MCWP 4 11.1 Health Service Support Operations ch. 2 & 8

MCWP 4-11.1 Health Service Support OMCWP 4-11.1 Health Service Support Operationsperations

Health Service Support Health Service Support Operations Ch. 2 & 8Operations Ch. 2 & 8

A presentation by:A presentation by:


PurposePurpose

To disseminate information on the mission, To disseminate information on the mission, functions, structure, and concept of employment functions, structure, and concept of employment of HSS units. of HSS units.

To provide overarching doctrine and establishes To provide overarching doctrine and establishes a practical approach to HSS from the a practical approach to HSS from the perspective of the commander or staff officerperspective of the commander or staff officer

This publication establishes general guidance This publication establishes general guidance that requires judgment in application and that requires judgment in application and pertains equally to small-unit leaders and senior pertains equally to small-unit leaders and senior commanders.commanders.


Chapter 2: Chapter 2: IntelligenceIntelligence

Accurate and timely intelligence—Accurate and timely intelligence—knowledge of the enemy and the knowledge of the enemy and the surrounding environment that is needed to surrounding environment that is needed to support decision making—is a prerequisite support decision making—is a prerequisite for military success.for military success.Intelligence is a fundamental component of Intelligence is a fundamental component of command and control that aids the command and control that aids the commander in applying combat power at the commander in applying combat power at the decisive time and place. decisive time and place. Intelligence activity is mission-focused.Intelligence activity is mission-focused.



In MAGTF intelligence operations, intelligence In MAGTF intelligence operations, intelligence operations are determined by the commander’s operations are determined by the commander’s intelligence requirements. intelligence requirements.

The resulting intelligence effort provides critical The resulting intelligence effort provides critical knowledge and understanding about the enemy and knowledge and understanding about the enemy and the environment to help the commander plan and the environment to help the commander plan and make decisions.make decisions.

Medical intelligence includes more than just Medical intelligence includes more than just information on disease or other environmental information on disease or other environmental hazards.hazards.



Raw data must be analyzed and properly acted Raw data must be analyzed and properly acted on to prevent an adverse operational impact.on to prevent an adverse operational impact.

Medical intelligence from all sources—internal Medical intelligence from all sources—internal and external to the MAGTF—must be and external to the MAGTF—must be assimilated for the commander to have a assimilated for the commander to have a complete picture of the medical threat.complete picture of the medical threat.


Preventive Medicine SectionPreventive Medicine SectionMost preventive medicine assets organic to the Most preventive medicine assets organic to the Marine expeditionary force Marine expeditionary force ((MEF) are found in MEF) are found in the preventive medicine section, headquarters the preventive medicine section, headquarters and service (H&S) company, medical battalion, and service (H&S) company, medical battalion, force service support group (FSSG). force service support group (FSSG).

General support includes identifying information General support includes identifying information on environmental health, demographics, living on environmental health, demographics, living conditions, water supply, waste disposal, conditions, water supply, waste disposal, insects, diseases, and vector issues of military insects, diseases, and vector issues of military importance, as well as evaluating local food importance, as well as evaluating local food sanitation and sight and hearing conservation sanitation and sight and hearing conservation programs.programs.


Local Command G-2 SectionsLocal Command G-2 SectionsAdditional medical intelligence may be Additional medical intelligence may be requested through G-2 sections of the requested through G-2 sections of the command element, ground combat element command element, ground combat element (GCE), aviation combat element (ACE), and (GCE), aviation combat element (ACE), and combat service support element (CSSE).combat service support element (CSSE).

Additional information on intelligence support to Additional information on intelligence support to medical operations can be found in the medical operations can be found in the intelligence series of the Marine Corps intelligence series of the Marine Corps warfighting publications (particularly MCWP 2-warfighting publications (particularly MCWP 2-12, 12, MAGTF Intelligence Production and MAGTF Intelligence Production and Analysis)Analysis)..


Health Service Support Health Service Support ElementElement

The health service support element (HSSE) is The health service support element (HSSE) is often the first to receive medical intelligence often the first to receive medical intelligence from on-site care providers due to multiple from on-site care providers due to multiple communications and information links available communications and information links available to sections within the FSSG combat service to sections within the FSSG combat service support operations center (CSSOC).support operations center (CSSOC).


The Armed Forces The Armed Forces Medical Intelligence CenterMedical Intelligence Center

The Armed Forces Medical Intelligence Center (AFMIC) is a The Armed Forces Medical Intelligence Center (AFMIC) is a field production activity of the Defense Intelligence Agency. It is field production activity of the Defense Intelligence Agency. It is the sole producer of medical intelligence in the Department of the sole producer of medical intelligence in the Department of Defense (DOD). Defense (DOD).

AFMIC provides all-source intelligence on—AFMIC provides all-source intelligence on—– Worldwide infectious disease and environmental health Worldwide infectious disease and environmental health

risks.risks.– Foreign military and civilian health care systems and Foreign military and civilian health care systems and

infrastructure.infrastructure.– Foreign biomedical developments and life science Foreign biomedical developments and life science

technologies of military medical significance.technologies of military medical significance.


The Armed Forces The Armed Forces Medical Intelligence CenterMedical Intelligence Center

AFMIC maintains extensive data bases; monitors foreign AFMIC maintains extensive data bases; monitors foreign research, development, production, and transitional flow research, development, production, and transitional flow of medical materiel for military interest; and provides of medical materiel for military interest; and provides intelligence liaison services to key customers.intelligence liaison services to key customers. It also conducts in-house and mobile training, including It also conducts in-house and mobile training, including a medical intelligence fellowship program; serves on a medical intelligence fellowship program; serves on numerous intelligence committees and working groups; numerous intelligence committees and working groups; and trains military reservists for mobilization and trains military reservists for mobilization assignments.assignments.AFMIC’s intelligence products provide direct support to AFMIC’s intelligence products provide direct support to U.S. military customers for operational planning; U.S. military customers for operational planning; development of policy, doctrine, and training priorities; development of policy, doctrine, and training priorities; and medical research and development.and medical research and development.


The Armed Forces The Armed Forces Medical Intelligence CenterMedical Intelligence CenterQueries for medical intelligence support are Queries for medical intelligence support are addressed via the HSS chain or direct from addressed via the HSS chain or direct from deploying units to—deploying units to—

Defense Intelligence Agency Armed Forces Defense Intelligence Agency Armed Forces Medical Intelligence Center Fort Detrick Medical Intelligence Center Fort Detrick Frederick, MD 21701-5004Frederick, MD 21701-5004

Via message to— DIRAFMIC FTDETRICKMD.Via message to— DIRAFMIC FTDETRICKMD.


Chapter 8: Patient MovementChapter 8: Patient Movement

Patient movement is a casualty management system.Patient movement is a casualty management system.

It is designed to coordinate the movement of It is designed to coordinate the movement of casualties from site of injury or onset of disease casualties from site of injury or onset of disease through successive levels of care to a facility that can through successive levels of care to a facility that can provide the appropriate level of treatment.provide the appropriate level of treatment.

Prompt movement of casualties through the Prompt movement of casualties through the evacuation system to treatment facilities is essential to evacuation system to treatment facilities is essential to decrease morbidity and mortality of battlefield decrease morbidity and mortality of battlefield casualties.casualties.


Chapter 8: Patient MovementChapter 8: Patient Movement

If casualties occurred at regular intervals, in constant If casualties occurred at regular intervals, in constant numbers, at predetermined locations, and with numbers, at predetermined locations, and with predictable injuries, their movement would require little predictable injuries, their movement would require little or no coordination. or no coordination.

Patient movement is a vital support factor that must be Patient movement is a vital support factor that must be planned. planned.

Personnel must be trained on equipment and Personnel must be trained on equipment and procedures in advance of operations in the field.procedures in advance of operations in the field.


PhasesPhasesCoordination of casualty movement is especially Coordination of casualty movement is especially critical during operations when casualties must be critical during operations when casualties must be moved from shore to task force ships. moved from shore to task force ships.

When properly followed, the medical regulating When properly followed, the medical regulating process ensures that patients move only as far process ensures that patients move only as far rearward in the continuum of care as their health rearward in the continuum of care as their health needs dictate which, in turn, assures the efficient and needs dictate which, in turn, assures the efficient and effective use of the limited HSS assets available to the effective use of the limited HSS assets available to the MAGTF.MAGTF.


Patient Movement May Occur Patient Movement May Occur In Two PhasesIn Two Phases::

Evacuation—the movement of patients between Evacuation—the movement of patients between point of injury or onset of disease to a facility point of injury or onset of disease to a facility that can provide the necessary treatment that can provide the necessary treatment capability.capability.

Medical regulating—the process of selecting Medical regulating—the process of selecting destination MTFs with the necessary HSS destination MTFs with the necessary HSS capabilities for patients being medically capabilities for patients being medically evacuated in, between, into, and out of different evacuated in, between, into, and out of different theaters of geographic combatant commands theaters of geographic combatant commands and CONUS.and CONUS.


Decision-makingDecision-making

Degree of care for the sick and wounded in any area Degree of care for the sick and wounded in any area of combat is greatly influenced by prevailing tactical of combat is greatly influenced by prevailing tactical situations. situations.

Conditions are seldom static, and success in combat Conditions are seldom static, and success in combat must remain the primary goal of combat, combat must remain the primary goal of combat, combat support, and combat service support units. support, and combat service support units.

This environment requires a dynamic casualty This environment requires a dynamic casualty management decision making process which must be management decision making process which must be applied at all HSS units and in the patient movement applied at all HSS units and in the patient movement system.system.


Casualty Sorting (Triage)Casualty Sorting (Triage)An effective process of casualty sorting, also An effective process of casualty sorting, also referred to as triage, is basic to the successful referred to as triage, is basic to the successful operation of a patient movement system. operation of a patient movement system.

Rapid evaluations must be made to identify Rapid evaluations must be made to identify which patients need immediate resuscitation which patients need immediate resuscitation and which patients can tolerate delay in and which patients can tolerate delay in treatment. treatment.

Deciding which patients should be moved after Deciding which patients should be moved after initial treatment to other medical facilities is of initial treatment to other medical facilities is of equal importance.equal importance.


Medical ManagementMedical ManagementUnder combat conditions, the flow of sick and Under combat conditions, the flow of sick and wounded puts variable pressure on capabilities of wounded puts variable pressure on capabilities of medical facilities. medical facilities. Incoming casualties necessitate the movement of Incoming casualties necessitate the movement of stable casualties who can be evacuated. stable casualties who can be evacuated. Close coordination between clinical and Close coordination between clinical and administrative services must be maintained to administrative services must be maintained to achieve effective management of individual achieve effective management of individual casualties. casualties. Medical officers who are responsible for decisions on Medical officers who are responsible for decisions on movement of individual casualties must work closely movement of individual casualties must work closely with administrative officers charged with with administrative officers charged with implementing patient movement for evacuation.implementing patient movement for evacuation.Underlying all considerations is the basic objective of Underlying all considerations is the basic objective of preserving life and limb.preserving life and limb.


Medical Evacuation AssetsMedical Evacuation AssetsThe assigned mission dictates the number and types of aircraft The assigned mission dictates the number and types of aircraft assigned to accomplish all assault support tasks. assigned to accomplish all assault support tasks.

This mission, along with the limited number of aircraft in the This mission, along with the limited number of aircraft in the Marine Corps inventory, precludes the assignment of dedicated Marine Corps inventory, precludes the assignment of dedicated aeromedical evacuation (AE) aircraft in most cases. aeromedical evacuation (AE) aircraft in most cases.

All Marine Corps rotary wing transport and utility aircraft have All Marine Corps rotary wing transport and utility aircraft have the capability to perform an AE mission. the capability to perform an AE mission.

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

Assets are designated to perform AE through implied mission Assets are designated to perform AE through implied mission tasking or by assuming a standby posture.tasking or by assuming a standby posture.


Medical Evacuation AssetsMedical Evacuation Assets

Prior planning is essential to ensure proper allocation of Prior planning is essential to ensure proper allocation of aircraft to support AE missions. Within the MEF, the aircraft to support AE missions. Within the MEF, the FSSG HSSE, in conjunction with the FSSG logistics FSSG HSSE, in conjunction with the FSSG logistics movement coordination center (LMCC), plans for movement coordination center (LMCC), plans for medical evacuation aircraft. medical evacuation aircraft. The LMCC air liaison officer is the direct link to the MAW The LMCC air liaison officer is the direct link to the MAW for identification of medical evacuation missions in the air for identification of medical evacuation missions in the air tasking order.tasking order.In the absence of an AE capability, casualty evacuation In the absence of an AE capability, casualty evacuation is accomplished using any surface (water or ground) is accomplished using any surface (water or ground) transportation available (ground ambulance, five-ton transportation available (ground ambulance, five-ton truck, smalltruck, small boat, landing craft air cushion).boat, landing craft air cushion).


Evacuation Concepts Used Evacuation Concepts Used By The Marine CorpsBy The Marine Corps

Dedicated medical evacuation assets are patient Dedicated medical evacuation assets are patient movement assets configured for medical evacuation, movement assets configured for medical evacuation, externally marked with a red cross, and specifically externally marked with a red cross, and specifically reserved to support the medical evacuation mission. reserved to support the medical evacuation mission. Dedicated medical evacuation assets are authorized Dedicated medical evacuation assets are authorized protection under the Geneva Conventions.protection under the Geneva Conventions.

Designated medical evacuation assets are non-medical Designated medical evacuation assets are non-medical patient movement assets, not externally marked with a patient movement assets, not externally marked with a red cross, but configured and allocated for patient red cross, but configured and allocated for patient movement. Designated medical evacuation assets are movement. Designated medical evacuation assets are not afforded protection under the Geneva Conventions.not afforded protection under the Geneva Conventions.


Aeromedical Evacuation Aeromedical Evacuation Request ProceduresRequest Procedures

Normally, when control is seabased, units request AE Normally, when control is seabased, units request AE by radio to the helicopter direction center using the by radio to the helicopter direction center using the helicopter direction net.helicopter direction net.When command and/or net control has been passed When command and/or net control has been passed ashore, units request AE from the direct air support ashore, units request AE from the direct air support center using the tactical air request/helicopter request center using the tactical air request/helicopter request net. net. The air officer will then consult with either the ATF The air officer will then consult with either the ATF medical regulating control officer when seabased or medical regulating control officer when seabased or the LF patient evacuation officer when ashore for a the LF patient evacuation officer when ashore for a recommendation of the best medical facility to care for recommendation of the best medical facility to care for the patient.the patient.


Aeromedical Evacuation Aeromedical Evacuation Request ProceduresRequest Procedures

In operations where dedicated AE assets are assigned, In operations where dedicated AE assets are assigned, the direct air support center will make liaison with the the direct air support center will make liaison with the units responsible to provide AE.units responsible to provide AE.AE missions are classified as preplanned or immediate.AE missions are classified as preplanned or immediate. Both types of support are delivered in response to Both types of support are delivered in response to specific requests via the assault support request.specific requests via the assault support request.AE missions from Marine Corps MTFs to theater AE missions from Marine Corps MTFs to theater hospitals will be coordinated by the patient hospitals will be coordinated by the patient evacuation/patient movement section, FSSG, in evacuation/patient movement section, FSSG, in coordination with the HSSE, the CSSOC, LMCC, and the coordination with the HSSE, the CSSOC, LMCC, and the theater patient movement requirements center.theater patient movement requirements center.


Further GuidanceFurther Guidance

NWP 4-02.2 Vol. 1, NWP 4-02.2 Vol. 1, Patient MovementPatient Movement, , provides a general summary of the HSS system provides a general summary of the HSS system and the specific tactic, techniques, and and the specific tactic, techniques, and procedures (TTP) for naval expeditionary force procedures (TTP) for naval expeditionary force medical regulating.medical regulating.

For joint operations, refer to Joint Pub 4-02.2, For joint operations, refer to Joint Pub 4-02.2, Joint Tactics, Techniques, and Procedures for Joint Tactics, Techniques, and Procedures for Patient Movement in Joint OperationsPatient Movement in Joint Operations..


Any questions?Any questions?

MCWP 4 11.1 Health Service Support Operations ch. 2 & 8

Health & Medicine

Transcript of MCWP 4 11.1 Health Service Support Operations ch. 2 & 8