MCWP 4-11.1 chapter 1, 2 and 4

Health Service Support OperationsHM3 Zachery Tyler

Physical Therapy TechNaval Hospital Camp Pendleton

Chapter 1 Fundamentals

● Health Service Support (HSS) is the employment of medical forces in support of the warfighter

● Mission: Minimize effects that wounds, injuries, and diesease have on unit effectiveness, readiness, and morale

A Healthy and Fit Force

● HSS supports wellness and quality of life in order to strengthen the human component of military forces

● Utilize all available medical specialties to ensure a healthy and fit force

Threat to the Force

● HSS Focuses on two forms of threat:

● The Enemy – Combat Casualties

- Depends on enemy’s intent and capability to cause causalties

● The Individuals Health – Diesease and Nonbattle Injuries (DNBI)

- Depend on environmental, physiological, and operational factors

Casualty Care Management

● The HSS deploys small, mobile and task-organized capabilities to provide care throughout the continuum of healthcare.

1. Policy and Resource Acquisition2. Prevention and Protection3. First Responder4. Forward Resuscitative Care5. Theater Hospitalization6. Definitive Care7. En Route Care

Functional Areas

● Medical plans must address the following funcitons

when developing the HSS concept of operations:

- Casualty Management from point of injury, triage, treatment, and transport to next taxonomy outside of Marine Corps capabilities.

- Force health protection and prevention – Prev Med

- Medical Logistics organize and provide specialized products and services

- Medical Command and Control (C2) integrates with tactical commanders to provide medical support to current and future operations

- Medical Stability Operations

Chapter 2 Intelligence

• Medical intelligence from all sources, internal and external to the Marine Air-Ground Task Force (MAGTF) gives the commander a complete picture of medical threats.

Internal Medical Intelligence Sources

Preventitive Medicine

● Most PVNTMED assets are organic to MEF, H&S Company, Med Batallion, CLR and MLG.

● PVNTMED activities include identifying environmental risks, assessing living conditions, water quality and supply, waste disposal, food safety and sanitation, entomology issues and hearing conservation.

Internal Medical Intelligence Sources

Local Command Intelligence

● Additional medical intelligence may be requested through the intelligence staff officer sections of the command element, ground combat element, aviation combat element and MLG.

Health Service Support Element

● HSSE within the MLG is typically first to receive intelligence from on-site care providers.

National Center for Medical Intelligence

● Sole producer of finished medical intelligence for the DoD and provide intelligence on:

o World Wide Infectious Disease and environmental health risks

o Foreign military and civilian health care systems and infrastructure

o Developments in biotechnology and biomedical subjects

Chapter 4 Logistics

● HSS Logistics encompasses procurement, initial issue, management, resupply, and disposition of material required to support medical and dental elements organic to MARFOR

● Guidance for procuring class VIII materials (blood products) can be found on DoD Instruction 6480.4 Armed Services Blood Program (ASBP) Operational Procedures.

Logistics

● The following information is critical for the medical planner to develop and plan for appropriate Class VIII support:

- Concept of Operation/Scheme of Maneuver

- Combat Intensity- Duration of Operation- Casualty Estimates

Allowance and Source of Logistics

• The MAGTF surgeon advises the MAGTF commander regarding medical and dental material support

• Allocation of material is documented in the table of equipment (T/E); the AMALs/ADALs; and the normal replenishment supply support

Allowance and Source of Logistics

● The total T/E and AMALs/ ADALs are designed to support:

- MEF for 60 days- Marine Expeditionary Brigade for 30 days- Maritime Prepositioning Force for 30 days- MEU for 15 days

● The authorizing commander is responsible for funding AMALs/ ADALs above the level prescribed by MCO 6700.5

Medical and Dental Support (class VIII) Material Support of the Marine Operational Forces

Table of Equipment (T/E)

● A unit's T/E includes items necessary for basic support of the organization

o Tentageo Vehicleso Toolso Communications equipmento Nuclear, biological, and chemical (NBC) gearo Specialized clothing. o Office equipment

AMALS/ADALS

● AMALs and ADALs are specialized equipment and supply assemblages for medical and dental elements to provide combat HSS:

Normal Replenishment Supply Support

● For first 60 days of operation additional supplies are maintained by the LCE combat detachment

● For operations longer than 60 days resupply provided by the theater lead agent for material management (TLAMM)/Single Integrated Medical Logistics Manager (SIMLM)

● TLAMM/SIMLM provide supplies, equipment repair, blood management and optical fabrication for all branches

Normal Replenishment Supply Support

● HSS logistics is normally a service responsibility

● SIMLM provides central logistics support in Joint environment

● TLAMM is designated by SIMLM to accomplish the mission of replenishment

● The Army was tasked by DoD to perform TLAMM/SIMLM missions as they are the dominant user

Individual HSS Equipment

● HMs assigned to combat support units are provided a Corpsman Assault Pack (CAP) as part of their field gear

● HM’s parent unit supply section is responsible for ensuring equipment is in good condition and medications are not expired

Routine Resupply

● HSS personnel request for resupply → unit supply section → supported activities supply system management unit or LCE if deployed → LCE orders, receives, and distributes

Combat Resupply

● HSS planners determine the number and type of AMALs/ADALs required to support the assault phase of the operation

● Once these are expended requests go through LCE

● Class VIII materials are provided by designated SIMLM provider once stockpiles are expended

Patient Movement Items

● Medical equipment to support patient during evacuation

● Originating MTF provides PMI

● PMI remains with patient from originating MTF to destination MTF

Disposal of Materials

● Must be accomplished with US forces and civilian safety in mind

● Must comply with local and international guidelines

● When in US coordinate with Defense Reutilization Marketing Office

● When overseas coordinate with Defense Reutilization Marketing Office or LCE

Disposal of Materials

• During combat operations, the safest method of field disposal is burning, followed by deep burial (over 6 feet)

• The burial site must be located at a safe distance from watersheds and populated areas.

• Responsibility for neutralization and disposal of clothing, equipment, and dressings removed during NBC decontamination processes resides with the command's NBC officer

Disposal of Materials

• Disposal of body parts, tissues, and Class VIII blood and blood products accomplished in the same manner as used by local medical facilities.

• Alternative disposal by burning or deep burial requires prior authorization and specific guidance of higher authority

Protection of Medical Supplies

• Medical material and supplies are protected under the law of land Warfare and the Geneva Conventions.

• When medical material and supplies are mixed with combat supplies, they lose the protection afforded by these covenants.

• Marking medical supplies with red cross is up to area commander.

• Destruction of medical material and supplies is prohibited. They must be abandoned in a retrograde movement occasioned by enemy action or other tactical considerations.

QUESTIONS• What is the mission of Health Service Support

Operations?• Minimize effects that wounds, injuries, and diesease have

on unit effectiveness, readiness, and morale

• What are the two forms of threat in a theater?• The Enemy and The Individual’s Health

• What is the purpose of medical intelligence?• Gives Area Commander a complete picture of medical

threats

QUESTIONS• What functions must Medical plans address when

developing the HSS concept of operations?

- Force health protection and prevention- Medical Logistics- Medical Command and Control (C2)- Medical Stability Operations

• What kind of intelligence does Prev Med provide?

• Identifying environmental risks, assessing living conditions, water quality and supply, waste disposal, food safety and sanitation, entomology issues and hearing conservation

QUESTIONS• Who is typically first to receive intelligence from on-site

care providers?

• HSSE within the MLG

• Guidance for procuring class VIII materials (blood products) can be found on what instruction?

• DoD Instruction 6480.4 Armed Services Blood Program (ASBP) Operational Procedures

QUESTIONS• What information is critical for the medical planner to

develop and plan for appropriate Class VIII support?

- Concept of Operation/Scheme of Maneuver- Combat Intensity- Duration of Operation- Casualty Estimates

• Who advises the MAGTF commander regarding medical and dental material support?

- MAGTF Surgeon

QUESTIONS• What does a unit's T/E include?• Items necessary for basic support of the organization

• What are AMALs/ADALs?• Specialized equipment and supply assemblages for

medical and dental elements to provide combat HSS

• What is the safest method of field disposal for class VIII material?

• Burning, followed by deep burial (over 6 feet)