
coordination by the companies, but it gives greater control of the overall defense to
the task force commander.
(g) There are many combinations of techniques that the commander could use to
position his forces. The examples show some of the possible combinations and
conditions that could exist.
Figure 23, Sector and BP Defense
60
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
b. Defense of a Battle Position.
 A BP is a general location and orientation
of forces on the ground, from which units
defend. The BP can be for units from battalion
TF to platoon size. A unit assigned a BP is
within the general area of the position.
Security forces may operate well forward
and to the flanks of BPs for early detection
of the enemy and for all-around security.
Units can maneuver in and outside of the
BP as necessary to adjust fires or to seize
opportunities for offensive action
in compliance with the commander's intent.
Figure 2-24,
Battle Position
 The commander may maneuver his elements freely within the assigned BP. When
the commander maneuvers his forces outside the BP, he notifies the next higher
commander and coordinates with adjacent units. Task force security, CS, and CSS
assets are frequently positioned outside the BP with approval from the headquarters
assigning the BP.
c. Defense of a Strongpoint.
 The mission to create and defend a
strongpoint implies retention of terrain with
the purpose of stopping or redirecting enemy
formations. Battalion strongpoints can be
established in isolation when tied to
restrictive terrain on their flanks. A bypassed
strongpoint exposes the enemy's flanks to
attacks from friendly forces.
Figure 2-25, Strongpoint
 The TF pays a high cost in manpower, equipment, material, and time for the
construction of a strongpoint. It takes several days of dedicated work to construct
one. Strongpoints also sacrifice the inherent mobility advantage of heavy forces.
Strongpoints may be on the FEBA, or in depth in the brigade MBA.
61
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
1. Other Defensive Operations and Techniques.
a. Counterreconnaissance Operations.
(1) Enemy reconnaissance operations will begin well ahead of any planed
tactical operation. The task force will attempt to prevent the enemy from seeing its
preparations. Enemy reconnaissance elements will conduct mounted and
dismounted patrols to define positions, identify units, and detect friendly activities.
His patrols will be small, move with stealth, and use concealment to observe friendly
forces. It is important that these elements be detected and denied information, or
destroyed before they can report their observations. The task force
countersurveillance operations are integrated into the brigade plan to counter the
enemy reconnaissance and surveillance efforts.
(2) Counterreconnaissance needs to be planned so as to use all assets
available to detect the enemy reconnaissance elements early. The following tasks
have to be preformed to ensure that this gets done:
(a) Specify the security force mission. Screen, in addition to preventing
direct observation by the enemy, implies long range observation of enemy avenues of
approach to provide early warning and detection, and neutralization or destruction of
enemy reconnaissance elements.
(b) Provide sufficient assets. At least a screening force is needed to detect
the enemy’s approach and defeat the enemy’s reconnaissance efforts.
(c) Establish security early and well forwarded. In coordination with
covering force operations, the task force security element should be in place before
the company teams move into their battle positions and before work on obstacle
begins.
(d) Put security in the right place; ensure complete coverage. Based on
terrain and threat analysis, the S2 templates likely enemy reconnaissance objective
and route and recommends the general location of the security force to the S3; the
commander approves the plan.
(3) The following are elements used in the counterreconaissance activities.
(a) Scouts. The primary counterreconnaissance asset of the task force.
(b) GSR. Usually limited to open terrain and best used to cover open, highspeed avenues of approach where early detection is critical.
(c) TOW/ITV. These elements can be used to occupy OPs and destroy
enemy reconnaissance vehicles. These crews are smaller and less familiar with
security operations than a scout squad.
62
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
a. Counterreconnaissance Operations (Cont.)
(d) Maneuver units (tanks and infantry). Manning OPs and patrolling are
normal infantry missions. Considerations for using infantry squads must be tempered
by the MBA preparation time these squads need. Each tank crew can man only one
OP, and the OP should be used to cover a relatively open, high-speed avenue of
approach.
b. Stay-Behind/Hide Forces.
(1) The purpose of stay-behind forces is
to surprise, counterattack, defeat, and confuse
the enemy. The stay-behind or hide force
counterattacks enemy combat forces from
the rear, or attacks and or ambushes his
command and control, combat support, and
combat service support elements (see
Figure 2-26). This is a high risk operation and
should not be considered lightly.
(2) In example shown in Figure 2-27, a
mechanized-infantry heavy battalion task
force hides in a covered and concealed
position forward of the FEBA. This task force
in is position to outflank an enemy avenue of
approach or attack a likely location or enemy
command and control, air defense, or trains
elements, and can defend BP 8. In the brigade
plan, after passage of the covering force, the
stay-behind/hide force is to counterattack to
Objective RED. The commander’s intent is to
destroy enemy command and control, air
defense, and supply vehicles. Upon completion
of the counterattack or on order, the task force
delays to Route Bill, returns through passage
point 1, and occupies assembly area JIM to
reconstitute, refit, rearm, refuel, and rest.
The task force maintains radio-listening silence
as it crosses the FEBA. It must be in position
before battle handover at PL HARRY and should
not begin the attack until the covering force
has passed and the enemy can be surprised.
63
Figure 2-26, Stay-Behind
force attack
Figure 2-27, Stay-behind
force attack and
withdrawal
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Defense”
Reference FM 71-1, 71-2, 71-3
c. Perimeter Defense. A perimeter defense
is oriented in all directions (see Figure 2-27).
A task force organizes a perimeter defense
to provide self-protection. A perimeter is
established when the task force must hold
critical terrain in areas where the defense is
not tied in with adjacent units. The task force
may also form a perimeter when it has been
bypassed and isolated by the enemy and
must defend in place.
Figure 2-27, Perimeter Defense
d. Reverse Slope Defense. The reverse slope defense uses the topographical crest
to mask the defender from the supporting direct fire and observation of the attacker.
The task force rarely conducts a reverse slope defense along it’s entire front;
however, there maybe situations where subordinate units and weapons systems
maybe employed on the reverse slope. The task force commander may adopt a
reverse slope position for elements of the battalion:
• When the forward slope is made untenable
by enemy fire.
• When the forward slope has been lost or
not yet gained.
• When the terrain on the reverse slope affords
better or equal fields of fire than on the forward
slope.
• When the possession of the forward slope is
not essential for observation.
• To avoid creating a dangerous salient in
friendly lines.
• To surprise the enemy and to deceive him
as to the location of the battalion main
defensive positions.
• To deny the enemy direct observation and
fires on to the defensive position and facilitate
resupply.
• When time to prepare positions is limited.
• When seeking to gain protection from the
effects of nuclear or chemical fires that are
anticipated forward of the friendly position.
Figure 2-28, Organization
of Reverse Slope Defense
64
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Reserve”
Reference FM 71-1, 71-2, 71-3
RESERVE OPERATIONS
When designated as a reserve for a higher headquarters, the battalion TF may be
assigned one or more of the following missions:
 Counterattack.
 Spoiling attack.
 Block, fix, or contain enemy force.
 Reinforce.
 Rear operations.
a. Counterattack.
(1) Attack Assignment.
Counterattack planning and execution
is assigned by brigade to committed
and reserve TFs. Normally, more than
one counterattack option is planned
for and rehearsed. Counterattacks may
be conducted to block an impending
penetration of the FEBA; to stop a force
that has penetrated; to attack through
forward defenses to seize terrain; or to
attack enemy forces from the flank and
rear.
(2) Timing the Attack.
A counterattack, at any level, is usually
the decisive point in an engagement.
The commander's timing in committing
Figure 2-29, Counterattack
his reserve to the counterattack is critical.
To ensure success, the counterattack
must be well planned and precisely executed. The battalion medical operations officer
must be in touch with the tactical scenario and prepared to execute the HSSPLAN.
b. Spoiling Attack. This is a preemptive, limited objective attack aimed at
preventing; disrupting; or delaying the enemy's ability to launch an attack. The
objective of the spoiling attack is the enemy force, not terrain. The reserve is often
used to conduct spoiling attacks so that forward units can concentrate on defensive
preparations within the MBA. Spoiling attacks are normally directed against an enemy
force that is preparing to conduct an attack; that has temporarily halted to rearm and
refuel; or is making the transition from mounted to dismounted operations. Enemy
artillery is also a prime target.
65
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in the Reserve”
Reference FM 71-1, 71-2, 71-3
c. Block, Fix, or Contain. The reserve may be ordered to establish a hasty BP
to block, fix, or contain enemy forces within a portion of the battlefield. This action
may be necessary to blunt a penetration while other forces maneuver against the
flanks or rear of the enemy force. An enemy force may be held in one area of the
battlefield while he is defeated in another.
d. Reinforce. Reserve forces may be committed to reinforce units that have
sustained heavy losses; also to build up stronger defenses in critical areas of the
battlefield. Considerations must be given to how they will be integrated into the
defensive scheme, C2 arrangements, and where they will be positioned. The
techniques used to reinforce are similar to those used during a relief in place.
e. Rear Operations. The reserve battalion may operate as a division combined
arms tactical combat force with a rear operations mission. The TF must not allow itself
to become so dispersed that it cannot mass for other reserve missions. Nevertheless,
the TF normally uses dispersed company positions; this reduces the TF signature on
the battlefield and helps spread its companies to accomplish rear operations. The TF
completes intelligence preparation of the rear area for probable enemy avenues of
approach and for likely enemy landing zones (LZs) and drop zones (DZs). It positions
forces at the locations to interdict the rear area threat. Based on the IPB, location of
CS and CSS elements within the brigade rear area, and their own dispositions, the TF
assigns areas of responsibility to its companies or teams. Task forces are responsible
for their own security within assigned areas. The TF also coordinates with CS and
CSS base clusters for their defense, to include - Critical CS and CSS assets to be protected.
 Intelligence preparation of the battlefield, to include local enemy approaches and
possible LZs/DZs
 Review of base and base cluster defensive preparations to include perimeter
defensive sketches, OPs, patrols, obstacles, AD weapons sites, and reaction forces.
 Coordination of fire support and aviation operations including reconnaissance and
transport.
 Coordination with MP and other combat-capable units and base cluster reaction
forces.
 Events or contingencies that will trigger commitment of the TF to destroy a rear
area threat.
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Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in Other Tactical Operations”
Reference FM 71-1, 71-2, 71-3
Retrograde Operations
Retrograde operations are organized movements away from the enemy. A retrograde
may be forced by enemy action or executed voluntarily. The underlying reason for
conducting a retrograde operation is to improve a tactical situation or prevent a worse
one from occurring. A retrograde operation may be used to economize forces,
maintain freedom of maneuver, or avoid decisive combat. A battalion TF conducts a
retrograde as part of a larger force to - Avoid combat under unfavorable conditions.
 Gain time.
 Reposition or preserve forces.
 Use a force elsewhere.
 Harass, exhaust, resist, and delay the enemy.
 Draw the enemy into an unfavorable position.
 Shorten lines of communication and supply.
 Clear zones for friendly use of chemical or nuclear weapons.
 Conform to the movement of other friendly forces.
a. Types. There are three types of retrograde operations: delay, withdrawal, and
retirement. They can be characterized as follows:
 Delay-trade space for time and avoid decisive engagement to preserve the force.
 Withdrawal-break contact. (Free a unit for a new mission.)
 Retirement-move a force not in contact to the rear.
b. Planning Considerations. All retrogrades are difficult and inherently risky. To
succeed, they must be well organized and well executed. A retrograde operation
requires the following elements:
(1) Leadership and Morale. Maintenance of the offensive spirit is essential
among subordinate leaders and troops in a retrograde operation. Movement to the
rear may be seen as a defeat or a threat of isolation; therefore, soldiers must have
confidence in their leaders and know the purpose of the operation and their role in it.
67
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in Other Tactical Operations”
Reference FM 71-1, 71-2, 71-3
Retrograde Operations (Cont.)
(2) Reconnaissance, Surveillance, and Security. Timely and accurate
intelligence is especially vital during retrograde operations. Reconnaissance and
surveillance must locate the enemy; then security elements must deny him
information and counter his efforts to pursue, outflank, isolate, or bypass all or a
portion of the TF. The commander must establish a security force that is strong
enough to - Secure enemy avenues of approach.
 Deceive the enemy and defeat his intelligence efforts.
 Overwatch retrograding units.
 Provide rear guard, flank security, and choke point security.
c. Mobility. To conduct a successful retrograde, the TF seeks to increase its
mobility and significantly slow or halt the enemy. The TF improves its mobility by - Reconnoitering routes and BPs.
 Positioning AD and security forces at critical points.
 Improving roads, controlling traffic flow, and restricting refugee movement to routes
not used by the TF.
 Rehearsing movements.
 Evacuating casualties, recoverable supplies, and excess materiel before the
operation.
 Displacing nonessential CSS early in the operation.
 Covering movements by fire.
The TF degrades the mobility of the enemy by - Occupying and controlling choke points and terrain that dominate high speed
avenues of approach.
 Destroying roads, bridges, and rafting on the avenues not required for friendly
forces.
 Improving existing obstacles and covering them with fire.
 Employing indirect fire and smoke to degrade the enemy's vision and to slow his
rate of advance. To ensure continuous coverage, TF mortars normally move in split
sections.
 Conducting spoiling attacks to keep the enemy off balance and force his
deployment.
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Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in Other Tactical Operations”
Reference FM 71-1, 71-2, 71-3
Retrograde Operations (Cont.)
d. Deception. The objective of deception is to hide the fact that a retrograde is
taking place; this is essential for success. Deception is achieved by maintaining
normal patterns of activity in radio traffic; artillery fires; patrolling; and vehicle
movement. Additional considerations include using dummy minefields or decoy
positions, and conducting feints and demonstrations under limited visibility conditions.
Retrograde plans are never discussed on unsecure radio nets.
e. Conservation of Combat Power. The commander must conserve his combat
power by - Covertly disengaging and withdrawing less mobile units and nonessential elements
before withdrawing the main body.
 Using mobile forces to cover the withdrawal of less mobile forces.
 Using minimum essential forces to provide security for withdrawal of the main body.
1. Delay.
a. Purpose. A delay is an operation in
which a force trades space for time while
avoiding decisive engagement. The delay
incorporates all of the dynamics of
defense, but emphasizes preservation of
the force and maintenance of a mobility
advantage. The TF may attack, defend,
or conduct other actions (such as
ambushes and raids) during the delay to
destroy the enemy or to slow the enemy.
The battalion TF may be given a delay
mission as part of the covering force;
as an economy-of-force operation to allow
offensive operations in another sector;
or to control a penetration to set up a
counterattack by another force.
Figure 2-30, Delay
from Successive Positions
b. Control of Actions. A delay may be conducted from successive positions or
from alternate positions. Successive positions are used when the delay is conducted
over a wide front; alternate positions are preferred for a narrow sector. The delay is
normally well planned and uses graphic control measures to display the commander's
intent. Incorporate these control measures in the CHS overlay.
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Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in Other Tactical Operations”
Reference FM 71-1, 71-2, 71-3
2. Withdrawal. A withdrawal is an operation in which all or part of the battalion frees
itself for a new mission. A withdrawal is conducted to break contact with the enemy
when the TF commander finds it necessary to reposition all or part of his force; or
when required to attain separation for employment of special purpose weapons. It
may be executed at any time, during any type of operation.
a. Types of withdrawals.
(1) Withdrawal not under enemy pressure.
(2) Withdrawal under enemy pressure.
b. Both types begin while the battalion is
under the threat of enemy interference.
Preferably, withdrawal is made while the
battalion is not under enemy pressure.
Withdrawals are either assisted or unassisted.
An assisted withdrawal uses a security force
provided by the next higher headquarters in
breaking contact with the enemy and to provide
overwatching fires. In an unassisted withdrawal,
the TF provides its own security force.
3. Retirement
a. Purpose. A retirement is a retrograde
operation in which a force that is not in contact
with the enemy moves to the rear in an
organized manner. A retirement is usually
made at night. If enemy contact is possible,
on-order missions are given to the march units.
Figure 2-31, Sequence
of withdraw al not under
pressure
b. Leadership Responsibilities. A retirement may have an adverse impact on the
morale of friendly troops. Leadership must be positive; they must keep troops
informed of the retirement purpose and future intentions of the command.
4. Passage of Lines
a. Purpose. A passage of lines is an operation in which one unit is passed through
the positions of another. When a unit moves toward the enemy through a stationary
unit, it is a forward passage. Rearward passages are movements away from the
enemy through friendly units. The covering force withdrawing through the MBA, or an
exploiting force moving through the initial attacking force, are examples.
70
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in Other Tactical Operations”
Reference FM 71-1, 71-2, 71-3
4. Passage of Lines (Cont.)
b. Conduct. A passage of lines is necessary when one unit cannot bypass another. A
passage of lines may be conducted to - Continue an attack or counterattack.
 Envelop an enemy force.
 Pursue a fleeing enemy.
 Withdraw covering forces or main battle
forces.
c. Vulnerability of Units. The TF vulnerable
during a passage of lines. As units are
concentrated, the fires of the stationary unit
may be masked and the TF is not dispersed
to react to enemy action. Detailed
reconnaissance and coordination are key to
ensure a quick and smooth passage.
5. Relief Operations
a. Responsibilities. A relief is an operation
in which a unit is replaced in combat by
another unit. Responsibilities for the mission
Figure 2-32, Passage of Lines
and assigned sector or zone of action are
assumed by the incoming unit. Reliefs may be conducted during offensive or
defensive operations and during any weather or light conditions. They are normally
executed during limited visibility to reduce the possibility of detection.
b. Purpose. The purpose for relief is to maintain the combat effectiveness of
committed elements. A relief may be conducted to - Reconstitute a unit that has sustained
heavy losses.
 Introduce a new unit into combat.
 Rest units that have conducted prolonged
operations.
 Decontaminate or provide medical treatment
to a unit.
 Conform to a larger tactical plan or make
mission changes.
71
Figure 2-33, Relief
Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in Other Tactical Operations”
Reference FM 71-1, 71-2, 71-3
6. Breakout from Encirclement
a. Encircled Force. A breakout is an offensive operation conducted by an encircled
force. A force is considered encircled when all ground routes of evacuation and
reinforcement are cut off by the enemy.
b. Conduct. A breakout is conducted to allow the encircled force to regain freedom of
movement; or to regain contact with friendly units. Encirclement does not imply that
the battalion TF is surrounded by enemy forces in strength. Threat doctrine stresses
momentum and bypassing of forces that cannot be quickly reduced. An enemy force
may be able to influence the TF's subsequent operations while occupying only
scattered positions; it may not be aware of the TF location, strength, or composition.
The TF can take advantage of this by attacking to break out before the enemy is able
to take advantage of the situation.
Figure 2-34, Organization of a Breakout
Figure 2-35, Conduct of a Breakout
7. Linkup
a. Purpose. A linkup is the meeting of two or more friendly ground forces that have
been separated by the enemy. The battalion TF may participate as part of a larger
force, or it may conduct a linkup with its own resources. Linkup is conducted to relieve
or join a friendly force, or to encircle an enemy force.
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TASK FORCE TACTICAL OPERATIONS
“Combat Operations in Other Tactical Operations”
Reference FM 71-1, 71-2, 71-3
7. Linkup (Cont.)
b. Coordination of Maneuver Schemes. All elements in a linkup carefully coordinate
their operations to minimize the risk of fratricide. This coordination is continuous and
increases as the units approach the linkup points. Control measures used are as
follows:
 Zones of attack or axes of advance.
If one or more of the forces are moving,
their direction and objective are controlled
by the higher headquarters.
 Phase lines. Movement is controlled by
a higher headquarters through the use of
phase lines.
 Restrictive fire lines. Restrictive fire lines
(RFLs) are used to prevent friendly forces
from engaging one another with indirect
fires.
 One technique is to make the phase lines
on-order RFLs. As the unit crosses a phase
line, the next phase line becomes the RFL.
 Checkpoints. Checkpoints are used to
control movement and designate overwatch
positions.
Figure 2-36, Linkup Operation
 Linkup and alternate linkup points. The linkup point is a designated location where
two forces meet and coordinate operations. The point must be easily identifiable on
the ground, and recognition signals must be planned. Alternate linkup points are
established in the event that enemy action precludes linkup at the primary point (see
FM 31-71). Changes in personnel and equipment authorizations are the result of
emphasis on mobility; maintenance; communications; and CSS. Equipment is
eliminated or added based on its suitability to the terrain and environment.
8. Guard Operations
a. Mission. A guard operation is a security operation in which a unit protects a larger
unit by - Maintaining surveillance.
 Providing early warning.
 Destroying enemy reconnaissance elements.
 Preventing enemy ground observation of main body.
 Preventing enemy use of direct fire against the main body.
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Chapter 2
TASK FORCE TACTICAL OPERATIONS
“Combat Operations in Other Tactical Operations”
Reference FM 71-1, 71-2, 71-3
8. Guard Operations (Cont.)
b. Functions. The guard force provides
the larger force warning, reaction time,
and maneuver space. The guard force
delays, destroys, or stops the enemy
within its capability. The commander
conducting the guard operation must
know the intent of the higher force
commander and the degree of security
required.
c. Performance. Guard operations can
be to the front, rear, or flanks of the main
body (see figure 2-35). Battalion TFs have
the mobility, organization, and equipment
to perform a guard operation as a part of
a brigade or division offensive operation.
They may be assisted by air cavalry or
attack helicopter units under their OPCON.
74
Figure 2-37, Rear, flank, and
advance guard operations.
Chapter 3
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATION
Reference FM 8-10, 8-10-4, FM 8-55, FM 7-20
TOPIC
Combat Health Support in a Tactical Operation.
Planning, Preparing, & Executing.
Follow-and-Support Concept.
Communications.
Maintenance and Casualty Evacuation.
Color- Coded Triage System.
Specialty Platoons.
Marking and Locating Casualties On The Battlefield.
Evacuation Techniques.
PAGE
76
77
77
77
78
78
78
79
Combat Health Support in Offensive Operations.
General Information and Guidelines.
Combat Health Support in Movement to Contact.
Combat Health Support in a Hasty Attack.
Combat Health Support in the Deliberate Attack.
Combat Health Support During Exploitation.
Combat Health Support During a Pursuit.
80
81
81
81
81
81
Combat Health Support in Defensive Operations.
Combat Health Support Flexibility in Defensive Operations.
General Information and Guidelines.
Combat Health Support to the Covering Force.
Combat Health Support during the Battle Handover.
82
82
83
84
Combat Health Support in Reserve Operations.
Combat Health Support in the Counterattack.
Combat Health Support in the Reinforce.
Combat Health Support in the Rear Operations.
84
85
85
Combat Health Support in Other Tactical Operations.
Combat Health Support in the Delay.
Combat Health Support in the Withdrawal/Retirement.
Combat Health Support in the Passage of Lines.
Combat Health Support in the Breakout from Encirclement.
Combat Health Support in the Linkup.
85
86
86
86
86
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Chapter 3
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATION
Reference FM 8-10, 8-10-4, 8-55, 7-20
1. PLANNING. Large numbers of unexpected casualties and casualties in unexpected
locations can hinder or defeat an attack. Commanders and medical platoon leaders
must plan beyond their immediate tactical objectives. Medical support must be
positioned so the commander can exploit the opportunities created by tactical success.
The BAS must mutually support companies; however, as with any battlefield system, its
positioning should weight the main effort. Evacuation assets should be task organized
and allocated by projected casualties. (Reference Chapter 6, “Medical Platoon Leader’s
Planning Checklist”, page 163)
2. PREPARATION. The medical platoon leader is the coordinating staff officer most
concerned with casualty evacuation and is an integral war gamer during the IPB
process. This allows the medical platoon leader to analyze the tactical plan and terrain
and to identify areas of anticipated casualty density. The BAS should be located as far
forward as METT-TC allows. The BAS must have enough medical supplies to treat the
highest number of expected casualties. Casualty collection points should be
predesignated and routinely planned. Ambulance exchange points (AXP) should be
used. Extra medical evacuation and treatment support should be planned for and
requested from the forward support medical company. The medical support matrix
should be integrated with the tactical overlay. If deviation from the matrix occurs, the
BAS location must be known at all times. The BAS should remain on location as long as
practical. Additional medical supplies should be issued to maneuver elements for
various missions. This will assist the medics and combat lifesavers in providing far
forward care. In addition, the CHS plan must be rehearsed and synchronized with all key
CSS/CHS nodes in the task force. The rehearsal should be rehearsed from point of
injury to platoon/company CCPs to the BAS or treatment team locations. The plan
should also be rehearsed at the Brigade CSS rehearsal. This allows final adjacent unit
coordination to occur and to finalize the plan prior to execution.
a. Offense. BAS mobility must be maintained. During offensive operations, BAS can
travel with the combat trains or with the last maneuver company in the order of
movement. This way the BAS can obtain aid in the event of a breakdown or navigational
help. (Reference Chapter 6, “Considerations in the Offense”, page 164)
b. Defense. The depth and dispersion of the defense creates important time and
distance considerations. In a nonlinear defense, enemy and friendly units intermingle,
especially in poor visibility. MSRs and routes between positions might be interdicted.
Tactical and logistical vehicles should be used as needed for patient evacuation, as this
does not adversely affect their mission. For example, empty ammunition trucks can
backhaul casualties. Also, damaged vehicles can be towed to the BSA and used to carry
casualties. A platoon can be tasked to "follow and provide casualty evacuation support"
to the main effort. (Reference Chapter 6, “Considerations in the Defense”, page 169)
76
Chapter 3
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATION
Reference FM 8-10, 8-10-4, 8-55, 7-20
3. EXECUTION. Casualty evacuation is a team effort. It is the responsibility of all
soldiers-not just the medics. This includes combat lifesavers, infantry squad leaders,
staff officers, the medical platoon leader, and the battalion commander. The primary
duty of a combat lifesaver is the mission. Providing enhanced first aid of casualties is
secondary. Appropriate ground and air evacuation techniques should be used based on
METT-TC and on patient evacuation precedence (URGENT, URGENT-SURGICAL,
PRIORITY, ROUTINE, and CONVEINCE).
4. FOLLOW-AND-SUPPORT CONCEPT. Use of a "jump" aid station by the medical
platoon can be effective. In anticipating surge requirements, the medical platoon leader
should forward deploy, or jump, part of the BAS. The distance is determined mostly by
the operation (offensive or defensive) and by the enemy threat. The physician assistant
should accompany the forward aid station to provide medical advice and expertise. This
"follow and support" concept simplifies triage forward, which in turn improves the rate at
which casualties are treated. To prevent ambulances and aid stations from being
positioned accidentally at risk from enemy action, "jump" aid stations must be properly
controlled. Planned checkpoints that are possible aid station locations must be
designated along the MSR. They should be included in the operation overlay in the
OPORD. The jump aid station follows the lead maneuver units; as one of these
maneuver units comes into contact, the jump aid station should move to the nearest
checkpoint and prepare to treat casualties. As the jump aid station moves into position,
the administrative/logistical net should be used to inform units of its location. Medical
leaders must be proactive and push forward. Ambulance drivers must have mounted
land navigation skills to allow them to move over unfamiliar terrain at night. This makes
finding CCPs, aid stations, and AXPs easier. Some wounded soldiers require limited
treatment only and can be returned to duty at once. While they wait to rejoin their units,
these soldiers can carry litters, freeing medics for patient care. They can also help guard
the perimeter, act as ground guides, handle patient administration, or work mess duty.
5. COMMUNICATIONS. Redundant communications are important to timely casualty
evacuation. In the BAS, they monitor the battalion command net. If message traffic
indicates units in contact and casualties, the jump aid station moves forward IAW a
predetermined plan and begins treating patients. This works faster than if the jump aid
station waits for a message. It also provides a backup in case the
administrative/logistical net is jammed.
6. MAINTENANCE AND CASUALTY EVACUATION. Collocating maintenance and
medical assets can be useful in evacuating casualties. Maintenance soldiers should be
cross trained as combat lifesavers and should know how to extract casualties from
combat vehicles. They should have appropriate medical supplies such as litters and IV
units. Vehicles evacuated to the rear for repair can also carry casualties.
77
Chapter 3
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATION
Reference FM 8-10, 8-10-4, 8-55, 7-20
7. COLOR-CODED TRIAGE SYSTEM. This system involves the use of color-coded
signs during daylight hours and color-coded chemical lights at night. The signs are
placed in front of the appropriate treatment areas. Any color combination can be used.
For example, red can be used for expectant, blue for immediate, and green for minimal.
When casualties arrive, a DA Form 1380 is marked for each with the appropriate color.
The litter team then takes the casualty to the treatment area for that color code. Litter
bearers are seldom medics; this method helps get the patients treated faster. The color
codes used should not conflict with other tactical signals.
8. SPECIALTY PLATOONS. Members of specialty platoons are not authorized medics.
Scouts often operate forward of the FEBA; mortars operate up to 1,500 meters behind
the FEBA. These distances from the companies (which have medics) can inhibit timely
casualty evacuation. This situation may also apply to other dispersed elements such as
ADA and GSR teams. To offset this problem, thorough coordination with maneuver units
near the dispersed unit is required. Maneuver units can help the scouts by evacuating
casualties from forward of the FEBA to preplanned CCPs in the company zone or
sector. Battalions must maximize combat lifesaver training for mortar and scout
platoons. (Reference Chapter 6, Specialty Platoons “Planning Considerations”, page
171)
9. MARKING AND LOCATING CASUALTIES ON THE BATTLEFIELD. Locating
casualties during and after a battle can be a time-consuming and difficult task, especially
at night or in dense woods. Whatever the signal used, it must conform with the unit
TACSOP and not conflict with other signals. Several techniques to facilitate patient
locating follow:
a. Vehicles carrying critically wounded personnel can be identified by a red flag or
VS-17 panel during daylight and a red chemluminescent light at night. This tells medics
which vehicle they should go to first.
b. Fallen casualties can be marked with visible or infrared chemiluminescent lights or
glint tape. These can be located at night by medics using the infrared source on night
vision goggles.
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Chapter 3
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATION
Reference FM 8-10, 8-10-4, 8-10-6, 7-20
10. EVACUATION TECHNIQUES
The rapidly employable lightweight litter,
referred to as the SKED litter, is designed
to be used as a rescue system in most types
of terrain, including mountains, jungle,
waterborne, and on snow or ice (see Figure 3-1).
a. The SKED litter is made of durable
plastic. It can be rolled and carried in a
camouflage case. The basic litter weighs 16
pounds complete with carrying case, straps,
snap link, and a 30-foot kernmantle rope.
Other optional items, such as the spine
immobilize and flotation system, increase the
weight to 32 pounds.
Figure 3-1, SKED Litter
b. The SKED is an excellent litter for evacuating light forces and scouts from forward
OPs. Reason being, is the SKED litter enables a single soldier to pull a casualty over
most types of terrain; a field-expedient poncho litter requires two soldiers or more. Up to
four soldiers can use hand loops to carry a SKED litter containing a seriously injured
casualty across difficult terrain.
c. The SKED can be used to move equipment, ammunition, or other heavy loads to
and from DZs, LZs, and objective areas in addition to its medical use.
d. The litter is listed in the GSA Federal Supply Schedule, March 1989, FSC Group
42, Part I, Section B, Special Item Number 465-10, Emergency Stretchers, Brand
SKEDCO Incorporated, page 8.
11. SAFETY. Leaders must retain common sense and attention to safety
considerations despite their concern for casualties. Ambulance drivers or soldiers
working around MEDEVAC helicopters must keep the risks in balance.
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Chapter 3
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATIONS
Reference FM 8-10 & FM 8-10-4
12. Combat Health Support in Offensive Operations.
a. General. The offensive operations of armored and mechanized forces are
characterized by speed, heavy direct and indirect fires, and audacious, independent
actions by subordinate elements. The potential for high casualty rates is greater for
offensive operations than for any other type of operation. It follows that CHS for
offensive operations will be a challenging endeavor. Through detailed planning and
realistic training in peacetime, creative methods of supporting offensive operations may
be developed. Some facts to consider in planning include - The M113A3, although an improvement over the A2, cannot match the top speeds of
the M1 and the M2/3.
 The need for mobility may preclude the use of company aid posts and will limit BAS
capabilities.
 Evacuation lines will lengthen.
 Combat medics may not be able to reach individual casualties in armored vehicles.
 Casualties will be incurred in uneven numbers among the attacking
companies/company teams.
b. Combat Health Support Guidelines. General guidelines for supporting offensive
operations include (Also reference Chapter 6, “Considerations in the Offense”, page
164) - Pre-position medical evacuation vehicles as far forward as possible prior to the attack.
 Provide additional ambulance teams to main attack companies/teams.
 Request additional ambulances from the FSMC.
 Use casualty collecting points.
 Use AXPs.
 Depend on combat lifesavers.
 Operate the BAS as treatment teams,either the follow-and-support method or leap
frogging them forward as the attack progresses.
 Practice tailgate medicine.
 Concentrate on stabilization care and rapid evacuation.
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Chapter 3
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATIONS
Reference FM 8-10 & FM 8-10-4
c. Combat Health Support in the Movement to Contact. To support the movement
to contact, medical personnel and evacuation vehicles are positioned within the
battalion. One arrangement is to place one combat medic with the scouts; the company
and platoon medics with the other elements; two ambulance teams with the advance
guard, one with each of the other companies, and the remainder with the treatment
teams; split BAS elements into treatment teams with one following the tactical CP
behind the advance guard and the other following the main CP in the main body. FSMC
ambulances move with the main body. The uncertainty inherent in the movement to
contact means the medical platoon must be prepared for any situation. Evacuation
routes are planned throughout the axis of advance. Ambulance teams must know the
location of the treatment teams at all times. The treatment teams must expect to perform
tailgate medicine and facilitate rapid evacuation. The medical platoon must be prepared
for a meeting engagement and whatever follows.
d. Combat Health in a Hasty Attack. Support for the hasty attack incorporates
basic principles of CHS to offensive operations. In the hasty attack, little time will be
available for planning and preparation. The tactical SOP is the primary guide to CHS
operations in this case. Key considerations in support of hasty attacks are - Ensure rapid patient evacuation. (Preplan and use your evacuation SOP.)
 Maintain mobility by practicing tailgate medicine.
 Locate BAS/treatment teams near MSRs.
 The follow -and-support method is effective in supporting the task force during a
movement to contact, but situational awareness and battle tracking are key to the
success of the medical platoon.
e. Combat Health Support in the Deliberate Attack. The deliberate attack is
supported through a detailed, coordinated CHSPLAN. Task organize medical assets in
support of elements in which high casualty rates are expected. Prepare a detailed
overlay indicating current and future treatment team locations, AXPs, and primary and
alternate evacuation routes. Inform the FSMC of the situation; request additional assets
if necessary (see chapter 6, “Breach Operations”, page ).
f. Combat Health Support During Exploitation. In exploitation operations, speed
becomes even more important. Medical elements must maintain their mobility; rapid
treatment and evacuation are essential. Because an exploitation follows immediately
upon a successful attack, medical supplies may become a problem. Ensure that
necessary supplies are brought forward in FSMC ambulances. Use FSMC drivers to
communicate urgent medical supply needs to the FSMC.
g. Combat Health Support During a Pursuit. Support is the same as for
exploitation operations. Covering force area forces will have conducted an intense fight
and may be considerably attrited and may require assistance in reaching and passing
through MBA forces. Worst case, the handover presents the potential for confusion,
disorganization, and resultant high casualty rates within both CFA and MBA elements.
Chapter 3
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATIONS
Reference FM 8-10 & FM 8-10-4
13. Combat Health Support in Defensive Operations.
a. Flexibility in Support. To support a battalion defending in sector requires
flexibility in adapting medical assets to the changing tactical situation. A sector defense
combines offensive, defensive, and retrograde actions within an overall mobile defense
framework. This combination results in a nonlinear front which creates confusion among
attacking forces and complicates CHS operations. The nonlinear front means that
planned evacuation routes, usable in some sectors, may be blocked by enemy
penetration in others. Some defending elements may become temporarily encircled or
bypassed by enemy forces. Rapidly moving enemy units may threaten or over-run the
BAS. (Reference Chapter 6, “Considerations of planning in the Defense”, page 169”)
b. General.
(1) Difficulties encountered. Combat Health Support in the defense is more
difficult than in the offense. Casualty rates may be lower, but due to the defensive
rearward maneuver, patient collection and evacuation will be more complicated. Combat
medics and ambulance teams will be exposed to more direct enemy fires. They will have
less time to locate, treat, and evacuate the wounded. Defensive operations will generally
produce higher casualty rates among medical personnel, thereby reducing treatment
and evacuation capabilities.
(2) Combat Health Support plan. The medical platoon should use the defensive
preparation time to resupply combat medics and to replace battle losses. The platoon
leader and medical operations officer should develop a detailed CHSPLAN. They should
contact the FSMC and thoroughly coordinate the CHS relationship. Either the medical
platoon leader or the medical operations officer must participate in the TF's battle
planning. When planning and coordinating CHS for defensive operations, consider the
following actions:
 Select covered and concealed BAS and company aid post sites.
 Ensure adequate medical supplies are available. If necessary, request additional
supplies.
 Plan for evacuation within the defensive area.
 Plan and coordinate in detail evacuation by the FSMC from BAS to the DCS.
 Plan to continue CHS should the unit become encircled.
 Consider the potential of having to hold patients for an indefinite period of time,
without adequate resources.
 Discuss with the FSMC commander the possibility of positioning a FSMC treatment
team within the BP/strongpoint.
 Have a detailed plan for the use and control of non standard evacuation assets.
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Reference FM 8-10 & FM 8-10-4
(3) Patient load. The heaviest patient load can be expected during the initial
phase of the enemy attack. Many casualties will be evacuated using nonmedical
vehicles during this phase (FM 8-10-6). The BAS, operating as a whole or as separate
treatment teams, should be established further rearward than in offensive operations.
Evacuation lines will shorten as the forward companies maneuver rearward.
Communication difficulties may arise due to enemy jamming. Enemy use of NBC
weapons is possible.
(4) Increased risk. Combat Health Support to a battalion defending from a BP or
a strongpoint is considerably different from that for a sector defense. Battle positions
and strongpoints are restrictive measures which limit maneuver. Reduced dispersion will
create shorter interval evacuation lines and a more centralized, controlled medical
operation. The reduced dispersion also creates increased risk of high casualty rates.
Evacuation out of a BP or strongpoint may be difficult or temporarily impossible.
c. Covering Force Support.
(1) Problem encountered. Support to a covering force can be extremely
complicated. The covering force will most likely face a much larger enemy force. It is
expected to trade minimum geographic space for maximum time. To be effective, the
covering force must remain highly mobile and avoid decisive engagement. The medical
platoon of a covering force unit faces all of the difficulties inherent in defensive
operations. Its mission is further complicated by the rapid movement and overpowering
number of attacking units.
(2) Employment. The medical platoon of a covering force unit will most likely
choose to operate its BAS in the split team configuration. It should concentrate on
providing expeditious stabilizing care and rapidly evacuating patients. Combat medics
and evacuation sections should be employed as for any other defensive operation.
When participating in a covering force operation, mobility of the medical platoon is
critical.
(3) Preparation. Some preparation time may be available prior to enemy contact.
During this time, the medical platoon leader meets with the supporting FSMC
commander or covering force medical staff officer. A detailed CHSPLAN is prepared.
The medical platoon leader must know who is providing evacuation support (a covering
force medical company or one from the MBA). Priorities for use of nonmedical vehicles
are established with the commander and S3. The medical platoon leader must clearly
establish with his unit commander situations under which patients may be abandoned.
This information is disseminated so that medical elements can continue to operate
without communications and while taking casualties among themselves.
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Reference FM 8-10 & FM 8-10-4
d. Battle Handover.
(1) Transition. As the covering force moves to the rear, the TF commander
prepares for the battle handover. The handover is the transition from the CFA battle to
the MBA battle in which the MBA forces begin to engage the enemy. Retirement is the
movement of a force not in contact to the rear.
(2) Coordination requirements. The battle handover can be a hazardous
operation and requires extensive coordination. Covering force area forces will have
conducted an intense fight and may be considerably attrited. They may require
assistance in reaching and passing through MBA forces. In the worst case, handover
presents the potential for confusion, disorganization, and resultant high casualty rates
within both CFA and MBA elements. The medical platoon must be prepared for this.
(3) Combat Health Support coordination. The medical operations officer should
contact the CFA battalion/TF medical operations officer to coordinate CHS
responsibilities for the battle handover and rearward passage, if possible. If the CFA
element has suffered heavy casualties, they may require augmentation of
personnel/equipment; if casualties have been light, they may be able to provide the MBA
medical platoon with Class VIII supplies or evacuation assistance, as necessary. The
medical operations officer should then contact the FSMC and pass on information
concerning enemy forces; casualty experience; evacuation routes; requisite site
selection; and possibly logistical assistance.
(4) Operation. The medical operations officer must stay on top of the tactical
situation in order to maneuver treatment teams and evacuation assets. Patient collecting
points and AXPs will contribute to CHS efforts. Treatment by CLS and combat medics
will be essential. Company medics and evacuation NCOs must be capable of performing
independently; this will ensure continuity of CHS under disrupted communications or
loss of key medical leaders.
15. Combat Health Support in Reserve Operations.
a. Counterattack. In preparing and executing the CHSPLAN, consider the
following:
 Forward movement may be very swift. Medical assets must keep up.
 Ambulance teams should move with supported companies.
 If attack covers a broad frontage, consider splitting BAS into two treatment teams.
 The commander may be forced to continue the mission under high casualty rates.
 The initial engagement will be violent and decisive.
 A successful counterattack will likely result in the capture of EPWs; some EPWs will
be in need of medical treatment.
 Consideration for support of offensive operations apply.
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Reference FM 8-10 & FM 8-10-4
15. Combat Health Support in Reserve Operations (Cont.)
NOTE: The Geneva Convention requires that sick, injured, or wounded enemy
prisoners be treated and evacuated through normal medical channels, but units must
ensure physical segregation from US, allied, or coalition patients.
b. Spoiling Attack. NOTE: Combat Health Support considerations for offensive
operations apply.
c. Block, Fix, or Contain. NOTE: Combat Health Support considerations for
offensive operations apply.
d. Reinforce. Reserve forces may be committed to reinforce units that have
sustained heavy losses; also to build up stronger defenses in critical areas of the
battlefield. Considerations must be given to how they will be integrated into the
defensive scheme, C2 arrangements, and where they will be positioned. The techniques
used to reinforce are similar to those used during a relief in place.
e. Rear Operations. The dispersion common to a battalion performing a rear
operations mission complicates the CHS situation. Evacuation lines are lengthy. Use
AXPs and FSMC or MSMC ambulances, if practical. Company aid posts are vital and
must operate somewhat autonomously- company medics must know their business. Due
to the dispersion, the BAS may choose to operate as separate treatment teams. Level II
support may come from the MSMC in the DSA-if this is a new support relationship it
should be well coordinated.
16. Combat Health Support in Other Tactical Operations.
A. Delay. Detailed CHS planning is essential to the medical platoon's ability to
support a delay operation. The nature of a delay, with its inherent mix of operations
(offensive and defensive), creates a complicated battlefield situation. Combat medics,
evacuation NCOs, and other key medical personnel must have a good understanding of
the commander's intent and the CHSPLAN. This will occur if planning is effective and
includes the following considerations implicit in delay operations:
 Expect evacuation difficulty. Patient evacuation in delay operations is complicated due
to the changing forward and rearward movement; to possible communication
disruptions; and to congested evacuation routes.
 Ambulance crews may be at increased hazard due to the rearward movement of the
force.
 Locate BAS further toward the rear and consider operating separate treatment teams
to support the successive or alternate positions.
 Plan for possible necessity to abandon patients.
 Plan for frequent BAS relocations.
 Plan for future operations; what happens when the retrograde ends?
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Reference FM 8-10 & FM 8-10-4
16. Combat Health Support in Other Tactical Operations (Cont.)
b. Withdrawal/Retirement. Support of a withdrawal or retirement should be
conducted much as for a movement to contact. However, in a withdrawal or retirement,
most of the medical vehicles are in the rear of the main body. Since these operations
are normally conducted as part of a larger force, necessary coordination with the FSMC
should be relatively easy.
c. Passage of Lines. The passage of lines may offer the medical platoon leader the
opportunity to interface with his counterpart in the unit being passed. This is an excellent
opportunity to share information concerning enemy forces; casualty experience;
evacuation routes; requisite site selections; and possibly logistical assistance. The
passage of lines can be a hazardous operation, particularly when conducted while in
contact with the enemy. Combat Health Support must be planned and coordinated
between participating units. Some essential pieces of coordination are as follows:
• Communications (callsigns, frequencies/hopsets, communication checks)
• Locations of each task force FAS/MAS.
• Dirty and clean routes for the each task force.
• CCPs.
• Unit day and night marking systems for casualties, FAS/MAS, and vehicle marking
systems.
• Visualization signals used day and night.
• Recognition signals.
d. Breakout from Encirclement. During the breakout, patients will most likely have
to be transported by combat units using nonmedical organic assets. Emergency medical
care will be given by self aid/buddy aid, combat lifesaver or unit medic. Aid station care
may be delayed until the operation is completed.
e. Linkup. Tailgate medicine will be employed during linkup movement. Upon
linkup, all medical assets will be consolidated into a medical platoon operation.
f. Guard Operations. Combat Health Support for offensive operations equally apply
to guard operations.
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Reference FM 8-10-6
TASKS
PAGE
Medical Evacuation Tenets
88
Planning for Patient Evacuation
89
Calculation of Patient Evacuation Requirements
91
Evacuation Factors
93
Evacuation Categories
94
Evacuation by Medical Air Ambulances
95
MEDEVAC LZ Example
98
MEDEVAC Request Format
99
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1. Evacuation Tenets
a. Patient evacuation is the timely and efficient movement of wounded, injured, or ill
persons from the battlefield and other locations to the Medical Treatment Facilities
(MTFs). Evacuation begins at the location where the injury or illness occurs and
continues as far as the patient’s medical condition warrants or the military situation
requires. Medical personnel provide en route medical care during patient
evacuation.
b. Service component commanders are responsible for evacuation of patients within
their Area Of Responsibility (AOR).
c. The unified commander is responsible for issuing procedures for evacuation of
formerly captured or detained US military personnel.
d. The unified commander will issue procedures for evacuation of Enemy Prisoners
of War (EPW) and civilian internees, other detainees, and civilian patients. (See FM 810 for discussions on the Geneva Conventions. The Conventions contain many
provisions which are tied directly to the Combat Health Support (CHS) mission. Also,
see AR 190-8 for disposition of an EPW after hospital care.)
(1) Sick, injured, or wounded EPW are treated and evacuated through normal
medical channels, but remain physically segregated from US and allied patients.
Helmets, gas masks, and like articles issued for personal protection will remain in the
possession of each Individual. Enemy prisoners of war are evacuated from the Combat
Zone (CZ) as soon as possible. Only those sick, injured, or wounded prisoners who
would suffer a great health risk by being evacuated immediately may be treated
temporarily in the CZ.
(2) The MTF commander is responsible for the treatment of sick, injured, or
wounded EPW patients. The echelon commander is responsible for the security of EPW
patients. (See FM 19-40 for further information concerning EPW evacuation and control.
Also, see FM 19-4 for a discussion on EPW operations.)
e. Procedures and policies for evacuation of injured and sick military working dogs
(MWDs) will be issued by the unified commander.
f. Army aeromedical evacuation units must be able to communicate with other
Service hospitals.
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Reference FM 8-10-6
2. Planning for patient evacuation.
a. Planning patient evacuation involves considering all available forms of
transportation and providing appropriate CHS personnel in the evacuation system to
assure continuity of patient care. It also involves planning the routing, controlling
evacuation movements, and planning the location of evacuation facilities. Patient
collecting points, ambulance exchange points, and an ambulance shuttle system
(ambulance loading points, relay points, and ambulance control points) must be planned.
Thorough investigation of all the available lines of communications is an essential
prerequisite to such planning. Field Manual 8-10-6 provides a comprehensive discussion
on medical evacuation in support operations across the operational continuum.
b. The AMEDD does not have dedicated fixed-wing aircraft for evacuation of patients
from the COMMZ or from the COMMZ to the CONUS. For additional means of evacuation,
coordination must be effected with-(1) The particular Service controlling aircraft and ships.
(2) The transportation command controlling the locomotive power for trains and
other forms of transportation.
c. Coordination with other Services and commands is usually accomplished through
medical regulating (MEDREG). The surgeon, however, must forecast the requirements
for air and surface evacuation so that coordination for its procurement may be done in
advance of the need. Aircraft are requested on the basis of anticipated needs and to
meet emergencies such as those occurring in nuclear warfare where CZ hospitals are
suddenly filled to capacity.
3. Evacuation Means.
a. The USAF Airlift System is primarily responsible for moving patients from the CZ to
the COMMZ, within COMMZ, and from COMMZ to CONUS. If movement requirements
exceed the capability of the USAF AE system, the MEDCOM medical regulating officer
(MRO) may have to seek alternative modes of transportation. He or She may task the
MEDCOM’s medical battalion (evacuation) for movement of patients by Army aircraft or
ground ambulances.
b. In addition to using ground evacuation when the USAF AE system cannot support
the number of patients requiring air evacuation, other factors that may require the use of
ground evacuation:
(1) Tactical considerations that prevent the use of aircraft for patient evacuation
during certain periods.
(2) Patients whose medical condition prohibits their evacuation by aircraft.
(3) Weather conditions.
(4) Lack of adequate or properly located airfields.
(5) Insufficient numbers of aircraft available.
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Reference FM 8-10-6
3. Evacuation Means (Cont.)
c. When patient evacuation by air from the CZ to the COMMZ is not possible or
appropriate, ambulances from medical ambulance companies assigned to the
medical battalion (evacuation) of the COMMZ medical brigade, MEDCOM, may be
used.
d. If air or ground ambulances must be used to transport large numbers of patients to
or within the COMMZ, the MEDCOM MRO must obtain clearance through the TA
movement control center (MCC), which is an agency of the TA transportation
command. This agency coordinates and controls the movement of Army aircraft and
ground transportation within the theater. When capabilities are expected, the MCC
coordinates requests for additional air and ground resources. It also obtains the
necessary clearances to support the mission from the CZ.
e. Modern warfare is likely to generate more casualties than the airlift system can
handle. Surface evacuation is then a possibility. It is possible that, under certain
circumstances, patients may be returned to CONUS by surface vessel rather than by
air. Such transportation is the responsibility of the Military Sealift Command (MSC).
Deliberate planners should strive to make requirements estimates known so that MSC
planners are able to provide medical evacuation. The MEDCOM MRO would be
responsible for coordinating the evacuation requirements. After coordination is
complete, the MEDCOM establishes patient-holding facilities at COMMZ ports.
Patients would be delivered to these facilities and held until loaded aboard
designated ships. Once in CONUS, patients would normally be taken to the nearest
Air Mobility Command (AMC) terminal for further airlift to destination hospitals.
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Reference FM 8-10-6
4. CALCULATION OF PATIENT EVACUATION REQUIREMENTS
a. Methodology. This section presents a methodology for calculating the time
and the number of units of transport required to evacuate a given number of patients,
or to support a specific operation.
b. Time Factors. The following are time factors for evacuation of patients
(including loading and unloading):
(1) Litter Squads.
(a) Average terrain, four-person squad—900 meters and return in 1 hour.
(b) Mountainous terrain, six-person squad—350 meters and return in 1 hour.
(2) Ambulance (wheel and track vehicle). During combat in the division
area—eight kilometers and return in 1 hour (optimal weather and terrain).
(3) Aircraft.
(a) Helicopter—150 kilometers one-way in 1 hour (based on the
operational capability and patient-loading ease of UH-60 helicopter).
(b) Transport—360 kilometers one-way in 2 hours (based on 1 ½ hour
mission for C-130E aircraft and 30 minutes patient- loading time).
(c) Army airplane—200 kilometers one-way in 1 hour (based on the
operational capability of U-21 aircraft, including patient-loading time).
c. Computations
(1) The following formulas may be used to calculate the time and the number
of units or transport required to evacuate a given number of patients:
(a) Time required:
T=NXt
UXn
(b) Unit required:
U=NXt
TXn
N = Total number of patients to be evacuated.
n = Number that can be transported in one load.
T = Total time.
t = Time required for one round-trip.
U = Number of units of transport (litter, ambulances, and aircraft).
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Reference FM 8-10-6
a. Computations (Cont.)
(2) The amount of evacuation resources required to support a specific
operation may be calculated by using the following formula for either
WIA or DNBI patients:
(A X B) X E = ambulance requirements by type per day
C
D
where:
A = The total patients (WIA or DNBI) generated for a specific operation per day. This
figure may be calculated using projected figures for the specific AO.
B = The percentage of those patients in A, above, requiring evacuation. Normally,
this figure will exceed 100 percent as a recognition of the fact that many patients will
need to be moved more than once. The number of times a patient will be moved will
depend on many factors. In assigning a specific percentage as a planning factor, the
CHS planner must consider—
 Terrain.
 Force structure.
 Enemy weapons systems.
 Weather.
 Airfield or seaport locations.
 Other factors affecting patient flow.
C = The average number of patients moved by means of evacuation. The figure will
vary depending on the type of ambulance (ground or air), or the specific model of
vehicle.
D = The average number of missions a particular evacuation vehicle can complete
per day.
E = The dispersion allowance for the specific types of evacuation vehicles in the
formula. The dispersion allowance is a recognition that a specific percentage of
vehicles in the force will be unavailable for missions due to maintenance, crew rest,
combat loss, or replacement lag time. The CHS planner will determine the specific
percentage used by reviewing maintenance historical data and considering the threat
in terms of the enemy, terrain, and weather.
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5. EVACUATION FACTORS
a. In addition to METT-TC, the following factors should be considered when
planning casualty evacuation:
 The BN/TF’s plan for employment of combat troops.
 Expected areas of patient density.
 Evacuation resources available.
 Location and type of MTFs available.
 Terrain and road networks.
 Weather conditions.
 Locations of CCPs.
 Location of AXPs.
 Primary/alternate evacuation routes.
 Lines of patient drift.
b. The primary means of evacuation is by ground. The preferred means of
evacuation is by air when assets are available.
c. Patients will be evacuated by the means that best meets the treatment demands
based on wounds, keeping METT-TC in mind. Patients will be treated as far forward,
maximizing RTDs. The casualty destination is determined by the treating element.
d. The medical company is responsible for evacuation from the BASs back to the
FSMC. It is key to remain in close proximity of the supported unit with continuous
communication.
e. Ambulances will normally be pre-positioned forward to facilitate rapid evacuation
based on METT-TC.
f. Ambulances will only be used for patient evacuation, Class VIII, and medical
personnel.
g. All medical units will monitor and use the BN/TFs designated medical evacuation
frequency. This frequency will be published in the OPORD/OPLAN.
i. Prior to all operations an evacuation plan will be established and
rehearsed, which will include the following as a minimum:






Indigenous personnel.
Primary and alternate channels to be used in submitting MEDEVAC requests.
Primary and alternate routes.
Methods of evacuation available.
Location of all medical treatment facilities and their capabilities.
Actions and assets available in the event of a MASCAL situation.
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Reference FM 8-10-6
3. EVACUATION FACTORS (Cont.)
j. Medical evacuation requests will be submitted by the most direct means available to
the supporting medical unit. MEDEVAC requests are submitted using the nine-line format
and brevity codes as required. All MEDEVAC requests will be submitted through secure
means.
k. Evacuation in an immature theater may have to be accomplished by C-130
backhaul to the CONUS. In this event, prior coordination must be accomplished.
4. EVACUATION CATEGORIES.
 URGENT: Should be evacuated as soon as possible and within a maximum of two
hours in order to save life, limb, or eyesight.
 URGENT-SURG: Must receive far forward surgical intervention to save life and
stabilize for further evacuation.
 PRIORITY: Sick or wounded requiring prompt medical care within a maximum of four
hours.
 ROUTINE: Sick or wounded requiring prompt medical care within a maximum of 24
hours. Psychiatric patients should be placed into this category.
 CONVENIENCE: Patient for whom evacuation by medical vehicle is a matter of
medical convenience rather than necessity.
5. DEFINITION OF TERMS.
Casualty -- Any person who is lost to his organization by reason of having been declared
dead, wounded, injured, diseased, interned, captured, retained, missing, missing in action,
beleaguered, besieged, or detained.
Casualty Evacuation (CASEVAC) -- The movement of sick, injured, or wounded soldiers
by non-medical vehicles to a medical treatment facility. The casualty receives no medical
care en route. It may also be referred to as casualty transportation.
Medical Evacuation (MEDEVAC) The movement of sick, injured, or wounded soldiers in
medical vehicles with the provision of en route medical care to a medical treatment
facility.
Patient – A sick, injured, or wounded soldier who receives medical care or treatment from
medically trained personnel. (NOTE: Once a casualty has been acquired by the CHS
chain [treated by a medic], he is referred to as a patient.)
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6. EVACUATION BY MEDICAL AIR AMBULANCES
a. Helicopter Landing sites
(1) Responsibility. The unit requesting aeromedical evacuation support is
responsible for selecting and properly marking the helicopter Landing Zones (LZs).
(2) Criteria for Landing Sites.
 Helicopter LZ and the approach zones free of obstructions.
 Sufficient space for hovering and maneuvering during landing and takeoff.
 Approach zones should permit the helicopter to land and take off into the
prevailing winds.
 Allows helicopter the opportunity to make shallow approaches.
 Definite measurements for LZs cannot be prescribed since they vary with
temperature, altitude, wind, terrain, loading conditions, and individual helicopter
characteristics.
 Minimum requirement for light helicopters LZ is 30 meters in diameter with
an approach and departure zone clear of obstructions.
(3) Removing or Marking Obstructions.
 Any object (paper, cartons, ponchos, blankets, tentage, or parachutes) likely
to blow about by rotorwash should be removed from the landing area.
 Obstacles, such as cables, wires, or antennas at or near LZs, which cannot
be removed and may not be readily seen by a pilot, must be clearly marked.
 Use red lights to mark all obstacles that cannot be easily eliminated within a
LZ. (In most combat situations, it is impractical for security reasons to mark the
tops of obstacles at the approach and departure ends of a LZ).
 If obstacles or other hazards cannot be marked, pilots should be advised of
existing conditions by radio.
NOTE In a training situation or at a rear area LZ, red lights should be used
whenever possible to mark obstructions.
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b. Identify the Landing Site.
(1) When the tactical situation permits, a landing site should be marked with the
letter “H” or “Y,” using identification panels or other appropriate making material. Special
care must be taken to secure panels to the ground to prevent them from being blown
about by the rotor wash. Firmly driven stakes will secure the panels tautly; rocks piled on
the corners are not adequate.
(2) If the tactical situation permits, the wind direction may be indicated by a  Small wind sock or rag tied to the end of a stick in the vicinity of the LZ.
 Man standing at the upwind edge of the site with his back to the wind and his arm
extended forward.
 Smoke grenades which emit colored smoke as soon as the helicopter is sighted.
 Smoke color should be identified by the air crew and confirmed by ground personnel.
c. In night operations, the following factors should be considered:
(1) One of the many ways to mark a landing site is to place a light, such as a
chemical light, at each of the four corners of the usable LZ. These lights should be
colored to distinguish them from other lights which may appear in the vicinity. A particular
color can also serve as one element in identifying the LZ. Flare pots or other types of
open lights should only be used as a last resort. They usually are blown out by the rotor
down wash. Further, they often create a hazardous glare or reflection on the aircraft’s
windshield. The site can be further identified using a coded signal flash to the pilot from a
ground operator. This signal can be given with the directed beam of a signal lamp,
flashlight, vehicle lights, or other means.
(2) When using open flames, ground personnel should advise the pilot before he
lands. Burning material must be secured in such a way that it will not blow over and start
a fire in the LZ. Precautions should be taken to ensure that open flames are not placed in
a position where the pilot must hover over or be within 3 meters of them. The coded
signal is continuously flashed to the pilot until recognition is assured. After recognition,
the signal operator, from his position on the upwind side of the LZ directs the beam of light
downwind along the ground to bisect the landing area. The pilot makes his approach for
landing in line with the beam of light and toward its source, landing at the center of the
marked area. All lights are displayed for only a minimum time before arrival of the
helicopter. The lights are turned off immediately after the aircraft lands.
(3) When standard lighting methods are not possible, pocket-sized white (for day)
or blue (for night) strobe lights are excellent means to aid the pilot in identifying the LZ.
(4) During takeoff, only those lights requested by the pilot are displayed; they are
turned off immediately after the aircraft’s departure.
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(c) The Approach.
(1) When the helicopter approaches the LZ, the ground contact team can ask the
pilot to turn on his rotating beacon briefly. This enables the ground personnel to identify
the aircraft and confirm its position in relation to the LZ (north, south, east, or west). The
rotating beacon can be turned off as soon as the ground contact team has located and
identified the aircraft. The ground contact team helps the pilot by informing him of his
location in relation to the LZ, observing the aircraft’s silhouette, and guiding the aircraft
toward the LZ. While the aircraft is maneuvering toward the LZ, two-way radio contact is
maintained and the type of lighting or signal being displayed is described by the pilot and
verified by ground personnel via radio. The signal should be continued
until the aircraft touches down in the LZ.
(2) The use of FM homing procedures can prove to be a valuable asset, especially
to troops in the field under adverse conditions. Through the use of FM homing, the pilot
can more accurately locate the ground personnel. The success of a homing operation
depends upon the actions of the ground personnel. First, ground personnel must be
operating an FM radio which is capable of transmitting within the frequency range of 30.0
to 69.95 megahertz; then they must be able to gain maximum performance from the radio
(refer to appropriate technical manual for procedure). The range of FM radio
communications is limited to line of sight; therefore, personnel should remain as clear as
possible of obstructions and have knowledge of the FM homing procedures. For
example, when the pilot asks the radio operator to “key the microphone,” he is simply
asking that the transmit button be depressed for a period of 10 to 15 seconds. This gives
the pilot an opportunity to determine the direction to the person using the radio.
NOTE When using FM homing electronic countermeasures, the possible site
detection of LZs by means of electronic triangulation presents a serious threat and
must be considered.
97
NIGHT LZ OPERATIONS
“The NTC Standard”
LZ CRITERIA
• Use chemical lights or bean bag lights
• Slope not to exceed 8 degrees
• Clear of debris
• Will land into the wind
• Ground guides not needed
• All lights should be turned off when aircraft approaches LZ
• “Day glow” panel markers used during the day
DIRECTION
OF LANDING
7 PACES
DIRECTION
OF WIND
14 PACES
14 PACES
AIRCRAFT WILL
LAND HERE
BETWEEN LIGHTS
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MEDICAL EVACUATION
Reference FM 8-10-6
MEDEVAC REQUEST FORMAT
LINE
1
2
3
ITEM/BREVITY CODES
Location of pickup site
Frequency/Call sign of pickup site
Number of patients by precedence
A - URGENT
B - URGENT SURG
C - PRIORITY
D - ROUTINE
E - CONVENIENCE
4
Special equipment
A - NONE
B - HOIST
C - EXTRACTION EQUIPMENT
D - VENTILATOR
5
Number of patients by type
L + # LITTER
A + # AMBULATORY
6
Security of pickup site
N - NO ENEMY
P - POSSIBLE ENEMY
E - ENEMY IN AREA
X - ARMED ESCORT NEEDED
7
Method of marking pickup site
A - PANELS
B - PYROTECHNICS
C - SMOKE
D - NONE
E - OTHER
8
Patient nationality and status
A - US MILITARY
B - US CIVILIAN
C - NON US MILITARY
D - NON US CIVILIAN
E - EPW
9
NBC contamination
N - NUCLEAR
B - BIOLOGICAL
C - CHEMICAL
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Reference ARTEP-17-236-12-MTP
TASKS
Disestablish Area
PAGE
101
Prepare Medical Platoon for Operations
103
Prepare all Elements for Movement
106
Conduct Medical Platoon Movement
107
Establish Treatment Area
109
Maintain Equipment & Supplies
111
Prepare for Medical Evacuation Mission
114
Provide Continuing Care And Comfort Measures
For Patients
117
Debrief Squad and Crews
118
Perform Triage
119
Employ Physical Security Measures
120
Provide Sick Call Services
121
Process Captured Documents And Equipment
124
Perform Maintenance
125
Establish Patient Decontamination Station On An
Integrated Battlefield Chemical Environment
Decontaminate Ambulatory Patients Chemical Environment
127
131
Decontaminate Litter Patients-chemical Environment
137
Use Passive Air Defense Measures
144
Perform Personnel Consolidation And Reorganization
146
Prepare for Operations in an NBC Environment
147
Respond to an NBC Attack
151
Perform Decontamination
153
Camouflage Vehicles & Equipment
155
Evacuation of EPWs
156
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TASK: DISESTABLISH AREA (08-3-0045)
TASK STANDARD: Patients are evacuated as tactical situation permits and
treatment section is disestablished within 15 minutes.
TASK STEPS
1. Treatment section pack and loads.
a. Packs supplies and equipment as specified by packing list and manufacturer's
instructions.
b. Strikes and loads erected shelters.
c. Load equipment and supplies as directed by unit loading plan to permit use en
route (tailgate medical support) or at relocation site.
d. Accomplished within 15 minutes or less.
2. Treatment section members police area.
a. Remove sources of intelligence.
b. Close waste facilities.
c. Remove trash.
3. Ambulance section evacuates patients.
a. Moves patients to new location according to established procedures if tactical
situation permits.
b. Notifies the tactical commander when the tactical situation does not permit patient
evacuation.
NOTE: The tactical commander must make the decision as to whether or not patients
must be left behind.
(1) Provides information on tactical operation's impact on the medical
situation.
(2) Stresses the urgent need for a timely decision.
c. IAW Geneva Conventions, If the decision is made to leave patients behind, the
commander must leave medical personnel and supplies will patients.
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TASK: DISESTABLISH AREA (08-3-0045)
TASK STEPS
*4. Platoon leader or field medical assistant notifies brigade surgeon and
supporting medical facilities. (MQS 01-9002.02-0010)
a. Includes in notification:
(1) Movement of BAS.
(2) New coordinates or location.
(3) Planned time to be operational at new site (if known).
b. Submits report to Bn S3 or S4.
c. Treatment section members disestablish treatment area on an integrated
battlefield.
(1) Keep the M51 shelter, with overhead cover, operational until supported
unit is withdrawn from contact.
(2) Provide tailgate medical treatment for lifesaving measures until all
patients have been evacuated.
(3) Disestablish and prepare for movement within 45 minutes in daylight or
60 minutes during hours of darkness, in accordance with TM 3-4240-24612.
(4) Avoid further contamination of supplies.
(5) Maintain MOPP level 4.
NOTE: If M51 shelter is operational and conditions exist which prohibit movement of
M51 shelter and auxiliary equipment after withdrawal of the supported unit, the M51
shelter and generator unit are destroyed as directed by TM 3-4240-264-12 to prevent
enemy use.
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TASK: PREPARE FOR MEDICAL PLATOON OPERATIONS
TASK STANDARD: The platoon leader (physician) and medical operations officer
develop and implement a medical support plan that meets the needs of the maneuver
element. Platoon leader (physician) briefs commander on plan; makes required
modifications immediately; issues operations order to subordinates at specified time
and location; and supervises execution of mission. Medical platoon issues class VIII
resupply to unit combat lifesavers.
TASK STEPS
*1. Platoon leader and medical operations officer develop tentative operational
plan. (01-3140.00-0001, 01-9002.02-0010, 01-9002.03-0010, 03-3201.000-0001)
a. Analyze and review all available information to ensure that all specific and implied
task limitations and constraints are in the order.
b. Use information to develop a plan that provides for:
(1) Coordination with higher, lower, adjacent, and supported headquarters
(HQ).
(2) Movement.
(3) Establishment.
(4) Disestablishment.
(5) Utilization of available resources.
(6) Reporting and replacement of personnel.
(7) Maintenance and accountability procedures.
(8) Operation security (OPSEC).
(9) Signal security (SIGSEC).
(10) Training and orientation of newly arrived personnel.
(11) Preventive medicine measures.
(12) Nonorganic support.
(13) Accomplishing the mission.
(14) Control.
(15) Use of existing resources.
(16) Fixed responsibilities.
(17) Contingencies.
(18) Patient evacuation to include: - Coordinate with commander or Bn S3
for primary and alternate routes. - Development of strip maps for primary
and alternate routes of evacuation.
(19) Coordination to ensure that attached medical assets are adequate to
support attached units.
(20) Adequate medical support for units detached to another Bn task force.
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TASK: PREPARE FOR MEDICAL PLATOON OPERATIONS
*2. Platoon leader briefs commander and modifies plan. (MQS 01-9002.02-0020,
01-9002.02-0030)
a. Briefs commanding officer (CO) on plan and modifies as directed by commander.
b. Resubmits modified plan for final approval.
c. Briefs approved to treatment section leader, evacuation section leader, and
supported elements, as required.
d. Presents briefing that includes:
(1) Situation.
(2) Mission.
(3) Execution.
(4) Support requirements.
(5) Command and control.
(6) Communication information, such as requirements, nets and
frequencies.
*3. Platoon leader or medical operations officer issues OPORD to subordinates.
(01-9002.04-0010)
a. Issues order at the specified time and location.
b. Issues OPORD that includes:
(1) Friendly and OPFOR situation.
(2) Clear, concise, mission statement.
*4. Platoon leader or medical operations officer supervises execution of platoon
mission. (01-9002.05-0010)
a. Implements and follows operational plan.
b. Communicates changes in plans or order to subordinate personnel and supporting
units. Fragmentary orders (FRAGO) include:
(1) Changed objectives/task organization.
(2) Situation.
(3) Control measures.
(4) Concept of operation.
(5) Coordinating instructions.
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TASK: PREPARE FOR MEDICAL PLATOON OPERATIONS
*4. Platoon leader or medical operations officer supervises execution of platoon
mission. (Cont.)
c. Monitors and directs operations of sections and subordinates.
d. Monitors to ensure that sections and subordinates accomplish the mission as
planned and directed.
e. Modifies support plan each time unit status, location, or mission changes.
5. Medical platoon/combat medics issue class VIII resupply to combat
lifesavers and requisitions shortages.
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TASK: PREPARE ALL ELEMENTS FOR MOVEMENT
TASK STANDARD: Medical platoon is directed to move from its present location.
Platoon is to be uploaded and prepared to move by time specified in FRAGO and
OPORD
TASK STEPS
*1. Platoon leader or sergeant briefs personnel. (MQS 01-9002.04-0010, 019002.06-0010, 03-3201.000-0001, 03-7151.00-0004, 03-7151.01-0100)
a. Briefs subordinates on:
(1) Routes to destination.
(2) Location in convoy.
(3) Nearest radio vehicle.
(4) Security.
(5) Coordination for emergency medical treatment and medical evacuation.
(6) Support available and pertinent times.
b. Informs subordinates of their specific duties during convoy.
2. Platoon members assemble equipment and supplies and load vehicles.
a. Medical assistant or platoon sergeant supervises operation.
b. Medical platoon members assemble and load supplies and equipment as directed
by load plans.
c. Medical platoon members assemble special equipment and load according to
instructions.
d. Medical platoon members load medical equipment so that it is available for
immediate use for en route emergency treatment.
*3. Medical operations officer or platoon sergeant inspects personnel,
equipment, and loads at staging area. (MQS 03-7151.00-0002)
a. Inspects vehicles prior to departure.
b. Inspects cargo to ensure it is properly secured.
c. NCOIC of each section inspects personnel for compliance with uniform and
equipment requirements.
d. Inspects vehicles to ensure all equipment and personnel are accounted for.
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TASK: CONDUCT MEDICAL PLATOON MOVEMENT
TASK STANDARD: Movement is conducted as specified in FRAGO and OPORD.
Communication and control of all elements are maintained throughout the movement.
TASK STEPS
*1. Platoon sergeant enters radio net. (MQS 03-7151.00-0002, 03-7151.00-0004)
a. Opens the radio net at least one-half hour before crossing start point (SP).
b. Performs minor radio repairs as required or replaces inoperable sets.
2. Medical platoon prepares to cross SP and crosses SP.
a. Assembles at convoy SP.
b. Lines up in order of march consistent with OPSEC, in sufficient time to cross the
SP.
3. Medical platoon participates in motor march.
a. Crosses start point, checkpoints, and release point within times listed in movement
order.
b. Maintains intervals and speed as specified by convoy commander and order.
c. Reports convoy locations as directed when crossing critical points or arriving at
release points (RPs), using SOI provided.
d. Drivers utilize ground guides and other nighttime convoy procedures specified by
convoy commander to minimize safety hazards, when conducting night convoy.
e. Make effective use of cover, camouflage (when directed), dispersion, radio silence,
blackout procedures, air guards, attached security, and so on.
f. Designated air guards remain upright and scan for aircraft throughout movement.
g. When a vehicle is disabled due to mechanical failure, the driver:
(1) Pulls to the side of the road and waves the convoy past.
(2) Attempts to repair the vehicle.
(3) Flags down the first recovery vehicle for assistance or towing.
(4) Stays with the vehicle.
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TASK: CONDUCT MEDICAL PLATOON MOVEMENT
*4. Platoon and convoy make halts for rest, personnel comfort and relief,
messing, refueling, maintenance, and scheduled adjustments. (MQS 01-9002.040010, 01-9002.60-0010, 03-7151.001-0100)
a. Platoon leader, medical operations officer, or platoon sergeant checks the welfare
of the men, security of loads, vehicle performance, and the performance of at-halt
maintenance.
b. Drivers move vehicles sufficiently off the road to keep march route clear.
c. Platoon establishes security immediately. At least one airguard remains alert,
manning authorized weapons at all times.
d. Drivers inspect their vehicles and loads and perform operator vehicle maintenance
and refueling.
e. Feed personnel and perform resupply of depleted supplies as required, if time
permits, and if movement is of long duration.
f. Leaders enforce light, noise, and trash discipline.
g. Drivers keep unauthorized personnel away from vehicles.
h. Drivers remain alert for immediate resumption of march, and platoon resumes
march on schedule.
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TASK: ESTABLISH TREATMENT AREA (08-4-0014)
TASK STANDARD: Treatment area is established within 15 minutes.
*1. Medical operations officer coordinates operational sites. (MQS 01-9002.020010)
a. Obtains approval from S3 to establish BAS at selected site within designated area.
b. Provides higher headquarters or brigade surgeon site location.
c. Notifies treatment teams of S3 approval.
*2. Platoon leader (physician) or PA selects operational site. (MQS 01-1910.111001, 03-3120.00-0002, 03-3140.00-0021, 03-3164.00-0005)
a. Surveys designated area for placement of assets.
b. Selects site that provides:
(a) Access to evacuation routes and main supply routes (MSR).
(b) Concealment and cover without hampering communication.
(c) Avoidance of likely target areas.
(d) Helicopter landing site.
(e) Proximity to likely lines of patient drift.
(f) Drainage.
(g) Area for decontamination if required.
(h) Effective area for support for tactical operation.
(i) Effective communication with supported units and platoon HQ.
3. Treatment section establishes BAS.
a. Establishes as directed by higher HQ.
b. Becomes operational within fifteen minutes of arrival.
c. Provides tailgate medical support during establishment.
d. Establishes treatment area that provides for:
(1) Access by evacuation vehicles and their turn around.
(2) Cover.
(3) Concealment.
e. Establishes patient treatment and holding areas.
f. .Arranges supplies and equipment in accordance with standardized procedures.
g. Camouflages unit with prescribed procedures if tactical situation permits.
(1) When the tactical commander makes the decision to camouflage,
platoon follows commander's directives.
(2) Does not display Geneva Convention markings with camouflage.
NOTE: Camouflage of the Geneva emblem is authorized on medical facilities where
the lack of camouflage may endanger tactical operations. If failure to camouflage
compromises tactical operations, the camouflage of medical facilities may be ordered
by a task force commander of at least brigade level or equivalent. (STANAG 2391)
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TASK: ESTABLISH TREATMENT AREA (08-4-0014)
3. Treatment section establishes BAS (Cont.)
h. Establishes a helicopter landing site that is of sufficient length and width to handle
the largest available aircraft if the tactical situation permits.
i. Clearly marks landing site.
4. Ambulance Section.
a. Selects site that provides:
(1) Access to evacuation routes.
(2) Suitable hardstand or terrain for parking ambulances.
b. Parks ambulance vehicles and prepares for evacuation mission.
(1) Refuels and resupplies.
(2) Backs into parking area.
(3) Disperses.
(4) Covers, conceals, and camouflages, as necessary.
(5) Performs preventive maintenance, checks and services (PMCS).
(6) Checks medical supplies.
5. Medical platoon unloads supplies and equipment.
a. Unloads expeditiously.
b. Does not damage or handle excessively.
c. Organizes storage area to expedite the use of frequently used items.
d. Protects supplies and equipment from weather.
e. Removes vehicles not used as a part of the battalion aid station from the area as
soon as unloading is completed.
*6. Medical operations officer reports location. (MQS 01-1910.11-1001, 013140.00-0021, 01-9002.02-0010)
a. Platoon leader (physician) or PA notifies medical operations officer of the
following:
(1) Movement of BAS.
(2) New coordinates of location.
(3) Planned time to be operational at new site, if known.
b. Medical operations officer reports the following information to higher headquarters
and supporting medical facilities:
(1) New location of BAS.
(2) Operational times.
c. Medical operations officer submits reports to Bn S3 or S4 as appropriate.
110
Draft
Handbook Task Force
Medical Platoon Leadership Tips
Chapter 5
EXECUTION CHECKLIST
AMEDD“ACenter
School Lessons
Learned
Office
WAY TOand
ESTABLISH
BATTALION
AID STATION”
TASK: ESTABLISH TREATMENT AREA
DS AMBULANCES
HASTY
GREGG
SITE
75-100 M
ROUTINE
PRIORITY
URGENT
EXPECTANT
CLS VIII
RESUPPLY
DELAYED
IMMEDIATE
PATIENT DROP OFF POINT
MEDICAL PLATOON
AMBULANCES
DISTANCE BETWEEN VEHICLES
100-150 M or Terrain dependent
110
MINIMAL
LZ
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Reference ARTEP-17-236-12-MTP
TASK: MAINTAIN MEDICAL EQUIPMENT AND SUPPLIES
TASK STANDARD: Platoon members maintain supplies to meet mission
requirements and appropriately utilize the ambulance section to transport
replacement supplies. Perform operator and preventive maintenance on equipment
as directed by equipment TM.
*1. Platoon sergeant requests supplies. (03-5101.00-0015)
a. Submits request to the Division Medical Supplyt Officer (DMSO).
b. Forwards request for items not available at forward support medical company
(FSMC) to DMSO.
NOTE: Items not available will be placed on back order and procured or substituted at
higher levels.
c. Obtains supplies as rapidly as possible, using available medical transportation
assets for back haul.
d. Submits request on DA Form 2765 or DA Form 2765-1, Request for Issue or TurnIn.
*2. Platoon sergeant receives supplies. (03-5101.00-0004)
a. Conducts a physical inventory of supplies.
b. Reports any errors to DMSO.
c. Resubmits request if supplies are missing or inadequate.
3. Medical platoon members maintain and transport medical supplies.
a. Platoon sergeant maintains operational levels of Class VIII supplies.
(1) Projects operating levels of Class VIII supplies to meet mission
requirements based on:
(a) Type of operation.
(b) Number and types of units supported.
(c) Expected casualties.
(2) Reorders Class VIII supplies as required from DMSO.
(3) If the BAS or treatment squad is supporting units conducting combat
operations, formal supply request procedures are not required. Medical
supply requirement may be informal between:
(a) BAS or treatment squad and FMSC forward.
(b) BAS or treatment squad and combat medics.
(c) BAS or treatment squad and ambulance teams.
b. Ambulance section transports supplies.
(1) Uses evacuation vehicles to transport supply requests from section or
squads to headquarters company or supply element.
(2) Utilizes back haul method (using evacuation vehicles) to transport
medical supplies to subordinate units.
(3) Logs and accounts for control items and medical supplies.
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TASK: MAINTAIN MEDICAL EQUIPMENT AND SUPPLIES
*4. Platoon sergeant stores, maintains, and issues medical materials. (033370.00-0001, 03-3370.00-0011)
a. Stores and handles medical materials requiring special handling. (03-5101.000002)
b.
c.
d.
e.
(1) Protects gases from dampness and excessive heat (150 degrees
Fahrenheit or 66 degrees Celsius).
(2) Uses adequate ventilation and flameproof covers.
(3) Takes advantage of natural and man-made protection against exploding
ordnance.
(4) Stores filled and empty cylinders separately and ensures cylinder valve
protection caps are securely in place.
(5) Stores cylinders on trucks, trailers, or pallets; however, vertically stored
cylinders must be securely banded or strapped.
(6) Stores medical gases separately from flammable gases and marks area
"NO SMOKING."
(7) Locates all storage containers for note R and Q items (items that require
special security) in limited access areas.
(8) Establishes procedures for the strict protection of locks and keys to
facilities and containers in which controlled medical substances and
sensitive items are stored.
Stores other medical materials.
(1) Protects supplies from environmental conditions (sun, rain, or cold).
(2) Stores supplies where they are accessible, centrally located, and easily
maintained and issued.
Maintains accountability and control of medical materials.
(1) Provides surveillance consistent with threat of theft or unauthorized
possession.
(2) Follows quality control standards as directed by higher headquarters.
Reports capture of medical material.
(1) Identifies, inspects, segregates, and evacuates captured medical
materials to designated medical supply facility.
(2) Forwards samples of all captured medical materials through medical
intelligence channels.
Issues medical supplies.
(1) Issues from stock on hand or forwards requisitions to DSMO utilizing
Tactical Army Combat Service Support Computer System (TACCS), if
available.
(2) Issues items with the earliest expiration date first.
Maintains a record of receipt, expenditure, and stock balance of controlled medical
items without error on the Stock Accounting Record (DA Form 1296).
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TASK: MAINTAIN MEDICAL EQUIPMENT AND SUPPLIES
*5. Platoon sergeant performs preventive maintenance (PM) on medical
equipment. (03-1210.00-0001, 03-1210.00-0002, 03-1210.00-0003)
a. Establishes and distributes procedures for PM.
(1) Distributes procedures to subordinate elements.
(2) Conducts follow-up, if tactical situation allows time, to ensure
procedures are known and complied with.
b. Schedules and performs preventative maintenance (PM).
(1) Schedules inspections and PM as in current established procedures.
(2) Accomplishes PM inspections and PM by applicable TM.
6. Medical platoon members perform operator maintenance.
a. Operators perform maintenance on equipment as directed in the equipment TM.
b. Operators inform organizational maintenance personnel or supply as soon as
possible of any maintenance problems beyond unit capabilities.
c. Platoon sergeant processes equipment requiring repairs beyond unit capabilities
for turn-in to the supporting medical maintenance shop or DMSO on DA Form 2407
(Maintenance Request). Ensures entries on the request are accurate and complete.
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TASK: PREPARE FOR MEDICAL EVACUATION MISSION
TASK STANDARD: Ground reconnaissance (recon) is accomplished if necessary to
prepare strip maps for ambulance teams. Routes are planned that facilitate
evacuation from forward areas to the BAS as the tactical situation permits.
Evacuation requests are processed and ambulance teams briefed within 5 minutes.
TASK STEPS
*1. Platoon leader, medical operations officer, or evacuation NCO conducts
ground reconnaissance. (MQS 03-3120.00-0001, 03-3164.00-0005)
a. Verifies information identified in map reconnaissance when additional information is
required and when time allows, conducts a physical inspection of possible routes
without compromising mission. Obtains information required to confirm or change the
map reconnaissance and original information.
b. Identifies: landmarks, obstacles, hazards, obstructions, problem areas, distances,
travel time, enemy activity (movement, potential ambush, and defensive positions),
terrain, weather conditions, traffic conditions (volume and patterns), and routes that
provide cover and concealment.
c. Makes accurate sketch map(s) of routes with appropriate annotation during
reconnaissance for use by ambulance personnel.
d. Forwards new intelligence information collected to higher headquarters in a timely
and secure manner.
*2. Medical operations officer and ambulance section sergeant portrays
information on strip maps or map overlays. (MQS 01-3140.00-0014, 051-1963009)
a. Portray accurate and legible representation of all essential elements of information
on strip map or map overlay.
b. Special attention is given to identifying landmarks (known and unknown points),
obstacles, obstructions, distances, enemy location, symbols of man-made objects,
adjacent units, collection points, routes, and camps.
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TASK: PREPARE FOR MEDICAL EVACUATION MISSION
*3. Medical operations officer and ambulance section sergeant coordinates field
siting of ambulances. (MQS 03-5101.00-0015)
a. Coordinate details of field siting with supported unit.
b. Ensure that Class I, II, maintenance, and Class V support is available.
c. Establish and follow administrative procedures for dispatch, use, and control of
ambulances.
*4. Ambulance section sergeant rotates ambulance teams and squads. (MQS
01-5104.02-0002, 01-9002.07-0050)
a. Ensures adequate evacuation support is provided.
b. Schedules adequate rest for squad members when possible.
c. Maintains vehicle readiness.
5. Ambulance section members receive and process evacuation request.
a. Acknowledge receipt of request.
b. Obtain required information when tactical situation allows (location and number of
casualties, nature of wounds, nationality, and EPW).
c. Follow proper communications authentication and security procedures;
authenticate by receiving or transmitting as directed by SOP; and communicate
information to squad or team en route.
*6. Leader briefs ambulance squad. (MQS 01-3140.00-0001, 03-7151.01-0100)
a. Presents briefing in a clear and concise manner.
b. Incorporates basic items such as strip maps or overlays, information from SOI to
include frequencies, call signs, and passwords.
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TASK: PREPARE FOR MEDICAL EVACUATION MISSION
*6. Leader briefs ambulance squad (Cont.). (MQS 01-3140.00-0001, 03-7151.010100)
c. Presents briefing that contains all necessary information (pickup point, destination,
route to follow, purpose of mission, procedures to follow in event of difficulty such as
maintenance problems or enemy action, authorized special equipment and supplies
required [such as cold weather equipment], support to be provided at supported site,
security, and safety).
7. Ambulance section NCO dispatches ambulances.
a. Records and maintains the dispatch log.
b. Records and maintains the following dispatch information on the dispatch log:
ambulance (bumper number), squad, time out, destination, purpose of mission, and
ETR.
c. Dispatches ambulance to designated area.
d. Maintains radio contact between ambulance driver and supported unit.
8. Squad team notifies supported unit of status.
a. Reports arrival to NCOIC of supported unit.
b. Reports departure to parent unit, medical company, and platoon leader.
c. Notifies nearest treatment team after patients have been picked up.
d. Provides BAS with estimated time of arrival (ETA), number of patients, and type of
injuries.
e. Provides any special information that will help a smooth efficient reception.
f. Follows proper communications security measures.
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TASK: PROVIDE CONTINUING CARE AND COMFORT MEASURES FOR
PATIENTS (08-4-0023)
TASK STANDARD: Care is given to patient to prevent further or undue discomfort.
TASK STEPS
1. EMT NCO or medical specialist administers prescribed treatment and care.
a. Provides care and treatment according to physician or PA's directive.
b. Monitors and records patient's vital signs.
c. Reports any charges in patient's condition.
2. Treatment member provides for patient safety during attack.
a. Briefs patients on actions or safety procedures to take in case of fire, ground, air,
or chemical attack.
b. Assists patients as needed in masking and movement.
3. Treatment section member prepares patient and records for disposition.
a. Briefs ambulance crew.
b. Instructs patients being returned to duty on self-care and follow-up.
c. Briefs patients to be evacuated.
d. Returns personal items.
e. Ensures DD Form 1380, FMC, is properly filled out.
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TASK: DEBRIEF SQUAD AND CREWS (08-4-0013)
TASK STANDARD: Debriefing is conducted, pertinent information concerning
mission is obtained and recorded, information is given to platoon leader and medical
platoon members.
*1. Section leader conducts debriefing and reports through chain of command.
(MQS 03-3365.00-0001, MQS 01-9002.02-0020)
a. Obtain information.
b. Records all pertinent information concerning mission. Includes:
(1) Deviations from scheduled mission and situations which pose a threat
to the accomplishment of future medical missions of the unit.
(2) Problems encountered with patients or routes.
(3) Problems with link-up to supported unit.
*2. Section leader updates situation maps and overlays. (MQS 01-3140.00-0014)
a. Updates situation maps and overlays immediately as appropriate.
b. Forwards pertinent information to higher headquarters and adjacent units, as
required.
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TASK: PERFORM TRIAGE (08-4-0005)
TASK STANDARD: All patients are assessed and categorized for priority of
treatment. Most seriously injured patients are treated first. Evacuation priorities are
established.
1. Combat medic examines each patient.
a. Conducts quick visual examination.
b. Determines which patients are most seriously ill or injured.
2. Combat medic treats the most seriously ill or injured first.
a. Reexamines the general condition, type of injuries, and need for immediate
lifesaving measures.
b. Conducts examination that is complete enough to identify injury or illness so that
priority and type of treatment can be determined and initiate lifesaving treatment as
condition indicates.
3. Combat medic reexamines patients.
a. Reexamines after all patients have been examined for life threatening injures and
lifesaving treatment.
b. Reexamines for extent of injury or previous nonapparent injury and determines
treatment needs.
c. Determines treatment needs.
4. Combat medic requests patient evacuation.
a. Requests additional evacuation support as needed.
b. Establishes priority for evacuation based on patient category, load, and vehicle
availability.
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TASK: EMPLOY PHYSICAL SECURITY MEASURES (19-3-C006)
TASK STANDARD: No vulnerable information, equipment, or operations are
accessible to the enemy.
*1. Platoon leader or platoon sergeant plans for physical security. (MQS 033400.00-0002, 03-3751.05-0500, 03-3751.05-0501)
a. Prepares and has access to platoon security plan.
b. Includes the following in plan:
(1) Prevention of vehicle entry to perimeter.
(2) Selection and manning of perimeter positions which detach and report
enemy intrusion or observation of perimeter.
(3) Prevention of civilian access to unit and defensive areas.
(4) Maintenance of communications between the perimeter posts and the
reaction force.
(5) Initial response to a ground attack.
(6) Establishment of primary and alternate means of communications from
the security Headquarters to the dismount point and perimeter posts.
2. Designated medical platoon members operate a guard force to protect
medical personnel and patients.
a. Establish communications with guard commander.
b. Stop unauthorized entry to restricted areas.
3. Designated medical platoon members react to enemy ground attack.
a. Assume preplanned positions.
b. Protect medical personnel and patients.
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TASK: PROVIDE SICK CALL SERVICES (08-4-0044)
TASK STANDARD: Routine sick call is established as tactical situation allows.
Patients are returned to duty without undue delay.
TASK STEPS
1. Treatment and combat medic section members conduct a screening sick call
for supported unit personnel.
a. Treat patients with minor illnesses and injuries and return to duty.
b. Aidmen refer patients requiring care beyond their capability to sick call at the BAS.
c. Initiate DD Form 1380, FMC, and utilize for each patient.
d. Enter basic information on each patient seen in aid station Daily Disposition LOG
(FM 8-10-1).
NOTE: Use of Individual Sick Slip (DD Form 689) is not required during combat
operations (AR 600-6). Use of DD 689 is at unit commander's discretion.
2. Treatment and combat medic section member’s record treatment.
a. Initiate FMC if necessary.
b. Record type of treatment, time, date, drugs administered, dose, and route,
immediately after each procedure.
3. Prepare patient for further evacuation.
a. Initiate evacuation request as soon as possible.
b. Coordinate with HQ and ambulance platoon or squad as required.
c. Transmit evacuation request to the FSMC for supporting air or ground evacuation.
4. Treatment section members prepare patient and records.
a. Brief patient to be evacuated.
b. Position non-ambulatory patients securely on litter. When preparing heat or cold
injury patients for evacuation, take the appropiate precautions.
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TASK: PROVIDE SICK CALL SERVICES (08-4-0044)
TASK STEPS
4. Treatment section members prepare patient and records (Cont.)
c. Return personal items to patient.
d. Attach the FMC to patient.
(1) Ensure FMC is signed and initialed.
(2) Record special instruction on FMC.
5. Treatment and combat medic section members initiate FMC for each patient
when first treated, if time allows.
a. Enter all identifying data on initial form along with known or estimated time of
injury.
b. Record all treatment and pertinent observations. Include:
(1) Name of medication.
(2) Dose.
(3) Route of administration, and time.
(4) IV solution.
c. Mark continuation copies of FMC in upper right corner "FMC #_____" and enter
appropriate sequence number, name, SSN, and grade.
d. Send original copy of FMC with patients transferred to other treatment facility.
e. Retain carbon copy and place in field medical file (See FM 8-10-4).
6. Maintain Daily Disposition Log.
a. Treatment section records information in disposition logbook.
(1) Mark front cover ”Daily Disposition" with:
(a) Unit designation.
(b) Dates of initial and closing entry.
(2) Each set of facing pages has vertical columns drawn with the following
titles:
(a) Patient number, name, grade/rank, SSN, and unit.
(b) Diagnosis and impression.
(c) Time seen.
(d) Disposition.
(e) Date-time group (DTG) of disposition.
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TASK: PROVIDE SICK CALL SERVICES (08-4-0044)
TASK STEPS
6. Maintain Daily Disposition Log (cont.).
(3) Make speculative entries for name, rank, and unit in pencil; change to
ink as verification is obtained or available.
(4) Enter all available data required in the log for each patient seen in the
BAS within one hour, and complete disposition of patient (except under
mass casualty situation).
(5) Begin patient numbering system with "1" each day.
b. Close log at end of each day (2400 hours local time or Zulu time as directed by the
command surgeon).
c. Retain and dispose of Daily Disposition Log as directed by DA Pam 25-400-2 and
AR 340-18.
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TASK: PROCESS CAPTURED DOCUMENTS AND EQUIPMENT (19-3-C005)
TASK STANDARD: Enemy equipment and documents are secured and processed to
higher headquarters as the tactical situation permits.
TASK STEPS
1. Medical platoon members tag documents and captured medical equipment
with necessary information, to include:
a. Type of document (such as map, photo, or orders) or medical equipment.
b. Date and time of capture.
c. Place of capture (grid coordinates).
d. Capturing unit.
e. Circumstances of capture.
f. Prisoner's name (if taken from EPW).
*2. Designated medical members report capture of documents or equipment to
company XO or 1SG. (MQS 03-3370.00-0001)
a. Report type of document or equipment.
b. Report date or time of capture.
c. Report place of capture (grid coordinates).
*3. Designated medical platoon members process captured equipment. (MQS
03-3365.00-0001)
a. Request disposition instructions.
b. Evacuate documents through the chain of command to intelligence personnel.
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TASK: PERFORM MAINTENANCE (91-3-C020)
TASK STANDARD: Scheduled operator maintenance is performed daily. Emergency
repairs are made as far forward as possible. PMCS is accomplished in accordance
with unit SOP.
TASK STEPS
*1. Platoon sergeant supervises maintenance of medical platoon equipment.
(MQS 01-4965.21-0001, 03-4966.21-0010, 03-5101.00-0007)
a. Platoon sergeant schedules PMCS. (STP 10-76C12-SM-TG)
(1) Keeps a preventive maintenance schedule and record on hand as
required for each item of equipment.
(2) Schedules PMCS appropriately.
(3) Properly records maintenance, lubrication, and non-available days.
(4) Checks to see that visual signal system is correct.
(5) Makes proper disposition of the form when a new form is prepared or
equipment has been transferred.
b. Platoon sergeant directs PMCS.
(1) Directs scheduled PMCS and notifies operators and crews accordingly.
(2) Keeps equipment, operator and crew, publications, tools, equipment,
POL, supplies, and repair parts on hand for scheduled PMCS.
(3) Performs PMCS in accordance with the applicable publications and
scheduled services on DD Form 314.
(4) Monitors and spot-checks performance of the PMCS.
c. Medical platoon members perform preventive maintenance.
(1) Perform PMCS as directed by appropriate TM.
(2) Note all malfunctions.
d. Platoon sergeant provides maintenance assistance and instruction to operator and
crew performing PMCS.
(1) Instructs operators and crews in proper operating and maintenance
procedures as outlined in the applicable TM.
(2) Instructs personnel in the correct interpretation and application of
instructions contained in appropriate TMs, TBs, and other technical
publications and directives.
(3) Maintains control of all DA Forms 348 (Equipment Operator's
Qualification Record).
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TASK: PERFORM MAINTENANCE (91-3-C020)
TASK STEPS
e. Platoon sergeant supervises PMCS.
(1) Checks to assure that the operator of each equipment item has the TM
-10 for the equipment and that it is used.
(2) Makes a record of faults which cannot be corrected on the spot.
(3) Assigns specific maintenance objectives for each scheduled period of
preventive maintenance.
2. Medical platoon members perform operator maintenance.
a. Perform maintenance on their assigned vehicles, individual weapons, and
equipment when tactical situation permits.
b. Inform organization maintenance personnel or company supply element as soon
as possible of any maintenance problems beyond unit capabilities.
3. Medical platoon members perform emergency repair.
a. Make repairs in accordance with equipment TM.
b. Make repairs as far as possible to ensure continued function of equipment.
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TASK: ESTABLISH PATIENT DECONTAMINATION STATION ON AN INTEGRATED
BATTELFIELD CHEMICAL ENVIRONMENT (08-4-0036)
TASK STANDARD: Decontamination station is operational within 45 minutes of
WARNING (60 minutes in darkness).
TASK STEPS.
1. Treatment section provides tailgate medical services.
a. Immediately assumes MOPP level as directed. Increases MOPP level if
necessary. Remains in MOPP while operating outside M51 shelter.
NOTE: M51 shelters will not be established if unit is to remain for less than 6 hours.
b. Provides emergency medical services within five minutes; continues until M51
shelter is operational, and the decontamination, triage, and holding areas outside the
shelter are established.
2. Treatment section and augmentee personnel erect M51 shelter.
a. Erect one M51 shelter with all necessary medical equipment placed inside.
Become operational and are prepared to receive first patient within 45 minutes (60
minutes during hours of darkness).
.
NOTE: The M15 shelter can be erected in a contaminated atmosphere but must be
purged for eight minutes.
b. Establish and disestablish shelter as directed in TC 8-12.
c. Platoon sergeant supervises personnel performing assigned specific tasks in
erecting shelter in accordance with TM 3-4240-264-12.
d. Erect only one M51 shelter. The second shelter remains on the trailer and is
protected against chemical contamination. Use this shelter upon relocation of the
treatment element.
e. Pad all litter stands and equipment placed on the floor of the M51 to prevent
puncture of the floor.
f. Place medical equipment and supplies in treatment area. Place litter stands in
shelter. place plastic bags and clean FMCs (DD Form 1380) in airlock. Place patient
protective wraps (PPW) in the shelter.
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TASK: ESTABLISH PATIENT DECONTAMINATION STATION ON AN INTEGRATED
BATTELFIELD CHEMICAL ENVIRONMENT (08-4-0036)
3. Treatment section and augmentees establish overhead cover.
a. Establish decontamination and holding areas.
b. Erect plastic sheeting downwind of M51 shelter, overlapping airlock entrance for
the decontamination and triage areas.
c. Erect plastic sheeting adjacent to the first sheeting and the side of the M51 shelter
opposite the generator for the evacuation holding area.
d. Erect sheeting within ten minutes.
e. Check to ensure sheeting for decontamination and triage area measures at least 6
meters by 15 meters
f. Check to ensure sheeting for holding area measures at least 6 meters by 7.6
meters.
g. Do not erect overhead cover if wind speed is greater than 10 knots. NOTE:
Camouflage netting should be erected over the area within fifteen minutes.
4. Treatment section and augmentees establish shuffle pit.
a. Position shuffle pit 3 to 4.6 meters from the center of the airlock entrance. Enter
shuffle pit not less than 3 meters nor more than 4.6 meters away from the M51 shelter
airlock.
b. Dig shuffle pit, 3 meters wide by 1.2 meters long by 15 centimeters deep, within
ten minutes, (humus soil), while M15 is being inflated. Harder soils will require a
longer time.
c. Fill shuffle pit with super tropical bleach and earth as directed by TM 3-220.
d. Position litters on litter stands in center of shuffle pit.
5. Treatment section establishes hot line.
a. Establishes hot line through shuffle pit around the waiting area, M51 shelter, and
holding area, and mark with engineer tape or other marking material.
b. Marks hot line within five minutes after shuffle pit is established.
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TASK: ESTABLISH PATIENT DECONTAMINATION STATION ON AN INTEGRATED
BATTELFIELD CHEMICAL ENVIRONMENT (08-4-0036)
6. Treatment section and augmentees establish decontamination and triage
areas.
a. Position litters, litter stands, EMT equipment, and required decontamination
materials contained in the Chemical Agent Patient Decontamination Set and
Chemical Agent Patient Treatment Set. Decontamination Set should be in the vicinity
of patient decontamination area. Patient Treatment Set should be with Trauma
Treatment Set.
b. Place physical barriers and sentries, if available, around hot line area to maintain
security and prevent transfer at other points.
c. Equip contaminated emergency treatment area with selected emergency lifesaving
equipment and supplies, including Chemical Agents Casualty Treatment Set.
d. Set up clothing removal area with one pair of litter stands, large plastic bags, extra
plastic bags for personal effects and FMCs, two pails or buckets filled with five
percent aqueous sodium hypochlorite solution (undiluted liquid bleach used for
laundry is near correct strength), four pair heavy-duty scissors (with spare ones
available), gauze or sponges, and M258A1 kits.
e. Establish patient decontamination area with one litter on a pair of litter stands.
NOTE: Standard litter is covered with plastic sheeting.
f. Equip decontamination area with plastic bags, two pails or buckets with five
percent sodium hypochlorite solution, gauze or sponges, M258A1 kits, replacement
tourniquets and bandages (for severe bleeding only), and M8 detector paper.
7. Treatment section and augmentees clean treatment area.
a. Establish clean treatment area inside hot line in front of the M51 shelter to the side
away from the generator.
b. Equip treatment area with PPW, medical supplies, and equipment as directed by
unit SOP.
8. Treatment section and augmentees establish patient waiting area.
a. Establish patient waiting area, inside hot line in front of M51 shelter to the side
near the generator trailer.
b. Equip with medical supplies, equipment, and PPW for those patients waiting over
10 minutes for entry into M51 shelter.
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TASK: ESTABLISH PATIENT DECONTAMINATION STATION ON AN INTEGRATED
BATTELFIELD CHEMICAL ENVIRONMENT (08-4-0036)
9. Treatment section and augmentees establish contamination sump.
a. Establish 75 meters downwind from the end of the overhead cover for disposition
of all contaminated waste.
b. Keep sump separate from contaminated holding area.
10. Treatment section and augmentees establish contaminated holding area.
a. Establish contaminated holding storage area for recoverable equipment 75 meters
downwind.
b. Keep area separate from contaminated sump.
c. Establish contaminated holding area for expectant patients near triage area,
downwind.
NOTE: Reference page 199-200, Battalion Aid Station Using the M51 Shelter
System and layout of a chemical agent patient decontamination station, in an
uncontaminated area, without collective protective shelter.
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TASK: DECONTAMINATE AMBULATORY PATIENTS CHEMICAL ENVIRONMENT
(08-4-0038)
TASK STANDARD: Patient is decontaminated and no cross-contamination occurs.
TASK STEPS
NOTE: If individual is returning to duty in a contaminated environment, only
decontaminate sufficiently enough to treat wound or injury.
1. Augmentees decontaminate patient's hood.
a. Ask patient to cover his air inlets.
b. Decontaminate hood with high-test hypochlorite solution or M258A1 skin
decontamination kit with litter patient.
NOTE: HTH is the same sodium chlorite chemical used for swimming pools. In liquid
form, it is the same as laundry bleach.
c. Ask patient to uncover air inlets.
2. Augmentees cut off patient's hood.
a. Dip scissors in decontaminating solution.
b. Cut off hood, redipping scissors in HTH every two or three cuts.
c. Fold hood out and away from patient's face.
d. Remove and discard hood in contaminated disposal container.
3. Augmentees decontaminate patient's mask and exposed skin.
a. Use decontaminating solution or M258A1 skin decontamination kit.
b. Decontaminate mask and exposed skin.
4. Augmentees remove gross contamination from patient's outer garments.
a. Wipe all obvious contaminated spots with HTH solution or package 1 and 2 from
M258A1 skin decontamination kit or chlorine bleach.
b. Cut out large contaminated spots.
c. Place cutaway materials into contaminated disposal container.
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Reference ARTEP-17-236-12-MTP
TASK: DECONTAMINATE AMBULATORY PATIENTS CHEMICAL ENVIRONMENT
(08-4-0038)
5. Augmentees maintain patient's FMC.
a. Cut FMC tie-wire.
b. Allow FMC to fall into plastic bag.
c. Seal plastic bag.
6.Augmentees remove load-bearing equipment.
a. Unfasten and unbutton or cut all zippers and buttons or tie straps.
b. Place contaminated equipment in plastic bag.
c. Place plastic bag in designated contaminated storage area.
NOTE: Depending on battlefield situation or medical transport method, load-bearing
equipment may or may not have been removed
7. Augmentees remove personal articles from outer garment pockets.
a. Ask patient to remove personal articles from breast and side pockets.
b. Place patient's personal articles in a clean plastic bag.
c. Give personal articles to the patient.
8. Augmentees check for and remove spot contamination.
a. Use M8 chemical agent detector paper.
b. Dab all areas of patient's clothing.
c. Pay particular attention to:
(1)Discolored areas.
(2)Damp spots.
(3)Tears in clothing.
(4)Neck.
(5)Wrists.
(6)Ears.
(7) Area around dressings.
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TASK: DECONTAMINATE AMBULATORY PATIENTS CHEMICAL ENVIRONMENT
(08-4-0038)
8. Augmentees check for and remove spot contamination (cont.).
d. Remove contamination.
(1)Cut away clothing with a large border around the contaminated area,
using scissors dipped in HTH solution.
(2) Use M8 chemical agent detector paper for contamination.
(3) Spot decontaminate with HTH or M258A1 decontamination kit.
9. Augmentees remove overgarment jacket.
NOTE: This procedure can easily be done with one decon person or with one decon
person on each side of the patient working simultaneously.
a. Instruct patient to:
(1)Clench his fists.
(2)Stand with arms held straight down.
(3)Extend arms backward at about 30-degree angle.
(4)Place feet shoulder-width apart.
b. Stand in front of patient.
(1) (1)
(2) (2)
(3) Unsnap jacket front flap.
(4) Unzip jacket front.
c. Move to the rear of the patient.
(1)Grasp jacket collar with both hands at sides of the neck.
(2)Peel jacket off shoulders at a 30-degree angle down and away from the
patient.
(3)Smoothly pull the sleeves inside out over the patient's wrists and hands.
d.Cut to aid removal, if necessary.
(1)Cut around all splints, bandages, and tourniquets.
(2)Cut sleeves from inside waist to armpit.
(3)Cut across shoulder through collar.
(4)Peel jacket back and downward to avoid spreading contamination.
(5)Insure that the outside of jacket does not touch the patient or inner
clothing.
e. Place overgarment jacket into contaminated disposal bag.
10. Augmentees remove patient's overboots.
a. Unzip trouser leg zipper and cut overboot laces with scissors dipped in HTH
solution.
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TASK: DECONTAMINATE AMBULATORY PATIENTS CHEMICAL ENVIRONMENT
(08-4-0038)
10. Augmentees remove patient's overboots.
b. Fold lacing eyelets flat on the ground.
c. Step on (or hold down) the toe and hell eyelet to flatten eyelets on the ground.
d. Instruct patient to step out of the overboot onto clean area.
e. Use same procedure for the other overboot.
11. Augmentees remove patient's overgarment trousers.
a. Unfasten or cut all ties, buttons, or zippers.
b. Grasp trousers at the waist.
c. Peel trousers down over the patient's boots.
d. Cut trousers to aid removal, if necessary.
(1) Cut around all bandages, splints, and tourniquets.
(2) Cut from inside pant leg, ankle to groin.
(3) Cut up both sides of the zipper to the waist.
(4) Allow the narrow strip with the zipper to drop between the legs.
(5) Peel or allow trouser halves to drop to the ground.
e. Place trousers into contaminated disposal bag.
12. Augmentees remove patient's butyl rubber gloves.
a. Remain at the rear or at the side of the patient.
b. Dip your gloved hands in HTH solution. NOTE: Patient's arms are still extended
backward at a 30-degree angle.
c. Use thumbs and forefingers of both hands.
d. Grasp the heel of patient's glove at top and bottom of forearm.
e. Peel glove(s) off with a smooth, downward motion.
f. Place glove(s) in contaminated disposal bag.
g. Tell patient to reposition his arms, but not touch his trousers.
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Reference ARTEP-17-236-12-MTP
TASK: DECONTAMINATE AMBULATORY PATIENTS CHEMICAL ENVIRONMENT
(08-4-0038)
13. Augmentees direct patient to remove glove inner liners.
a. Tell patient to remove white glove liners.
(1) Grasp heel of gloves without touching exposed skin.
(2) Peel inner liner downward and off.
(3) Drop in contaminated disposal bag.
b. Remove the remaining liner in the same manner.
14. Augmentees spot decontaminate.
a. Use M8 detector paper.
b. Dab all areas of patient's clothing.
c. Give particular attention to:
(1) Discolored areas and damp spots.
(2) Tears in clothing.
(3) Neck.
(4) Wrists.
(5) Area around dressings.
f. Decontaminate gross contamination by cutting away areas of clothing or washing
with HTH solution.
15. Augmentees route patient to skin decontamination area and check patient
with M8 chemical detector paper.
a. Route to skin decontamination area.
b. Decontaminate detected areas with HTH solution or M258A1 decontamination kit.
c. Decontaminate exposed neck and wrist areas.
d. Decontaminate areas exposed by cutting clothing.
e. Decontaminate around dressings, splints, and tourniquets.
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TASK: DECONTAMINATE AMBULATORY PATIENTS CHEMICAL ENVIRONMENT
(08-4-0038)
15. Augmentees route patient to skin decontamination area and check patient
with M8 chemical detector paper.
f. Decontaminate face.
(1) Use or provide patient with M258A1 decontamination kit or HTH
solution.
(2) Wet sponge with HTH solution or open decontamination wipe packets.
(3) Tell patient to hold his breath and close his eyes.
(4) Lift mask off his face at the chin and wipe and sponge patient's face, or
have patient wipe and sponge his face.
(6) Wipe face quickly and around top of ears and wipe carefully all folds of
skin: top of upper lip, chin, dimples, ear lobes, and nose creases.
(8) Wipe all surfaces inside the mask which touch the face.
(9) Drop used wipes into contaminated disposal container.
(10)Instruct patient to reseal, clear, and check his mask.
16. Treatment section members replace tourniquets.
a. Place new tourniquet 1.27 centimeters to 2.54 centimeters above the old
tourniquet.
b. Remove old tourniquet and decontaminate the exposed skin area.
17. Treatment section members remove splints and cut away bandages.
a. Replace bandages only to control bleeding and instruct combat medics not to
replace splints.
b. Decontaminate any exposed skin.
18. Augmentees recheck patient for contamination.
a. Use M8 detector paper.
b. Redecontaminated, if necessary.
19. Platoon leader (physician) or PA determines patient's disposition.
a. Assign as augmentee.
b. Route for evacuation or return to unit.
20. Augmentees route patient to clean treatment area.
a. Instruct patient to shuffle his feet as he crosses the hot line.
b. If patient is to remain on the contaminated side as an augmentee, reissue
complete MOPP 4 uniform.
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Reference ARTEP-17-236-12-MTP
TASK: DECONTAMINATE LITTER PATIENTS-CHEMICAL ENVIRONMENT (08-40039)
TASK STANDARD: Patient is decontaminated and no cross-contamination occurs.
TASK STEPS.
1. Augmentees decontaminate patient's hood.
a. Cover mask air inlet valves.
(a) Get help from your assistant.
(b) Use clean gauze pads.
(c)Ask patient to cover his air inlet valves with his hand (if he is able).
b. Wipe off front, sides, and top of hood with sponge soaked with HTH or use
M258A1 skin decontaminating package 1 and 2.
NOTE: HTH is the same sodium chlorite chemical used for swimming pools. In a
liquid form it is the same as laundry bleach.
c. Uncover mask air inlet valves.
2. Augmentees cut off patient's hood.
a. Dip scissors in HTH solution.
b. Release or cut hood straps.
c. Cut or untie neck cord.
d. Cut off zipper cord.
e. Cut away drawstring below voicemitter.
f. Unzip the hood zipper.
g. Begin cutting at zipper "V" below voicemitter.
(1) Proceed cutting upward, close to the filter-inlet covers and eye-lens
outserts.
(2) Cut upward to top of eye outsert.
(3) Cut across forehead to the outer edge of the next eye outsert.
(4) Cut downward toward patient's shoulder staying close to the eye lens
and filter inserts.
(5) Cut across the lower part of the voicemitter to the zipper.
(6) Cut from center of forehead over the top of the head.
(7) Fold left and right sides of hood to the side.
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TASK: DECONTAMINATE LITTER PATIENTS-CHEMICAL ENVIRONMENT (08-40039)
3. Augmentees decontaminate patient's mask and exposed skin.
a. Use M258A1 skin decontamination kit or HTH Solution.
b. Cover both air inlet valves with gauze or hands.
(1) Wipe external parts of mask.
(2) Wipe mask straps and strap buckles.
c. Uncover both air inlet valves.
d. Wipe exposed skin area.
(1) Chin and neck.
(2) Back of ear.
4. Augmentees remove gross contamination from patient's outer garments.
a. Wipe all evident contaminated spots with HTH solution or M258A1 packages 1
and 2.
b. Cut out large contaminated spots and place any cutaway material into
contaminated disposal container (plastic bag).
5. Augmentees maintain patient's FMC.
a. Cut FMC tie-wire.
b. Allow FMC to fall into a plastic bag.
c. Seal plastic bag.
(a) Zip lock, if appropriate.
(b) Tie opening into a knot.
d. Wash plastic bag with decontamination solution.
e. Place plastic bag under mask head straps.
6. Augmentees remove and secure personal effects.
a. Remove articles from breast and side pockets.
b. Place articles in plastic bag.
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TASK: DECONTAMINATE LITTER PATIENTS-CHEMICAL ENVIRONMENT (08-40039)
6. Augmentees remove and secure personal effects.
c. Print patient's social security number (SSN) and name on a piece of paper.
(1) Get the patient's name from:
(2) Patient.
(3) Patient's FMC.
(4) Right battle dress uniform (BDU) breast pocket after carefully unzipping
outer garment jacket.
(5) Get from other sources:
(6) Identification card.
(7) Buddy.
(8) Other patient.
d. Place the paper with the name and SSN into plastic bag.
e. Seal plastic bag.
f. Place plastic bag in clean holding area.
7. Augmentees remove patient's protective overgarment jacket.
a. Cut overgarment jacket.
(1) Make initial cut at neck area down to groin area of right side.
(2) Cut from inside cuff area of right sleeve up to armpit, then through the
collar.
b. Roll chest sections to respective sides with inner surface outward.
c. Carefully tuck clothing between arm and chest.
d. Repeat procedure for other side of jacket.
8. Augmentees remove butyl rubber gloves.
a. Lift patient's arm up and out of the cutaway sleeve.
b. Grasp the cuff of patient's glove on the raised hand.
c. Roll the cuff over the fingers, turning the gloves inside out.
d. Lower patient's arm across his chest.
e. Place removed gloves in contaminated disposal container.
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TASK: DECONTAMINATE LITTER PATIENTS-CHEMICAL ENVIRONMENT (08-40039)
9. Augmentees remove overgarment trousers.
a. Cut down from waist along zipper and each inner leg seam.
b. Cut both sides of zipper from waist.
c. Fold trouser halves onto litter with contaminated sides away from patient.
10. Augmentees take off patient's protective overboots.
a. Stand at foot of litter facing patient.
b. Cut overboot laces.
c. Unzip protective trouser leg zippers.
d. Hold legs up and slightly off the litter with one hand.
e. Grasp heel of overboots with the free hand.
f. Pull heels up and toward you until removed.
g. Place overboots in contaminated disposal container.
11. Augmentees remove inner boots.
a. Position yourself at foot of the litter.
b. Cut bootlaces along the tongue.
c. Grasp boot at heel and toe.
d. Pull the heel upward and toward you until removed.
e. Place boots in contaminated disposal container.
12. Augmentees cut off BDUs.
a. Unbuckle or cut belt material.
b. Cut off fatigue or BDU trousers following same procedure as for outer garment
trousers.
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TASK: DECONTAMINATE LITTER PATIENTS-CHEMICAL ENVIRONMENT (08-40039)
12. Augmentees cut off BDUs.
c. Cut off fatigue or BDU shirt.
(1) Uncross patient's arms.
(2) Cut shirt using same procedure as for outer garment jacket.
(3) Recross patient's arms over his chest.
13. Augmentees cut off undergarments.
a. Cut off undershorts or panties following the same procedure as for outer garment
trousers.
b. Cut off T-shirt following the same procedure as for outer garment jacket.
c. Cut off brassiere.
(1) Hold patient’s arms off chest.
(2) Cut the elastic between the cups.
(3) Cut both shoulder straps where they attach to the cups.
(4) Lay the cups away from patient onto litter.
(5) Lay shoulder straps up and over the shoulders onto the litter.
14. Augmentees remove patient's identification tags.
a. Cut ID tag chain.
b. Allow chain to fall to the litter.
c. Slip ID tags from chain.
c. Place chain in contaminated disposal container.
d. Rinse ID tags in HTH solution.
e. Place ID tags in clean plastic bag.
f. Seal plastic bag.
g. Place plastic bag on patient's chest.
15. Augmentees remove glove inner liners.
a. Pull off glove liners using the same procedure as for removing butyl rubber gloves.
b. Cross patient's arms over his chest.
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TASK: DECONTAMINATE LITTER PATIENTS-CHEMICAL ENVIRONMENT (08-40039)
16. Augmentees remove socks.
a. Position yourself at foot of the litter.
b. Slightly raise patient's leg off litter with one hand.
c. Grasp top of sock in the back with free hand.
d. Pull top of sock toward you, over the heel and off the foot.
e. Place socks into contaminated disposal container.
17. Augmentees lift patient, using three personnel (Cont.).
a. Rinse aprons and gloves in HTH solution.
b. Lift patient out of cutaway garments.
(1) Man #1 slides his arms (palms turned upward) under the patient's head
and shoulders.
(2) Man #2 slides his arms (palms turned upward) under the patient's back
and buttocks.
(3) Man #3 slides his arms (palms turned upward) under the patient's
thighs and calves.
(4) Lift patient on Man #1's signal and turn the patient in against your
chest.
(6) Carry the patient to the decontamination litter and lower the patient to
litter in supine position, if possible.
c. Place the patient's contaminated clothing in contaminated disposal container.
18. Augmentees check for and perform skin decontamination.
a. Check patient for contamination:
(1) Dab patient with M8 chemical agent detector paper.
(2) Decontaminate detected areas with decontamination kit or HTH
solution as necessary.
b. Pay particular attention to:
(1) Neck and wrists.
(3) Lower part of face.
(4) Areas which may have been touched during clothing removal.
(5) Areas around wounds.
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Reference ARTEP-17-236-12-MTP
TASK: DECONTAMINATE LITTER PATIENTS-CHEMICAL ENVIRONMENT (08-40039)
19. Treatment platoon members cut off splints and bandages and replace
tourniquets.
a. Remove splints.
(1) Cut off all tie stays holding splints in place and remove splints.
(3) Cut off the clothing that was covered by the splints.
(4) Place splints, tie stays, and clothing in contaminated disposal container.
(5) Decontaminate area where splint(s) were with M258A1
decontamination kit or HTH solution.
b. Remove bandages.
(1) Cut off bandages and the clothing that was covered by the bandage(s).
(3) Decontaminate areas covered by bandages and clothing with HTH
solution.
(4) Irrigate wound with water or saline solution.
(5) Wrap massive wounds with plastic sheeting or plastic bags.
(6) Secure with tape or clean tourniquet.
(7) Mark wound as "contaminated" as directed by local SOP.
(8) Place removed bandages and clothing in contaminated disposal
container.
c. Replace tourniquets.
(1) Decontaminate a large area above the present tourniquet.
(2) Place a new tourniquet 1.27 centimeters to 2.54 centimeters above the
old tourniquet.
(3) Cut off or remove old tourniquet.
(4) Cut off any remaining clothing sections covered by old tourniquet.
(5) Decontaminate area covered by old tourniquet and clothing.
(6) Place old tourniquet and clothing into contaminated disposal container.
20. Augmentees recheck patient for contamination.
a. Dab patient with M8 chemical agent detector paper.
b. Decontaminate detected areas, as necessary.
21. Augmentees transfer patient through shuffle pit to ensure uncontaminated
and sterile area.
a. Lift patient from litter and carry patient to clean litter in shuffle pit.
c. Place patient on clean litter on litter stand.
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Reference ARTEP-17-236-12-MTP
TASK: USE PASSIVE AIR DEFENSE MEASURES (44-3-C001)
TASK STANDARD: Unit members successfully identify enemy aircraft and implement
passive defense measures to defend against attack from enemy aircraft.
TASK STEPS
*1. Platoon leaders/medical operation officer supervises platoon members use
of air defense measures in a tactical position. (MQS 01-1920.00-0029, O13154.00-0206)
a. Use all available resources (camouflage when authorized, cover, concealment,
dispersion, and so on) to hide the platoon and limit its vulnerability.
b. Cover or shade shiny items, particularly windshield and optics.
c. Establish and rehearse air attack alarms.
d. Disperse vehicles, tents, and supplies to reduce vulnerability to air attack.
e. Construct field fortifications with organic equipment as necessary to protect
personnel and vulnerable mission-essential equipment.
f. Man observation posts (daytime and nighttime) to provide warning of approaching
aircraft.
g. Visually identify threat aircraft.
h. Report any aircraft action to higher headquarters.*
*2. Medical platoon members use passive air defense measures in a convoy.
(MQS 01-1920.00-0029)
a. Leader ensures the convoy commander briefs all unit personnel.
b. Camouflage vehicles and equipment when authorized (personnel wear BDUs and
helmet cover) before moving out.
c. Selects column interval based on instructions, mission, and terrain.
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TASK: USE PASSIVE AIR DEFENSE MEASURES (44-3-C001)
*2. Medical platoon members use passive air defense measures in a convoy.
(MQS 01-1920.00-0029)
d. Alternate individual weapons throughout the convoy to cover front, rear, and flanks
(avenues or approach).
e. Assign soldiers to air guard duties with specific search sectors covering 360
degrees.
f. Visually identify threat aircraft.
g. Leader reports all aircraft actions to higher headquarters.
h. Establish and rehearse air attack alarms.
*3. Medical platoon members use passive air defense measures when the unit
is occupying or displacing. (MQS 01-3154.00-0014)
a. Maintain vehicle interval specified in the unit order.
b. Stagger vehicles to avoid linear patterns.
c. Leader assigns airguards to designated sectors of search that covers 360 degrees
and maintain coverage until movement is completed.
d. Visually identify threat aircraft.
e. Leader reports all aircraft actions to higher headquarters.
f. Establish vehicle order according to precedence.
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Reference ARTEP-17-236-12-MTP
TASK: PERFORM PERSONNEL CONSOLIDATION AND REORGANIZATION (12-3C019)
TASK STANDARD: Unit personnel are reassigned to key leadership positions to
reestablish the chain of command and fill key positions vacated by casualties.
Casualties and EPWs are appropriately treated, reported, and evacuated.
TASK STEPS
1. Senior platoon member present cross-levels personnel and reassigns
responsibilities. MQS 03-3153.00-0028)
a. Fills leadership positions.
b. Verifies local security.
2. Senior platoon member present determines personnel and equipment status.
(MQS 03-5101.00-0004, 01-5104.02-0002)
a. Accounts for all assigned and attached personnel.
b. Medics provide emergency medical treatment and initiates medical evacuation.
c. Assesses personnel and weapon system and equipment conditions.
+3. Report personnel and weapon system and equipment status to next higher
headquarters.
a. Report killed, wounded, missing, and captured personnel using DA Forms 1155
and 1156.
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Reference ARTEP-17-236-12-MTP
TASK: PREPARE FOR OPERATIONS IN AN NBC ENVIRONMENT (03-3-C013)
TASK STANDARD: Medical platoon prepares for NBC environment without
interruption of the mission. Medical platoon takes actions necessary to minimize
effects of friendly nuclear blast within 30 minutes prior to detonation.
TASK STEPS
*1. Leaders issue NBC defense equipment. (MQS 03-5030.00-2006, 03-3060.006005)
a. Issue to each soldier individual NBC defense equipment authorized by TOE and
applicable common table of allowances (CTA).
b. Check to ensure that unit NBC defense equipment authorized by TOE and
applicable CTA is operational and is issued to designated, trained, and
knowledgeable operators.
c. Identify shortages, and take replacement action.
d. Fill decontamination apparatuses.
2. Medical platoon members check M258A1 kit.
a. Check components to ensure expiration dates have not been reached.
b. Check to ensure kit contains a minimum of five samplers--detectors, instruction
card, and NBC M8 paper.
*3. Leaders adjust operations based on the situation. (MQS 01-9002.03-0010)
a. Check to ensure subordinates are equipped to comply with MOPP level.
(1) Each soldier carries (protective mask with hood, skin decontamination
kit, and detector paper).
(2) In MOPP 0, the soldier carries or stores nearby (mask, overgarment,
overboots, and gloves).
(3) In MOPP 1, the soldier wears overgarment with M9 paper affixed and
carries overboots, gloves and mask.
b. Inform ambulance teams of location of protective shelters.
c. Direct platoon members to harden positions (defense only).
(1) Improve foxholes and bunkers.
(2) Locate natural and man-made features which provide protection (such
as caves, ditches, ravines, culverts, overpasses, tunnels, basements).
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TASK: PREPARE FOR OPERATIONS IN AN NBC ENVIRONMENT (03-3-C013)
*3. Leaders adjust operations based on the situation. (MQS 01-9002.03-0010)
d. Check to ensure M13 decontamination apparatus is full.
e. Fill decontamination apparatuses.
f. Identify shortages of NBC equipment and request resupply as needed.
g. Enforce field sanitation measures.
TASK: PREPARE FOR OPERATIONS IN AN NBC ENVIRONMENT (03-3-C013)
*4. Medical platoon members prepare for nuclear attack. (MQS 03-5030.00-2005,
03-5030.00-2007)
a. Warn personnel.
b. Medical platoon members place vehicles and equipment in a position that provides
the best terrain shielding.
c. Turn off and disconnect nonessential electronic equipment. Tie down essential
antennas and take down nonessential antennas and antenna leads.
d. Improve shelters giving consideration to blast, thermal, and radiation effects.
e. Zero dosimeters, if available.
f. Secure loose, flammable, explosive items, food, and water containers. Protect
them from nuclear weapon effects.
g. Leaders check to ensure individuals know the appropriate action if an attack
occurs.
h. Leaders conduct periodic monitoring.
i. Take additional actions consistent with the tactical and medical situation.
5. Medical platoon members prepare for a chemical attack.
a. Leaders warn teams.
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TASK: PREPARE FOR OPERATIONS IN AN NBC ENVIRONMENT (03-3-C013)
5. Medical platoon members prepare for a chemical attack.
b. Determine and follow MOPP-level guidance.
(1) Ensure all individuals are at or above required MOPP-level.
(2) Adjust levels based on weather, work rate, and threat (identify criteria
for automatic masking, identify "buddy" for first-aid decontamination, and
disseminate criteria for automatic masking and buddy-aid decontamination).
(3) Identify activities that become more difficult due to MOPP and take
actions to compensate; for example, allow more time, assign additional
personnel, or rotate ambulance crews.
c. Use expendable or readily decontaminated material to cover all equipment,
munitions, POL, food, and water containers that cannot be placed in a shelter.
d. Place detector paper to provide maximum exposure to toxic rain and where it can
be easily observed.
e. Check to ensure M258A1 kits are serviceable and are issued down to crew level.
f. Fill decontaminating apparatuses.
g. Leaders check to ensure individuals know the appropriate action if an attack
occurs.
h. Take additional actions consistent with the tactical situation.
6. Medical platoon members prepare for a friendly nuclear strike.
a. Acknowledge warning (STRIKWARN).
b. Leaders warn and advise platoon personnel of:
(1) Time, location, and area coverage of the planned decontamination.
(2) Element vulnerability to immediate effects and residual contamination.
(3) Measures required to prevent casualties, damage, and interference
with the mission.
c. Leaders monitor to ensure platoon personnel execute directed actions.
(1) Minimize skin exposure by rolling down sleeves, buttoning collars, or
wearing additional clothing, such as MOPP gear.
(2) Take cover in foxholes, bunkers, armored vehicles, basements,
culverts, caves, or tunnels.
(3) Place vehicles so that terrain provides shielding.
(4) Protect electronic equipment from electromagnetic pulse (EMP) by
(removing or tying down antennas, and disconnecting power and antenna
leads.
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TASK: PREPARE FOR OPERATIONS IN AN NBC ENVIRONMENT (03-3-C013)
6. Medical platoon members prepare for a friendly nuclear strike.
(5) Move loose items that could be blown around by the explosion so that
they do not represent a hazard.
(6) Warn all individuals.
(7) Leaders brief personnel on the actions to take and when to take them.
d. Leaders implement protective measures as directed by company HQ.
e. Complete actions before detonation occurs.
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TASK: RESPOND TO AN NBC ATTACK (03-3-C016)
TASK STANDARD: Platoon members react immediately to minimize effects of
chemical or nuclear attack. MOPP 4 is reached within 8 minutes of identified alarms.
Protective measures are taken immediately in the case of a nuclear attack.
TASK STEPS
*1. Medical platoon members respond to chemical agent attack.
a. Take immediate protective action.
(1) Recognize the chemical alarm or hazard.
(2) Put on assigned protective mask with hood and give the alarm.
(3) Put on chemical protective clothing and equipment to reach MOPP 4
within 5 minutes.
b. Evaluate contamination and decontaminate skin.
*2. Leaders reconstitute the platoon.
a. Reestablish chain of command and communications.
b. Receive evacuation section status, consolidate, and report to higher headquarters.
c. Identify, treat, mark, and evacuate medical platoon casualties. Decontaminate
medical platoon personnel wounded in action (WIA) before medical evacuation. Wrap,
mark, and evacuate medical platoon personnel killed in action (KIA) to designated
collection point.
d. Resume mission operations.
e. Leaders provide NBC reports.
(1) Submit initial NBC 1 (chemical reports).
(2) Identify type of agent, and submit subsequent NBC 1 (chemical) report
within 20 minutes after the attack.
f. Leaders initiate unmasking procedures.
g. Adjust MOPP level as required.
h. Replenish chemical defense equipment and supplies, as required.
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Reference ARTEP-17-236-12-MTP
TASK: RESPOND TO AN NBC ATTACK (03-3-C016)
3. Medical platoon members respond to residual effects of nuclear attack.
a. Take immediate protective action.
(1) Immediately drop to the ground or floor if you are in a building or
vehicle.
(2) Close your eyes.
(3) Turn your body so your head is away from the flash of light, as you fall.
(4) Put your hands under your body and keep face down.
(5) Keep your helmet on.
(6) Stay down until the blast wave passes and the debris stops falling.
b. Reconstitute the unit.
(1) Leaders reestablish chain of command and communications and report
the situation.
(2) Identify, treat, and evacuate casualties.
(3) Check to see if any equipment has been damaged.
(4) Evacuate KIAs to designated collection point.
(5) Resume mission operations
(6) Leaders provide NBC reports.
c. Commence continuous monitoring and report dose rate readings if area survey
meter is available.
d. Check dosimeters and report total dose, as required.
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TASK: PERFORM DECONTAMINATION (03-3-C017)
TASK STANDARD: Decontamination measures are started immediately and
personnel are decontaminated within 15 minutes and recontaminate is negligible.
TASK STEPS
1. Medical platoon members perform chemical decontamination.
a. Conduct basic skin decontamination.
(1) Start skin decontamination within one minute after contamination.
(2) Resume mission operations on completion of decontamination.
b. Conduct decontamination by performing personal wipe down and spray down
within 15 minutes.
(1) Personnel use buddy system and M258A1 towelettes to wipe hood,
mask, gloves, weapon, helmet, and individual use items.
(2) Operators use M11 or M13 decontaminating apparatus. Spray the
control surfaces of vehicles and crew-served weapons that must be
touched during entry, exit, occupancy, and operation.
c. Exchange MOPP gear if tactical situation permits and a secure area is available.
(1) Prepare dry mix STB by mixing the container of STB with 1-1/2
containers of uncontaminated soil.
(2) Pair soldiers into buddy teams, and space them around a circle with 1
to 3 meters between teams.
(3) Squad leader and a companion direct exchange from center of circle as
they go through it themselves.
(4) Teams follow these steps:
(5) Drop gear.
(6) Use dry mix to decontaminate gear.
(7) Decontaminate hood.
(8) Remove overgarment.
(9) Remove boots and gloves.
(10) Put on new overgarment.
(11) Put on new boots and gloves.
(12) Secure hood.
(13) Secure gear.
d. Resume mission operations.
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TASK: PERFORM DECONTAMINATION (03-3-C017)
*2. Medical platoon performs radiological decontamination.
a. Perform individual sustainment decontamination.
(1) Brush and shake dust off their clothing.
(2) Wash exposed skin, paying particular attention to hair and finger nails.
(3) Use M258A1 towelettes if soap and water are not available.
(4) Brush or scrape contamination off equipment, vehicles, and crewserved weapons. If runoff can be controlled and water is available, flush
away the contamination.
b. Leaders update platoon radiation status.
(1) Read dosimeters, average the total dose, and round off to nearest 10
centigray (cGy) or radiation absorbed dosage (rad).
(2) Report results to higher headquarters.
(3) Resume mission operations.
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Reference ARTEP-17-236-12-MTP
TASK: CAMOUFLAGE VEHICLES AND EQUIPMENT WHEN AUTHORIZED
TASK STANDARD: The platoon camouflages individual positions and equipment so
that it cannot be detected from 35 meters or greater. Vehicles are camouflaged so
that they cannot be detected from 100 meters or greater.
*1. Platoon leader and squad leader selects concealed vehicle positions and
traffic routes. (MQS 01-1910.11-1001, 01-1920.12-1001)
a. Make vehicle tracks follow terrain lines such as edge of woods or fields.
b. Make sure vehicle tracks continue past park location to some other logical spot.
c. Use concealed routes whenever possible.
d. Drive all vehicles in the same tracks.
e. "Obliterate" tracks where they turn into concealed positions.
f. Position vehicles under natural cover or in shadows.
g. Position vehicles so their shape will blend with surroundings.
h. Avoid terrain features, which may be used as reference points by enemy ground
and aerial fires (such as hill tops and road intersections).
2. Medical platoon members conceal vehicle or equipment.
a. Use natural materials that blend with surrounding area to break up shape or
shadow.
b. Change natural materials when they start to wilt and remove them from the area.
c. Cover shiny objects as windows and headlights.
d. Use nets to create shadows.
e. Use camouflage-screening systems to enhance natural materials.
f. Keep heat sources (such as generators and engines) under screening systems
even when natural concealment is used.
3. Medical platoon members enforce light and noise discipline.
a. Use only blackout lights.
b. Use other noise to muffle or mask noise that cannot be eliminated.
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Reference ARTEP-17-236-12-MTP
TASK: EVACUATE EPW PATIENTS (08-4-0010)
TASK STANDARD: EPW patients are transported without danger to ambulance team
members or other patients.
1. Ambulance team evacuates EPWs with same medical evacuation standards
as friendly patients.
a. Maintains continuous security of EPW patients.
b. Transports guards along with EPW patients.
c. Secures EPW patients by restraining devices, if guards are not available.
d. Ensures that EPW patients have been searched for weapons and ordnance prior to
boarding the ambulance.
e. Searches EPW patients, if required. Squad personnel ensure that there are no
weapons or ordnance accessible to the EPW patients throughout the mission.
.
*2. Platoon sergeant sends information concerning EPW through command
channels. (MSQ 03-3370.00-0011, 03-3751.00-1000, 03-9060.10-1000)
a. Reports date, time, and location of capture.
b. Forwards equipment or document found on EPW.
c. Reports destination of EPW.
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MISCELLANOUS INFORMATION/CHECKLIST
Reference FM 8-10-4, FM 8-55
TASKS
PAGE
Principles of Combat Health Support Checklist
158
Task Force Medical Platoon Leaders Planners Checklist
160
Task Force Medical Checklist for the Offense
161
Task Force Medical Checklist for the Breach
162
Task Force Medical Checklist for the Defense
166
Task Force Medical Support Checklist for the Scouts
168
Combat Health Support In Specific Environments
170
Mountain Operations
Desert Operations
Jungle Operations
Cold Weather Operations
River Crossing Operations
Medical Support in a Light Infantry Task Force
Medical Planning Checklist for a Light Infantry Task Force
Rear Operations and Damage Control
Military Operations on Urbanized Terrain
Health Service Support in an NBC or Directed Energy
Environment
Humanitarian Assistance
170
175
176
176
178
179
181
183
183
187
196
Evacuation Capabilities
197
Divisional Medical Assets
198
Air Force Evacuation Assets
201
Two Man Fighting Positions
204
Defend Assigned Area Checklist
207
Triple Strand Concertina
209
Range Card
210
Sector Sketch
211
Informal After Action Review
215
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COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATION
Reference FM 8-10-4 & FM 8-55
1. PRINCIPLES OF COMBAT HEALTH SUPPORT:
A. CONFORMTIY.
 Conforms with the tactical plan
 CHS planner must participate in the tactical operations planning to ensure CHS is
at the right place and time
 Use of medical intelligence
 CHS planning is forward oriented
 Plan for rapid replacement of forward echelons
B. CONTINUITY.
 CHS is continuous from the FLOT through CONUS
 Modular in design
C. CONTROL.
 Must ensure CHS resources are effective employed to support tactical plan
 Centralized control with decentralized execution
D. PROXMITY.
Location is directed by:
 METT-TC factors
 Requirements far forward for stabilization
 Early identification and forward treatment of RTDs
 Forward orientation of evacuation assets
 Other logistical units/complexes
 Doesn’t interfere with combat operations
E. FLEXIBILITY.
 CHS has the ability to quickly shift medical assets On the battlefield
F. MOBILITY.
 CHS units organic to maneuver elements must have mobility equal to the forces
supported
 Must retain mobility to support combat operations
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IN A TACTICAL OPERATION
Reference FM 8-10-4 & FM 8-55
G. PLANNING.
 Must understand the tactical commander’s plan, decisions, and intent.
 Must be proactive, not reactive, and must know:
 What what each supported element will do
 When will it be done
 Where it will be done
 How it will be done
 Must know CHS requirements needed to support the tactical plan
H. PREVENTION.
 Preventive medicine programs
 Leadership emphasis at all command levels
 Field Sanitation Teams
 Immunizations
I. FAR FORWARD CARE.
 Identify and treat casualties close to the FEBA as tactical situation permits
 Self aid/buddy aid, combat lifesavers, unit level medical support
 Emergency medical treatment with 30 minutes of wounding
 Location of FAS/MAS
J. EVACUATION.
 Starts at point of injury to BAS (manual/litter/non-standard carries)
 Must provide enroute care to medical treatment facility
 Use of air evacuation assets
 Use of non medical evacuation assets
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COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATION
Reference FM 8-10-4 & FM 8-55
2. CONSIDERATIONS OF THE MEDICAL PLATOON LEADER WHEN PLANNING
 Attends all operational briefings/planning sessions.
 Must stay informed of the concept of operations, commander's intent, and
anticipated CHS requirements.
 Develop a task force patient estimate.
 Develops CHS plan and provides overlays of preplanned evacuation routes,
treatment teams, patient collecting points, and AXPs to the task force.
 Plan is published in medical support/synchronization matrix with overlay.
 Ensures adequate medical elements are in the support package.
 To reduce turnaround time in providing ATM to patients within 30 minutes of
wounding, the BAS may slit and place its treatment teams as close to maneuvering
companies as tactically feasible.
 Treatment teams within 1000 meters of maneuver unit must be ready to withdraw
to preplanned positions
 When anticipating large numbers of casualties, augment with one or more
treatment teams from the FSMC.
 Augmenting teams are under the S4s tactical control, but operational control of the
battalion surgeon
 Ground vehicle planning factors: 8km and return in 1 hour
 4 km support distance = 30 minutes round trip for ground ambulance under ideal
circumstances
 Plan aid station/treatment team movement triggers
 Planned checkpoints along MSR can be used as possible aid station locations
 Integrate medical operations into the task force maneuver and CSS rehearsals
 4 man litter team 900 meters and return 1 hour avg. terrain
 6 man litter team 350 meters and return 1 hour mountainous terrain
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Reference FM 8-10-4 & FM 8-55
3. PLANNING OF COMBAT HEALTH SUPPORT
Considerations in the Offense:
 Pre- position medical evacuation vehicles as far forward as possible prior to the
attack.
 Provide additional ambulance teams to main attack companies/teams.
 Request additional ambulances from the FSMC.
 Use patient collecting points.
 Use AXPs.
 Concentrate on stabilization care and rapid evacuation.
 Depend on combat lifesavers.
 Leap frog teams forward as attack progresses or follow-and-support concept.
 Practice tailgate medicine.
 Select covered and concealed BAS and company aid post sites.
 Ensure adequate medical supplies are available, if necessary, request additional
supplies.
 Plan for medical evacuation within the defensive area.
 Plan and coordinate in detail medical evacuation to FSMC from BAS.
 Plan to continue CHS should the unit become encircled.
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Reference FM 8-10-4 & FM 8-55
4. PLANNING HEALTH SERVICE SUPPORT FOR BREACH OPERATIONS
a. Medical Assets prior to/at LD:
 Split BAS into two teams (Team A and Team B)
 Divide FSMC ambulances up between Teams A and B accordingly.
 Ensure each company team has 1 - M113 for casualty evacuation.
 If engineer company is the breach force ensure they have 1 - M113 for
evacuation.
 Preposition Teams A and B within the task force prior to LD (FAS follows one of
the supporting company teams, MAS follows the task force formation).
 The AXP operated by FSMC must be integrated into the task force scheme of
maneuver. (Without the AXP the task force medical elements will lose their
ability to move forward, as casualties collect at Teams A and B)
 The AXP should be augmented with a treatment team and wheeled ambulances,
the wheeled ambulances will move forward with the task force combat trains.
 The task force combat trains should move within four, but no more than ten
kilometers behind the lead elements of the task force.
 If passage of lines are conducted with another task force ensure proper
coordination is with the medical platoon prior to execution of the mission. (The
stationary task force should provide medical support to the passing unit, this
allows the other medical platoon to provide continuous medical support for his
task force)
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A WAY TO SUPPORT
THE NEAR SIDE OF A BREACH
4. PLANNING COMBAT HEALTH SUPPORT FOR BREACH OPERATIONS
b. Medical Assets at Execution:
 Team A positions behind the support element, establish near side medical support and
begins medical evacuation.
 Casualties at the breach are moved to Company CCPs on the near side of the breach
lane, but out of the fire sack, then evacuates casualties to Team A
 When breach opens company medics establish far side CCP.
 Team B follows the assault force moves through breach lane and establishes and
supports far side of the breach (Synchronization is the key!)
x
x
OBJ C
x
x
..
LO1
TEAM A
..
CTB
FSMC
AXP
OBJ B
x
x
LO2
AE0002
ISOLATE
OBJ A
x
ASLT
PSN
BLUE
..
x
L03
POINT OF
BREACH
x
TEAM B
x
x
PL RIFLE
PL BAYONET
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A WAY TO SUPPORT
IN THE BREACH
4. PLANNING COMBAT HEALTH SUPPORT FOR BREACH OPERATIONS
c. Medical Assets in the Breach:
 Medics must be at the breach rehearsal and understand the breach operation.
 Medics must understand how the lane is marked and where they will need to pass
to go to the far side of the breach.
 Casualties are evacuated to Team A, until Team B is established on the far side.
 All casualties on the far side are sent to the Company CCP established on the far
side, this will occur until Team B is in position and ready to receive casualties
x
x
OBJ C
x
x
..
LO1
TEAM A
..
CTB
FSMC
AXP
OBJ B
x
x
AE0002
..
ISOLATE
OBJ A
x
TEAM B
x
L03
x
x
x
PL RIFLE
LO2
PL BAYONET
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A WAY TO SUPPORT
THE FAR SIDE OF THE BREACH
4. PLANNING COMBAT HEALTH SUPPORT FOR BREACH OPERATIONS
d. Medical Assets on the FAR Side of the Breach:
 Once Team B is established on the far side all casualties will be sent to Team B.
 Once Team B is established, Team A prepares to move.
 FSMC AXP moves to Team A’s location and assumes responsibility for their
casualties.
 Team A moves forward and follows the task force to its objective, providing
continuous medical support.
 METT-TC DEPENDENT, Team A and B may consolidate after the attack. This
depends on were the casualties are and what the tactical situation is.
x
x
OBJ C
x
x
LO1
..
CTB
FSMC
AXP
OBJ B
x
x
..
LO2
AE0002
ISOLATE
TEAM A
x
x
L03
x
..
OBJ Ax
x
PL RIFLE
PL BAYONET
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TEAM B
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Reference FM 8-10-4 & FM 8-55
5. PLANNING OF COMBAT HEALTH SUPPORT
Considerations in the Defense.
 Select covered and concealed BAS and company aid post sites.
 Ensure adequate medical supplies are available.
 Plan for medical evacuation within the defensive area.
 Plan and coordinate in detail evacuation to FSMC from BAS.
 Plan to continue CHS should the unit become encircled.
 Consider the potential of having to hold patients for an indefinite period of time,
without adequate resources.
 Coordinate and position FSMC TX team within a battle position/strongpoint.
 Designate area for chemical contaminated patients.
 Request Air MEDEVAC for urgent personnel.
 Have the non-standard evacuation assets identified and know what the plan is to
use them, who controls them, and what is the trigger for their use.
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A WAY IN THE DEFENSE
..
LZ
TX TEAM A
CCP
MSR CAT
LZ
..
MSR DOG
CMED
TX TM
CCP
CTCP
CCP
CCP
..
LZ
TX TEAM B
167
CONSIDERSATIONS
• Select covered and concealed
BAS and company aid post sites.
• Ensure adequate medical supplies
are available.
• Plan for evac within the defensive
area.
• Plan and coordinate in detail evac
to FSMC from BAS.
• Plan to continue CHS should the
unit become encircled.
• Consider having to hold patients
for periods of time.
• Position FSMC TX team within a
battle position/strongpoint.
• Designate area for NBC
contaminated patients
• Request air medevac for urgent &
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Reference FM 8-10-4 & FM 8-55
6. SPECIALTY PLATOONS - “Planning Considerations”
 Scouts often operate forward of the FEBA
 Mortars operate up to 1500 meters behind the FEBA
 Coordination with maneuver units near the dispersed unit/platoon is required. The
maneuver unit can then assist in casualty evacuation.
 Below is “A way” of planning scout extraction within a task force:
STEP 1 - Template enemy locations.
STEP 2 - Identify projected OP locations.
STEP 3 - Identify infiltration routes.
STEP 4 - Determine ground evacuation limit of advance. NOTE: project number
of ambulances required for MEDEVAC & determine which route the ambulance will
use moving into sector.
STEP 5 - Identify casualty collections points.
STEP 6 - Identify air extraction PZs. NOTE: dedicate aircraft to CASEVAC (day
and night)
STEP 7 - Identify ingress and egress routes.
STEP 8 - Develop SEAD plan to secure air corridor
 Task Force Commander and S3 must establish priorities for the use of nonmedical vehicles for scout extraction.
 Use of far and near recognition signals greatly assist in identifying scout CCPs and
conducting scout extraction.
 The scout extraction plan must be understood and rehearsed by all key elements
to ensure proper execution.
 Position Treatment Team forward prior to LD to provide echelon I medical care to
the scout platoon.
 Position Treatment Team forward in the defense to provide echelon I medical care
to the counter recon force and the scout platoon.
 All scouts should be trained as combat lifesavers and have to standard CLS bags.
 Understand the importance of non-standard evacuation, have standard and nonstandard litters (SKED) readily available for their use.
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SCOUT PLATOON EXTRACTION “A WAY”
Ground
Evac
Limit of
Adv
LD
LZ
LZ
CAR
LOCATION
RTE 1
RTE 2
..
Plt AA
LZ
RTE 3
LZ
• STEP 1 - TEMPLATE ENEMY LOCATIONS
• STEP 2 - ID PROJECTED OP LOCATIONS
• STEP 3 - ID INFILTRATION ROUTES
RTE 3
• STEP 4 - DETERMINE GROUND EVAC LIMIT OF ADVANCE NOTE: PROJECT NUMBER OF
AMBULANCES REQUIRED FOR MEDEVAC & DETERMINE WHICH ROUTE THE AMBULANCE
WILL USE MOVING INTO SECTOR
• STEP 5 - ID CASUALTY COLLECTIONS POINTS
• STEP 6 - ID AIR EXTRACTION PZS NOTE: DEDICATE AIRCRAFT TO CASEVAC (DAY AND
NIGHT)
• STEP 7 - ID INGRESS AND EGRESS ROUTES
A15
A
• STEP 8 - DEVELOP SEAD PLAN TO SECURE AIR CORRIDOR
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Reference FM 8-10-4
7. General. Combat Health Support is limited to the same degree as combat
effectiveness when operating in areas of extreme weather and/or terrain hazards.
Medical units require special purpose equipment (primarily shelter and transportation) in
quantities commensurate with their support mission to overcome these restrictions.
Operations in freezing or extremely hot temperatures require continuing protection of
medical items that deteriorate rapidly. Environmental restrictions may reduce the
capability of the division's evacuation assets; therefore, litter bearers and ground/air
ambulance elements must be reinforced with other medical and/or nonmedical
resources. Medical treatment elements require special shelter protection which
neutralizes extremes in weather; adapts easily to difficult terrain; and can be erected
and dismantled quickly. Unusual types and larger numbers of patients often result from
prolonged exposure to extreme nature hazards; therefore, prevention is the most
effective method in dealing with extreme conditions. Abnormally high numbers of
patients require augmentation of division treatment and/or evacuation resources.
8. Mountain Operations.
a. The tactical problems of the division medical companies in mountain operations
are similar to those encountered in other terrain. Lack of good road networks will add to
the difficulties. One DCS should be established in support of each committed brigade.
These should be as close as possible to the BAS supported, yet must be situated so as
to permit easy evacuation by the units in support. Use of ambulances forward of the
DCS may be impossible. Personnel normally employed in this link of evacuation may be
used as litter bearers; or they may supervise litter bearers furnished from other sources.
Problems will arise, but by maximum use of personnel and equipment, the division
medical company can give support within its area of responsibility.
b. Troops operating in mountainous terrain are subject to unusual illnesses; these
include mountain sickness, high altitude pulmonary edema, and cerebral edema. All
three are caused by rapid ascent to altitudes of 2,400 meters (about 7,875 feet) and
above.
c. Mountain operations require medical personnel to carry additional equipment.
Items such as ropes, pitons, piton hammers, and snap links are all necessary for the
evacuation of patients and establishment of a BAS. Unnecessary items of equipment
including those for which substitutes or improvisations can be made are left behind.
Heavy tentage, bulky chests, extra splint sets, excess litters, and non-essential medical
supplies should be stored. If stored, these supplies should be readily available for
airdrop or other means of transport. Medical items that are subject to freezing must not
be exposed to the low temperature experienced in mountainous areas.
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Reference FM 8-10-4
d. For forward medical elements to maintain a satisfactory level of medical supplies,
all personnel, vehicles, and aircraft going forward should carry small amounts of medical
supplies and equipment; examples are IV fluids, dressings, and blankets. Smaller
supplies and equipment may be rolled in blankets and lashed to packboards or carried
in partially folded litters.
e. Since the transportation of heavy tentage may be impracticable, shelter for
patients must be improvised to prevent undue environmental exposure. In the summer
or in warm climates, improvision may not be necessary, but there is a close relationship
between extreme cold and shock; thus medical personnel should always consider the
need to provide shelter for patients. Shelter may be found in caves, under overhanging
cliffs, behind clumps of thick bushes, and in ruins. They may be built using a few
saplings, evergreen boughs, shelter halves, or similar items. The time a patient is to be
held will influence the type of shelter used. When patients are to be kept overnight, a
weatherproofed shelter must be constructed.
f. The evacuation of patients in mountain warfare presents varied problems. In
addition to the task of carrying a patient to the nearest medical element, there is the
difficulty of moving over rough terrain.
(1) The proportion of litter cases to ambulatory cases is increased in mountainous
terrain; even a slightly wounded individual may find it extremely difficult to move across
the terrain. Because of the added exertion and increased pain, it may be necessary to
transport a patient by litter who would normally be able to return to the BAS by himself.
(2) In cold weather and in high mountains, speed of evacuation is vital; there is a
marked increase in the possibility of shock among patients in extreme cold.
(3) Special consideration must be given to the conservation of manpower. Litter
hauls must be kept as short as the tactical situation will permit. A litter team is not
capable of carrying a patient for the same distance over mountainous terrain as over flat
territory. To decrease the distance of litter hauls, medical elements should locate as
close as possible to the troops supported.
(4) It is important to be able to predict the number of patients that can be
evacuated with available personnel. It has been demonstrated that when the average
terrain grade exceeds 20° to 25° the four-man litter team is no longer efficient; it should
be replaced by a six-man team. The average mountain litter team should be capable of
climbing 120 to 150 vertical meters of average mountain terrain and return with a patient
in approximately one hour.
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Reference FM 8-10-4
(5) Another problem is evacuation at night. The wounded should be located and
evacuated during the day. Many casualties would not survive the rigors of the night on a
mountain in cold weather. Night evacuation over rough terrain is impractical and results
are rarely equal to the effort. When possible the night evacuation route should be
marked with tracing tape and rope handlines; they are installed during daytime.
However, if routes are exposed to enemy observation and fire by day, patients must be
removed from the area by night; but only as far as necessary. At the first point affording
shelter from enemy observation and fire, a holding station should be established;
shelter, warmth, food, and supportive care should be provided. Patients should be
brought from forward areas to this point; they are held until daylight, then evacuated to
the rear.
(6) Before initiating evacuation, conduct a reconnaissance of the terrain and the
road network in the area. To this, add information on climatic conditions, facilities and
personnel available, and the tactical mission. Only after all of these factors are
assembled and evaluated can a sound medical evacuation plan be formulated. The
following factors peculiar to mountain operations should be considered before making
the final selection of evacuation routes:
 Snow and ice are firmest during the early morning hours.
 Glacial or snow fed streams are shallowest during the early morning.
 Mountain streams afford poor routes of evacuation because of rough, slippery rocks
and the force of moving water.
 Talus slopes (those slopes with an accumulation of rock debris strewn around) should
be avoided; they are difficult to traverse. Loose and slippery rocks on such slopes will
often cause litter bearers to fall or drop the patient; compounding his existing injury and
possibly causing injury to members of the litter bearer team.
 Choose routes that are just below the crest of a ridge. These trails are usually easiest
to follow and the ground affords the best footing.
(7) The difficulties of medical evacuation encountered in mountain operations
emphasize the advantages of air evacuation. The time between injury and treatment is a
determining factor in the patient's recovery. Evacuation by air, which is the most rapid,
most comfortable, and the safest means is the optimum method. However, total reliance
on air ambulances is inadvisable; rapidly changing weather conditions in mountainous
areas adversely affect aeromedical evacuation. All available means of collection and
evacuation should be used.
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Reference FM 8-10-4
g. When operating in mountainous terrain, the maneuver battalion is often
decentralized to an extent that a centrally located BAS is not practical In these
circumstances, it may be necessary to split the medical platoon into two small sections
capable of minimal CHS. Close-terrain conditions severely limit the platoon's capabilities;
personnel and equipment augmentation may be required.
h. In mountainous terrain, there is usually adequate concealment and defilade to
allow the medical platoon to establish the BAS close to the FLOT. If one station is
operated, it should be located as close as possible to the fighting troops, generally in the
center of the battalion's area of operations. If the platoon is required to operate more
than one treatment site, each treatment team is given a specified area of responsibility;
it is located centrally as far forward as possible in support of the troops for which the
station is responsible. The term centrally located does not necessarily mean the
geographical center of an area. Many factors must be considered in determining a
central location for a given area. These include expected patient loads; lines of drift;
roads or paths for evacuation to and from the station; and terrain features having a
direct influence on litter carry. The following advantages are obtained when
consideration is given to the location of BAS:
 Relatively short or easy litter hauls.
 Medical facilities closer to the units they support.
 Closer contact with company commanders affords greater ease in following changes
in the tactical plan.
 Adequate shelter.
Patients are sorted, given necessary emergency medical care, RTD, or provided shelter
and warmth until transportation becomes available.
i. When the BAS is in a split mode, it is desirable that the medical platoon
headquarters section be augmented with additional six-man litter teams. The
augmentation litter teams may be recruited from all available sources (including the use
of indigenous personnel); they must be familiar with military mountaineering techniques.
The augmentation should be completed before the actual need.
j. As in normal situations, combat medics will be furnished to the rifle companies by
the medical platoon. Emphasis should be placed on training the combat medics in
hazards of cold and wind; relationship of these factors to the problem of shock;
conservation of body heat and improvised methods of providing warmth (to include the
construction of small windbreaks and shelters); and techniques of military
mountaineering and mountain evacuation procedures.
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Reference FM 8-10-4
k. Supported companies should establish patient collecting points.
(1) In mountainous terrain, it will often be necessary to consider the establishment
of patient collecting points. These patient collecting points operated by combat medics
are designated intermediate points along the route of evacuation where patients may be
gathered. Whenever patients are to be transferred from one type of transportation to
another, a patient collecting point/AXP is needed.
(2) Defilade positions are abundant in mountainous areas. Patient collecting
points should be established as far forward as possible. An AXP may be established
behind each of the BASs, or a centrally located point may be operated; whichever will
ensure the most efficient CHS and provide the greatest relief to litter bearer personnel.
(3) Patient collecting points are movable and should be placed, whenever
possible, away from difficult terrain. Patient collecting points along routes of march
should not be established routinely, unless - It is certain that these points will be in territory under secure control of
friendly forces.
 The number or severity of wounded justifies such a point.
l. Litter relay points may also have to be established during mountain operations.
(1) If sufficient litter bearers are available, a chain of litter relay points, from the
BAS to a point where evacuation can be taken over by ambulances, should be
established.
(2) Each relay point should have one NCO and four litter bearers. However, when
short of personnel, one NCO could be used to supervise more than one relay point.
Each point is responsible for the evacuation of all patients received. When returning to
their relay point, litter bearers bring empty litters and other medical supplies which are
required by forward medical personnel. This will permit maximum use of available litter
bearers; litter bearers operating in a chain of relay points can evacuate far more
wounded than teams attempting to evacuate the wounded from the frontline to the
BASs; or from the BASs to the ambulance pickup point. Personnel can rest on the return
to their post; they also become familiar with the short section of mountain trail over
which they travel. This makes it possible for them to operate over the trail at night; also
gives the wounded a much smoother ride.
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Reference FM 8-10-4
9. Desert Operations.
a. Planning for CHS is especially important in the desert; the greater distances used
in maneuver and deployment complicate medical treatment, evacuation, and supply
procedures. Roads and trails are scarce and usually connect villages and oases.
Wheeled vehicles can travel in any direction over much of the desert; they need not be
confined to roads and trails because much of the desert area is flat and hard surfaced.
Limited water supplies, coupled with the increased demands created by very high
temperatures, low humidity, and dust, cause additional concerns for CHS planners. Use
FM 90-3 when preparing CHS plans for desert operations.
b. The greater distances between units limit the availability of combat medics.
Medical units should be augmented when possible; also troops should be given
additional first aid training before desert operations.
c. The large area over which a battle is fought presents special problems in the timely
acquisition, treatment, and evacuation of patients. Any number of patients in a fighting
unit may restrict the maneuverability of that unit and jeopardize its mission. Medical units
may be furnished a greater number of evacuation vehicles for operating in deserts.
Medical treatment elements are located farther to the rear in desert operations. Medical
evacuation by fixed-wing aircraft and helicopters is valuable because of their speed and
the reduced turnaround time.
d. Many diseases of military significance may be found in the desert. The diseases
are found in its human inhabitants, animals, arthropods, and local water and food
supplies. The cold of the desert night, even in summer, may require warm clothing. Cold
weather injuries may occur during the desert winter. It is the desert sunshine, wind, and
heat, however, that have the greatest effect upon military operations. The dryness of the
desert heat distinguishes it from the heat of the tropics; this adds to the problem of
coping with it. Medical elements must be provided additional water supplies to treat heat
injuries (heat cramps, heat exhaustion, and heat stroke). All water, except from
quartersmaster water points, is considered contaminated and unfit for drinking; it may
also be unfit for bathing or for washing clothing.
e. Intestinal diseases tend to increase among personnel living in the desert. This may
be prevented by good food service sanitation, including supervision of cleaning eating
and cooking utensils; supervision of food handlers; disposal of garbage and human
wastes; and protection of food and utensils. Solid wastes should be burned when the
situation permits. Soakage pits are used to dispose of liquid wastes; they are filled with
soil when leaving an area. Deep pit latrines should be used if the soil is suitable.
Arthropods and rodents must be controlled to prevent the diseases they carry.
Preventive medicine measures include protective clothing; clothing impregnants;
arthropod repellents; residual and space sprays; immunizations; and suppressive drugs.
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Reference FM 8-10-4
10. Jungle Operations.
a. Difficult terrain, wide dispersion of combat units, inadequate roads, and insecure
lines of communication all have a direct influence on CHS in jungle operations. The
manner in which medical units support tactical organizations depends on how they are
employed. Wide variations may be expected, but the general principles of CHS will
apply.
b. The evacuation of wounded in jungle warfare presents difficult problems.
Ambulances may not be practical on trails, unimproved muddy roads, and in swamps.
There is a higher proportion of litter cases; even a slightly wounded individual may find it
impossible to walk through dense undergrowth. As a result, the patient normally
classified as ambulatory may become a litter case. Evacuation is usually along supply
routes which are adequately protected against enemy action.
c. There are other problems encountered in jungle operations; personal hygiene and
sanitation is a serious and continuous one, as is the incidence of diseases peculiar to
jungle areas. The incidence of fungus diseases of the skin is especially serious. In
addition to maintaining high standards of personal hygiene and sanitation, strict
preventive medicine measures must be observed and enforced at all times. For more
detailed information on jungle operations see FM 90-5. For management of skin
diseases in the tropics, see FM 8-40.
11. Cold Weather Operations.
a. The environment in cold weather operations is a primary factor. Individuals must
understand the effects of the cold environment; they must have the training, stamina,
and willpower to take protective actions. In this climate, the human element is allimportant; The effectiveness of equipment is greatly reduced; therefore, specialized
training and experience are essential. The climate does not allow a margin of error for
the individual or the organization. The mobility of units is restricted; their movement must
be carefully planned and executed; a movement can be as difficult to overcome as the
enemy. Momentum is difficult to achieve and can be quickly lost.
b. Changes in personnel and equipment authorizations are the result of emphasis on
mobility; maintenance; communications; and CHS. Equipment is eliminated or added
based on its suitability to the terrain and environment.
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Reference FM 8-10-4
c. The conduct of military operations is limited by considerations that are foreign to
more temperate regions:
 Long hours of daylight and dust of summer.
 Long nights with bitter cold and storms of winter.
 Mud and morass in the transition periods of spring and autumn.
 Scarcity of roads and railroads.
 Vast distances and isolation.
 The lack of maps can adversely affect mobility, firepower, and communications.
In spite of these conditions, operations are accomplished; they require employment of
aggressive leadership; a high state of training; and full logistical support.
d. Because of the hostility of cold weather, units operating in northern latitudes
should establish a relatively short patient holding period. Adverse environmental
conditions make it difficult for medical units to provide definitive care over an extended
period. The evacuation policy is changed as the tactical situation dictates. The general
nature of the terrain makes surface evacuation of patients difficult in winter and virtually
impossible in summer. The lack of good evacuation routes and the need to move
supplies over the same route greatly restrict patient evacuation. The most practical
means of patient evacuation is air evacuation. Aircraft resupplying the area can be used
to carry patients on the return trip. Total reliance on air evacuation must be avoided;
aircraft operations will be restricted by cold weather conditions.
e. To enhance CHS in extremely cold weather, the following operational principles
apply:
(1) Prompt acquisition and evacuation of patients to heated treatment stations.
(2) Augmentation of unit collecting elements by division level medical elements.
(3) Use of enclosed and heated vehicles for medical evacuation.
(4) Provision of heated shelters at frequent intervals along the evacuation route.
(5) Readily available air transportation for patient evacuation.
(6) Special vehicles for surface evacuation of patients.
(7) Heated storage for medical supplies.
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f. In the deep snows, storms, and bitter cold of winter, prompt evacuation and
treatment of patients is even more essential. It is extremely difficult to find and evacuate
patients; early medical care can be rendered only if medical personnel are immediately
available. Procedures should be established for medical care on patrols, at strongpoints,
and in heated aid stations near front lines. If medical personnel are not readily available,
other personnel must promptly evacuate casualties. Medical treatment elements must
be well forward in the combat area to prevent unnecessary losses due to evacuation
delays.
12. River Crossing Operations.
a. The river barrier itself exerts decisive influence on the use of CHS units. Attack
across a river line creates a medical problem comparable to that of the amphibious
assault. Medical elements cross as soon as combat operations permit. Early crossing of
treatment elements reduces turnaround time for all crossing equipage which must load
patients on the far shore. Maximum use is made of air evacuation assets to prevent
excessive patient buildup in far shore treatment facilities. Near shore treatment facilities
are placed as far forward as assault operations and protective considerations permit;
this reduces evacuation distances from off loading points. For more detailed information
on river operations, see FM 90-13.
b. In defensive operations, CHS resources deployed on the far shore are restricted to
the minimum needed to provide support. Evacuation from far shore treatment facilities is
accomplished using both surface and air evacuation; this reduces the accumulation of
patients forward of the river barrier. Near shore treatment facilities are located farther to
the rear to preclude their having to displace in a cross-river withdrawal. Defilade
locations are avoided for medical elements because they are prime target areas for
enemy artillery and air attack.
c. CHS in the attack of river lines, while conforming in general to the CHS doctrine of
offensive operations, present special problems during ferrying and bridging operations.
CHS must concern itself with the support of the combat troops during the advance to the
river line (preliminary phase); during the river crossing and capture of the initial objective
(phase); during operations to seize the intermediate objective (phase II); and during the
attack to gain the bridgehead (phase III).
(1) Combat Health Support, preliminary phase. There are relatively few
patients resulting from this phase when secrecy in movement to the river is maintained.
Patient collecting points may or may not be established along the main approaches to
the crossing sites.
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(2) Combat Health Support, phase I. At the end of the preliminary phase, BAS
and DCSs are established to provide normal support in the area of each crossing. Litter
bearers may be employed near each crossing site. Ambulances are moved as near to
the river as possible. Medical platoons furnish close CHS; combat medics accompany
their companies in the crossing. Ambulance squads organic to the medical platoons
cross in succeeding waves; and the treatment squad establishes the BAS on the far
bank as soon as the situation permits. Patients are placed on returning craft for
evacuation to the near bank. When helicopters are employed as a means of air landing
assault troops, the returning aircraft may be used to evacuate casualties to medical
treatment elements on the near bank. Air ambulance elements provide air evacuation of
patients from the far bank during phase I if the tactical situation allows air assault
operations.
(3) Combat Health Support, phase II. During this phase, the FSMC provides
evacuation on both banks of the river until a DCS has been established on the far bank.
When phase II is nearing completion, the DCS is moved forward to a position close to
the near bank or across to the far bank as conditions dictate. A relatively high priority is
granted to division CHS elements for movement across any established bridges. In the
absence of bridges, movement of CHS elements is accomplished by surface craft or air.
(4) Combat Health Support, phase III. During this final phase, CHS units are
moved across the river as rapidly as possible; they resume normal operations on the far
bank. Division clearing stations may be called upon to care for a larger number of
patients, pending the establishment of bridges and the resumption of normal evacuation
by higher command.
13. CHS for Light Infantry Task Force - “Deliberate Attack”.
a. Recent trends illustrate the fact that echelon I CHS planning is not integrated or
well developed for the deliberate attack. Plans have frequently included deploying
treatment teams forward to maneuver with the company headquarters section. This is a
good concept when terrain/mission dictates. However, to simply send a dismounted
treatment team forward without the appropriate amount of Class VIII supplies, medical
equipment, or a well-rehearsed, integrated MEDEVAC plan, is not a sound TTP. Units
forward deploy the physician and PA to decrease the died of wounds rate, which is
laudable. Yet, several other key factors are not addressed. A forward deployed
treatment team can only provide medical treatment commensurate with the tactical
situation and medical supplies/equipment available. The medical planner must
determine the most feasible CHS plan that provides far forward treatment, casualty
acquisition, and rapid evacuation. Training medics to perform airway management skills,
breathing management, bleeding control initiating IVs, applying bandages and splints is
critical to the success of these types of missions on the modern battlefield.
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13. CHS for Light Infantry Task Force - “Deliberate Attack” (Cont.)
b. Echelon I CHS includes providing immediate lifesaving measures, emergency
medical treatment (EMT) and advanced trauma management (ATM) to stabilize the
patient for evacuation to the echelon of medical treatment required. It also provides
routine medical treatment to return the soldier to duty. Echelon I is not capable of
performing surgery or patient holding. The battalion aid station consists of a treatment
squad that can spilt into two treatment teams.
c. The ability to provide continuous combat casualty care forward of the LD/LC is a
considerable challenge. "The prehospital phase of caring for combat casualties is
critically important, since up to 90 percent of combat deaths occur before the casualty
ever reaches a medical treatment facility." A casualty management protocol is important
to develop and train for when considering operational deployments. In a recent article
"Tactical Combat Casualty Care in Special Operations," the authors present three
distinct phases which include the following:
(1) Care under fire: care rendered by the medic at the scene of the injury while
he and the casualty are still under effective hostile fire. Available medical equipment is
limited to that carried by the medic in his aid bag.
(2) Tactical field care: care rendered by the medic once he and the casualty are
no longer under effective hostile fire. It also applies to situations in which an injury has
occurred on a mission but there has been no hostile fire. Available medical equipment is
still limited to that carried into the field by the medic and other personnel.
(3) Combat casualty care evacuation: care rendered once the casualty has
been picked up by an aircraft, vehicle, or boat. 2 The key to keeping soldiers alive is to
provide treatment as far forward as the tactical situation permits and aggressively
executing an effective evacuation plan. These phases offer a sound plan that medical
platoons should strive to become proficient with and incorporate into their training
program.
d. The battalion surgeon and the PA play a critical role in helping the medics achieve
and sustain the standards identified in the protocols listed in Figure 1. To deploy a
treatment team forward without proper supplies, equipment, and a responsive
evacuation plan is not a combat multiplier. Physicians, PAs, and medics require certain
tools and supplies to provide EMT and ATM. The Battalion Aid Station is outfitted to
provide these supplies and equipment which are packed in medical chests. If treatment
teams do not establish SOPs/battle drills and packing lists to conduct dismounted
treatment teams, then casualties will die. The doctrinal method to determine the most
feasible course of action for a deliberate attack is through the TDMP and CHS estimate.
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13. CHS for Light Infantry Task Force - “Deliberate Attack” (Cont.)
e. Planning Checklist for CHS for Light Infantry.
 Does the platoon have the experience/training to conduct a dismounted treatment
team operation?
 Is the BAS at 100-percent strength?
 Does the platoon have an SOP battle drill for conducting dismounted treatment team
operations? Has the platoon ever conducted this type of mission before?
 Do the infantry companies have all authorized combat medics? How many combat
lifesavers do they have?
 Do the infantry companies have SKED litters and/or poleless litters? Do they know
how to make and use improvised litters?
 Do combat medics have all required Class VIII? Are Class VIII supplies cross-loaded
among platoon members? Does the first sergeant have a resupply chest in his vehicle to
get resupplied? How do combat lifesavers get resupplied?
 Does the medical platoon issue IVs to each individual soldier? Who maintains the
starter sets?
 Do treatment teams have an established packing list for the minimal types of supplies
and equipment required for the mission? Does the platoon have a plan to cross-load
Class VIII supplies with supported unit and with attached litterbearers?
 Are medics trained to initiate IVs with night-vision devices?
 Are soldiers physically fit?
 Are litterbearers capable of moving casualties over extended distances?
 Can each medic on the treatment team perform the following procedures? Is the
equipment available to perform the following procedures?
a. nasopharyngeal airway
b. endotracheal intubation
c. laryngeal mask airway
d. cricothyroidotomy
e. needle thoracostomy
f. apply tourniquet
g. start an IV
h. administer Morphine
i. splint fractures
j. administer antibiotics
k. perform cardiopulmonary resuscitation
l. apply bandages
 Do the infantry companies have aid/litter teams identified?
 Does the treatment team have FM communications or access to a radio?
 Does the unit have a sound air/ground evacuation plan? Is the plan coordinated with
the FSMC/MEDEVAC unit? Are CASEVAC procedures rehearsed along with the
maneuver rehearsal and at the Brigade CSS rehearsal?
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f. Planning Checklist for Medical Support for Light Infantry (Cont.)
 Does the battalion have a plan to clear a ground route for CASEVAC?
 Are landing zones/patient collecting points identified? Do the MEDEVAC helicopters
have hoist capabilities.
 Is there a CHS plan for actions at the breach site?
 Is the Mech/Armor team M113 ambulance integrated into the CHS plan? Does the
senior medic attend the Task Force rehearsal?
 Are additional litter bearers requested from the field trains/brigade support area?
 Are non-standard CASEVAC vehicles/aircraft on standby and identified? Do they
have litters/communications capability?
 Are reinforcing treatment teams provided from the FSMC?
 Is there a plan to use ambulance exchange points (AXPs)? Is there any treatment
capability at the AXP? Can a helicopter land at the AXP?
 Is the MEDEVAC communication net identified? Does the task force conduct a
communications exercise?
 Is there a contingency plan to bring additional medical assets forward for MASCAL
situations?
 Is CHS planned beyond the objective?
 Is there a plan for marking casualties during limited visibility operations? Is there a
plan to leave personnel with the wounded to treat for shock?
The medical platoon leader should answer these questions for the mission analysis.
Once the questions are answered, then develop courses of action to best support the
mission. Medical platoons must have the opportunity to train this complex task at home
station prior to deploying to a contingency mission.
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14. Rear Operations and Area Damage Control.
a. Rear operations consist of those actions, including area damage control, taken by
all units (combat, CS, CSS, and host nation) singly or in combination to secure the force;
to neutralize or defeat enemy operations in the rear area; and to ensure freedom of
action in deep and close-in operations. It is a system designed to ensure continuous
support.
b. Area damage control operations are those measures taken before, during, or after
a hostile action or a natural or man - made disaster to minimize its effects.
c. Combat Health Support is provided by division medical companies and medical
platoons. These elements establish and operate a BAS/DCS on or near the edge of the
damage area.
d. See FM 90-14 and FM 3-100 for additional information on area damage control
operations.
15. Military Operations on Urbanized Terrain.
a. General. Throughout history, battles have been fought on urbanized terrain. Some
recent examples are the battles for Manila, Stalingrad, Hue, Beirut, and Panama City.
Military operations on urbanized terrain (MOUT) are planned and conducted on a terrain
where man-made structures impact on the tactical options available to the commander.
This terrain is characterized by a three-dimensional battlefield, having considerable
rubble; ready-made fortified fighting positions; and an isolating effect on all combat, CS,
and CSS units. In this environment, the requirement for a detailed CHSPLAN cannot be
overstated. Medical and tactical planners must plan, train, prepare, and equip for
medical evacuation from under, at, and above ground level. An additional concern in
urbanized terrain is the increased potential for disease transmission due to disruption of
utilities (water, sewage, waste disposal), the large numbers of refugees and displaced
persons, and breakdowns in sanitation and personal hygiene.
b. Equipment Requirements. Materiel requirements for CHS of MOUT includes
unique equipment, especially for the extraction and the evacuation of patients.
 Axes, crowbars, and other tools used to break through barriers.
 Special harnesses, portable block and tackle equipment, grappling hooks, collapsible
stretchers and SKED stretchers, lightweight collapsible ladders, heavy gloves, and
blankets with shielding for use in lowering patients from buildings or moving them from
one building to another at some distance above the ground using ropes and pulleys.
 Equipment for the extraction of patients from tracked vehicles, safe and quick retrieval
from craters, basements, sewers, and subways. Patients may have to be extracted from
beneath rubble and debris.
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15. Military Operations on Urbanized Terrain.
 b. Equipment Requirements (Cont.)
The anticipated increase in wounds and injuries requires increased supplies of
intravenous (IV) resuscitation fluids. Individual soldiers may carry these fluids to hasten
their availability and shorten the time between wounding and initiation of vascular
volume replacement.
 Air ambulances equipped with a rescue hoist may be able to evacuate patients from
the roofs of buildings or may be able to insert needed medical personnel and supplies.
The use of SKED stretchers expedites patient hoisting.
 Effective communications face many obstacles during MOUT. Line of sight radios are
not effective. Individual soldiers will not have access to radio equipment. Alternate forms
of communications, such as markers, panels, or field expedients (fatigue jacket or Tshirt), which can be displayed by wounded or injured soldiers indicating where they are,
may be employed.
c. Nonmaterial Requirements.
(1) Patient collecting points should be established at relatively secure areas
accessible to both ground and air ambulances. Life- or limb threatening injured or
wounded soldiers should be evacuated by air ambulance, when available. Patient
collecting points should be designated in advance of the operation and should - Offer cover from enemy fires.
 Be located as far forward as the tactical situation permits.
 Be identified by an unmistakable feature (natural or man-made).
 Allow rapid turnaround of ambulances.
(2) Route markings to the MTF and display of the Geneva Red Cross at the facility
must be approved by the tactical commander. Camouflaging the Red Cross can forfeit
the protections, for both medical personnel and their patients, afforded under the
Geneva Convention. Refer to Appendix H for additional information. The site selected
must be accessible, but separated from lucrative enemy targets, as well as civilian
hazards such as gas stations or chemical factories.
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c. Nonmaterial Requirements (Cont.)
(3) Medical evacuation in the MOUT environment is a labor-intensive effort. Much
of the evacuation effort must be accomplished by litter teams; this is due to rubble,
debris, barricades, and destroyed roadways. When this occurs, an ambulance shuttle
system or litter shuttle should be established. Medical personnel must be able to use
and teach manual carries, as well as improvise as the situation dictates. In moving
patients, you should - Use covered evacuation routes such as storm water drains and subways. Sanitary
sewers should not be used; there is a danger of methane gas buildup in these systems.
 Use easily identifiable points for navigation and patient collecting points.
 Rest frequently by using a litter shuttle system.
(4) Self-aid, buddy aid, and the CLS skills are essential in this environment. Due
to the nature of MOUT, injured and wounded soldiers may not be reached by the
combat medic for extensive periods of time. The longer the period between injury or
wounding and medical treatment, the poorer the prognosis. Therefore, units operating in
this environment must ensure that all soldiers are proficient in self-aid and buddy aid,
and that CLS are trained. In paragraph b above, it is recommended that each soldier
carry IV resuscitation fluids with him so that the CLS can initiate replacement fluid
therapy before the combat medic reaches the casualty. The soldier's chance for survival
increases when he begins receiving IV resuscitation fluids early.
d. Ground Evacuation. When using ground evacuation in support of MOUT, the
CHS planner must remember that built-up areas have many obstructions to vehicular
movement. Factors requiring consideration include - Vehicular operations within the urban terrain are complicated and canalized by rubble
and other battle damage.
 Bypassed pockets of resistance and ambushes pose a constant threat along
evacuation routes.
 Land navigation using tactical maps proves to be difficult. Commercial city maps can
aid in establishing evacuation routes, when available.
 Ambulance teams must dismount, search for, and rescue casualties.
 Movement of patients becomes a personnel intensive effort. There are insufficient
medical personnel to search for, collect, and treat the wounded. Litter bearers and
search teams will be required from supported units, as the tactical situation permits.
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d. Ground Evacuation (Cont.).
 Refugees may hamper movement into and around urban areas.
 Civilian personnel, detainees, and enemy prisoners of war are provided medical
treatment in accordance with the command policy and the Geneva Convention.
e. Aeromedical Evacuation. When using aeromedical evacuation assets in support
of MOUT, the medical planner must consider enemy AD capabilities and terrain features
(both natural and man-made) within and adjacent to the built-up areas.
(1) Factors which may affect the use of air ambulances are - Movement is highly restricted and is canalized over secured areas, down wide roads,
and open areas.
 Telephone and electrical wire and communications antennas hinder aircraft
movement.
 Secure landing zones must be available.
 Landing zones may include buildings with helipads on their roofs or sturdy buildings,
such as parking garages.
 Snipers with AD capabilities may occupy upper stories of taller buildings.
(2) Helicopters remain the preferred method of evacuation.
f. Training. In addition to the self-aid, buddy aid, and CLS training, CHS personnel
must be familiar with the tactics, techniques, and procedures used by the combat soldier
in MOUT.
(1) For CHS personnel to survive and serve in this environment, they must know
how to --Cross open areas safely.
 Avoid barricades and mines.
 Enter and depart buildings safely.
 Recognize situations where booby traps or ambushes are likely and are
advantageous to the enemy.
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f. Training (Cont.)
(2) Many of the techniques used in a mountainous terrain for the extraction and
evacuation of patients can be applied to medical evacuation in a MOUT. By using the
SKED stretcher, the patient can be secured inside the litter for ease in vertical
extractions and evacuations.
(3) Health service support personnel must practice and become proficient in using
a grappling hook, scaling walls, and rappelling. Rappelling techniques can be used to
gain entry into upper levels of buildings as well as accompanying the patient during
vertical extraction and evacuation.
(4) Detailed information on the conduct of combat operations in the urban
environment is contained in FM 90-10-1. Additional information on CHS to MOUT is
contained in FMs 8-42 and 8-10-6. Health service support planners and providers must
be proficient in the skills required for this environment.
16. Combat Health Support In A Nuclear, Biological, Chemical, Or Directed Energy
Environment.
a. On future battlefields, the enemy may employ NBC weapons and directed energy
(DE) devices. Chemical, biological, and DE protective measures and procedures to
mitigate the effects of nuclear weapons must be included in the medical platoon training
programs and daily operations. This section provides guidance for CHS during nuclear
warfare, enemy biological or chemical attack, and enemy employment of DE devices.
The material presented in this section emphasizes contingency planning for immediate
problems confronting CHS units following enemy actions. The large numbers of patients,
the loss of MTFs and personnel from NBC attacks, and DE device employment will
reduce our capability to provide CHS.
b. Nuclear, biological, chemical, and DE actions create high casualty rates, materiel
losses, obstacles to maneuver, and contamination. Mission oriented protection posture
Level 3 and 4 results in body heat buildup, reduces mobility, and degrades visual, touch,
and hearing senses. Laser protective eyewear may degrade vision, especially at night.
Individual, and ultimately, unit operational effectiveness and productivity are degraded.
c. Contamination is a major problem in providing CHS in an NBC environment. To
increase survivability as well as supportability, the medical platoon must take necessary
action to avoid NBC contamination. Maximum use must be made of - Alarm and detection equipment.
 Unit dispersion.
 Overhead cover, shielding materials, and collective protective shelters.
 Chemical agent resistant coatings.
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16. Combat Health Support In A Nuclear, Biological, Chemical, Or Directed Energy
Environment (Cont.)
Generally, a biological aerosol attack will not significantly impact materiel, terrain, or
personnel in the short term. Detailed information on characteristics and soldier
dimensions of the nuclear battlefield; NBC operations; extended operations in
contaminated areas; NBC decontamination; NBC contamination avoidance; and NBC
protection are contained in Field Manuals 8-285, 8-250, 8-50, 3-100 3-5, 3-4, and 3-3.
d. On the integrated battlefield CHS is focused on keeping the soldier in the battle.
Effective and efficient triage and emergency treatment in the operational area saves
lives, assures judicious evacuation, and maximizes the return to duty rate.
e. Medical Planning Factors.
(1) To provide CHS, definitive planning and coordination is required at all levels of
command. This includes provisions for treatment, evacuation, and hospitalization. Field
Manuals 8-285, 8-55, 8-9, and TM 8-215 contain additional information in planning for
CHS operations. Higher headquarters must distribute timely plans and directives to
subordinate units. Provisions for emergency medical care of civilians, consistent with the
military situation, must be included.
(2) The medical platoon leader should make a quick appraisal to determine the
expected patient load. Consider the use of triage and EMT decision matrices for
managing patients in a contaminated environment. A sample decision matrix is shown in
Figure 6-2. Training medical personnel in the use of these matrices should enhance their
effectiveness in providing CHS.
f. Logistical Considerations.
(1) The medical platoon is organized and equipped to provide support in a
conventional environment. However, it must be trained and prepared to operate in all
battlefield situations. Employment in an NBC environment will necessitate the issue of
chemical patient treatment sets, and chemical patient decontamination sets.
(2) The DMSO maintains a 48-hour contingency stock level of Class VIII supplies.
These medical supplies and equipment must be protected from contamination by
chemical agent. Class VIII stocks are dispersed to prevent or reduce damage or
contamination caused by NBC weapons. Health service support plans include the
protection (NBC hardening) of contingency stocks and the rapid resupply of affected
units. Contaminated items are decontaminated prior to issue to using units.
(3) The division PVNTMED section is responsible for testing the quality of water
for the division. Water from local sources (lakes, ponds, or public water systems) is
subject to being contaminated; therefore, it is essential to test the local source for
contaminants before use. Frequent retesting by water production personnel is
recommended. Once a water source is contaminated, it is marked with appropriate NBC
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f. Logistical Considerations (Cont.)
contamination markers. The water is not used until a determination is made that it is safe
for use, or water treatment equipment capable of removing the contaminants is
employed. When water becomes contaminated, it is disposed of in a manner that
prevents secondary contamination; the area is marked. All water dispensing equipment
is monitored frequently for possible contamination. Water supply on the NBC battlefield
is provided on an area basis by elements of the supply and transportation battalion.
Water supply is normally provided to maneuver elements through unit distribution.
g. Personnel Considerations. During NBC actions, CHS requirements will
increase and medical reinforcement may be necessary. Following an enemy NBC
attack, or employment of DE devices, medical personnel will be fully active in providing
emergency medical care; they will provide more definitive treatment as time and
resources permit. Nonmedical personnel should provide search and rescue of the
injured or wounded; provide immediate first aid; and perform decontamination
procedures. Nonmedical personnel will be needed to man the patient decontamination
station at the BAS (FM 8-285 and TO 8-12). The requirement for nonmedical personnel
should be included in the battalion tactical SOP.
h. Disposition of Treatment Elements. Site selection factors dictate that the BAS
not be located at or near likely target areas. Selecting a covered and concealed site is
extremely important in a potential NBC environment.
(1) A minimum of eight medical personnel are required to operate a collective
protective shelter (CPS) system and provide medical care. One EMT NCO performs
triage and EMT on patients before decontamination. One aidman monitors the patient
during decontamination procedures. Two aidmen monitor and provide care to patients
when they leave the decontamination site. These individuals care for patients awaiting
admission to the CPS; they also provide care for RTD or other patients requiring
evacuation without receiving treatment in the CPS. One medic operates from the CPS
airlock. He removes patient’s protective mask and monitors patient’s prior to their
entering the interior of the CPS. He also assists with treatment in the CPS. The
physician and PA operate inside the CPS with the assistance of the airlock aidman and
one additional aidman.
(2) Operation of CPS systems at the BAS in a chemical environment requires
more than four medical personnel. This is why the squad does not split into teams. A
viable method of obtaining additional CHS in the area of operations would be to request
additional medical teams from the FSMC.
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h. Disposition of Treatment Elements (Cont.)
(3) The BAS is equipped with two medical equipment sets for chemical agent
patient treatment and one medical equipment set for chemical agent patient
decontamination. Each set has enough consumable supplies for the decontamination
and treatment of sixty chemical agent patients. These sets are also used at clearing
stations, corps and COMMZ hospitals, and dispensaries to decontaminate and treat
chemical agent patients. The number of sets vary, depending on the treatment site.
i. Civilian Casualties. Civilian casualties may become a problem in populated or
built-up areas; the BAS may be required to provide assistance when civilian medical
resources cannot handle the workload. Aid to civilians, however, will not be undertaken
at the expense of health services for US personnel.
j. Nuclear Environment. The medical platoon must be capable of supporting the
maneuver unit's operations in a nuclear environment. The three damaging effects of a
nuclear weapon are blast, thermal radiation (heat and light), and nuclear radiation
(principally gamma rays and neutron particles). Well - constructed foxholes with
overhead cover and expedient shelters (for example, reinforced concrete structures,
basements, railroad tunnels, or trenches) provide good protection from nuclear attacks.
Armored vehicles also provide protection against both the blast and radiation effects of
nuclear weapons. Nuclear radiation casualties fall into three categories:
 Irradiated casualty. The irradiated casualty is one who has been exposed to ionizing
radiation, but is not contaminated. They are not radioactive, and pose no radiation threat
to medical care providers. Casualties who have suffered exposure to initial nuclear
radiation will fit into this category.
 Externally contaminated casualty. The externally contaminated casualty has
radioactive dust and debris on his clothing, skin, or hair. He presents a "housekeeping"
problem to the BAS, similar to the vermin infested patient arriving at a peacetime MTF.
The externally contaminated casualty should be decontaminated at the earliest time
consistent with required CHS. Lifesaving care is always rendered, when necessary,
before decontamination is accomplished. Radioactive contamination can be monitored
with a radiation detection instrument such as the AN/PDR-27 or AN/VDR-2. Removal of
the outer clothing will result in greater than ninety-percent decontamination; soap and
water can be used to further reduce the contamination levels.
 Internally contaminated casualty. The internally contaminated casualty is one that has
ingested or inhaled radioactive materials, or has had radioactive material injected into
the body through an open wound. The radioactive material continues to irradiate the
casualty internally until radioactive decay and biological elimination removes the
radioactive isotope. Attending medical personnel are shielded, to some degree, by the
patient's body. Inhalation, ingestion, or injection of quantities of radioactive material
sufficient to present a threat to medical care providers is highly unlikely.
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j. Nuclear Environment (Cont.). Medical units operating in a residual radiation
environment will face three problems - Immersion of the treatment facility in fallout, necessitating decontamination efforts.
 Casualty production due to gamma radiation.
 Hindrances to evacuation caused by the contaminated environment.
k. Medical Triage. Medical triage, as discussed in earlier sections, is the
classification of patients, according to the type and seriousness of injury. This achieves
the most orderly, timely, and efficient use of medical resources. However, the triage
process for nuclear patients is different than for conventional injuries. The four
categories for triage of nuclear patients are:
 Immediate treatment group (T1). Those requiring immediate lifesaving surgery.
Procedures should not be time-consuming and concern only those with a high chance of
survival, such as respiratory obstruction and accessible hemorrhage.
 Delayed treatment group (T2). Those needing surgery but whose conditions permit
delay without unduly endangering safety. Life -sustaining treatment such as intravenous
fluids, antibiotics, splinting, catheterization, and relief of pain may be required in this
group. Examples are fractured limbs, spinal injuries, and uncomplicated burns.
 Minimal treatment group (T3). Those with relatively minor injuries, such as minor
fractures or lacerations, who can be helped by untrained personnel or look after
themselves. Buddy care is particularly important in this situation.
 Expectant treatment group (T4). Those with serious or multiple injuries requiring
intensive treatment, or with a poor chance of survival. These patients receive
appropriate supportive treatment compatible with resources, which will include large
doses of analgesics as applicable. Examples are severe head and spinal injuries,
widespread burns, or high doses of radiation; this is a temporary category.
191
Chapter 6
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATIONS
“Combat Health Support in Specific Environment”
Reference FM 8-10-4
l. Biological Environment.
(1) A biological attack (using bomblets, rockets, or spray/vapor dispersal, release
of arthropod vectors, and terrorist/insurgent contamination of food and water, frequently
without immediate effects on exposed personnel) may be difficult to recognize. The
medical platoon must monitor biological warfare indicators such as:
 Increases in disease incidence or fatality rates.
 Sudden presentation of an exotic disease.
 Other sequential epidemiological events.
(2) Passive defense measures such as immunizations, good personal hygiene,
physical conditioning, using arthropod repellents, wearing protective mask, and good
sanitation practices will mitigate the effects of most biological intrusion.
NOTE: Normally, biological agents delivered as a vapor will be nonpersistent.
(3) Decontamination of most biologically contaminated patients can be
accomplished by bathing with soap and water.
(4) Treatment of biological agent patients will require observation and evaluation
of the individual to determine necessary medications.
m. Chemical Environment.
(1) Handling chemically contaminated patients may provide the greatest
challenge to medical units on the integrated battlefield. All casualties generated in a
liquid chemical environment are presumed to be contaminated. Due to the vapor hazard
associated with contaminated patients, medical personnel operating BAS and DCS
without a collective protective shelter (CPS) system may be required to remain at MOPP
level 4 for long periods of time. When CPS systems are not available, clean areas must
be located for treating patients.
192
Chapter 6
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATIONS
“Combat Health Support in Specific Environment”
Reference FM 8-10-4
m. Chemical Environment.
(2) A patient processing station for chemically contaminated patients must be
established by the medical platoon to handle the influx of patients. Generally, the station
is divided by a "hotline" into two major working areas; a contaminated working area
situated downwind of a clean working area. Personnel on both sides of the "hotline"
assume a MOPP level commensurate with the threat agent employed (normally MOPP
4). The patient processing station should be established in a contamination-free area of
the battlefield. When CPS systems are not available, the clean treatment area should be
located upwind 30 to 50 meters of the contaminated work area. When personnel in the
clean working area are away from the hotline, they may reduce their MOPP level,
especially the physician and PA. Chemical monitoring equipment must be used on the
clean side of the hotline to detect vapor hazards due to slight shifts in wind currents; if
vapors invade the clean work area, medical personnel may have to remask to prevent
low level chemical agent exposure and minimize clinical effects (such as miosis).
(3) Initial triage, emergency medical treatment, and decontamination are
accomplished on the "dirty" side of the hotline. Life-sustaining care is rendered, as
required, without regard to chemical contamination. Secondary triage, ATM, and patient
disposition are accomplished on the clean side of the hotline. When treatment must be
provided in a contaminated environment, outside of CPS, the level of care may be
reduced to first aid procedures because treaters are in MOPP 3 or 4.
(4) Medical platoons will require augmentation with nonmedical personnel to meet
patient decontamination requirements created by a chemical attack. This augmentation
must come from the supported units.
n. Directed Energy Environment. A new dimension on the battlefield of the future
will be the employment of directed energy devices. These may be laser, microwave, or
radio frequency generated sources. Medical management of casualties from these
sources will compound the already overloaded medical treatment resources. Medical
management of DE patients at the BAS will consist of evaluation, application of eye
ointment, patching, and evacuation. Injuries from microwave and radio frequency
sources will be discussed in other publications as data becomes available. Refer to FM
8-50 for additional information on prevention and medical management of laser injuries.
o. Special Operations. Possible enemy employment of NBC weapons in the
extremes of climate or terrain warrants additional consideration. Consideration must
include the peculiarities of urban terrain, mountain, snow and extreme cold, jungle, and
desert operations in an NBC environment; also the NBC-related effects upon medical
treatment and evacuation.
193
Chapter 6
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATIONS
“Combat Health Support in Specific Environment”
Reference FM 8-10-7
Figure 6-1, Battalion Aid Station Using the M51 Shelter System.
Figure 6-2, Battalion Aid Station interior layout of the M51.
194
Chapter 6
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATIONS
“Combat Health Support in Specific Environment”
Reference FM 8-10-7
Figure 6-3, Layout of a chemical agent patient decontamination station, in an
uncontaminated area, without collective protective shelter.
195
Chapter 6
COMBAT HEALTH SUPPORT
IN A TACTICAL OPERATIONS
“Combat Health Support in Specific Environment”
Reference FM 8-10-4
p. Humanitarian Assistance. The attitude of host governments varies from helpful
cooperation to forbidding a peacekeeping force from providing aid to its citizens.
However, a force within a buffer zone is justified in providing humanitarian assistance to
individuals within the AOR. A special humanitarian staff can be established whose areas
of concentration can include the following:
 Investigation of missing persons.
 Emergency medical treatment (for life-threatening illnesses or injuries).
 Resupply of minority communities separated by a buffer zone.
 Transfer of minority populations.
 Repatriation of prisoners of war.
 Repatriation of human remains.
 Return of property.
196
Chapter 6
EVACUATION CAPABILITIES
United States Air Force
Type of Aircraft
Litter
Ambulatory
Remarks
C-130
74
92
C-9A
40
40
C-141
48
170
C-5
70
C-17A
36
54
KC-135 & KC-10
8
24
*BOEING B-767
111
22
87 litter/22 ambulatory
The BOEING B-767 is a Civil Reserve Air Fleet Aircraft used only when activated.
United States Army
Type of Aircraft
M113
M996
M997
M998 (4 Man)
M998 (2 Man)
Trk Cgo 2 1/2 Ton
Trk Cgo 5 Ton
C12
C21
CH-47
UH-60 (w/o hoist)
UH-60 (w / hoist)
UH-1H/V
Litter
4
2
4
3
5
12
12
0
10
24
6
3
6
Ship/Aircraft
LHD
LHA
LPH
LPD
LSD
LKA
LCC
CH-46
CH-53D
V22
Litter
604
367
222
14
108
12
24
15
24
12
Ambulatory
10
6
8
4
0
16
16
8
3
31
7
4
9
Remarks
or 1 litter/3 ambulatory
or 2 litter/4 ambulatory
or 3 litter/3 ambulatory
or 4 litter/1 ambulatory
or 3 litter/4 ambulatory
United States Navy
Ambulatory
604
367
222
14
108
12
24
25
55
24
197
Remarks
Amphib Assault Ship
GP Assault Ship
Amphib Assault Ship
Amphib Transport Dock
Dock Landing Ship
Amphib Cargo Ship
Amphib Command Ship
Sea Knight
Sea Stallion
Osprey
Chapter 6
DIVISION LEVEL MEDICAL ASSETS
BATTALION AID STATION
Personnel:
40
Mobility:
100%
Boa:
One unit per maneuver battalion
Assigned To:
Battalion
Mission: Provide echelon I CHS To assigned battalion and attached slice elements.
BAS Capabilities:
1. Prevention of disease and illness through applied preventive medicine programs.
2. Acquisition and immediate treatment of the sick, injured, and wounded.
3. Clinical stabilization of the critically injured or wounded.
4. Provision of routine medical care (sick call) and the immediate return to duty of
soldiers fit to fight.
Organization:
Headquarters Section
Treatment Squad (A & B)
Ambulance Section
Combat Medic Section (Line Medics)
Mechanized Infantry/armor:
Light Infantry/airborne:
8 X M113 Armored Ambulances
8 X M997/998 HMMWV Ambulances
198
Chapter 6
DIVISION LEVEL MEDICAL ASSETS
FORWARD SUPPORT MEDICAL COMPANY
Personnel:
64
Mobility:
100%
BOA:
One per FSB, operates in BSA
Assigned To: Forward Support Battalion, DISCOM
MISSION: Provide Echelon II CHS for organic and attached brigade elements and other
units operating in the Brigade Support Area.
FSMC CAPABILITIES:
1. Provide triage, initial resuscitation, and stabilization.
2. Prepares sick/injured/wounded patients for evacuation.
3. Performs emergency/sustaining dental care and limited preventive dentistry.
4. Provides limited medical laboratory and radiology services.
5. Provides patient holding, up to 40 patients who will return to duty with 72 hours.
6. Provides ground ambulance support from BAS to FSMC and to units within the
BSA.
7. Reconstitutes/Reinforces Battalion Aid Stations.
ORGANIZATION:
Company HQ
Treatment Platoon
- Plt HQ
- Treatment Squad x 2
- Area Support Section (Area Treatment/Pt Holding/Area
Support)
Ambulance Platoon
- Platoon HQ
- Wheeled Ambulance Sqd
- Tracked Ambulance Sqd (Heavy/Cav Division Only)
199
Chapter 6
DIVISION LEVEL MEDICAL ASSETS
MAIN SUPPORT MEDICAL COMPANY
Personnel:
114
Mobility:
100%
BOA:
One per division, operates in DSA
Assigned To: Forward Support Battalion, DISCOM
MISSION: Provide Echelon I & II CHS to units operating in the division support area
(DSA) and to provide reinforcement and reconstitution of supported FSMC elements.
MSMC CAPABILITIES:
1. Provide triage, initial resuscitation, and stabilization.
2. Prepares sick/injured/wounded patients for further evacuation.
3. Performs emergency/sustaining dental care and limited preventive dentistry.
4. Provides limited medical laboratory and radiology services.
5. Provides patient holding, up to 40 patients who will return to duty with 72 hours.
6. Reconstitutes/Reinforces FSMC’s.
7. Provides ground ambulance support to units within the DSA.
8. Provides mental health support (limited psychiatric care) to combat stress
casualties, evaluates effects of battle fatigue, operates the division mental
health program.
9. Provides preventive medicine services to division units.
10. Provides optometry support, to include routine eye examinations, emergency
treatment for eye injuries, and fabricates/repairs single-vision lens devices.
11. Operates the Division Medical Supply Office (DMSO),
procuring/storing/distributing medical supplies for the division and performs
maintenance on biomedical equipment.
200
Chapter 6
USAF COMMAND AND CONTROL
AEROMEDICAL EVACUATION COORDINATION CENTER
MISSION: Serves as the operations center where overall planning, coordinating, and
directing of AE operations are accomplished.
CAPABILITIES:
1. Advises the senior airlift commander on AE issues
2. Coordinates the selection and scheduling of theater airlift aircraft allocated for AE
mission
3. Monitors AE crews
4. Coordinates special medical equipment/supplies
5. Maintains statistical data/provides reports
6. Monitors resupply for subordinate AE units
7. Monitors field equipment maintenance
8. Serves as the HF radio net control station
1 x Flight Surgeon on 100% Tactical/ 80% Strategic
2 x Nurses
3 x Aeromedical Technicians
AEROMEDICAL EVACUATION CONTROL ELEMENT
MISSION: Serves as the functional manager for AE operations at a specific airfield.
CAPABILITIES:
1. Supervises ground handling and on/off loading of patients
2. Manages special equipment requirement tracking
3. Arranges for casualty in-flight feeding
4. Coordinates mission prep, to include aircraft configuration.
5. Maintains communication between AECC, ASF, and MTFs
201
Chapter 6
USAF LAISION & TRANSPORT TEAMS
AEROMEDICAL EVACUATION LIAISON TEAM
Personnel:
6
MISSION: Provides a direct HF radio communications link and immediate
coordination between the user service requesting aeromedical evacuation and the
AECC.
CAPABILITIES:
1. Coordinates casualty movement requests and movement activities between the
AECC and the user service.
2. Determines the time factors involved for the user service to transport patients to
the designated staging facility.
3. Determines requirements for special equipment and/or medical attendants to
accompany casualties during flight.
PERSONNEL:
2 x MSC’s
1 x Nurse
3 x RTO’s
AEROMEDICAL EVACUATION TEAMS
Personnel:
5
Mobility:
100%
Assigned To:
USAF Aeromedical Evacuation Squadron
MISSION: Provide in-flight supportive nursing care, 1 per 50 patients. Ensures
aircraft is properly configured and loaded for aeromedical evacuation.
PERSONNEL:
1 x Flight Surgeon on 100% Tactical/ 80% Strategic
2 x Nurses
3 x Aeromedical Technicians
CRITICAL CARE TRANSPORT TEAMS
Personnel:
3
Mobility:
100%
Assigned To: USAF Medical Group
MISSION: Augments the traditional aeromedical evacuation team. Enhances in-flight
capability without depleting forward medical resources.
PERSONNEL:
1 x Critical Care Physician
1 x Critical Care Nurse
1 x Respiratory Technician
202
Chapter 6
USAF STAGING FACILITIES
AEROMEDICAL STAGING FACILITY
Mobility:
Non-Mobile, Fixed Facility
Location:
Located on or near an enplaning/deplaning airbase or airstrip.
Strategic Aeromedical Evacuation.
CAPABILITIES:
1. 50 to 250 bed holding facility
2. Has physicians assigned.
3. Can hold patients for up to 24 hours.
4. Provides patient reception, administrative processing, ground transportation,
feeding, and limited medical care for patients entering, en route to, or departing
the aeromedical evacuation system.
MOBILE AEROMEDICAL STAGING FACILITY
Assigned To:
OPCON to AECC or AECE
Mobility:
Mobile and Tactical
Location:
Near runways/taxiways of forward airfields or operating bases.
Tactical Aeromedical Evacuation.
CAPABILITIES:
1. 25-50 beds, 4-6 hour holding capability
2. Staffed by flight nurses/AE technicians, and RTOs
3. Notifies AECC when AE aircraft has departed.
4. Prepares patient manifests
5. Assist in configuring aircraft for patients.
USAF Elements Do Not Exchange Blankets and Litters!
203
Chapter 6
TWO MAN FIGHTING POSITION
WITH BUILT-DOWN OHC
Reference GTA 7-6-1, FM 5-34, FM 5-103,
FM 7-8, FM 21-75
STAGE 1 (SITE POSITION - H+0 - H+.5 HRS):
CHECK FIELDS OF FIRE FROM PRONE POSITION
• Assign sector of fire
• Emplace aiming and limiting stakes
• Decide whether to build OHC up or down,
based on potential enemy observation of
position
Prepare:
• Scoop out elbow holes
• Trace position outline
• Clear primary and secondary fields of fire
Inspect:
• Site location tactically sound
• Low profile maintained
• OHC material requirements identified
STAGE 2 (PREPARE - H+.5 - H+1.5 HRS):
• OHC supports to front and rear of position
• Front Retaining Wall, at least 10 inches
high
• Rear Retaining Wall, at least 10 inches
high
• Flank Retaining Walls, at least 10 inches
high
INSPECT:
• Set back for OHC Supports - minimum of
1 foot or 1/4 depth of cut
STAGE 3 (PREPARE - H+1.5 - H+6 HRS) :
DIG POSITION - fill parapets in order front,
flanks, and rear
• Install revetments to prevent wall
collapse/cave-in (if soil is unstable)
• Place OHC stringers
Inspect:
• Stringers firmly rest on structural support
• Stringer spacing based on values found on
page
• Lateral bracing placed between stringers at OHC supports
• Revetments built in unstable soil to prevent wall cave-in. Slope walls if needed
204
Chapter 6
TWO MAN FIGHTING POSITION
WITH BUILT-DOWN OHC
Reference GTA 7-6-1, FM 5-34, FM 5-103,
FM 7-8, FM 21-75
STAGE 4 (PREPARE - H+6 -H+11HRS):
INSTALL OHC
• Use plywood, sheeting mat or
foxhole cover for dustproof layer
• Nail plywood dustproof layer to
stringers
• Use minimum of 18 inches of
sand-filled sandbags for overhead
• Use plastic or a poncho for
waterproof layer
• Fill center cavity with soil from
dug hole and surrounding soil
• Camouflage Position - use
surrounding topsoil and camouflage
screen system
INSPECT:
• Dustproof layer - plywood or panels
• Sandbags filled 75% capacity
• Burst layer of filled sandbags at
least 18 inches deep
• Waterproof layer in place
• Camouflage in place
• Position undetectable at least
35 meters
• Soil used to form parapets, used
to fill cavity, or spread to blend with
surrounding ground
Fill cavity made
by sandbags
with
surrounding
packed soil and
cover top of
OHC with
waterproof layer
205
Chapter 6
TWO MAN FIGHTING POSITION
WITH BUILT-DOWN OHC
Reference GTA 7-6-1, FM 5-34, FM 5-103,
FM 7-8, FM 21-75
The checklists remain the same as for
built-up OHC fighting position. However,
there are three major differences /
concerns.
• The maximum height above ground for a
built-down OHC should not exceed 12
inches. Parapets may be used up to a
maximum height of 12 inches. Leaders
must ensure that soldiers taper OHC
portions and parapets above ground
surface to conform to the natural lay of
the ground.
• The position is a minimum of 3 M16s in
length. This provides adequate fighting
space between the end walls of the
fighting position and the built-down OHC.
This requires an additional 2.5 hours to
dig.
• When firing, soldiers must construct a
firing platform in the natural terrain upon
which to rest their elbows. They position
the firing platform to allow the use of the
natural ground surface as a grazing fire
platform.
206
Chapter 6
DEFEND ASSIGNED AREA CHECKLIST
Positioning.
Place defensive perimeter inside a wood line to maximize cover and concealment.
Place a section perimeter at least 35 meters (hand grenade range) from its
vehicles and sleep areas.
Fighting Positions.
Arrange fighting positions normally in a "Lazy W" configuration.
Arrange so that positions are mutually supporting. (A direct attack on a single
fighting position must be able to be supported by direct fire from two other positions.)
Ensure distance between positions makes maximum use of terrain for dispersion.
Locate positions outside of hand grenade range of one another.
Stagger positions alternately along the perimeter to achieve depth in the "Lazy W."
Range Cards.
Prepare range cards for each primary and alternate position.
Place range cards by the firing stakes unless the position is not manned at that
time.
Section Sector Sketch.
The platoon leader's section sketch includes-__ All individual positions identified by individual.
__ All dead space to their front.
_ __ Wire and obstacles.
__ Adjacent section positions to left and right.
__ Supplementary positions.
Section Sector Sketch.
Each platoon will:
Turn-in initial sector sketches within one hour of arrival.
Update as required by priorities of work.
Wire Obstacles.
Tactical wire.
Place tactical wire in section sectors for a minimum of 50 meters.
Ensure tactical wire consists of triple strand concertina wire with a single
strand of barbed wire run along the top row of wire and another anchoring the base
of the friendly side.
Hang concertina wire on long pickets tied together with communications wire
to avoid breaks.
Anchor wire on each end by a short picket.
207
Chapter 6
DEFEND ASSIGNED AREA CHECKLIST
Protective Wire.
String protective wire in front of individual fighting positions.
String protective wire outside hand grenade range of positions not less
than 35 meters to the front.
Techniques.
Start tactical wire 25-30 meters from the muzzle of the weapon.
Lay in tactical wire with a stake string tied to the muzzle of the weapon.
Use wire obstacle to confuse the enemy as well as stop, impede, or
canalize the enemy's force.
Place single strand concertina wire/barbed wire between trees.
Improve the wire/barbed wire later with tangle foot.
Wire Obstacles.
Work Considerations.
Keep troops in uniform.
One soldier works; one rests or provides security.
Ensure troops keep personal gear/weapons within reach at all times.
Conceal range cards and other relative object.
Maintain effective light discipline.
208
Chapter 6
TRIPLE STRAND CONCERTINA
• Ensure job site security
• Organize work into three crews
• First crew lays pickets
• Second crew lays out wire. Place one roll on enemy side at every third picket and
two rolls on enemy side at every third picket
• Third crew installs all pickets
• Reorganize party into four soldier crews
• Install wire
• Ensure wire is properly tied and all horizontal wire properly installed
90cm
Taut Horizontal
Support Wire Tacked
To Upper Concertina
Halfway Between
(36”)
Taut Horizontal
Support Wire
Pickets
90cm
(36”)
x
x
x
x
x
x
1 Meter
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
5 Paces
x
x
x
x
x
x
x
x
x
5 Paces
5 Paces
Picket Installation
209
RANGE CARD
Chapter 6
SQD
May be used for all types of direct fire weapons
PLT
CO
MAGNETIC
NORTH
-
-
-
-
-
-
-
-
DATA SECTION
Position Identification
Date
Weapon
No.
Each Mark Equals ___________ Meters
Direction/
Reflection
Elevation
Range
Remarks:
210
Ammo
Description
SECTOR SKETCH
Chapter 6
Magnetic
North
OUTPOST
M16
TRIP WIRE
CHEM ALARM
M60
t
DEAD SPACE/TREES
LIKELY AVE OF APPROACH
M2
FLARE
M203
F
TRP
UNIT:
M203
M19
M19
ROAD BLOCK XX
Chapter 6
INFORMAL AFTER ACTION REVIEW
1. Used to:
(a) evaluate unit performance against published Army standard,
(b) identify unit strengths & weaknesses,
(c) decide how to improve performance during next iteration of the task(s).
2. Planning and Execution Sequence.
Planning
 Select & train OCs.
 Ensure correct standard by reviewing MTP, STP, SMCT etc.
 When AAR occur? (Train, AAR, Train, [AAR]).
 Whose at AAR? (All, squad ldrs only)
 Where site? (Good for concentration)
 What training aids?
 How conduct AAR? (Review the plan)
Preparation
 Make a plan to be at the right place at the right time to assess the right events.
 Plan to measure performance against a published Army (unit) standard.
 Recon training site
 Rehearse assessment plan
 Conduct assessment using published standard.
 Include other OC observations.
 Prepare AAR site
 Conduct rehearsal of AAR. Know major issues and sequence of events. Practice
summation that motivates soldiers not degrades them.
Conduct
 Ground rules - seek maximum participation.
 Maintain focus on training objectives.
 Guide discussion by asking questions of participants.
-Constantly review teaching points.
 Emphasize published standard & where to find it.
 Ensure that "untrained performance assessment" does not equal "unsatisfactory
soldier."
Follow Up
 Identify tasks requiring retraining.
 Fix the problem immediately by retraining, changing SOP, and integrate into next
training event for practice.
 Ensure that AAR has performance based measurable outcome so that the benefits
are observable by participants.
212