MODULAR MEDICAL SUPPORT
The modular support system facilitates common medical functions performed throughout the CZ and incorporates subunit designs (modules of personnel and equipment) to accomplish those functions. It enables the medical resource manager to rapidly tailor, augment, regenerate, or reconstitute the battlefield in areas of
critical need. The modular medical support system is built around six modules. The modules are oriented to casualty assessment/collection, treatment, and RTD or evacuation.
Combat medic. The combat medic module consists of one combat medical specialist and his prescribed load of medical supplies and equipment.
Ambulance squad. An ambulance squad is comprised of four medical specialists and two ambulances, either tracked or wheeled. The squad evacuates casualties throughout the division and ensures continuity of care en route.
Treatment squad.This squad consists of a primary care physician, a PA, and six medical specialists. The squad is trained and equipped to provide advanced trauma life support (ATLS) to battlefield casualties.
Area support squad. This squad includes one dentist trained in ATLS, a dental specialist, an X-ray specialist, and a medical laboratory specialist.
Patient-holding squad.This squad consists of two practical nurses and two medical specialists. It can hold and provide minimal care for up to 40 patients who will RTD. When a treatment squad, an area support squad, and a patient-holding squad are collocated, they form a treatment platoon. This platoon provides CHS on an area basis to all forces within a geographic AOR by operating a clearing station. The treatment platoon normally operates in the BSA, DSA, corps, and EAC areas.
Surgical squad/detachment. This module is composed of two surgeons, two nurse anesthetists, two operating room specialists, one medical/surgical nurse, and two practical nurses. It provides early resuscitative surgery for seriously wounded or injured casualties to save life and to preserve physical function. Surgical squads are organic to airborne and air assault divisions.
UNIT-LEVEL CHS (ECHELON I/LEVEL I)
General. In combat, acquiring and treating sick, injured, and wounded soldiers from forward locations are unit-level functions. Unit-level CHS is closely reinforced by the other levels of CHS, each providing increased medical capabilities to the patient. During noncombat periods, unit-level medical personnel operate a sick call facility; conduct MOS training; and provide instruction to nonmedical personnel in first aid, field sanitation, patient evacuation, and personal hygiene procedures.
Medical platoon. In maneuver battalions, the medical platoon is organic to each battalion and provides unit-level CHS to it and other units on an area basis. As an organic part of the battalion HHC, the medical platoon operates under the command of the HQ company commander.
Like the HQ's other subordinate elements, the medical platoon receives (other than class VIII) supply, trans-portation, and food service support from the battalion support platoon and maintenance support from the battalion maintenance platoon. Medical supplies (class VIII) are requested and received from the supporting forward support medical company organic to the FSB. Requests are transmitted by the fastest means available, and supplies are moved forward by requesting unit vehicles or by supporting ground or air ambulances. Medical platoon functions include,
Establishing and operating a BAS.
Providing aidmen to the unit's maneuver elements as required.
Providing ground evacuation from the point of injury or illness or from predetermined collection points to the BAS.
Supervising and directing medical operations conducted in the unit area.
The medical platoon's size varies depending on the structure of the combat or combat support unit it supports. It is composed of a medical platoon HQ, a combat medic section, an ambulance section, and a treatment squad.
DIVISION MEDICAL SUPPORT (ECHELON II/LEVEL II)
The division surgeon serves as a special staff officer to the division commander and normally functions under the general staff supervision of the division chief of staff. (Brigade and battalion surgeons operate under the general staff supervision of brigade or battalion XOs.) The division surgeon has primary coordinating staff responsibility with the G1.
Generally, his duties are administrative. The division commander normally charges him with full responsibility for staff supervision, including technical supervision of all unit-level medical activities in the command. He has direct access to the division commander and staff in performing his duties and advises the division commander on all medical matters.
The division medical operations center (DMOC) staff is responsible to the DISCOM commander for staff supervision of CHS within the DISCOM. The division surgeon exercises technical control of all medical activities within the division. The DMOC coordinates CHS according to the technical parameters the division surgeon establishes. All CHS issues and requirements are coordinated with the DISCOM units, division staff, and division surgeon before committing any CHS resources. The DMOC staff assists the division surgeon in planning and accomplishing division CHS operations. The DMOC consists of a medical operations branch, medical materiel management branch, a patient disposition and reports branch, and a medical communications branch.
c. The division medical supply office (DMSO), a section of the main support medical company organic to the MSB, operates under the control of a health service materiel officer who provides division-level medical supply support to the division's organic and attached units and supervises the biomedical maintenance specialists assigned to each medical company. He also establishes stock levels and maintains demand data on stock record systems separate from the DMMC. Requirements and replenishment may be transmitted and received using communication assets in the DMMC. The line of medical supply flow generally follows patient-evacuation channels to the maximum extent possible and practical.
Division MTFs.
The main support medical company operates in the DSA. This company provides unit- and division-level CHS to units operating in the division rear area. The main support medical company's and the forward support medical company's treatment platoons are identical in capabilities. In addition, the main support medical company provides specialized medical services in support of the division. These services include aviation medicine, consultation, PM, mental health services, and optometry services. This company also evacuates patients from units operating in the division rear to the clearing station.
One forward support medical company operates in each BSA. The treatment platoons organic to these companies provide division-level CHS to units operating in the brigade area. Patients are either treated and RTD immediately or held for treatment in a 40-cot holding facility if they are expected to RTD within 72 hours. Patients who cannot RTD within this time are evacuated to a CZ hospital for echelon III/level III treatment. The medical company's ambulance platoon evacuates patients from BASs and from units that do not have organic medical support to the clearing station operated by the medical company's treatment platoon. The ambulance platoon normally positions evacuation assets forward at BASs and evacuates patients back to the clearing station located in the BSA. Patients requiring treatment beyond the capabilities of division-level CHS may be evacuated directly from the aid station to corps-level medical facilities by aeromedical evacuation assets if the weather, tactical situation, and aircraft availability permit.
CORPS MEDICAL SUPPORT (ECHELON III/LEVEL III)
The COSCOM, unlike the DISCOM, is not a fixed organization. It is tailored to support the varying combat, combat support, and CSS elements of the force. The medical organization, whether it be a medical brigade or a medical group subordinate to the COSCOM, is tailored to provide the necessary medical evacuation, hospitalization, medical regulation, medical supply and maintenance, dental care, veterinary services, PM, and other health services required to support the corps.
The corps senior medical organization commands and controls all medical units in the corps except those organic to corps MSCs (less the COSCOM). This medical organization may be a medical brigade supporting a large corps consisting of three to five divisions or a medical group supporting a small corps consisting of only two divisions. The decision as to whether the organization is a brigade or a group depends on many factors (e.g., the mission, number of medical units in the command, or number of troops supported). The senior corps medical organization commander is also the COSCOM surgeon.
The medical brigade's mission is to provide command, control, administrative assistance, and technical supervision of assigned and attached medical units. Medical brigade commanders task organize medical assets to meet the patient work load. The medical assets are modularly designed by duty functions and are replicated throughout the theater of operations to meet these requirements. Medical brigades also regulate patient movements to and between assigned and attached MTFs and coordinate with the medical command (MEDCOM) and/or Joint Medical Regulating Office (JMRO) for all medical regulating for evacuation from the medical brigade MTFs to supporting MTFs in the COMMZ and CONUS.
The medical group's mission is to provide command, control, and administrative supervision of assigned and attached corps medical units, including area support medical battalions (ASMBs), hospitals, evacuation battalions, combat stress control companies, dental battalions, and PM detachments. The command of the assigned medical units includes coordination for employment, patient evacuation, supply and equipment management, and various other HQ requirements. This command coordination is between its units and other medical elements operating in the medical group's AOR. Medical group units may be task organized to support close, deep, and rear operations.
The mission of the 30-bed MASH is to provide hospitalization for patients who require far forward surgery and medical treatment to stabilize them for further evacuation. Although the MASH is an echelon III unit, it is designed to primarily function within the division rear area or in the corps rear area near the division rear boundary. The MASH provides lifesaving initial wound surgery for patients requiring stabilization before further evacuation, and preoperative and postoperative acute nursing care. A hospital unit surgical forward (HUSF) with 1 operating room and 10 beds may operate detached in a BSA or DSA for up to 48 hours.
The mission of the 296-bed CSH is to stabilize patients before further evacuation and to RTD those soldiers within the corps evacuation policy. This hospital can handle all types of patients and will normally be employed in the corps rear area. The CSH provides hospitalization for up to 296 patients; surgical capacity with 8 operating room tables; consultation services for patients referred from other MTFs; pharmacy, clinical laboratory, blood banking, radiology, and nutrition care services; and physical therapy support to patients.
The evacuation battalion commands and controls air and ground medical evacuation units within the corps. An evacuation battalion normally commands and controls three to seven ground and air ambulance companies.
The mission of the medical company [air ambulance (UH-1V or UH-60A aircraft)] is to provide air evacuation and support within the theater of operations. This unit provides helicopter ambulances to evacuate patients consistent with evacuation priorities and operational considerations from points as far forward as possible to division MTFs and corps-level hospitals. The air ambulance company also expeditiously delivers whole blood and biological and medical supplies to meet critical requirements; rapidly moves medical personnel; and accompanies equipment and supplies to meet the requirements for mass casualty reinforcement, reconstitution, or emergency situations. This unit also moves patients between hospitals (land-based or afloat), aeromedical staging facilities (ASFs), mobile ASFs (MASFs), seaports, or railheads in both the corps and COMMZ.
The mission of the medical company (ground ambulance) is to provide ground evacuation of patients within the theater of operations. This unit evacuates patients from division medical companies to corps hospitals; evacuates patients from area support medical companies to corps and EAC supporting hospitals; and moves patients between hospitals and ASFs, MASFs, seaports, or railheads in both the corps and COMMZ. The ground ambulance company also provides area evacuation support beyond the ASMB's capability and emergency movement of medical supplies.
The mission of the medical battalion (logistics) (forward) is to provide class VIII supplies, optical fabrication, medical equipment maintenance support, and blood storage and distribution to divisional and nondivisional units operating in the supported corps. This unit provides class VIII supply based on 10 DOS for the supported corps; DS medical equipment maintenance on an area basis; and blood processing, storage, and distribution within the corps and division medical units. Routine distribution of class VIII other than blood is via corps transportation units.
The ASMB provides routine health services (dispensary care), emergency care, and patient evacuation on an area basis to all corps elements that do not have organic medical resources. The ASMB provides echelon I and II CHS and medical staff advice and assistance, as required, for all assigned and attached corps and COMMZ elements. The ASMB incorporates the same modular medical support system found in the division medical structure. This battalion's secondary mission is to rapidly augment/replace standardized like modules to divisional units. The ASMB commands and controls four organic area support medical companies.