Medical Platoon Survival Guide

CPT Joseph McGee

SFC Kevin Smith
2014
The past trends at the National Training Center have shown that the task force
medical platoon has had difficulty in conducting medical operations and
supporting the maneuver elements within their task force. The platoons show
difficulty in utilizing troop leading procedures (TLPs), integration of the medical
platoon leader in the task force military decision making process (MDMP),
understanding and planning t health service support operations (HHS)/ Force
Health Protection, and understanding the task force commander’s intent and
concept of operations. In particular, the medical platoon leader (the Medical
Service Corps lieutenant) is often challenged when it comes to integrating with his
task force battle staff. As a result, this inability to effectively integrate health
service support planning into the Military Decision Making Process often leads to
an incomplete, underdeveloped combat health support plan that fails to support
the commander’s intent. The This guide comes from various previous NTC MDMP
products, Field Manuals, Mission Training Plans, Concepts of Support and TTPs I
have found successful at the National Training Center. Although there are
numerous areas to consider during the “preparation” and “execution” of
aggressive and effective health service support, I primarily focused on tips that
contribute to effective “planning”- since this is where the maneuver plan is
synthesized with the task force battle staff. My intent for this guide is to assist
medical platoon leaders in developing a comprehensive, effective combat health
support plan that supports the entire width and depth of their unit’s combat
operation- from the reconnaissance and surveillance phase to the main battle
fight, during actions on contact and actions on the objective, to destruction of
enemy forces in the engagement area, to reorganization and consolidation on the
objective. Additionally, I have added input from my fellow Observer/Controllers
from the Tarantula Team. This guide is not intended to substitute current
directives, instructions, or doctrinal publications and there is no official
endorsement by any Department of Defense or Department of Army personnel.
Please add comments and recommendations for the improvement of this guide to
email address below.

CPT Joseph McGee

Tarantula 24
Light Infantry (Airborne) TF Medical Trainer
SFC Kevin Smith
Tarantula 24
Light Infantry (Airborne) TF Medical Trainer

Forward Feedback To: joseph.w.mcgee.mil@mail.mil

2
Pre-Rotation
 Pre-Rotation Checklist

Task Applies To

Identify critical medical personnel shortages to Division/BCT

Surgeon Section for PROFIS Plus submission MEDO
Create Medical Platoon SOP MEDO

Verify Medical personnel proficiency (EMT, BLS, M.E.D.I.C.) MEDO

Certify Unit Combat Lifesavers (Goal =100% personnel) MEDO
Establish Field Sanitation Teams (1 x NCO, 1 x Soldier) Unit
Field Sanitation Team Supplies on order Units (Co Lvl)
Class VIII MES SKO component shortages on order MEDO
USARRED Drug Set supplies on order MEDO
Identify personnel requiring Glasses, Protective Mask Inserts,
Ballistic Lens insets, Medical Warning Tags and Chronic
Medications MEDO
Turn medical equipment in to BMSO for services MEDO
Verify and order CLS bag/ IFAK component shortages MEDO
Load/ Verify all medical equipment in BMSO SAMS-E MEDO
Execute deployment SRP MEDO
Transfer custody of medical recordes to TMC Medical Officer
Pick up Glasses, Protective Mask Inserts, Ballistic Lens
insets, Medical Warning Tags from appropriate agencies Indiv Soldier/ Unit
Pick-up chronic meds from (x60 day supply); units verify
Solider Pick-up Indiv Soldier/ Unit
Deploy with 15-30 days of Class VIII MEDO
Pick up narcotics Medical Officer

It is critical for the MEDO to actively engage with Task Force Staff
prior to arriving at NTC. Historical observations have shown the
MEDO to be absent in nearly all phases of the Rotational Unit’s
MDMP. Develop relationships with Commanders/1SG and Staff
early, and be an active participant in TF planning.
 Tarantula 24 TM O/C CHECKLIST

PLANNING YES NO REMARKS

1) CHS plan developed during MDMP (by MEDO)

2) Casualty estimates completed (by MEDO or TF S-1)

3) R/S CHS plan developed (NAIs, OPs, retrans spt)

4) Task Organization (EN, ADA, smoke/decon plt, etc.)

5) Templated FAS/MAS locations w / movement triggers

6) Non-Standard CASEVAC assets forecasted
7) Asset distribution (b/w FAS & MAS) based upon
situation, scheme of maneuver, casualty estimates
8) PDS plan (augmentees, clean/dirty rtes, w ater
source)
9) Adjacent unit coordination w ith aid stations/AXPs/C-
Med
PREPARATION YES NO REMARKS
1) OPORD prepared and issued
2) PLT rehearsal conducted/Senior medics at TF CSS
Rehearsal
3) Graphics completed & disseminated (FAS/MAS
jumps, AXPs, Co/Tm positions, MFPs, CCPs, Sct OPs,
retrans sites, clean/dirty routes)
4) PCCs/PCIs conducted (do w e have a standard
checklist and do w e follow it?)
5) 5988Es turned in (Required/Performed/ToStd)
6) Plan for Nonstandard CASEVAC assets (vehicles
linked up, clear of trash/equipment, litters on hand,
drivers briefed)
7) TF (or BCT) standardized marking system & is it
enforced? (day and night marking system)
8) Communications check (A/L, Co/Tms, plt internal,
adjacent FAS/MAS, AXPs, C-Med)
9) Plan synchronized for Air MEDEVAC/CASEVAC if
available
10) Vehicle readiness (patient-ready at all times?)
11) Plan/Prep "RISK ASSESSMENT" (IAW AR 600-14)
EXECUTION YES NO REMARKS
1) Situational Aw areness
2) Reporting (by 1SGs and Co/TM medics) on A&L
3) Aid Station Site Management (by SOP if applicable)
4) Class 8 Resupply execution at all levels (CLS-Co
Medic-BAS-AXP-C/Med)
5) Treatment by self-aid, buddy-aid, CLS)
6) Treatment by combat medic (DD Form 1380,
treatment, litter transport)
Considerations for the OFFENSE
1) Templated FAS/MAS locations throughout scheme
of maneuver
2) Near Side/Far Side treatment for breach/DATK
Considerations for the DEFENSE
3) R&S CHS plan
1) Supplementary/alternate FAS/MAS locations
2) Route recons from BPs/CCPs to FAS/MAS locations
3) R&S CHS plan
4) Friendly obstacle overlay posted on map(graphics)

18
Rollout Checklist
HHS/FHP Planning
 Principles of HHS/FHP

• CONFORMITY: SYNCH WITH

MANEUVER PLAN
• CONTINUITY: CHS MUST BE
CONTINUOUS
• CONTROL: TECHNICAL
SUPERVISION
• PROXIMITY: LOCATION OF CHS BY
METT-TC
• FLEXIBILITY: SHIFT ASSETS IN THE
BATTLE
• MOBILITY: AIR, GROUND, NON-
STANDARD
 10 Medical Functional
Areas (ATTP 4-02)
• Treatment (Role I and II)
• Hospitalization (Role III and IV)
• Evacuation and Patient Regulating
• Medical Logistics and Blood
• Dental Services
• Preventive Medicine Services
• Veterinary Services
• Combat Operational Stress Control
• Medical Laboratory Services
• Medical Mission Command
10 Medical Functional Areas ATTP 4-02 (cont’d)

• MEDICAL MISSION COMMAND

– Communication plan (internal and external plan)
– S2 Intelligence Preparation of the Battlefield (ANNEX B) and it’s effects on Medical Assets
(terrain; weather; enemy)
– Enemy’s Most Likely and Most Dangerous Course of Action. Is there an impact on our medical
plan? Are there any concerns?
– Medical Rules of Engagement as it applies to the mission (NGO’s in the area / VIP support /
Detainees / EPWs / Civilians)
– Mission & Launch authority of evacuation assets (ground and air)
– What is the alert process for a MASCAL?
– Graphics completed and disseminated (Do we have a Common Operational Picture?)
– Command and Support Relationship (FM 3-0)
• MEDICAL TREATMENT
– Role I: Immediate life Saving Care. Self Aid, Buddy Aid, Combat Lifesaver, Combat Medic,
Physician's Assistant, Battalion Aid Station. Assigned to Maneuver Battalions.
– Role II: Advanced Trauma, Patient Hold (72 hours), Dental, Lab, X-ray, Physical Therapy,
Behavioral Health, Blood (when Forward Surgical Team attached).
• MEDICAL EVACUATION AND MEDICAL REGULATING
– Assets pre-positioned forward to facilitate rear-ward evacuation (asset distribution)
– Establish Casualty Collection Points
– Establish Ambulance Exchange Points (AXPs). It is critically to synchronize the plan with the
Brigade Medical Company and Brigade Surgeon.
– MEDEVAC: Performed on a standard medical platform, provides en-route care, and the platform
has the capability to sustain casualties while en route to additional care.
– CASEVAC: Performed in a nonstandard evacuation platform, does not have en-route medical
care, and the nonstandard platform does not have medical capabilities.
– Theater evacuation policy in number of days
– Evacuation categories (urgent; urgent-surgical; priority; routine; convenience)
– Casualty estimates (patient density locations / requirements; capabilities; shortfalls)=How many
have to be evacuated / When / Where
– Time / Distance analysis from POI through Role III
– Evacuation process (SOPs –internal and external; CCPs; Convoys; MASCAL).
– MASCAL plan established for unit locations (FOB; TAA; TCP; etc.).
– Primary and Alternate routes
– Triggers to move MTFs on the battlefield
– Detainee / EPW / Displaced Civilian evacuation plan
– Combat Lifesaver plan
– Air Evacuation assets
10 Medical Functional Areas ATTP 4-02 (cont’d)
• HOSPITALIZATION
– Combat Support Hospitals (Level III)
– In additional to Role I and II capabilities, Role III provides pre and post operative
care, resuscitative surgery, general anesthesia, initial wound surgery,
– Inpatient health care delivery – person admitted and treated in a hospital and not
RTD the same day
– Outpatient – person receiving medical and dental care but not admitted to the
hospital for treatment
• PREVENTIVE MEDICINE SERVICES
– Medical Threat – occupational/environmental health hazards; endemic/epidemic
diseases; allergies; altitude;
– Medical Intelligence – medical infrastructure; geography; socioeconomic situation;
threat forces (Personnel/Weather/Terrain)
– Bottomline – what are we facing and how does this all affect the overall medical
concept of support
– Enemy’s Most Likely COA & Most Dangerous COA…..What is the medical impact for
each COA?
– Enemy’s Center of Gravity
– Field Sanitation teams and procedures
– SWEAT-MS of the local areas (Host nation Sustainment)
– Personal Preventive Measures (Tell me how we can mitigate the risk)
• DENTAL SERVICES
– Operational care – emergency and essential dental care
– Comprehensive care – optimal care located at a Role-III facility
• VETERINARY SERVICES
– Inspection of Class-I items
– Inspection and approval of locally procured food, dairy, and water products
– Control of zoonotic diseases
– Treatment of government owned animals
• COMBAT OPERATIONAL STRESS CONTROL
– Preventing battle fatigue and misconduct stress behaviors
• HEALTH SERVICE LOGISTICS
– Medical supply / resupply of all sets, kits & outfits (Class VIII products and Blood
products……AUTH / OH / FMC)
– Medical equipment repair procedures
– Medical waste disposal plan
Example Medical Concept of Support (SFAB Scenario)
Example Medical Concept of Support using Medical Functional Areas
Example Medical Concept of Support using Medical Functional Areas
EXAMPLE DA COS
HSS Considerations when
Planning
• Attendance at all operational plans and briefings
• Awareness of Concept of Operations, CDRs Intent, HSS
requirements
• Work with S1 to develop casualty estimate (see MCOAT)
• HSS plan includes preplanned evac routes, treatment teams, CCP,
and AXP
• Ensure adequate medical elements in support
• ATM within 30 minutes of wounding
• BAS may split and place its treatment teams as close to maneuver
companies as tactical feasible
• Treatment teams within 1000 meters of maneuver unit must be
ready to withdraw to pre planned position
• When anticipating large number of casualties, augment with one or
more treatment teams from the BSMC
• Ground vehicle planning factors – 8km and return in 1hr
• 4 km support distance – 30 minutes round trip for ambulance under
ideal circumstances
• Plan aid station/treatment team triggers
• Planned checkpoints along MSR can be used as possible aid station
locations
• Integrate medical operation into the task force maneuver and CSS
rehearsal
• 4 man litter team 900 meters and return in 1 hr with avg terrain
• 6 man litter team 350 meters and return in 1 hour mountainous
terrain
FM 4-02.4
 HSS Considerations
during RECON
• RECON
– Determining the CHS requirements.
– Deploying trauma specialists and medical assets in DS of
RECON operations, as required/appropriate.
– Planning for casualty evacuation/extraction operations.
– Developing a CHS SOP for supporting RECON elements
deployed deep into enemy territory.
– Selecting evacuation sites (remembering that all cache sites are
potential casualty evac sites).
– Developing TTPs for cross-FLOT casualty extraction.
– Establishing the time for pick up and the pickup point for aerial
extraction of casualties. (The last known/reported location is
normally the aerial pickup point and the best time is 30
minutes prior to BMNT or 30 minutes after EENT.)
– Developing a detailed plan for ground extraction, to include link
up to quick reactionary force (QRF) and escort to casualty
exchange point.
– Conducting rehearsals for day and night extractions.
– Requesting escort if a QRF is not established.

FM 4-02.4
HSS Considerations in the
Offense
• OFFENSE
– Pre-position medical evacuation vehicles as far forward as possible
prior to attack
– Provide additional ambulance teams to main attack companies/teams.
– Request additional ambulance from the BSMC
– Use Ambulance Exchange Points (AXP) and Casualty Collection Points
(CCP)
– Fosuc on stabilization care and evacuation
– Train and plan to use Combat Lifesavers
– Leap frog teams forward as attack progresses or follow and support
– Tailgate medicine
– Cover and Concealment
– Adequate medical supplies and plan for emergency resupply
– Plan and Coordinate evacuation with BSMC from BAS
– Plan for continued HSS should unit become encircled
– Location of BAS
• Tactical situation/commanders plan
• Expected areas of high casualty density.
• Security.
• Protection afforded by defilade.
• Convergence of lines of drift.
• Evacuation time and distance.
• Accessible evacuation routes.
• Avoidance of likely target areas such as bridges, fording locations, road
junctions, and firing positions.
• Good hard stand on solid ground with good drainage.
• Near an open area suitable for helicopter landing.
• Available communication means.
FM 4-02.4
HSS Considerations in the
Offense (cont’d)
• Exploit and Pursuit
– Fewer casualties
– Decentralized operations.
– Unsecured ground evacuation routes.
– Exceptionally long distances for evacuation.
– Increased reliance on convoys and air ambulances.
– More difficult communications.
• Deliberate Attack
– Higher percentage of casualties.
– Casualties will be more concentrated in time and space.
– Once the objective is secured, treatment teams can move to
the objective instead of evacuating patients from the objective
to the treatment teams.
– Use of air ambulance to overcome some obstacles may be
required.
– Higher likelihood of wounded EPW.

FM 4-02.4
 HSS Considerations
Defense
• Defense
– Cover and Concealment
– Ensure adequate medical supplies
– Plan for evacuation within the defensive area
– Plan and coordinate, in detail, evacuation to BSMC from BAS
– Plan to continue HSS should the unit become encircled
– Consider the potential to hold patients for an indefinite period
of time without adequate resources
– Position BSMC Tx team within a battle position/ strongpoint
– Designate area for chemically contaminated patients
– Request Air MEDEVAC for Urgent Personnel
– Have nonstandard evacuation assets identified and know what
the plan is to use them, who controls them, and what is the
trigger for use

FM 4-02.4
Mission Command
 Medical Platoon
Operations Tracker

A way to display Useful information

• BAS CP SOP
• By RTO: DA1594, Alpha and Battle
Rosters, Commo Cards/Cheat
Sheets, 9-Line MEDEVAC, MAL,
Sensitive Items with sign out, CO CP
Battle Drills (book), communication
devices
• Clock
• Equipment capabilities and asset
references
• Map and/or Wing Board
• Orders historical and read reference
book (higher HQ and Co issued
orders)
• Task and Purpose Card
• Dry erase boards (with carry box)
• Comprehensive CP Supply list
• CP Direct Fire Plan and blank range
cards
• Publications (ATTP, FM, TM, User
Books, etc.)
 Company Battle Rhythm
:01 :01
:15 :15
0000 hrs 1200 hrs
:30 :30
:45 :45
:01 :01
:15 :15
0100 hrs 1300 hrs
:30 :30
:45 :45
:01 :01
:15 :15
0200 hrs 1400 hrs
:30 :30
:45 :45
:01 :01
:15 :15
0300 hrs 1500 hrs
:30 :30
:45 :45
:01 PERSTAT S-1 EQU/TROOPS :01 PERSTAT S-1 EQU/TROOPS
:15 :15
0400 hrs 1600 hrs
:30 :30
:45 :45
:01 :01
:15 :15
0500 hrs 1700 hrs
:30 :30
:45 :45
:01 SHIFT CHANGE 0600-0700 :01 SHIFT CHANGE 1800-1900
:15 BREAKFAST 0600-0800 :15
0600 hrs 1800 hrs
:30 :30
:45 UPDATE PLT TRACKERS :45 UPDATE PLT TRACKERS
:01 LEADERS HUDDLE :01 LEADERS HUDDLE
:15 :15
0700 hrs 1900 hrs
:30 RSOI HUDDLE/SHIFT BRIEF :30
:45 :45
:01 BN BUB CO/1SG :01 BATTLE UPDATE BRIEF
:15 :15
0800 hrs 2000 hrs
:30 :30
:45 :45
:01 :01
:15 :15
0900 hrs 2100 hrs
:30 :30
:45 :45
:01 :01
:15 :15
1000 hrs 2200 hrs
:30 :30
:45 :45
:01 :01
:15 :15
1100 hrs 2300 hrs
:30 :30
:45 :45
BN
CO
PLT
 Command Post Duty
as of ____________
SHIFT: CREW
__________________
___
BDE CALL SIGN
BDE FREQ:
BN CALL SIGN
BN FREQ:
CO CALL SIGN:
CO FREQ:
MEDEVAC CALL
SIGN
MEDEVAC FREQ:
BDOC CALL SIGN:
BDOC FREQ:
 Company
PERSTAT / Sensitive Items Date/Time:_______

OFFICER WARRANT NCO ENLISTED TOTAL

PLATOON % FILL
AUTHORIZED ASSIGNED AUTHORIZED ASSIGNED AUTHORIZED ASSIGNED AUTHORIZED ASSIGNEDAUTHORIZEDASSIGNED
HEADQUARTERS 4 4 0 0 5 3 6 3 15 10 67%
TREATMENT 10 6 0 0 10 6 13 18 33 30 91%
EVACUATION 1 1 0 0 6 3 15 16 22 20 91%
Totals 15 11 0 0 21 12 34 37 70 60 86%
C Co NTC Reporting Tracker

TMT EVAC HQ CP Total

PAX 32 20 11 0 63
M4 32 20 11 0 63
INDIVIDUAL MILES
ACOG 28 19 11 0 58
M68 4 1 0 0 5
M9 4 0 2 10 16
JCR TOC 0 0 0 1 1
MTS TOC 0 0 0 1 1
JCRs 2 8 5 0 15
RADIOS 3 9 8 18 38
NVG 7B 0 0 0 46 46
NVG 14 0 0 0 62 62
SKL 2 8 5 0 15
DAGR 2 8 5 0 15
BINOCULARS 0 0 0 10 10
VEHICLES 4 9 6 0 19
VEHICLES MILES
TRAILERS 6 6 5 0 17
3K GEN 3 0 2 0 5
10K GEN 0 0 2 0 2
30K GEN 1 0 0 0 1
 C Co Med Status
as of ___________

TX EVAC HQ OVALL REMARKS

Lab
Refrigerator
Dental Emer
Dental Sick Call
Dental X-Ray
Sterilizer
X-Ray
Patient Hold ____ of ____ beds
Trauma
Sick Call
Defib
Suction
Aid Bag
PM
Field San
Chem Decon
Chem Tx
 Combat Effectiveness Graph
Headquarters Platoon
Date/Time:________
Admin # OP Y/N Issues
C4
C5
C6
C7
C81
C82
C9T
10K CG10H1
3K GEN CG3H1
3K GEN CG3H2
 Combat Effectiveness Graph
Treatment Platoon
Date/Time:_________

Admin # OP Y/N Issues

C11
C16
C14T
30K CG30T1
3K GEN CG3T1
3K GEN CG3T2
3K GEN CG3T3
 Combat Effectiveness Graph
Evacuation Platoon
Date/Time:__________

Admin OP Y/N Issues

#
C26
C101
C202
C203
C204
C205
C206
C207
C208
 Treatment Crew Status
as of ____________

SHIFT:
Crew
_____________________
Medical Officer on Duty
ATLS Sergeant
Tm Ldr:
Med 1:
Bed 1
Med 2:
Rec:
Tm Ldr:
Med 1:
Bed 2
Med 2:
Rec:
Tm Ldr:
Med 1:
Bed 3
Med 2:
Rec:
Tm Ldr:
Med 1:
Bed 4
Med 2:
Rec:
X-RAY
LAB
Tm Ldr:
Patient Hold
Med 1:
 Evac Crew Status
as of ____________

Bumper # Crew FM Check JCR Check Trip Ticket

D:
1st UP TC:
Med:
D:
2nd UP TC:
Med:
D:
3rd UP TC:
Med:
D:
4th UP TC:
Med:
 BMSO
as of _______

Push Package Status

OH Next Push DTG / Unit
PP 1
PP2
PP3
CLS
Ped

Connectivity
TCAM Status Received DTG Sent DTG
BMSO
TF1
TF2
TF3
Med Maintenance
Jobs Open Status
 AIR EVACUATION STATUS
as of ____________

STATUS FM FREQ VOIP

REAL WORLD FM 38.900
AIR MEDEVAC SC / PT

ROTATION
AIR MEDEVAC

MSR ROUTE STATUS

STATUS

IA DRANG WEST

BULLRUN

SAN JUAN

IA DRANG EAST

LONG ISLAND
 UPCOMING MISSIONS NEXT __________

MISSION # REFERENCE WHAT WHEN WHERE

BRIEF TIME FINAL PCIs

WHO ASSETS SP TIME
(SP-2h) (SP-3h)
Patient Tracker
Combat Lifesaver
 Combat Lifesaver (AR 350-1)
• The Combat Lifesaver (CLS) is a member of a non-medical unit selected by the
unit’s commander for additional training beyond first aid skills.

• The goal is to have one CLS per squad, crew, team or equivalent-sized unit as
per AR 350-1.

• The CLS serves as a bridge between buddy aid and the arrival of the combat
medic on the scene. In Sustainment units, the CLS helps when medics may or
may not be close.

• Combat Lifesavers are trained by the medical personnel assigned to, attached
to or supporting the unit. CLS training program consists of an initial 40 hour
certification program led by medical personnel. Certification is good for one
year and requires re-certification every 12 months (normally a 1 day POI).

• A properly trained combat lifesaver is capable of stabilizing many types of

casualties.

• The combat lifesaver is not intended to take the place of medical personnel,
but to slow deterioration of a wounded soldier's condition until medical
personnel arrive.

Combat Lifesaver (AR 350-1)

Medical Evacuation
 REAL WORLD MEDEVAC

• Unit’s responsibility
• Cease MILES play in the immediate area
• Call directly to range control – 38.900 (SC, PT), use standard
10-line MEDEVAC request format, stay in contact with Range
Control throughout
• Ensure that all Soldiers are familiar with procedures
• Red smoke/Star cluster– only used for real world
emergencies (OC/T provided)
• OC/Ts will assist, if necessary
NTC REAL WORLD MEDEVAC PROCEDURES
NTC MEDEVAC REQUEST 9 Line

1. Initiate life-saving procedures

1. Rotational Unit is responsible
for Real World MEDEVAC
2. OC/Ts will assist as needed

2. Call MEDEVAC 9-LINE

1. P: RCS 295 Range Support
LINE ITEM
2. A: 38.90 SC/PT Range
1 Location of Pickup Site
Support 2 Radio Frequency, Call Sign, Suffix
3. C: 760-380-3878/3673 Range
No of Patients by Precedence
Support 3
A = Urgent, B = Urgent-Surg, C = Priority, D = Routine, E =Convenience
4. E: RCS 100 OPS CMD
Special Equipment Needed
4
A = None, B = Hoist, C = Extraction equipment, D = Ventilator
3. Marking of HLZ:
1. Daylight hours – Red 5
No of Patients by Type

smoke, VS-17 panel L = Litter, A = Ambulatory

2. Limited visibility – IR chem-
light (buzz saw). Avoid blue
or green chem-lights. Red
star cluster.
4. First OC/T on scene report 5Ws on RCS
161 INF 1 to 03A, Tango, 24 (push
updates until MEDEVAC A/C depart
with patient) & secure site. Begin
5W’s with precedent of patient. i.e.
Routine, Priority, Urgent
6 Number and type of Wound, Injury,Illness
(Peacetime)
Method of Marking Pickup Site
7
A = Panels, B = Pyrotechnic signal, C = Smoke Signal, D = None, E = Other
Patient Nationality and Status
8
A = US military, B = US civilian, C = Non-US mil, D = Non-US civilian, E = EPW
Terrain Description (Peacetime)
9 Include details of terrain features in and around proposed landing site If possible, describe the relationship of site
to a prominent terrain feature ( lake, mountain, tower)
MIST= Mechanism, Injuries, Signs, Treatment
Mechanism - (What caused the injury)
Injuries - (What are the casualties injuries)
Signs - Blood Pressure

10 Pulse
5. AXP’s Respirations
• AXP 1 – Bull Run light line SPO2 (Pulse Ox)
11S NV3190 0540
• AXP 2 – Langford Lake Treatment Given to include Medications
light line 11S
NV2951 0052
• AXP 3 – Goldstone Light
line 11S NV1320
1330

Note #1 – NTC MEDEVAC aircraft are for

urgent patients with Life/Limb/Eye
Sight injuries as determined at the POI
 Army Medical Evacuation
In a contiguous and non-contiguous
Battlefield
CSH

Corp / DIV Spt BSA Combat Company

Area Trains Trains
F
L
CC O
AX P T
ASM P BA
BSM S
C POI
C

CSH

Role II/ III Role II Role I

NOTE: In Afghanistan current technique is evacuate to closest Medical

Treatment Facility (example: IED casualty can be evacuated to a BSMC
rather than their parent BAS).
 Army Medical Evacuation

UH-60 M1133 M997

4 Litter/8 4 Litter/6 4 Litter/8
Ambulatory Ambulatory Ambulatory

MRAP
(HAGA)

M113
3 Litter/6
4 Litter/8 Ambulatory
Ambulatory

FM 4-02.4
 STANDARD
EVACUATION VEHICLES

• M996 (GROUND AMBULANCE)

• M997 (GROUND AMBULANCE)

• M113 (T113A2 ARMORED PERSONNEL

CARRIER)

• ATMV (ARMORED
TRANSPORT/TREATMENT MEDICAL
VEHICLE)

• M1010 (TRUCK AMBULANCE)

• M718 (TRUCK AMBULANCE-JEEP)

 M996/M997
“Ground Ambulance”

M996
• CARRIES UP TO 2
LITTER OR 6
AMBULATORY
• OR 1 LITTER AND 3
AMBULATORY

M997
• CARRIES UP TO 4
LITTER OR 8
AMBULATORY
• OR 2 LITTER AND 4
AMBULATORY
 M113 T113E2
“Armored Personnel Carrier”

WITH LITTER SUSPENSION KIT INSTALLED:

• IT HAS A CAPACITY OF 4 LITTER OR 10
AMBULATORY
• OR 2 LITTER AND 5 AMBULATORY
 The AMEV
“Armored Medical Evacuation
Vehicle”

• USES THE M2A0 BRADLEY

FIGHTING VEHICLES (BFVS)

• OVERCOMES THE SHORTFALLS OF

OPERATION DESERT SHIELD/STORM.

• PROVIDES THE CAPABILITY TO

PERFORM EN-ROUTE PATIENT
MONITORING.

• HAS ON-BOARD OXYGEN, SUCTION, STORAGE OF

ESSENTIAL MEDICAL ITEMS AND EQUIPMENT.

• CARRIES FOUR LITTER PATIENTS, FOUR

AMBULATORY PATIENTS, AND A CREW OF THREE.
 NON-STANDARD
EVACUATION VEHICLES
• ARMORED PERSONNEL CARRIER,
M113
• HMMWV, M998
• TRUCK CARGO, M35, 2 1-2 TON
• TRUCK CARGO, 5 TON
• LMTV 1095/1093
• BRADLEY INFANTRY FIGHTING
VEHICLE M2/3
• LIGHT WEAPONS CARRIER, M274
• TRUCK CARGO, M880/890/1008
• TRUCK CARGO, HEMTT, M977
• SEMI-TRAILER CARGO, 22 1/2 TON
• TRUCK UTILITY, M151
 NON STANDARD
EVACUATION

• VEHICLE LOAD MUST SUPPORT THE

MOVEMENT OF CASUALTIES

• ALL CASUALTIES MUST REMAIN SEATED

DURING TRANSPORT

• LITTER CASUALTIES MUST HAVE A LITTER

(IMPROVISED OR STANDARD) AND ALL
REQUIRED EQUIPMENT PRESENT

• LOAD/UNLOAD ON A LITTER

• APPROPRIATE MEDICAL TREATMENT MUST BE

PERFORMED PRIOR TO EVACUATION
M998, UTL VEH, 1.25, 4X4
“The HMMV”

• PLACE THREE LITTERS SIDE-BY-SIDE ACROSS

THE SIDE
BOARDS. SECURE THE LITTERS IN PLACE

• PLACE TWO LITTERS LENGTHWISE, HEAD

FIRST, IN THE BED OF
THE TRUCK. SECURE THE LITTERS IN PLACE.

• CLOSE THE TAILGATE.

• LITTERS ARE UNLOADED IN THE REVERSE

ORDER OF LOADING.
TRUCK, CARGO, 2 1/2 or 5 TON

• MAX LITTER CAPACITY IS 12

• LOWER THE SEATS.

• THREE LITTERS CROSSWISE ON THE SEATS

AND THREE LITTERS
LENGTHWISE ON TRUCK BED (FAR FORWARD
AS POSSIBLE)

• SECURE THE LITTERS INDIVIDUALLY ON THE

SEATS.

• REPEAT AS REQUIRED

• RAISE THE TAILGATE

 M1095, LMTV

• MTV LONG WHEEL BASE

• 12 LITTER CASUALTIES
• COMBAT MEDIC RIDES IN
THE CENTER
 M1093, LMTV

• MTV SHORT WHEEL BASE

• CAN TRANSPORT 8
LITTER
• COMBAT MEDIC IN THE
CENTER
 M2, BRADLEY FIGHTING
VEHICLE
CASUALTIES
TRACK COMMANDER
GUNNER

DRIVER
CASUALTIES

• BFV CAN TAKE 6 WALKING WOUNDED, NO LITTER

CASUALTIES.
• THE BFV, QUICKEST AND SAFEST WAY TO
EVACUATE CASUALTIES
• CASUALTIES SHOULD BE MOVED TO A COVERED
AND CONCEALED CCP TO THE REAR OF THE
PLATOON
• IF ENEMY INDIRECT FIRE PRESENTS THREAT,
KEEP CASUALTIES IN THE BFV, TRANSFER TO THE
AMBULANCE WHEN IT ARRIVES.
 MDMP
FM 5-0, Chg1 ATTP
FM 5-0, Chg1 ATTP
FM 5-0, Chg1 ATTP
 Medical IPB
• The Medical Officer:
• In coordination with the S2, determines terrain and weather effects on
the health and medical care of friendly and threat forces
• Identifies civil considerations that may affect friendly and threat health
and medical treatment and possible health care and medical support
needed by civil authorities
• Assesses the medical threat in the AO and AOI and determines effects
on personnel, rations, and water
• Determines how military operations will affect the health of the civilian
population
• Identifies medical ROE
• Identifies disposition, composition, capabilities, and vulnerabilities of
threat medical treatment
• Assists the S2 with health and medical expertise to develop threat
COAs
• Determines anticipated types and locations of friendly and threat
casualties and disease and non-battle injuries (DNBI)
• Assesses anticipated health care and medical treatment that will be
required by EPWs and detainees
• Identifies to the S2 potential intelligence gaps pertaining to the medical
threat and threat forces’ health and medical care
 MEDO/MDMP PLANNING CHECKLIST
POC PLANNING FACTOR PRODUCT
Casualty estimates by plt/sect/co tm by
S1 Task Organization phase
Combat Lifesaver personnel/bag
Co/Tm Personnel Strengths distribution
Possible medic team augmentation for
Casualty Estimate-by phase projected MASCAL
S-1 representative at each aid station to
BPT DO IT YOURSELF!! collect DA Form 1155/1156s
Safe plan for continuous medical support
Enemy Sitemp(DRT-CSOP- throughout entire fight for the task force,
MRC locations, obstacles, plan projected FAS/MAS locations away
templated chemical, enemy R & from enemy locations and projected
S2 S plan-objective) chemical strikes
BLUFOR BDA by phase(R&S,
LD, main battle fight, breach, Forecast casualty densities for each unit
defense) by phase of battle
R&S combat health support plan (CHS) for
task force scouts and screen co/tm- (I.e.
CCPs, ingress/egress routes, SEAD plan)
TTP: position FAS in trains of
OPs, NAIs for scouts, screen screening co/tm for security and
co/tm "proximity" to R&S forces
Friendly scheme of Plan FAS/MAS locations(1-3 km from
maneuver(SBFs, ABFs, breach supported forces), plan for movement with
S3 plan, co/tm battle positions) task force
Do NOT position FAS/MAS locations w/
mortars or artillery battery positions
Mortar plt positions (counter-battery fire!!)
Enemy air avenues to plan away from
those routes, BLUFOR air avenues to plan
BLUFOR and enemy air avenue for FAS/MAS locations- especially for
ADA routes CCPs for scouts and R&S fight
Plan FAS/MAS locations around obstacle
plan, plan evac routes around and through
obstacles - ensure you add "friendly
ENG Friendly obstacle locations obstacle overlay" to platoon graphics
Breach plan and lane marking Synch plan and rehearse breach drills for
method, breach signal "far side" treatment team
Consult for "terra-base" for Use to forecast commo problems (line of
terrain analysis sight) for antennas, OE-254
 MEDO/MDMP PLANNING CHECKLIST
(con’t)
Plan FAS/MAS locations along MSRs,
ASRs, "dirty" routes, AXP locations, Level
II (C-Med) location, templated Level II
jumps- look for medical/non-standard asset
S4 BCT CSS Annex and graphics augmentation to our Task Force

Plan for quantity of additional non-standard

Non-Standard evacuation plan
Patient Decon plan
Templated enemy chemical
CHEMO strikes
BCT and TF "dirty" routes
Wind direction during fight
BCT decon sites
Consult for "terra-base" for
SIGO terrain analysis
evacuation vehicles based upon casualty
densities, linkup with FAS/MAS prior to LD
Plan for water buffalo and augmentees for
PDS operations
Plan for likelihood of PDS operations and
when/where in the task force
Plan for "most likely" dirty aid station and
use the appropriate routes
Know wind direction for PDS site
setup(upwind)
May be possible to co-locate with decon
platoon if dirty aid station is in same
vicinity (they have water source also)
Use to forecast commo problems (line of
sight) for antennas, OE-254

TF Signal Plan CHS plan for retrans/TOC elements

Get prepositioned ambulances, templated
AXP locations and operational triggers,
Level II location(s), AXP frequencies of all medical units, when is air
locations, other FAS/MAS medevac available, adjacent unit
FSMC CDR/AXP locations, commo plan, air coordination with other FAS/MAS locations
PL/other MED PL(s) medevac available and AXPs
NCS support plan and procedure for calling
Air MEDEVAC/CASEVAC plan Air CASEVAC/MEDEVAC
Ensure Medical PSG and Co/TM Senior
MED PL, MED PSG, CSM, BN XO, BN
Medics attend TF CSS rehearsal with
S4, SENIOR MEDICS, CO/TM 1SGs, EN
CO 1SG, SCOUT PSG, MORTAR PSG,
CSS graphics already posted on map-
ADA PSG, AMB PL OR AMB PSG, Key to success: Rehearse/coordinate
TF CSS REHEARSAL OTHER TASK FORCE ATTACHMENT TF CHS plan directly with the
ATTENDEES NCOICs executors- 1SGs and specialty PSGs!!!

BCT CSS
REHEARSAL
ATTENDEES MED PL, BN XO, BN S4

NOTE: If BCT/TF CSS rehearsals conflict, MEDO should attend BCT rehearsal
in order to answer/resolve issues at BCT-level with adjacent and higher units.
Medical PSG should attend and rehearse TF HHS plan with 1SGs, specialty
platoon sergeants, and company/team senior medics. So he must know the
TF scheme of maneuver and the concept of support prior to the rehearsal!!!
 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.
q Precipitation.
q Temperature.
q Other weather conditions (wind, dust, or fog).
q Light data:
BMNT: __________ Sunrise: __________
Sunset: __________ EENT: __________
Moonrise: __________ Moonset: __________
Percent illumination: __________
(2) Terrain (Factors of OCOKA)
q Observation and fields of fire.
q Cover and concealment.
q Obstacles.
q Key terrain.
q Avenues of approach.
(3) Enemy Forces.
q Location
q Activity
q Composition/order of battle.
q Strength

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
q Passage of lines
q Routes
q Movement formations.
q Movement techniques.
q Actions on contact, at obstacles, during consolidation and
reorganization.
 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).
q Patient decontamination locations & operations.
q Decontamination points.
q Dirty and clean evacuation routes.
q AXP locations.
q FSMC or echelon II locations.
q Plan for non-standard evacuation.
q Air MEDEVAC frequency and LZ operations.
q Location of casualty collection points (in each phase of the operations).
q Method of marking wounded on the battlefield.
q 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.
 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.
Casualty Estimate
and
MCOAT
 CASUALTY ESTIMATE- OFFENSE
MAIN EFFORT ELEMENTS
________ X ________ = __________ (X “combined value” of other four factor val ues)
Combat Miss ion
Strength Factor
__________ X .60 = ____________ (1) “Main Effort Casualties”

OTHER AXI S ELEMENTS

________ X ________ = __________ (X “combined value” of other four factor val ues)
Combat Miss ion
Strength Factor
__________ X .40 = ____________ (2) “Other Axis Casualti es”

SUPPORT BY FIRE ELEMENTS

________ X ________ = __________ (X “combined value” of other four factor val ues)
Combat Miss ion
Strength Factor
__________ X .32 = ____________ (3) “Support By Fire Casualti es”

*ADD (1), (2), and (3) = __________ X (.72) = ___________ (Total Number of Casualties)
**NOTE: 18% KIA, 72% WI A, 10% MIA/CAPTURED

MISSION FACTORS: Meeting Engagement(.24), Hasty Attack (.30), Deliberate Attack (.38), Attack of strongpoint(.64), SBF(.32)
OTHER FACTORS: a) Day (1.0), Night Illum (0.9), Night (0.7)
b) Enemy Fatigue: Rested (1.0), 24 hrs no rest (0.8), 48 hrs no res t (0.6)
c) Surprise: Minimum (1.0), Substantial (0.9), Complete (0.7)
d) Vel oci ty: No Momentum (1.0), Moderate (0.9), High Speed (0.7)

CASUALTY ESTIMATE- DEFENSE

AGAINST ENEMY MAI N EFFORT ELEMENTS
________ X ________ = __________ (X “combined value” of other three factor values)
Combat Miss ion
Strength Factor
__________ X .54 = ____________ (1) “Against enemy main effort casualties ”

AGAINST ENEMY SECONDARY EFFORTS

________ X ________ = __________ (X “combined value” of other three factor values)
Combat Miss ion
Strength Factor
__________ X .45 = ____________ (2) “Against enemy secondary efforts Casualti es”

SUPPORT BY FIRE ELEMENTS

________ X ________ = __________ (X “combined value” of other three factor values)
Combat Miss ion
Strength Factor
__________ X .32 = ____________ (3) “Support By Fire Casualti es”

*ADD (1) and (2) = __________ X (.72) = ___________ (Total Number of Casualties)

MISSION FACTORS: Hasty Defens e (.32), Deliberate Defense (.19), Strongpoint (.11)
OTHER FACTORS: a) Day (1.0), Night Illum (0.9), Night (0.7)
b) Enemy Fatigue: Rested (1.0), 24 hrs no rest (0.8), 48 hrs no res t (0.6)
c) Posture: Has ty (1.0), Improved (0.9), Prepared (0.7)
MCOAT
 Division Estimator (WIA and DNBI)
Blue cells are user input areas, yellow cells are formulas and are locked so the user can’t change them, green cells are
information cells, and cells with red arrows in the corner have a “pop up” help window.

Step 1, enter the security classification. Don’t process classified materiel on unclassified computers!

Step 2, Enter the troop

population for your unit.
Include everyone operating
in your Area of
Responsibility.

Step 3, select the

appropriate terrain,
weather, posture, and
strength factor. The
strength factor should
approximate the population
number.

Step 4, push the Calculate

Combat Effectiveness
Button. Go to next page
for instruction on this area.

Step 5, select the

appropriate surprise (the
enemy surprising you),
equipment, and operation
pattern. See Annex A for
description of operational
Step 6, select the appropriate pattern.
percentage for Killed, Captured and
Missing in Action. Step 8, Use the
Visualization Tool to
look at the credible
casualty range that
resulted from the
WIA estimate.

Step 9, select the appropriate

Step 7, Enter the number of soldiers
that parachute into the battle and
select the appropriate factor for day
or night, Rucksack Weight, and Drop
Zone Conditions
Step 10, The Total Casualties Requiring
Treatment per day is the sum of the Battle
Casualties and DNBI casualties.
factors that describe the
operation location (i.e. division
area) and the geographic
location (i.e. South Korea). This
determines the Disease & Non-
Battle Injury rate.
 Combat Effectiveness Calculator
Step 1, Enter the Step 2, Adjust the factors that are provided Step 3, Enter the Step 4, Repeat
number of are for training purposes only, they are strength of the units steps 1,2 & 3 for the
battalions that will derived from CGSC Student Text 100-3. that are involved in enemy forces.
be involved in the These factors must be updated with the fight.
fight by type of unit. operational factors based on the Intelligence
Officers assessment of friendly and enemy
capabilities.

Step 5, Examine the ratio of friendly to

enemy forces. Push the “Return to
Estimator” button to return to the estimator.
Patient Flow Worksheet

Step 1, Adjust the

RTD values at level
1, 2 and 3 as a
result of the
mission analysis.
 Battalion Aid Station Workload Estimates
Step 1, Enter the duration of
the operation. This should
be the length of time that
soldiers are at risk of
becoming WIA casualties as
a result of being in the “red
zone” fight.
Duration of Mission (Hours)
Urgent Priority
Casualty Distribution 30% 40%
Workload Factors Echelon 1 (BAS)
Point Of Injury to Echelon 1
Ground Distance from CCP to BAS km
Air Distance from CCP to BAS km
Number of Ground Ambulances
Step 3, (Must enter at least
Step 2, Select where the “1” in each area!)
expected peak casualty a. Enter the distance that
arrival will occur; early the evacuation vehicles will
(Airborne mission), middle have to travel in Kilometers.
(Movement to Contact), or b. Enter the number of
late (Deliberate Attack). evacuation vehicles, by
type, the average number of
patients and the average
Unclassified
speed of the vehicle.
10 Recommend a minimum of 10 hours
Account for the time
Routine
required to load and unload
30%
patients when determining
the average speed.
Minimum Required
311
10 Expected Peak Arrival of Casualties
1
15 10 Early in the Mission

Number of patients per ambulance 3

In the Middle of the Mission
Ground Ambulance Speed km/hr 20
Number of Nonstandard Ground Vehicles 1 0 Late in the Mission

Number of patients per vehicle 1

Nonstandard Vehicle Speed km/hr 1
Number of Casualties POI to BAS
Number of Air Ambulances 1 0 The Line Shows Max. Evac. Per Time Period
Number of patients per ambulance 1
60
Air Ambulance Speed km/hr 1
Number of Nonstandard Aircraft 1 0 50
Number of patients per aircraft 1 40
Patients

Aircraft Speed km/hr 1 30

Percentage of Patients to go by Ground Amb. 100.00%
20
Percentage of Patients to go by NS Ground 0.00%
Percentage of Patients to go by Air Amb. 0.00% 10
Percentage of Patients to go by NS Air 0.00% 100.00% # Round Trips 0
Time required for Ground Amb. Patient Evac hrs 6.91 7 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0
Time required for NS ground Patient Evac hrs 0.00 0 Hours
Time required for Air Amb. Patients Evac hrs 0.00 0
Urgent Priority Routine Patient/Time Period
Time required for NS air Patients Evac hrs 0.00 0
Unclassified

Step 4, Select the

percentage of patients to be
Step 5, Examine the
transported by each method.
minimum evacuation
The total must add up to Step 7, Use this chart to
duration. This is the
100%. If there is a method Step 6, Look at the determine if there any
minimum time required to
that will not be used, i.e. air number of round evacuation shortfalls. The
move the casualties if they
ambulance, then enter 0%. trips necessary to blue line is the maximum
all showed up at the same
evacuate the evacuation capability and
time. The user should adjust
casualties. the bars are the number of
the evacuation percentage
Determine if this casualties per time period. If
to order to reduce the
number of round the bars are above the line,
required time as much as
trips is feasible casualties exceed
possible.
(escorts required evacuation requirements.
and available?)
 Medical Supply (Class VIII) Estimates
Step 1, Enter the number of patients that can be treated using one Trauma
Treatment Set, Sick Call Set, and/or Forward Surgical Team Set. The more
patients that can be treated per set, the less resupply that will be required.

Step 2, Enter the units of blood per patient that will be required. A study
conducted by the International Committee of the Red Cross recommends 47.7
units per one hundred patients for casualties treated by a surgical team. This
study was published in the British Journal of Anesthesia, 1992; 68: 221-223.

Step 3, The total short tons of class VIII required to support this patient load is
provided in this area.
 Patient Accumulation Worksheet

This worksheet is an attempt to show the impact of various

lengths of stay on hospital bed requirements
Step 1, Enter the average length of stay for patients. This factor should take into
account the evacuation policy and the evacuation delay. It is usually between 3
and 5 days.

Step 2, Manually input other days admissions. These should be done on

separate Workbooks. The daily census numbers reflect the total bed requirement
over time. The hospital capacity numbers come from the Workload Worksheet.
Tools
Time Factors
Role I BAS
FM 4-02.4
CBRNE

FM 4-02.7
CBRNE
Military Decision Making Process

Offen Defen
sive sive
IO IO
Effect Effect
s
Destr s
Detec
oy t
Disru Prote
pt ct
Degra Resto
de re
Deny Resp
ond
Decei
ve
Exploi
t
Influe
Emerging IO
nce
Doctrine

Damag Warn
e
Limit
Delay
Mitiga
Divert te
Isolate Prese
rve
Co-opt
Organiz
e
Disorga
nize
Inform
Propos
e
Encour
age
Promot
Harass (FM e
3-60)
 9 – LINE MEDEVAC

CHS Leaders’ Reference REQUEST

(FM 8-10-6)
Line 1- Location of pickup
Card PRINCIPLES
OF CHS site
(FM 4-02.6) Line 2- Radio call sign &
1. Conformity frequency
2. Continuity Line 3- # of patients by
3. Control precedence
AMEDD BATTLEFIELD RULES TROOP LEADING
4. Proximity a. Urgent b. Urgent
(FM 4-02.6) PROCEDURES (FM 7-8)
5. Flexibility (surgical)
1. Maintain medical presence 1. Receive mission
6. Mobility c. Priority d. Routine
with the soldier 2. Issue warning order
e. Convenience
2. Maintain health of the command 3. Make a tentative plan
Line 4- Special equipment
3. Save lives 4. Start movement
needed
4. Clear the battlefield 5. Reconnoiter
SPOT REPORT a. None b. Hoist
5. Provide state-of-the-art care 6. Complete the plan
S- Size c. Extraction equipment
6. Return soldiers to duty as soon 7. Issue the plan
A- Activity d. Ventilator
as possible 8. Supervise
L- Location Line 5- # of patients by
U- Unit/Uniform type
T- Time L- # of Litter patients
E- Equipment A- # of Ambulatory
patients
Line 6- Security of pickup
site (war)
N- No enemy troops in
area
P- Possible enemy troops
in area
CHS FUNCTIONAL AREAS
METT-TC MILITARY ASPECTS OF E- Enemy troops in area
1. C4I (FM 4-02.6)
ANALYSIS TERRAIN (OCOKA) X- Enemy troops in area
2. Medical Treatment
(FM 7-8) (FM 7-8) Line 6- Number and type
3. Evacuation & Med Regulating
1. Mission 1. Observation & Fields of wound
4. Hospitalization
2. Enemy of Fire injury or illness
5. Combat Health Logistics
3. Terrain 2. Cover & Concealment (peace)
6. Dental Services
4. Troops 3. Obstacles Line 7- Method of marking
7. Veterinary Services
5. Time 4. Key Terrain at HLZ
8. Preventive Medicine
6. Civilians 5. Avenues of Approach a. Panels b. Pyro c.
9. Combat Stress Control
smoke
10. Medical Laboratory Services
d. None e. Other
Line 8- Patient Nationality
& Status
a. US Military b. US
Civilian
c. Non US Military
d. Non US Civilian e.
EPW
OPORD FORMAT (FM 101-5) Line 9- NBC (war)
N- Nuclear B- Biological
TASK ORGANIZATION: 3. EXECUTION: (Intent) C- Chem
1. SITUATION: (Enemy/Friendly) Concept of Operation / Concept of Support Line 9- Terrain description
2. MISSION: (Task & Purpose) 4. SERVICE & SUPPORT: (peace)
who, what, when, where, why 5. COMMAND & SIGNAL:
TC3 Cards (new)
TC3 Cards (old)
 Command Posts
Strong

Patient tracking boards during MASCAL MC4 NIPR, Printer

CONOPS/ Battle Drills SIPR/ FM/SVOIP/JABBER

 NTC Medical Platoon Trends and Observations

PRE-DEPLOYMENT
•MES and CLS bags not packed according to UALs by USAMMA
•NBC MES not deployed to the NTC
•Medical platoons do not deploy with OE-254s
•Medical platoons do not deploy with NBC equipment (M8 & M9 papers, M256
kits, CAM, and M-8 alarm(s)
•Deploy with little or no maps and acetate to support graphics for combat
operations
•MEDOs have not or seldom train with their battlestaff during MDMP at
homesation
•Little to no concept of Mission Command

RSOI
•Medical platoons are not synchronized with their task force’s combat power
build-up
•No BCT HHS plan to link Echelon I with Echelon II
•BSMC fails to link-up DS ambulances from ambulance platoon with
supported aid stations prior to rollout for combat operations- often leads to
extended distances between Echelon I and Echelon II with NO link between
them (DS ambulances, AXPs, Air MEDEVAC/CASEVAC)

HHS PLANNING
•Lack of cooperation between BDE Surgeon, BSMC CDR and TF
MEDOs
•Casualty estimates seldom done by MEDO or TF S-1
•Non-standard CASEVAC assets are seldomly planned for- most
units usually rely solely upon organic ambulances for evacuation
requirements
•MEDOs absent or ill-prepared to contribute to the MDMP- fail to
develop HSS plan that is synchronized with scheme of maneuver
and the commander’s intent
•Often times fail to consider HSS with adjacent unit aid stations to
support elements within our Task Force operating in another area
of operations (AO)- “adjacent unit coordination”
•Fail to develop plan to conduct Patient Decon operations for
potential NBC contamination during the operation
 NTC Medical Platoon Trends and Observations

HHS PREPARATION
•Lack of rehearsals and planning
•PLs and PSGs struggle significantly with conducting PCCs/PCIs
•OPORDs by Med PLs are often incomplete and not in 5-paragraph
format
•MEDOs, TF Xos, and TF S4s seldom plan and prepare for non-
standard CASEVAC assets
•Med PLs and PSGs do not enforce that company/team senior
medics attend TF CSS rehearsal
•Ambulance PL or PSG (from BSMC) never attend TF CSS rehearsal
although they are in “direct support” (DS) to TF FAS/MAS for
combat operation
HHS EXECUTION
•Med PLs struggle with ability to gain and maintain situational
awareness as combat operations develop
•Company/team senior medics are grossly under-utilized in
providing SITREPs to Med PL or Med PSG (seldomly update Med
Plt leadership via FM- A/L or Plt net, very seldomly attend TF CSS
rehearsals)
•Med PLs struggle with basic HSSconcepts and TTPs (near and far-
side treatment teams for breach operations, displacement triggers
to echelon treatment teams forward during offensive operations,
techniques to provide HSS for cross-FLOT operations, etc.)
GENERAL OBSERVER/CONTROLLER MDMP
OBSERVATIONS

MISSION ANALYSIS
• MEDICAL PLATOON LEADER ABSENT DURING MISSION ANALYSIS
• LACK OF KNOWING STATUS OF AVAILABLE ASSETS (PERSONNEL, VEHICLE
MISSION STATUS, ON-HAND CLASS VIII)
• FAILS TO PRODUCE CASUALTY ESTIMATES BASED UPON UPCOMING OPERATION
• LACK OF READING HSS/CHS PLAN FROM THE BCT/RCT/IBCT CSS ANNEX
• CANNOT DRAW SPECIFIED, IMPLIED, AND ESSENTIAL TASKS FROM BCT/RCT/IBCT
ORDER
• MED PLT LDR/S-1/S-4 FAILS TO BRIEF BASE CHS PLAN, CHS CONSTRAINTS, OR
CASUALTY ESTIMATES TO COMMANDER DURING MISSION ANALYSIS BRIEF
• MED PLT LDR FAILS TO ISSUE WARNING ORDER #1 TO MED PLT

COMMANDER’S GUIDANCE
• MED PLT LDR ABSENT DURING COMMANDER’S GUIDANCE
• MED PLT LDR FAILS TO ADVISE COMMANDER OF CONSTRAINTS/LIMITATIONS (I.e.
TF CDR wants 4 treatments teams to provide DS to each company/team)
• MED PLT LDR FAILS TO PLAN/EXECUTE CDR’S GUIDANCE

COURSE OF ACTION (COA) DEVELOPMENT

• MED PLT LDR ABSENT DURING COA DEVELOPMENT
• MED PLT LDR FAILS TO ARRAY INITIAL POSITION OF TREATMENT TEAMS IN
SUPPORT OF UNITS DURING R&S PHASE
• MED PLT LDR FAILS TO ASSIGN TASK & PURPOSE TO TREATMENT TEAMS
IN DIRECT SUPPORT (DS) OF MAIN & SUPPORTING EFFORTS
• MED PLT LDR FAILS TO ISSUE WARNING ORDER #2 TO MED PLT
* This step of MDMP analyzes unit combat power, array of initial forces, scheme of
maneuver, generations of options, and COA statements/sketches prepared

COURSE OF ACTION (COA) ANALYSIS- “WARGAME”

• MED PLT LDR ABSENT DURING WARGAMING PROCESS
• MED PLT LDR ILL-PREPARED FOR WARGAME (LACK OF CASUALTY ESTIMATE
TOOLS, LACK OF KNOWING BCT/FSMC CHS PLAN ALTHOUGH IT IS STATED IN BCT
CSS ANNEX, LACK OF KNOWING STATUS OF ASSETS AVAILABLE)
• FAILS TO ECHELON TREATMENT TEAMS FORWARD WITH MOVEMENT OF
FORWARD UNITS TO MAINTAIN ADEQUATE SUPPORT DISTANCE (FAILS TO
CONDUCT TIME/DISTANCE ANALYSIS OF FORWARD UNITS WITH TREATMENT
TEAMS)
• FAILS TO PLAN FOR COMBAT HEALTH SUPPORT BASED UPON BASIC
FUNDAMENTALS- TTPs FOR R&S, BREACH OPERATIONS, DEFENSIVE OPERATIONS,
OFFENSIVE OPERATIONS

4
REFERENCES:

• FM 101-5, Staff Organization and Operations

• FM 101-10-1/2 and -2/2, Staff Officers’ Field Manual (Vol. 1 & 2)
• FM 100-14, Risk Management
• FM 3-90, Tactics
• FM 3-90.2, The Tank and Mechanized Infantry Battalion Task Force
• FM 8-55, Planning for Health Service Support
•ATTP 4-02 AHS
• FM 4-02.6, The Medical Company
• FM 4-02.4, Medical Platoon Leader’s Handbook
FM 4-02.7 MULTISERVICE TACTICS, TECHNIQUES, AND PROCEDURES FOR
HEALTH SERVICE SUPPORT IN A CHEMICAL, BIOLOGICAL,RADIOLOGICAL,
AND NUCLEAR ENVIRONMENT
• Task Force Medical Platoon Leader’s Handbook, CPT Rigdon (Scorpion 24, 1999-2001)
• Cobra Team Combat Health Support TTPs Workbook, CPT Al-Ali (Cobra 24, 2000-2001)
• Medical Operations Handbook, MAJ Michael Smith