FMST Student Manual - 2008 Web Edition*
UNITED STATES MARINE CORPS
Field Medical Training Battalion
Camp Lejeune
FMST
1501
Aid Station Procedures
TERMINAL LEARNING OBJECTIVES
1.
Given a BAS environment and standard field medical equipment
and supplies, perform Battalion Aid Station (BAS) procedures, to provide
optimum Health Service Support per the references. (FMST-HSS-1501)
2.
Given a mission in a field environment, T/E-designated
tentage, and assistants, employ T/E-designated tentage, to provide shelter for
Health Service Support operations per the references. (FMST-HSS-1502)
3.
Given an aid station in a garrison setting and the standard
medical equipment and supplies, provide optimum Health Service Support, per
the references. (FMST-HSS-1503)
ENABLING LEARNING OBJECTIVES
1.
Without the aid of references, given a description or list,
identify the mission of the Battalion Aid Station, per the student handout.
(FMST-HSS-1501a)
2.
Without the aid of references, given a description or title,
identify the areas of responsibility within the Battalion Aid Station, per the
student handout. (FMST-HSS-1501b)
3.
Without the aid of references, given a description or list,
identify the medical support responsibilities of the Battalion Aid Station in
a garrison environment, per the student handout. (FMST-HSS-1501c)
4.
Without the aid of references, given a description or list,
identify the medical support responsibilities of the Battalion Aid Station in
a field environment, per the student handout. (FMST-HSS-1501d)
5.
Without the aid of references, given a description or list,
identify equipment used to establish a Battalion Aid Station, per the student
handout. (FMST-HSS-1501e)
6.
Without the aid of references, given a tactical environment
and the necessary Table of Equipment (T/E) and supplies, employ tentage, per
the student handout. (FMST-HSS-1502a)
7.
Without the aid of references, given a simulated combat
environment, utilize AMAL equipment, per the student handout. (FMST-HSS-1502b)
8.
Without the aid of references, given a description or list,
identify the mission of the Aid Station in garrison, per the student handout.
(FMST-HSS-1503a)
9.
Without the aid of references, given a description or title,
identify the areas of responsibility within the Aid Station in garrison, per
the student handout. (FMST-HSS-1503b)
10.
Without the aid of references, given a
description or list, identify the procedures for patient assessment during
routine sick call, per the student handout. (FMST-HSS-1503c)
1.
OVERVIEW
Health
Service Support (HSS) of today's Marine Corps Operational Forces emphasizes the
provision of far-forward, mobile, medical support in the stabilization and
evacuation of casualties. The Aid Station is the HSS unit that will deliver
these services to our Marine Corps Forces (MARFOR) in sustaining the combat
power of the force. Throughout this lesson, the term Battalion Aid Station
(BAS) is used to describe various Aid Stations. A true BAS is a term used to
describe an Infantry Battalion Aid Station. Know that there are many different
Aid Stations, i.e. BAS, Group Aid Station (GAS), Regimental Aid Station (RAS),
etc., each with different numbers of personnel assigned.
2.
MISSION OF THE AID STATION
The Aid
Station has a dual mission, one that will be fulfilled while in a field/combat
environment, and the other fulfilled while in garrison. The mission of the aid
station is to be the primary HSS source for a unit. While in a field/combat
environment, the mission of the Aid Station is to minimize the effect wounds,
injuries, and diseases have on a unit’s effectiveness, readiness and morale.
Treatments such as surgical airways, administration of IV fluids and
antibiotics, as well as stabilization of wounds and fractures are common. The
mission of the Aid Station while in garrison is to keep the Marines assigned
ready for deployment. As such, responsibilities include conducting sick-call,
providing medical support during training, and undergoing continued medical
training.
3.
ORGANIZATION
Aid stations throughout
the Marine Corps are staffed based on the mission of the individual
organization. Manpower requirements for each unit are listed on its Table
of Organization (T/O). Large units, such as Infantry Battalions, may have
up to two medical officers (MO) and 65 Corpsmen to support 1,000 Marines.
Smaller units, such as Combat Engineer Battalion or a Tank Battalion may
only have one or no MO and a few Corpsmen but receive additional support
from a Headquarters Company. In the field, the BAS is co-located with the
command post. Around-the-clock operating capability is required. The BAS
is manned by Hospital Corpsmen of the battalion medical platoon under the
direction of the battalion surgeon.
Aid Station Group (Infantry
Battalion) - a
section of H&S Company, the aid station group is headed by the Battalion
Surgeon, and is capable of splitting into two sections to operate two separate
aid stations when necessary; the Assistant Battalion Surgeon heads the second
aid station.
Medical officer
- there are two MOs within each medical battalion
-
Battalion Surgeon
- Assistant Battalion Surgeon
Religious Ministry Team (RMT)
- each BAS is assigned one RMT consisting of:
-
Chaplain
- Religious Programs Specialist
(RP)
Hospital Corpsmen
- there are 21 corpsmen headed by a Leading Chief assigned to the Aid
Station under the Assistant Battalion Surgeon
Line Company Corpsmen
- there are 44 Corpsmen assigned to the line companies. They are divided into
four groups of 11 Corpsmen.
4. BAS RESPONSIBILITIES IN GARRISON (NOT IN THE
FIELD)
Maintain medical and dental readiness
- One of the most important missions of the BAS while in garrison is to keep the
unit medically and dentally prepared to deploy. Aid Stations use a web based
data tracking system known as the Medical Readiness Reporting System (MRRS).
Because it is web based, immunization information for Marines and Sailors can be
transferred electronically when they check-in to a new unit. This system
provides an overall readiness snapshot of the unit.
Conduct sick call - Aid stations act
as the primary medical treatment facility for active duty Sailors and Marines
for that particular unit. Sick call will normally be conducted under the
direction of the MO or Independent Duty Corpsman (IDC). Responsibilities of the
general duty Corpsman include identifying the chief complaint and performing a
routine patient assessment to include vital signs. You may be expected to
present the patient to the MO or IDC to complete the assessment and develop the
treatment plan. It is also the responsibility of the sick call Corpsman to
complete much of the official documentation.
Sick Call Procedures
Check in
- Aid Stations generally have sick call hours each morning. Patients will sign
in and receive their medical record from the records office. Vital signs are
taken and documented on a Standard Form (SF) 600.
Patient encounter
- is documented using the SOAP Note fashion (Subjective, Objective, Assessment
and Plan). You may be expected to complete and document the first half of the
note before presenting the patient to the IDC or MO at which time the assessment
will be made and a treatment plan will be developed.
Discharge
- basic treatments that can be performed at the BAS will be accomplished as
required. Routine medications that are stocked in the BAS will be dispensed as
needed. The patient is given instructions on the remainder of the plan of care
and when they should report back for any follow up appointments.
Binnacle List
- each morning a Binnacle List (Report of the Sick and Injured) is sent to the
company office detailing individuals who had been seen that day. It also lists
Marines who are Sick in Quarters or currently on Light Duty.
Disease Non Battle Injury
- information from the Sick Call log is also transferred into a Disease Non
Battle Injury (DNBI) Report. This report breaks down the categories of injuries
and illness for the unit. It is forwarded up the chain and collected for the
major unit. This information can be used to track the spread of disease or
identify injury trends.
Administration - Aid Stations are
the focal point of all medical administrative matters for the unit. These
include everything from simple light duty chits to complicated Physical Exam
Boards (Med Boards).
Supply - Aid Stations in garrison
have limited amounts of consumable supplies. Unit funds are used to provide
office supplies and medical supplies needed to provide basic care for unit
personnel.
Provide medical coverage as needed for training
- whenever Marines train, they will need Corpsmen. Examples of events requiring
medical coverage include weapons ranges, obstacle courses, and physical fitness
tests.
Provide training to non-medical personnel to enhance self/buddy aid and litter
team responsibilities - training programs such as
Combat Life Saver are taught while in garrison. A thorough training program for
your Marines, to include sustainment training, will save lives on the
battlefield.
5.
BAS
RESPONSIBILITIES IN THE FIELD/COMBAT ENVIRONMENT
While in the field or combat
operations, some of the responsibilities the BAS performed while in garrison
will continue. However, there are additional responsibilities the BAS and
the corpsman assigned to the BAS will assume. For instance;
- Conduct
sick call
- Conduct
Triage
- Treat casualties to minimize mortality, prevent further injury,
and stabilize for further evacuation.
- Record all casualties received and treated, and report them to
the appropriate unit section for preparation of casualty reports.
- Provide
temporary shelter in conjunction with emergency treatment.
- Return
patients to duty when possible.
- Transfer evacuees from the BAS to ambulance, helicopter, or
other evacuation transportation.
-
Initiate treatment of combat stress casualties.
-
Maintain deployment health records (DHR) of battalion personnel.
- Provide personnel
replacement and medical re-supply for company level Hospital Corpsmen.
During combat operations, the BAS is
structured to be able to split its personnel and supplies into two BAS's (Alpha
and Bravo) and "leapfrog" ahead as the battlefield advances, (see figure 2). As
Alpha BAS advances with the battalion, Bravo BAS will remain behind and continue
to provide medical care/evacuations until all patients have been CASEVAC’ed, or
until relieved by medical support elements such as Medical Battalion Shock
Trauma Platoon (STP). This allows for continuity of care as the unit advances.
Once the STP assumes all casualties, Bravo BAS, personnel and supplies will
rejoin Alpha BAS to form the complete BAS (see figure 2).
The BAS does not have a
patient holding capability. It is similar to a crude emergency room.
Depending on the tactical situation, the BAS can be assembled in a fully
equipped General Purpose (GP) tent or employed in a mobile configuration
from two M1035s and two 7-ton trucks. An individual’s privacy is a main
concern while they are being treated. Any and all practical measures
necessary to provide patient privacy should be used. A Religious Ministry
Team (RMT) may be assigned to the BAS. The RMT is made up of a Chaplain
and a Religious Program Specialist (RP). Their job is to aid in the
comfort of the sick and wounded and to perform religious rites, as
needed. This team can provide emotional support for the wounded and can
also assist the BAS personnel at the discretion of the Medical Officer.
Sections of the BAS
- the BAS can be broken down into five internal sections, which operate as a
whole in providing HSS to the Marine Infantry Battalion. (See figure 3)
Internal Security - provides
perimeter security for the immediate BAS area, searches patients for weapons,
munitions, and booby traps prior to being admitted to the triage area. AT NO
TIME will any weapon or ammunition be allowed into the medical treatment area.
Triage - sorts and records all
incoming patients prior to entry into treatment area. Limited emergency first
aid and fluid replacement may be provided here while patients are waiting to
enter treatment area. Initiate and/or continue patient documentation of
treatment provided in this area. Also provides comfort/ease of pain to the
dying.
Treatment Area - usually done in the
GP tent, but could be any secure area assigned by the Battalion Surgeon to treat
patients. It’s where all the life saving treatment/procedures are performed as
directed by the MO or Senior Medical Department Representative.
Evacuation Area - staging area for
patients awaiting evacuation, those requiring continued monitoring or continued
care. It is also the area where casualty reporting and CASEVAC requests are
made.
Expectant
Area - area used to hold personnel with very serious injuries who are not
expected to survive. Supportive medical care is provided, i.e. pain
medications, and ministry and sacrament for the dying are provided appropriate
for the casualties’ faith group.
Figure 3. Typical Field BAS Setup
Responsibilities of Specific
Personnel
Battalion Surgeon
One of
the two medical officers in an infantry battalion is designated as the Battalion
Surgeon. The Battalion Surgeon is a special staff officer who advises the
battalion commander on matters pertaining to the health and medical care of
battalion personnel. The duties of the Battalion Surgeon include:
- Supervising patient treatment, planning, and organization.
- Education of the battalion medical staff.
- Other duties as
the battalion commander may direct.
Assistant Battalion Surgeon
The
other medical officer in an infantry battalion is designated as the Assistant
Battalion Surgeon. The primary job of the Assistant Battalion Surgeon is to:
- Direct, manage, and supervise the operation of the BAS.
- Perform such
additional duties as may be assigned by the Battalion Surgeon.
Battalion Chief
Maintains the BAS to include:
- Administration, personnel, and logistical matters.
-
Ensures that all battalion HSS commitments and operational requirements have the
appropriate medical and logistical support.
- Advises the Battalion Surgeon on
all matters relating to the BAS or battalion medical personnel.
Joint responsibilities of the Battalion Surgeon/Chief
-
Organizing/Assignment of medical platoons personnel.
-
Preparing HSS appendix to battalion's operational plan.
- Supervising and assisting in the collection, treatment, and
evacuation of the sick and injured.
- Develop HSS Standing Operation Procedures (SOP) in accordance
with guidance by higher authority.
- Conduct
medical sanitation inspections.
-
Maintaining and submitting appropriate records and reports.
- Train
medical personnel in subjects relating to HSS.
- In the absence of a Preventive Medicine Technician, supervise
instruction for non-medical personnel in personal hygiene, preventive medicine,
and field sanitation.
- Ensuring medical supplies and equipment are properly managed,
and that a responsive re-supply system is established to ensure adequate
re-supply at garrison and combat levels.
6.
BAS LOGISTICS
Logistics is the military specialty
dealing with the procurement, storage, distribution, inventory, and maintenance
of material. Supplies and equipment are divided into ten classes for management
purposes. Class VIII supplies are specifically medical related items. Careful
consideration should be given to stock levels of Class VIII materials
(consumable and equipment) so as not to overstock. The following information is
crucial when medical planners develop HSS logistical support system:
-
Concept of operation/scheme of maneuver
-
Combat intensity
-
Duration of the operation
-
Casualty estimates
Supply Terminology
Table
of Equipment (T/E) - a unit's T/E includes items
necessary for basic support of the organization and include:
-
Tentage
-
Vehicles
- Tools
-
Communication equipment
-
Nuclear, biological and chemical (NBC) gear
- Office equipment and supplies
Authorized Medical Allowance List
(AMAL) - a list of authorized allowances of equipment
and consumable supplies required to perform operational HSS. There are many
types of AMALs that can be requested based on the nature of the operation. Each
AMAL is composed of equipment and consumable supplies. The T/E assigned AMALs
for the BAS are designed to support one Infantry Battalion.
AMAL
635 (Equipment) - Aid Station equipment and reusable
material supporting HSS of the BAS. Examples include:
-
Litters
- Litter
stands
- Blankets
AMAL
636 (Consumable Items) - Consumable supplies required
to provide HSS to the BAS, to include, initial resuscitation, and stabilization
of 50 casualties with major wounds prior to evacuation, and re-supplying to the
company line Corpsmen. Examples include:
-
Intravenous solutions
-
Bandages
- Medications
Authorized Dental Allowance List (ADAL)
- a list of authorized allowances of equipment and consumable supplies required
to perform a dental function. As with the AMAL, there are various types of
ADALs and they are also composed of equipment and supplies.
ADAL 662
Field Dental Items - equipment and reusable material
required establishing a dental clinic in the field. Consumable supplies
required providing emergency, diagnostic, and preventive maintenance of dental
care for 400 patients.
DD-1348
(see figure 4) - form used to requisition materials. It is used primarily by
the battalion corpsman in ordering supplies by line item only, e.g., IV fluids,
bandages, splints, etc., to re-stock the equipment and consumable AMAL/ADAL.
Line items
- an item having a National Stock Number (NSN)
Figure 4. DD
FORM 1348
Medical Logistics Company (MEDLOG),
Supply BN - the only permanent medical/dental supply
source in a Marine Expeditionary Force (MEF). It supports both the ground and
air elements of a MEF. MEDLOG maintains all AMALs/ADALs while in garrison.
They are also responsible for preventive maintenance, repair, and replacement of
all medical equipment and replacement of supply items.
Naval Medical and Dental Material
Bulletin (NMDMB) - monthly publication which provides
information on medications, supplies, equipment and authorizes additions or
deletions to the AMALs and ADALs. It also provides information on expiration
dates, defective materials, and disposition instructions.
Medical Supply and Replenishment
Chain
of re-supply under combat situations:
Unit
Corpsman
BAS
Logistics Command Element
MEDLOG,
Supply Battalion, MLG
referenceS
Marine Corps Warfighting
Publication (MCWP), 4-22 MED 021-6
Combat Health Support in Specific
Environments, FM 8-10-1
Class VIII Supplies, MCO 6700.2
Health Service Support Operations,
MCWP 4-22
Hospital Corpsman, NAVEDTRA 14295
Emergency War Surgery Handbook
NATO, 2004
Medical Evacuation in a Theater of
Operations, FM 8-10-6
REV: July 2008
Aid Station Review
1. Describe the Disease Non
Battle Injury Report (DNBI).
2.
List five requirements of the BAS in combat.
3.
What types of things are found on a Table of Equipment (T/E)?
4. Which AMAL contains consumable
supplies? List three.
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*The FMST Student
Manual was produced by the Field Medical Training Battalion-East, Camp Lejeune,
North Carolina. This 2008 web edition has been enhanced by the Brookside
Associates, Ltd., preserving all of the original text material, while
augmenting, modifying, eliminating or replacing some of the graphics to comply with
privacy and copyright laws, and to enhance the training value. These
enhancements are marked with a red box
□
and are C. 2008, with all rights
reserved.
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