MCWP 4-11.1, HEALTH SERVICE SUPPORT

OPERATIONSCHAP 3, 7, 8, 10

HM1 VIDAL

OPERATIONSCHAPTER 3

Health Services Support (HSS) is a mission area common to every Marine Air-Ground Task Force (MAGTF), regardless of mission.

Size, type, and configuration of HSS capabilities is determined by mission, enemy, terrain, weather, troops and support/time available.

OPERATIONS

MAGTF ELEMENTS

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

OPERATIONS

MARINE CORPS FORCES (MARFOR) Commanders coordinate/integrate HSS within their

AOR MARFOR surgeon, dental officer, medical planner,

and medical admin officer advise MARFOR commander on:◦ Health of command◦ Medical logistics◦ Patient movement◦ Sanitation◦ Disease surveillance medical intelligence◦ Medical personnel issues◦ Current and future HSS planning

OPERATIONS

MARINE EXPEDITIONARY FORCES (MEF) Include surgeon, medical planner, admin

officer, preventive medicine officer, HMs and DTs.

MARFOR - OPERATIONAL LEVEL MEF - TACTICAL LEVEL

OPERATIONS

ELEMENTS OF THE MEF 1. MARINE DIVISION 2. MARINE AIR WING 3. FORCE SERVICE SUPPORT GROUP

◦ Medical Battalion Surgical Company Shock Trauma Platoon

◦ Dental Battalion◦ Medical Logistics Company

OPERATIONS

ELEMENTS OF THE MEF MARDIV consists of:

◦ Division surgeon◦ Medical planner/administrator◦ Psychiatrist◦ HMs

Responsibilities are similar to the MEF Planning occurs on a company or platoon

level with HMs assisting

OPERATIONS

ELEMENTS OF THE MEF MAW HQ consists of:

◦ Surgeon◦ Medical planner/administrator◦ Environmental health officer◦ Industrial hygienist◦ Optometrist◦ HMs

A MAW has four Marine Aircraft Groups (MAGs).◦ Each MAG has a surgeon and several HMs

OPERATIONS

ELEMENTS OF THE MEF FSSG consists of:

◦ Surgeon (has cognizance over the group aid station)

◦ Health Service Support Officer◦ Medical battalion with three Surg COs and eight

STPs◦ Dental battalion◦ Supply battalion through Med Log Co

OPERATIONS

ELEMENTS OF THE MEFFSSG

MEDICAL BATTALION Provides initial resuscitative HSS Only source of organic USMC medical support above

the aid station Primary mission: perform emergency medical/surgical

procedures that, if not performed, could lead to death or loss of limb/body function

260 holding beds and 9 operating rooms Consists of H&S CO and three Surg COs. H&S CO contains 8 STPs with 10 holding beds each Each Surg CO contains 60 beds and 3 operating rooms

OPERATIONS

MEF

FSSG

MED BATTALION

H&S CO8 STPs x 10

BEDS

A CO60 BEDS

3 ORs

B CO60 BEDS

3 ORs

C CO60 BEDS

3 ORs

DEN BATTALION

SUPPLY BATTALION

OPERATIONSMEF HEIARCHY

ELEMENTS OF THE MEFFSSG

MEDICAL BATTALION, SURGICAL COMPANY HQ platoon Triage/evacuation platoon Surgical platoon Holding platoon Combat stress platoon Services platoon (2 lab, pharmacy and x-ray

sections) Components of the Surg CO may be used to

reinforce an STP

OPERATIONS

ELEMENTS OF THE MEFFSSG

MEDICAL BATTALION, H&S BATTALION, STP Smallest most mobile medical support

platoon Can serve as

◦ a beach evacuation station◦ Reinforcement to a BAS◦ Operate as an intermediate casualty collecting

and clearing point◦ The forward element of a Surg CO

OPERATIONS

ELEMENTS OF THE MEFFSSG

DENTAL BATTALION Focuses on emergency dental care Personnel may perform post-op, ward, CSSR

duties

OPERATIONS

ELEMENTS OF THE MEFFSSG

SUPPLY BATTALION, MEDICAL LOGISTICS COMPANY

Maintains medical equipment Maintains centralized acquisition, storing,

and stock rotation Constructs and resupplies AMAL/ADAL

OPERATIONS

EXTERNAL MAGTF CAPABILITIES

FLEET HOSPITALS Transportable, medically/surgically intensive, deployable. Substantially self-supporting and relocatable.

HOSPITAL SHIPS (T-AH) Considered a floating surgical hospital. Provides acute medical care in support of combat

operations at sea and ashore. Support is provided to ATFs, joint task forces, and

combined forces. Designed to receive patients primarily by helicopter.

OPERATIONS

MARINE EXPEDITIONARY UNIT (MEU) Each MEU element deploys with its own

organic HSS capability Includes

◦ STPs◦ H&S CO, medical battalion elements◦ Med Log CO detachments◦ Dental detachments◦ Surg Co (triage/evacuation platoons)

OPERATIONS

PHASING SUPPORT ASHORE During the movement phase of amphibious

operations, commander, amphibious task force (CATF) has overall responsibility for HSS services.

Landing force (LF) HSS personnel aboard ATF ships augment with MED/DEN departments to provide care to embarked personnel.

LF Class VIIIA equipment and supplies WILL NOT be used aboard ship unless authorized by the MAGTF commander in support of an overwhelming emergency.

Senior medical officer of each ATF ship is responsible to the ship’s commander for HSS to all personnel

OPERATIONS

EXTERNAL MAGTF CAPABILITIESCASUALTY RECEIVING AND TREATMENT SHIPS

Largest medical capability of any amphibious ship in the ATF.

Medical spaces include operating rooms, ICUs, quiet room, ward beds, and over-flow beds.

Dental spaces include general dental operating rooms, maxillofacial operating room, and a prosthetics lab.

ATF ships used for CRTSs are LHD, LHA and LPHs.

OPERATIONS

AUGMENTATIONFLEET SURGICAL TEAMS

FSTs HSS augmentation teams assigned to the fleet CINCs.

Combined, PAC/LANT fleets have 9 teams Provide medical support to routine

deployment medical requirements. Medical support for other peacetime

contingencies that cannot be covered will be provided MMARTs

OPERATIONS

AUGMENTATIONMOBILE MEDICAL AUGMENTATION READINESS

TEAMS Provide rapid peacetime response teams of

pre-identified medical department personnel trained to augment elements of the operating forces.

OPERATIONS

AUGMENTATIONMEDICAL AUGMENTATION PROGRAM

The means by which operating forces are brought to wartime manning levels by personnel augmentation from CONUS-based activities.

MAP is managed by BUMED. Staffing may be above authorized staffing or in

addition to authorized billets when directed by CNO.

Units participating in MAP include CRTSs, MARFOR HSS units, fleet hospitals and hospital ships.

OPERATIONS

H&S COMPANY3 SURGICAL COMPANIES

WHAT ELEMENTS MAKE UP A MEDICAL BATTALION?

10 BEDS

HOW MANY BEDS ARE IN EACH OF THE 8 SHOCK TRAUMA PLATOONS OF A MEDICAL BATTALION?

DENTAL BATTALION, FSSG

WHICH ELEMENT OF THE MEF IS RESPONSIBLE FOR PROVIDING EMERGENCY DENTAL CARE?

FALSE

TRUE OR FALSE? THE SENIOR MEDICAL OFFICER OF AN ATF SHIP IS RESPONSIBLE FOR SHIPS COMPANY ONLY.

SUPPLY BATTALION

WHICH ELEMENT OF THE MEF IS RESPONSIBLE FOR MAINTENANCE OF MEDICAL EQUIPMENT?

NINE

HOW MANY FLEET SURGICAL TEAMS EXIST?

MEDICAL AUGMENTATION PROGRAM (MAP)

WHAT PROGRAM BRINGS OPERATING FORCES TO WARTIME LEVELS BY AUGMENTING PERSONNEL FROM CONUS-BASED ACTIVITIES?

PREVENTIVE MEDICINE

CHAPTER 7

Throughout military history, military forces have lost more personnel to disease and nonbattle injuries than to wounds sustained in combat.

During the Civil War, more federal soldiers died from disease than wounds.◦ 44, 238 KIA◦ 49, 205 died from wounds◦ 186,216 died of disease

PREVENTIVE MEDICINE

PRE-DEPLOYMENTSpecific preventive medicine taskings and efforts to be

conducted before deployment include: Collect and disseminate environmental and

epidemiological information to elements that might be affected.

Recommend immunization and other preventive measures to counter medical threats.

Train individuals in personal hygiene, personal protective measures, protection equipment, and field sanitation practices.

Assists medical units in completing pre-deployment requirements and preparing for embarkation of preventive medicine equipment.

PREVENTIVE MEDICINE

DEPLOYMENTSpecific preventive medicine taskings and efforts to be

conducted while deployed include: Disseminate significant information to commanders and HSS

units in theater. Provide technical oversight on food service operations and

procurement. Provide oversight and testing at water points and bulk water

storage areas. Conducting disease vector and pest surveillance and control

when feasible. Maintain environmental health and pest control equipment Conduct weekly disease and injury surveillance at all

battalions and squadrons.

PREVENTIVE MEDICINE

MEF PREVENTIVE MEDICINE SOURCES MEF surgeon staff includes a preventive medicine officer with

special expertise in preventive medicine and public health. Assets are found in FSSG’s preventive medicine section of

the medical battalion’s H&S company. Support includes identifying information regarding:

◦ Environmental health factors◦ Demographics◦ Living conditions◦ Water supply◦ Waste disposal◦ Insects◦ Diseases and vector issues◦ Evaluating local food sanitation, sight and hearing conservation

programs.

PREVENTIVE MEDICINE

MOBILE MEDICAL AUGMENTATION READINES TEAM

During peacetime, any operational commander may request preventive medicine MMART assistance from the Chief of Naval Operations via the operational chain of command.

PREVENTIVE MEDICINE

NAVY ENVIRONMENTAL HEALTH CENTERLocated in Norfolk, VA and supports operational units by

conducting: Risk screening Data evaluation Exposure assessments Toxicity assessments Health risk evaluations Health and safety planning Environmental risk communication workshops and seminarsSupporting activities include: Navy Environmental Preventive Medicine Units Navy Disease Vector Ecology and Control Centers Forward Deployed Laboratory

PREVENTIVE MEDICINE

PATIENT MOVEMENTCHAPTER 8

PHASES When properly followed, the process ensures

that patients only move as far rearward as their healthcare needs dictate.

Occurs in 2 phases:◦ Evacuation: the movement of patients between

point of injury or onset of disease to a facility that can provide the necessary treatment capability.

◦ Medical regulating: the process of selecting destination MTFs with the necessary HSS capabilities for patients being medically evacuated.

PATIENT MOVEMENT

DECISION MAKINGIncludes: Casualty Sorting (Triage)

◦ Identifies which patients need immediate resuscitation and which patients can tolerate delay in treatment.

Medical Management◦ Controls the flow of sick and wounded.

PATIENT MOVEMENT

MEDICAL EVACUATION ASSETS All USMC rotary wing transport and utility aircraft have

the capability to perform aeromedical evacuation (AE) missions.

Allocation of aircraft to perform the AE mission is at the discretion of the MAGTF commander.

Evacuation concepts used by the USMC are defined as the following:◦ Dedicated medical evacuation assets are patient movement

assets configured for medevac, externally marked with a red cross. They are authorized protection under the Geneva Conventions.

◦ Designated medical evacuation assets are non medical patient movement assets, not externally marked with a cross. Not afforded protection under the Geneva Conventions.

PATIENT MOVEMENT

EVACUTIONMEDICAL REGULATING

PATIENT MOVEMENT OCCURS IN WHAT 2 PHASES?

TRIAGE

WHAT TERM DESCRIBES IDENTIFYING WHICH PATIENTS NEED IMMEDIATE RESUSCITATION AND WHICH PATIENTS CAN BE DELYAYED TREATMENT?

WHAT IS THE DIFFERENCE BETWEEN DEDICATED AND DESIGNATED MEDICAL EVACUATION ASSETS?

COMBAT CASUALTY REPORTING

CHAPTER 10

G-1/S-1 section of a command is responsible for submitting casualty reports to higher headquarters.

HMs are primary sources of individual casualty data.

Casualty reporting in the MARFOR is addressed in the MCO P3040.42 Marine Corps Casualty Procedures Manual and in other local guidance in the 3040 series.

COMBAT CASUALTY REPORTING

FIELD MEDICAL CARD HMs at the unit level provide the first

written info on a casualty through the use of a U.S. Field Medical Card (DD Form 1380).

The FMC is a casualty tag where the original is attached to the casualty and a carbon copy is retained by the HM

COMBAT CASUALTY REPORTING

IDNTIFICATION TAGS (DOG TAGS) Essential to casualty ID and recording Every service member is issued 2 tags that

should be worn at all times. Contains member’s name, SSN, blood type,

service component, religious preference, and protective mask size.

Both tags remain with casualty at all times except when remains are buried in the combat area. One tag is attached to grave marker and the other remains with the deceased.

COMBAT CASUALTY REPORTING

HOSPITAL CORPSMAN

WHO ACTS AS THE PRIMARY SOURCE FOR REPORTING COMBAT CASUALTYS?

FIELD MEDICAL CARD(DD FORM 1380)

WHAT FORM IS ATTACHED TO THE CASUALTY WITH A CARBON COPY BEING RETAINED BY THE HM?

FALSE

TRUE OR FALSE? BOTH DOG TAGS REMAIN WITH THE CASUALTY EVEN IF BURIED ON THE BATTLEFIELD.

QUESTIONS?