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CSH-A-1 17 May 2004

MEMORANDUM FOR See Distribution

SUBJECT: 399th Combat Support Hospital Tactical Standing Operating Procedure (TACSOP)

1. The 399th Combat Support Hospital TACSOP is published to prescribe procedures in the conduct of tactical operations for all assigned or attached personnel.

2. The TACSOP is designed to facilitate adaptability to any theater in the world and to enable the unit to respond to change in assignment in a rapid and efficient manner. Each mission received by the 399th Combat Support Hospital should be planned and executed utilizing the procedures within the TACSOP. Each mission will also be planned utilizing available information concerning the mission, enemy, terrain, troops, and time available (METT-T). Where variations from this SOP must be made due to METT-T, they will be publicized in the appropriate mission order (OPORD, FRAGO etc).

3. The proponent for this SOP is the S3, 399th Combat Support Hospital at COM 508-884-8014.

MAXIMUM CARE!

(First Mi. Last)Rank, BranchCommanding

DISTRIBUTION:CDR, HHC, 399th CSHCDR, A Company, 399th CSHCDR, B Company, 399th CSHCDR, 388th MIN CARE DETCDR, 912th FSTS1 S2 S3 S4 BMOChaplainMROChief NurseChief, Medical Maintenance

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ANNEX TITLEA Hospital Organization and Staff Responsibilities

B Establishing Hospital Operational Areas Appendix 1 - Tactical Operations CenterAppendix 2 – ALOC OperationsAppendix 3 – Advance/Quartering Party ActivitiesAppendix 4 – Hospital DefenseAppendix 5 – Theater Hospitalization – Refer – FM – 4-02.10

Extract: Capabilities, org, etc

C Intelligence

D Convoy Operations

E NBC

F Personnel and AdministrationAppendix 1 – Admin Services and Personnel Services Support Appendix 2 – Casualty Management and Operations Appendix 3 – Personnel and Administration Reports

TAB A – PERSITREP InstructionsTAB B – Hospital Feeder Report For PRR

Appendix 4 – Postal OperationsAppendix 5 – Public AffairsAppendix 6 – Legal

G Supply and Services Appendix 1 - Class I SubsistenceAppendix 2 - Class II & IV: Secondary Items/BarrierAppendix 3 - Class III: Petroleum, Oil and Lubricants Appendix 4 - Class V: Ammunition Appendix 5 - Class VI: Hygiene & Comfort ItemsAppendix 6 - VII: Major End items Appendix 7 - Class VIII: Medical Supply Appendix 8 - Biomedical Equipment MaintenanceAppendix 9 - Motor Maintenance OperationsAppendix 10 - Laundry and Bath Appendix 11 - Management of Remains Appendix 12 - Water Distribution Appendix 13 - Waste Disposal Appendix 14 - Blood Resupply

H PAD Operations

I Hospital Services

J Mass Casualty (MASCAL) Procedures

K Reports

Attached Units and Personnel

• FM 4-02-10 2-3.

Assignment and Capabilities

a. The CSH will normally be assigned to a medical Brigade(Corps, TOE 08-422A100 or EAC, TOE 08422A200), but may be assigned to a MEDCOM (Corps, TOE 08411A000 or Theater, TOE 08611A000) or a joint/combined task force.

b. The CSH provides hospitalization for up to 248 patients. It provides treatment for all classes of patients.

c. Surgical capacity is based on six operating room (OR) tables staffed for 96 operating table hours per day. The six OR tables are contained in three OR International Organization for Standardization (ISO) shelters. Surgical capabilities include general, orthopedic, thoracic, urological, gynecological, and oral maxillofacial.

d. An ISO tactical shelter is used for C-arm fluoroscopy capability. It will be used for the operating microscope of the hospital augmentation team, head and when attached. The C-arm will be assigned to the 164-bed hospital company.

e. Other capabilities include----

. Command and control of organic and attached elements to include CHS planning, policies, and support operations within the hospital’s areas of responsibility.

. Emergency treatment to receive, triages, and resuscitates causalities.

. Consultation services for inpatients and outpatients to include unit- level support.

. Pharmacy, psychiatry, community health nursing, clinical laboratory, blood banking, radiology, physical therapy, and nutrition care services.

. Routine an emergency dental treatment to staff and patients.

f. There are some differences between the corps CSH and the EAC CSH. The corps CSH will have split-based capability, whereas the EAC CSH will not (see chap 4). In the corps CSH, the 84-bed and the 164-bed hospital companies with their headquarters and headquarters detachments (HHDs) are completely functional hospital companies. In the EAC CSH, The 84-bed hospital company with is HHD is a functional hospital company; the 164-bed hospital company is not a functional element. The EAC 164-bed hospital company can augment the EAC 84-bed company with and additional OR, intensive care unit (ICU);

L Automation

M Communication

ANNEX A (HOSPITAL ORGANIZATION AND STAFF RESPONSIBLITIES) TO THE 399th CSH TACSOP

intermediate care ward (ICW), and dental capabilities. The supply and services and the mobility of the EAC CSH is reduced. Also, the EAC CSH has no laundry service capability. Other differences between the corps and the EAC 84-bed and the 164-bed companies are shown in figures 2-4 and 2-7 (refer to FM 4-02-10).

1. Hospital Headquarters. This section provides internal command and control (C2) and management of all hospital services. Personnel of this section supervise and coordinate the surgical, nursing, medical, pastoral and administrative services. Staffing includes the hospital commander, deputy commanders, the chiefs of surgery, nursing, and medicine, executive officer, chaplain, command sergeant major, HHC commander, and an administrative assistant.

1. Executive Officer (XO).

a. General. The XO is the commander’s principal staff assistant and advisor. He directs, supervises and coordinates the work of the staff. He provides guidance to the tactical operations center (TOC) staff in planning future operations. He also functions as the Chief, Administrative Service.

b. Directs the activities of all staff members, except those specific areas the commander reserves for his own actions.

c. Determines objectives and priorities, and establishes procedures necessary for the accomplishment of the hospital’s mission.

d. Formulates and announces the staff operating policy.

e. Keeps the commander and staff informed of matters affecting the situation.

f. Represents the commander when authorized.

g. Receives the commander’s decisions and ensures that the staff prepares and issues implementing estimates, plans and orders based on the commander’s intent / decisions; assigns specific staff officer the task of preparing detailed plans, orders, reports, and other staff actions.

h. Approves actions or obtains the commander’s approval.

i. Alerts subordinate unit commanders of actions that are required of them.

j. Provides oversight to the execution of the hospital’s SOP, and takes action to initiate changes as required.

k. Requires that all staff officers inform him of any recommendations or information given directly to the commander as well as any instructions they receive directly from the commander.

l. Ensures that any liaison requirements are accomplished.

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m. Serves as the Operations and Security Officer when one is not assigned.

2. Chief, Surgical Service. The chief surgeon is the principal advisor to the commander for surgical activities. He provides supervision and control over the surgical services to include the ORs. He coordinates and is responsible for all matters pertaining to the evaluation, management, and disposition of patients received by the section. He also functions as the Deputy Commander for Professional Services.

3. Chief Nurse. The chief nurse is the principal advisor to the hospital commander for nursing activities. This officer plans, organizes, supervises, and directs nursing care practices and activities of the hospital. This officer is also responsible for the orientation and professional development programs for the nursing staff.


5. S1 (Hospital Adjutant).

a. General. The adjutant is the principal staff advisor to the commander for matters related to the administration and management of all individuals under U.S. military control. He also advises other staff officers and assists them in handling personnel problems within their functional areas. Such assistance may include actual preparation of plans and some direct supervision of subordinate unit activities.

b. Maintenance of Unit Strengths.

(1) Collects, prepares and presents command strength status data and loss estimates.

(2) Prepares records and reports showing status of personnel matters

in the command.a. Responsible to the commander for standards of nursing care and the

organization, direction, supervision, training and effective utilization of nursingservice personnel.

(3) Determines requirements for individual and unit replacements;handles individual and unit requisitions; allocations and administrative processingof units; and locates operating replacement units.

b. Plans and collaborates efforts for nursing services to reach commongoals. (4) Represents the commander when authorized and directed.

c. Maintains liaisons with the chiefs of other hospital services in the c. Personnel Management and Administration.interest of patient welfare, effective management, coordination of activities andaccomplishment of the stated policies of the hospital. (1) Supervises personnel procurements, classifications, assignments,

d. Evaluates the operation of nursing service against the established standards for patient care, goals, objectives and other indicators on a continuous and timeless basis taking corrective actions as required to maintain or alter these performance criteria.

e. Evaluates qualifications and determines assignments of all nursing personnel according to nursing requirements and SOP.

f. The Chief Nurse ensures compliance with Annex N (Nursing Procedures and Duties) and Annex P (Mass Casualty).

4. Chief, Medical Services. This officer is responsible for the examination, diagnoses, and treatment, or recommended course of management for patients with medical illnesses. He controls the length of patient stay through continuous patient evaluation, early determination of disposition, or evacuation to the next echelon of care.

transfers, promotions, reclassifications, demotions, eliminations, retirements, separations, and rotations.

(2) Directs collection, protection, processing, evacuation, treatment use and discipline of prisoners of war (POW) and civilian internees.

(3) Supervises location of sources, procurement, administration, and control of all types of civilian personnel.

d. Development and Maintenance of Morale.

(1) Oversees leaves, rest and recreational facilities, special services, savings program, housing, voting, postal, legal, financial, and exchange services.

(2) Supervises evacuation of remains, personal effects, and burial ceremonies.

(3) Develops plans and policies pertaining to decorations and awards.

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(4) Develops plans and policies for reporting casualties.


e. Information Program. Ensures that an active program is conducted and coordinated with higher headquarters.

(1) Provides advice on general educational development and marriage to foreign nationals; supervises reception of visitors; prepares personnel estimates, plans, orders and reports; supervises administrative matters not specifically assigned to other staff sections.

(2) Ensures compliance with Annex G (Administration and Personnel) and Annex 0 (Civil-Military Operations) to this TACSOP.

6. S3 (Operations Officer) S2 (Security and Intelligence Officer).

a. The S-3 officer is responsible for communications (internal / external), security, plans and operations, Ensures that an active information program is coordinated with higher headquarters, deployment, and relocation of the hospital. He manages the operations/security section on a 24-hour basis. The mission of the section is to collect, analyze, process and disseminate pertinent combat information to provide situational awareness to the command.

b. Receives units, detachments or teams and orients, trains and reorganizes them as necessary. Supervises the mobilization, demobilization and inactivation of units.

c. Plans Operations, prepares and coordinates orders, produces orders.

d. Supervises tactical troop movement and publishes the tactical movement order in conjunction with the S4.

e. Supervises and coordinates TOC operations.

f. Determines requirements and allocates training facilities and resources.

g. Supervises and coordinates information collection activities, in conjunction with the S1, including interrogation of POWs, refugees, and civilians.

h. Coordinates weather data. (S-2)

i. Supervises and coordinates predictions of fallout from enemy employed nuclear, biological, and chemical weapons; coordinates chemical and biological detection and radiological surveys.

j. Processes intelligence data. (S-2)

(1) Estimates how the characteristics of the area of operations will affect friendly and enemy courses of action.

A-4ANNEX A (HOSPITAL ORGANIZATION AND STAFF RESPONSIBLITIES) TO

THE 399th CSH TACSOP

(2) Prepares intelligence estimates, annexes, reports, and summaries of country/area studies.

7. S4 (Chief, Supply and Services).

a. General. The S4 is the principal staff officer in charge of all Service and Supply functions of the Hospital. Plans, coordinates, and manages logistics and financial systems. Also responsible for hospital field waste, controlled substances, and safety procedures. Manages medical supply, nutrition care, medical and unit maintenance, and laundry / bath sections. Selects routes in coordination with operations; coordinates airlift use in support of CSS operations; and prepares movement orders, and the service and support annex.

b. Supply.

(1) Determines supply requirements.(2) Requisitions, receives and distributes all non-expendable

equipment, maintains property book records.(3) Advises the command on security requirements for supplies &

equipment in depots and other storage areas(4) Supervises the distribution of critical equipment according to

priorities established by the commander.(5) Recommends prescribed basic loads.(6) Provides technical assistance to dispose of excess supplies &

equipment

c. Under each Classes of Supply

Class IAll units will maintain their basic load of MREs on-hand, (3-days or 9

meals per soldier).Ration cycle as directedAll units will deploy with full water containers of all types and maintain a

12-hour reserve.

Class IIReorder as need, Clothing individual equipment, tentage, organizational

tool sets and kits, administrative and house keeping supplies and equipments. All units will maintain sufficient CL II supplies to sustain company operations for no less than 15 days.

Class IIIPOL, Petroleum fuels, lubricants, hydraulic and insulating oils,

preservatives, liquid and compressed gases, bulk chemical products, coolants, deicing and antifreeze compounds and coal.

a. All units are directed to deploy with all vehicle fuel tanks 3/4 full and fuel carrying equipment topped-off.

A-5ANNEX A (HOSPITAL ORGANIZATION AND STAFF RESPONSIBLITIES) TO

THE 399th CSH TACSOP

b. The unit POL section will coordinate through the S4 for signed DA Form 2765-1s only.

Class IVConstruction materials, including installed equipment and

fortification/barrier materials.

Class VAmmunition (each type required). The designated representatives are

responsible for the transport of CL V from their respective ASPs IAW unit N-hour sequence. Ammunition resupply will be coordinated through the S4.

Class VIPersonal demand items (nonmilitary sales). Sundry packs will be

issued on a per capita basis.

Class VIIMajor End Items (M-TOE) Equipment ready for use.

Class VIIIMedical Supplies. Requisitioned through TCAM to the supporting

Agency.

Class IX:Repair parts required for maintenance of equipment. All units will deploy

with and maintain PLL IAW AR 710-2 and DA Pam 710-2-1. Controlled substitution is authorized IAW AR 750-1 and the Hospital Commanders’ approval

Class XMaterial support nonmilitary programs. Requested through supply point

distribution as necessary for mission support.

Maintenance of Supplies. If the tactical situation dictates that supply and equipment must be abandoned, every effort will be made to render them unusable to the enemy. Class VIII supplies will not be destroyed under any circumstances.

SERVICES:

ChemicalDecontamination services in excess of unit organic capabili8ty will be

coordinated through the S3.

Laundry & Bath399th CSH will provide all organic needs

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Transportation.

a. Convoy clearance numbers are required for groups of six or more vehicles, vehicles carrying ammunition, weapons, or bulk fuel.

b. All transportation requests must be coordinated through the S4 NLT 24 hours prior to the time of desired movement.

c. Transportation service sites will be posted to OPORDs/overlays as the tactical situation changes

Field Sanitation (Company Function).

a. Requirements for field latrines must be submitted to the S4 NLT 30-days out of any exercise. I.e. numbers of personnel to be supported

b. Units will establish latrines in sufficient numbers as to prevent over-crowding. Recommended 4(ea) per 100 males & 6(ea) per 100 females.

Example: 75 males and 50 females would require 6 latrines (4 X 75/100 = 3 plus 6 X 50/100 = 3) TOTAL: 6

c. Units will cover ground latrines with lime prior to closing or burn waste material as the tactical situation permits. Under no circumstances will waste be left in open areas or above the ground. Units will ensure that approval through the S4 is granted prior to burning waste.

d. Trash collection points are to be established by each unit. In combat, trash will be buried or hauled according to theatre trash disposal polices.

e. Supervises evacuation of remains, personal effects, and burial ceremonies.

8. BMO (Battalion Maintenance Officer). Advises the command on the status, maintenance, and repairs of general support equipment. He supervises organizational maintenance of wheeled vehicles, associated support equipment, and power support equipment.

a. Is responsible for the preparation of log books, maintenance records, drivers training, and associated reports.

b. Supervises, trains, advises, and inspects subordinate personnel in the use of the Army Maintenance Management System (TAMMS), prescribed load list (PLL), and automated systems output.

c. Also responsible for the training and licensing of vehicle and equipment

d. Operators and ensuring their skills qualification.

9. Hospital Chaplain (CH). The 399th CSH UMT will provide direct religious support to the hospital and its attachments.

a. The 399th CSH UMT will provide direct religious support to the hospital and its attachments.

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b. Responsibilities. By exercising staff authority and technical supervision, the senior Hospital chaplain:

c. Prepares a religious support plan for the hospital.

d. Provides chaplain/religious activities data for operation plans/orders.

e. Sets ministry objectives for the hospital and measures the results.

f. Coordinates management of chaplain and chaplain assistant personnel within the hospital.

g. Monitors ecclesiastical supplies and equipment procurements and distribution Serves as liaison to local clergy, religious organizations, and chaplains of higher/adjacent headquarters, other services, and allied nations.

h. Advises the hospital commander and staff officers in assessing the impact of indigenous religious customs on the command mission.

i. Ensures that UMT members receive prompt casualty data.

j. Initiates and supervises training for chaplains and chaplain assistants to enhance personal, professional, and soldier skills.

k. Communications will be either in person, or through chaplain log book.

l. Priority of Coverage.

(1) Before engagement: Nurturing the living: by visiting soldiers on wards and in their workplace, leading them in worship and bringing hope in the midst of hardship and privation. Protestant and Catholic worship will be held at regular intervals in the hospital. Jewish and Denominational services will be conducted when available.

(2) During engagement: Caring for casualties: by ministering in the triage area, with priority to expectant, and soldiers who must wait for treatment, caring for the spiritual needs of casualties.

(3) After engagement: Honoring the dead: by conducting funerals, memorial services, and memorial ceremonies to remember those who have fallen. The overall priority of religious coverage is to: assigned or attached soldiers; patients; military members in the hospital area of operation (AO); enemy prisoners of war


m. Religious Service Schedules.

(1) The hospital chaplain will provide regular religious services in the hospital, and will include a service schedule in the Religious Support Plan.

(2) Denominational Services will be provided, as resources are available, and will be coordinated through the senior hospital chaplain.

n. Chaplain Support Activities Religious Rites and Services. The hospital chaplain will conduct or provide worship services, funeral, and memorial services, and other sacraments, rites, and ordinances.

o. Pastoral Care. The hospital chaplain will provide pastoral counseling to help soldiers handle stress, and enhance moral and spiritual well-being.

p. Religious Education. The hospital chaplain will support, conduct, or provide for religious study groups. In addition the hospital chaplain will provide religious literature and materials.

q. Mass Burial. In the event of a mass burial, the hospital chaplain will provide a memorial ceremony as directed by the hospital commander. A report of record must be kept on any mass burial. The report will include and eight-digit coordinate of the location of the gravesite; the number of persons buried; names of deceased if available; and details of the ceremony provided.

r. Civil Actions. The hospital will provide ethical and moral advice or counsel to the Hospital Commander or staff in connection with all civil actions.

s. Supplies. The following blank forms are needed to perform the UMT Battlefield mission: DD Form 130 US Field Medical Card; DA Form 1594 Daily Staff Journal or Duty Officer’s Log; DA Form 2404 Equipment Inspection and Maintenance Worksheet; DA Form 2765-1 Request for Issue or Turn-In; DA Form 3163 Request for Issue or Turn-In. Clerical supplies as determined by the UMT.

t. Accommodation of Religious Practices. Each hospital chaplain will safeguard and protect every solder’s right to freedom of religion. Hospital Chaplains will assist and advise the commander on issues relating to accommodation of religious practices IAW DA Pam 600-75

10. Patient Administration Officer

a. General. Coordinates and supervises all patient administrative activities within the hospital, to include patient admissions and disposition, maintenance of patient records and patient evacuation and regulations.

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b. Informs and advises the commander and higher headquarters on all matters concerning patient administration and regulating, and the hospital’s bed status.

c. Ensures compliance with Annex M (Patient Administration Division) and Annex P (Mass Casualty) to this TACSOP.

ANNEX B (ESTABLISHING HOSPITAL OPERATIONAL AREAS) TO THE 399TH CSH TACSOP

1. Purpose. To outline the policies and procedures for establishing hospital operational areas. The priority of establishment will be based on METT-T.

2. General. The defense of the hospital will always have priority. Other areas may be established simultaneously based on the OPORD / OPLAN.

3. The following personnel and sections have the following responsibilities:

a. The Hospital Commander and Staff Officers finalize the operational area layout plan and accomplish the following.

(1) Develop a traffic pattern that facilitates the movement of equipment and patients.

(2) Coordinate and supervise the Hospital Commander’s Priorities of Work. They are dependent on METT-T, and may change from mission to mission. Establish completion goals by day for each section.

b. Sections

(1) Each section will complex their area of operations IAW the approved layout diagram and the Hospital Commander’s priorities of work. All sections will follow the directions of the Chief Nurse when establishing operational areas.

(2) Sections will continuously report stages of completion and overall capabilities through the Chief Nurse to the TOC.

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APPENDIX 1 (TOC OPERATIONS) TO ANNEX B (ESTABLISHING HOSPITAL OPERATIONAL AREAS) TO THE 399th CSH TACSOP

1. Purpose. To provide guidance on location, organization, and operations of the hospital tactical operations center (TOC).

2. General. The 399th CSH TOC is the command operations facility which is established to ensure that continuous medical support is provided in support of combat operations or operations other than war (OOTW).


(1) Maintenance of NBC situation and overlays.(2) Maintenance of situation map and overlays.(3) Assist with logs and reports.

e. Communications Chief

3. Units Responsibilities.

a. Battle Captains (S-3)

(1) Establishment TOC and hospital communications.(2) Maintain message traffic and RFI logs.(3) Message posting.

(1) Supervise TOC Operations. 4. Organization.(2) Track establishment of hospital and of security plan.(3) Coordinate shift change briefings. a. The TOC will include the following personnel.(4) Coordinate hospital and TOC defense.(5) Track RFIs. (1) Commander.(6) Coordinate with adjacent units regarding force protection. (2) Chief Nurse (if ALOC unavailable d/t METT-T).(7) Track CDR’s CCIRs (PIR, EEFI, IR’s). (3) Executive Officer.(8) Track all movement in and out of compound / gives final approval (4) S2/3.

for leaving the compound. (5) Operations NCO.(8) Track BLUFOR activities (6) NBC NCO.

(7) Communications personnel.(8) S1 (if ALOC not available d/t METT-T).

b. S2. (9) PAO (if ALOC not available d/t METT-T).

(1) Track establishment of defensive measures.(2) Supervise/check physical security from an “enemy” perspective.(3) Maintain security of classified material and ensure

OPSEC procedures are followed.(4) Track and report enemy significant activities / locations(5) Conduct IPB for Hospital Commander’s area of interest and area of

operations.(6) Give convoy briefs / de-briefs to all convoys. (7) Monitor weather.(8) Question EPWs / Patients for intel.(9) Review INSUMS.

c. OPS NCO.

(1) Establish security force and security plan for TOC.(2) Maintenance of message traffic.(3) Maintenance of logs.(4) Maintenance of situation map and overlays.(5) Control access to the TOC / personnel leaving.(6) Maintenance of convoy tracking sheet.(7) Plot BLUFOR activities.

d. NBC NCO.

(10) S5 (if ALOC not available d/t METT-T).(11) S4 (if ALOC not available d/t METT-T).(12) PAD Representative (if ALOC not available d/t METT-T).

b. At least one battle captain, NCO, S-2 rep and RTO will be in the TOC at all times.

5. Establishment.

a. The TOC will be located in proximity to and/or or preferably attached to the hospital proper (METT-T).

c. A slice of TOC personnel and equipment will be part of the Quartering Party and will establish initial communications out of a vehicle until the TOC tent is established at the new site.

d. Maximum use of deception must be utilized. Antennas will not be placed directly next to the TOC tent. An alternate TOC will be established in the ALOC (primary) or the HHC Commander’s CP (alternate) that will mimic the actual TOC and have the same communications equipment, as is available.

e. The TOC will have only one entrance/exit, guarded at all times (Dependant on threatcon).

B-11-1 B-2-2


f. The TOC will not be protected on exterior boundaries by barrier material/ concertina wire to ensure concealment; but will be worked into hospital layout and establishment plan.

6. Functions.

a. The TOC will operate 24-hours a day. Shifts will vary according to Battle Rhythm A, B, C, Personnel will report one half hour prior to shift change for the Commander’s update and shift change briefing. To Battle Rhythm A, B, C.

b. Priorities.

(1) Establish communications with higher and lower headquarters. (2) Establish communications with adjacent headquarters. (3) Verify compound defense and QRF with Force Protection OIC.(4) Set up staff working areas to include status charts and map boards.

c. All messages, reports, plans or other documents dispatched and received will be recorded in the operations journal. Verbal messages and/or orders will be recorded verbatim in the journal.

7. Security.

a. Security for the TOC is the responsibility of the Operations Sergeant. Access is controlled at the entrance by means of an access roster.

b. The S2 will make final resolution concerning any questions regarding the security clearance of personnel assigned to or visiting the TOC.

c. Access rosters will be prepared, maintained, and issued by the S2d. All commanders will submit a list of those persons requiring access to

the TOC.e. The access roster will contain name, rank, and position. Access will be

limited to key leaders and staff.f. Warning signals. Are listed in “Hospital Defense Operations” annex.g. Fixed Call Signs. Are listed in the Communications Annex.

8. The shift change briefings will also serve as the daily update briefing.

a. The staff sections will maintain their status charts in a manner that constantly reflects the most current data to the commander so that he may assess the situation with out the staff officers’ presence.

b. Each briefer will be allowed three minutes.c. Sequence of the briefings is as follows:

APPENDIX 1 (TOC OPERATIONS) TO ANNEX B (ESTABLISHING HOSPITAL OPERATIONAL AREAS) TO THE 399th CSH TACSOPSECTION SUBJECT

S2 General Situation/ SIGACTS/ Weather and Terrain Analysis / Enemy Sit. / Probably & Most Dangerous COA / Intel Analysis

S3/Battle CPT Summary of Last 12 Hours / Current Situation / Future OPS

S4 Supply / Logistics Estimate / Maintenance Status / BIOMED Maintenance Status

S1 Personnel Status Report / Casualty & Replacement Operations Civil Affairs

Media on the battlefield / VIP site visits / SIGACTS

CA activities

Bed Status / Evacuation Status

Nursing Activities

Commo Status / Automation Status

Status / Issues

Status / Issues

CSM Soldier Issues

XO Safety / Accountability / Command Issues

DCCS

CDR’s Comments

Battle CPT Summary and Due outs (if necessary)

PAO

S-5

MRO

Chief NurseS6 Mayor

Attachments

B-2-12 B-2-4

APPENDIX 1 (TOC OPERATIONS) TO ANNEX B (ESTABLISHING HOSPITALOPERATIONAL AREAS) TO THE 399th CSH TACSOP

APPENDIX 2 (ALOC OPERATIONS) TO ANNEX B (ESTABLISHING HOSPITALOPERATIONAL AREAS) TO THE 399th CSH TACSOP

1. General: The ALOC is responsible for the tracking and implementation of allSupport and Service Operations in support of Hospital Operations within its areaof operations.

APPENDIX 3 (ADVANCE/QUARTERING PARTY) TO ANNEX B (ESTABLISHINGHOSPITAL OPERATIONAL AREAS) TO THE 399th CSH TACSOP

1. Purpose: This appendix outlines the policies and procedures for theAdvance/Quartering Party (ADVON) Activities.

2. General: The ADVON composition and mission will vary due to METT-Tfactors.

3. The XO (or S3, if part of the mission) organizes hospital advance/quarteringparty and completes the following:

a. It is designated as the alternate TOC. In the event the TOC is no longer

maintainable, the ALOC will come under the command and control of theExecutive Officer immediately upon activation as the TOC. a. Provide the required size of parties to subordinate units.

b. Sections included (but not limited to) in the ALOC are:

(1) S1 – Personnel

b.

c.

Brief the advance/quartering party leaders.

Dispatch the advance/quartering party as prescribed in the movement(2) PAO order.(3) PAD(4) S4 – Supply and Services d. The ADVON will generally consist of the following:(5) S5—Civil Affairs(6) S6 (1) Jump TOC: XO, OPS NCO and Communications Team(7) NS – Nursing Services – “Blood and Plasma Request”. (2) NBC Team: NBC NCO and NBC Recon/Survey Team

2. Operations(3) Security Team: NCOIC and Security Team(4) Staking Team

a. Battle Tracking will be conducted on a continuous basis.

b. Each section is responsible to ensure information is accurate in both the TOC and ALOC.

c. All Logistical, Personnel, and Support information and data boards will be maintained on a continuous basis. Date time groups will be updated on the appropriate boards immediately after any change is noted.

d. The ALOC’s required stock of Class II will be maintained inside of the ALOC. The ALOC will maintain a separate cache of Class II in the event of activation as the TOC.

3. Shift changes (if the “shift” method of staffing is used as opposed to the “surge” method) will be conducted with all ALOC personnel changing at the same time. A shift change briefing will contain all pertinent information and events that occurred or are expected to take place during the next shift.

4. ADVON Responsibilities.

a. Conduct recon and develop occupation plan.

b. Coordinate for assistance (MPs, crew served weapons, etc).

c. Move along designate route to assembly area.

d. Security team dismounts, sweeps area, and calls back to OIC when area is secure.

e. NBC team dismounts, conducts NBC recon, determines area is clear and reports back to OIC.

f. OIC leads remainder of troops forward, reports back to the old site, and directs establishment of security, communications, and staking in accordance with the Commander’s priorities of work.

g. ADVON awaits arrival of main body elements and guides them into their designated positions.

B-13-5 B-3-1

APPENDIX 4 (HOSPITAL DEFENSE) TO ANNEX B (ESTABLISHING HOSPITAL OPERATIONAL AREAS) TO THE 399th CSH TACSOP

1. Responsibilities.

a. One of the Company Commanders (designated by the Hospital Commander), in accordance to the Hospital Commander’s guidance, is responsible for set up of the hospital defense and complete the following:

(1) Develop the hospital defense plan based on METT-T.(2) Assign defensive area of fire for each position as described in the

defense plan.(3) Assign alternate and supplementary positions for each primary

position.(4) Assign defensive area of fire for each supplementary position.(5) Verify defensive area of fire before digging.(6) Supervise construction of individual defensive (fighting) positions.(7) Supervise clearing of fields of fire.(8) Supervise construction of dismount points.(9) Assign personnel to defense based on METT-T.(10) Inspect preparation to ensure compliance with defense plan. .

b. S3

(1) Coordinate defense plan with Base Cluster Commander.(2) Develop the overall hospital defense plan using METT-T.(3) Prepare target reference point plan.(4) Assign sectors of fire to subordinate commanders.(5) With the S2, identify likely avenues of approach and direct

emplacement of LP/OPs and early warning devices.(6) Direct the use of decoy tactics (i.e. fake TOC, fake antennas, run

antennas away from TOC, etc).(7) Implement TOC defense plan.(8) Ensures the Challenge and Password is changed every night at

midnight.(9) Common Defensive Signals. The following signals will be used for

threat actions:


OPFOR in the Compound Take cover/ engage enemy VOCAL: “RENEGADE!” AIRHORN: N/APA/LL: “RENEGADE”

Take cover/ engage enemy VOCAL: “SNAKE EYES!” AIRHORN: N/APA/LL: “SNAKE EYES”

Take coverVOCAL: “DYNAMITE!” Engage on command AIRHORN: Double blasts PA/ LL: “DYNAMITE”

Mask/ MOPP IVVOCAL: “GAS!”AIRHORN: Triple blasts PA/ LL: “GAS”

CN. Develop and implement defense battle drills for the care of patients.

c. FORCE PROTECTION OIC. Force Protection OIC is responsible for the internal security and local defense of the hospital area. This includes the conduct of training regarding measures and techniques for defense, security, and supervision of defense activities. The Force Protection OIC will do the following:

(1) Advise the S3 and/or Battle Captain on all matters pertaining to the security and defense of the hospital.

(2) Prepare and maintain plans for the security and defense of the hospital area.

(3) Organize, train, and equip personnel for local security and perimeter defense.

(4) Implement defense plan.

(a) Fortify the perimeter defense.(b) Disperse all vehicles IAW Hospital layout.(c) Dig fighting positions, establish interlocking fields of fire using

sector stakes, and draw range cards to be left near sector stakes.(d) Conduct terrain walk with S3 to determine locations of bunkers,

fighting positions, likely avenues of approach, dead space and sectors of fire using METT-T and OCOKA.

(e) Post LP/OPs as determined by the S3.(f) Improve dismount point and ensure that natural terrain and

barrier material is used to influence the traffic flow.(g) Establish two layer perimeter with concertina wire (triple strand

and six pack) around entire hospital complex.

B-4-1 B-4-2

SITUATION ACTIONS/SIGNALS

Enemy attack Take cover/ engage enemy VOCAL: “BANDITS!”AIRHORN: Single blasts PA/LL: “BANDITS”

Artillery Take coverVOCAL: “INCOMING!” AIRHORN: N/APA/LL: “INCOMING”

Sniper

Air Attack

NBC Attack


(h) Place early warning devices in perimeter such as trip flares,motion detector lights, etc. Focus on likely avenues of approach and dead space.

(i) Verify and adjust NBC alarm placement upwind as necessary.(j) Provide 2 personnel to TOC defense.(k) Prepare a sector sketch and turn in to S3.(l) Direct defense in the event of an attack.(m) On order establish and guard an EPW holding area.(n) Manage Guard Force and Quick Reaction Force.

2. DEFEND AGAINST AIR ATTACK

a. Individual spotting enemy aircraft will sound a verbal alarm“DYNAMITE” to alert personnel in the area and then notify TOC.

b. TOC will sound alarm by broadcasting signal “DYNAMITE” followed by the direction of approach over the PA/landline.

c. Personnel will occupy defensive positions and take cover.d. Search assigned sectors for approaching aircraft.e. ID threat aircraft.f. Report aircraft actions to TOC.g. The Force Protection OIC or senior person present will prepare soldiers

to fire on enemy aircraft.h. If fired on return fire immediately.i. Engage aircraft until it is destroyed or warded offj. Wait for all clear from TOC.k. Clear weapons; perform Area Damage Control (ADC) sweep, treat

casualties and report casualties and equipment damage to the TOC.


4. REACT TO INDIRECT FIRE

a. Without Warning.

(1) Yell “INCOMING”.(2) Hit the ground, cover patients.(3) Essential health care providers remain in place to care for patients.

All other personnel take cover.(4) Mask, go to MOPP IV.(5) Wait for all clear or directions to move to designated fighting

positions.(6) Sections report casualties/equipment losses to TOC immediately

after all clear.

b. With Warning.

(1) Go to MOPP IV.(2) Care providers place litter patients on ground and evacuate

ambulatory patients to trenches and cover.(3) Designated health care providers remain in place. All other

personnel report to designated fighting positions/trenches.(4) Wait for all clear from TOC.(5) Sections report casualties/equipment losses to TOC immediately

after all clear.

5. DEFEND AGAINST SNIPER ATTACK3. DEFEND AGAINST ATTACK ON THE PERIMETER

a. Personnel on Perimeter.a. Individual spotting enemy or hostile civilian activity will sound the alarm

“BANDITS” and send salute report to the TOC.b. TOC will sound alarm by broadcasting signal “BANDITS” and direction

of approach over PA/landline.c. Personnel in LP/OP will report activity (SALUTE report) but will not

engage unless fired upon.d. Personnel will occupy defensive positions and take cover, returning fire

within their sectors.

(1) Take cover and return fire.(2) Notify fighting positions to your left and right of sniper’s activity and

instruct to lay down suppressive fire.(3) Attempt to locate the sniper without leaving your position.(4) Submit SALUTE report to TOC.(5) Destroy/suppress sniper if possible.

e.f.

QRF will assemble at pre-designate point and await orders. b.Force Protection OIC or senior person present will assess situation and

Personnel in Hospital Area.

determine best use of QRF. Coordinate movement of QRF with TOC before (1) Sound the alarm “SNAKE EYES”.moving. (2) Individuals outside of tented areas remain behind available cover.

g. TOC will request assistance from outside perimeter (MPs, TCF) as (3) Individuals inside of tented areas stay low and remain in place.required. (4) Submit SITREP to TOC.

h. Personnel not on the perimeter or designated defensive positions will (5) TOC will attempt to arrange external support to destroy the snipertake cover.

i. Wait for all clear from TOC.j. Clear weapons; perform Area Damage Control (ADC) sweep, treat casualties and

report casualties and equipment damage to the TOC.

B-4-3

(artillery, mortar, and maneuver forces).(6) Remain in place until TOC sounds all clear.

c. Personnel in LP/OP.

B-4-4

APPENDIX 4 (HOSPITAL DEFENSE) TO ANNEX B (ESTABLISHING HOSPITALOPERATIONAL AREAS) TO THE 399th CSH TACSOP

APPENDIX 4 (HOSPITAL DEFENSE) TO ANNEX B (ESTABLISHING HOSPITALOPERATIONAL AREAS) TO THE 399th CSH TACSOP

(1) Attempt to locate the sniper’s position without leaving the LP/OP.(2) Forward SALUTE report to TOC.(3) Remain in place until directed to do otherwise by the TOC.

b. Implement protective measures for patients.c. Cover exposed equipment and supplies.d. Provide buddy aid for chemical casualties, if needed.e. NBC team forwards an NBC-1 report ASAP to TOC.f. Do not unmask until advised by TOC.g. Standard alarms for chemical attacks consist of the following:

6. REACT TO BAD GUYS INSIDE WIRE(1) M8 alarms(2) One minute horn blast(3) Metal against metal(4) Visual/verbal signals

a.b.c.

Sound the alarm “RENEGADE”.Close all entrances to facility.Personnel will take defensive positions in each ward/section to includeentrances to the hospital.

8. CAPTURED EPW6. REACT TO CONTACT - CONVOY

a. Execute the five S’s (Search, Segregate, Silence, Seize, Speed to thea. Sniper Fire. rear) and Safeguard IAW all MROE, Laws of War, and the Geneva Convention.

b.

(1)(2)(3)

Report sniper fire to march commanderDesignated personnel return fire immediately.Increase rate of March and vehicle interval.

b. Guard prisoner at gunpoint.c. Person not covering prisoner at gunpoint conducts thorough search

while exercising caution for booby traps.d. Captured documents are turned over to the S-2.e. S-2 interrogates prisoner.f. TOC notifies higher headquarters.g. Prisoner is detained in EPW holding area. The EPW holding area will be

Ground Ambush, Road not Blocked.

(1) Report ambush to march commander. established at the discretion of the commander. It is recommended that the Fake(2) Identify enemy positions. TOC serve a dual purpose.(3) Return fire immediately.(4) Stop vehicles not in kill zone. (1) Responsibilities. The Force Protection OIC, in coordination with the(5) Vehicles in kill zone increase rate of March until out of kill zone. S3, will direct the construction of an EPW holding area.(6) Keep roadway clear by pushing disabled vehicles aside.(7) Senior ranking soldier organizes security element of soldiers not in (2) HASTY.

kill zone to suppress/destroy enemy forces and allow remaining vehicles to pass through kill zone.

(8) Forward SITREP to march commander

c. Ground Ambush, Road Blocked.

(1) Report ambush and its direction to march commander.(2) Dismount vehicles on opposite side of ambush.(3) Soldiers in kill zone return fire immediately.(4) Soldiers not in kill zone take up firing positions and await further

instructions.(5) Senior ranking soldier organizes security element of soldiers not in

kill zone to suppress I destroy forces and remove roadblock.(6) Forward SITREP to march commander.

7. RESPOND TO A CHEMICAL ATTACK a.

Don mask, go to MOPP IV. B-

4-5

(a) Triple strand concertina with pickets can be use to construct a holding pen.

(b) A guard will maintain vigilance over prisoners.(c) Prisoners should remain segregated, blindfolded, and silenced.

(3) IMPROVED.

(a) A holding tent (for warmth) can be constructed surrounded by triple strand concertina.

(b) Care should be maintained as to not inadvertently equip a prisoner with any hasty weapons.

(c) A guard will maintain vigilance over prisoners.

9. REORGANIZE AFTER AN ATTACK

a. Replace key leaders if necessary.b. Treat and evacuate casualties.

B-4-6


c. Occupy newly assigned fighting positions.d. Establish new sectors of fire.e. Each Ward/Section submits ACE report to TOC.

ANNEX C (INTELLIGENCE) TO 399th CSH TACSOP

1. Purpose. This appendix establishes the policies and procedures for the planning, collection, processing, dissemination of combat intelligence, counter-intelligence and the handling/processing of enemy prisoners of war (EPW) and equipment.

(1) A - Ammo status(2) C - Casualties 2. Responsibilities.(3) E - Equipment losses/damage

a. S-2: Supervise the safe evacuation of EPWs, to include relateddocuments from hospital collection point to the Corps Support Command Collection Point.

b. Operati ons/Secu rity:

(1) Identify both tactical and counter-intelligence (CI) Essential Elements of Information (EEl), depending on the tactical situation, and ensure that these

requirements are disseminated throughout the hospital elements.

(2) Integrate the intelligence information collection efforts of other appropriate military and civilian agencies with information collection efforts of this command, and supervise all attached intelligence personnel allocated to this command from higher headquarters.

(3) Supervise and coordinate the acquisition and distribution of maps.

(4) Coordinate the collection of weather data from higher headquarters, and supervise the dissemination of this data to subordinate elements.

(5) Process collected information into suitable intelligence and disseminate this intelligence in a form that ensures greatest assistance.

(6) Estimate the effects of the characteristics of the area of operations on friendly and enemy courses of action.

(7) Estimate enemy capabilities, vulnerabilities, and probable courses

of action.

(8) Provide counter-intelligence information for operational security activities, to include: tactical security against the enemy’s reconnaissance and surveillance efforts, protecting information/material from enemy espionage, protect personnel from enemy subversion, and hospital equipment from enemy sabotage.

(9) Plan measures to be taken to deny the enemy information on planned, ongoing, and completed operations (OPSEC).

(10) Plan and develop defenses and counter-measures to the enemy’s

C-18

f. Repair fighting positions and replace damaged camouflage. g. Replace early warning devices, repair obstacles.

B-4-7

Signal Intelligence Threat (SIGNIT).

(11) Controls the hospital security assets, to deny observation by local civilians of operations/activities that would be of intelligence interest to the enemy.

c. Materiel Officer: (S-4)

(1) Coordinate with the Operation/Security Officer for information on the enemy’s situation relating to traffic ability of roads for transportation and movement.

(2) Evacuate captured supplies and equipment by direction of higher headquarters.

d. Force Protection OIC: Establish a hospital EPW Collection Point. 4.

Procedures:

a. Enemy Prisoners of War (EPW): Units capturing Enemy Prisoners of War (EPW) will handle them utilizing the “5-Ss” plus safeguard:

Search: Ensure the prisoner is thoroughly searched for all weapons and documents. If necessary, strip the prisoner of all clothing to ensure a thorough search. NO item of clothing or equipment will be left unexamined for concealed documents, letters, weapons, wallets, etc. Wallets often contain a great deal of information of intelligence value. These items must be removed from the prisoner and forwarded with the prisoner to higher headquarters. All items removed from the prisoner must be tagged to ensure rapid identity of their owner by higher headquarters. The tags on documents and equipment should relate directly to the tag on the prisoner himself. All weapons must be removed from the prisoner to prevent his use of them against his captors. Immediately following the initial capture and search of prisoners, a report will be rendered to the next higher headquarters referencing any specific items of intelligence interest found on the prisoners. EPWs in the hospital as patients should be searched thoroughly as any other EPW.

Silence: EPWs will be tagged, blindfolded, and kept quiet until company-level evacuation is made. Foot-mobile EPWs transported in vehicles will, in all cases, be blindfolded. Unauthorized personnel are not allowed to speak to EPWs.

Segregate: All EPWs will be segregated according to rank and sex immediately following capture as follows: Officer, NCOs, EMs, Civilians, Males, and Females. EPWs found to have any of the following categories of knowledge/documents will be further segregated for immediate evacuation: Special Weapons (Nuclear) data, Chemical or Biological data, or Cryptographic information.

Safeguard: Forward units may question EPWs for voluntary disclosure of immediate tactical information. EPWs who will not volunteer information will be evacuated as soon as possible in order to allow professional interrogators to question them. Under provisions of the UCMJ and the Hague and Geneva


Conventions, when enemy soldiers surrender, no longer have the means to resist, or any civilians or their private property comes under US Military control, they must be treated humanely. Personnel in these categories are considered “non-combatants.” Non-combatants must never be shot, harmed or cruelly abused. The regulations and laws allow for no exceptions or compromises. Violations of this principle must be reported immediately to the chain of command.

Speed to the Rear: Timely evacuation of EPWs is absolutely essential to the Intelligence Collection effort. The initial “5-S” actions taken by the capturing elements, ideally should not take longer than five (5) minutes. All EPWs of high priority interest will be separated from other EPWs reported, and evacuated ASAP. High priority prisoners are classified as: Officers, Signal or CBR personnel, Air Crews, Forward Observers, Rocket Crews, and Political or Intelligence Cadre. Evacuation from the hospital-level to the next higher headquarters will normally be within one (1) to three (3) hours of capture, depending upon the priority of the EPWs and the tactical situation. Wounded EPWs will be evacuated through medical facilities, if necessary. Military Police units, when available, will provide guards for wounded EPWs that are ready for interrogation. Interrogation will be limited to the immediate tactical situation. EPWs will not be allowed to eat, smoke, or rest prior to arrival at the Hospital Collection Point, unless such treatment would cruel. The EPWs will be under armed guard at all times. The arrival and departure of all EPWs in the hospital collection will be reported immediately to the TOC.

(1) All EPWs will be tagged by the capturing element, using a standard EPW tag, which will contain as a minimum, the following information: Capturing Unit, DTG of capture, Location of capture (six-digit grid coordinates), and Circumstances of capture.

(2) All EPWs will be treated IAW treaties governing Land Warfare, Ref.: DA PAM 27-1, and FM 30-15.

b. Defectors:

(1) All defectors will be immediately segregated from the other regular EPWs during normal screening. They will be searched for weapons and documents, which will be removed from them and processed as EPWs, but identified as defectors.

(2) Defectors will be questioned initially for any intelligence information they may have of immediate tactical value.

c. Returnees: The recovery of US and Allied personnel will be reported immediately to the TOC. These personnel will be placed under armed guard until positive identification can be made. They will be interviewed for information of immediate tactical value; however, no questions concerning their escape or evasion will be asked.


C-20 C-3

d. Civilians, Refugees, and Displaced Persons (DPs):

(1) Personnel in this category will be searched for weapons and/or documents. If a weapon and/or document is found on a person, the individual will be immediately treated as a priority EPW.

(2) Personnel will be segregated from other EPWs, etc., and will be screened for intelligence information of immediate value. Following the screening, the refugees and DPs will be evacuated through collection point channels, where they will be interrogated and handed over to the Military Police for further disposition. Wounded or injured persons will be afforded care and will be transferred to a civilian health care facility as soon as the patient’s condition permits.

4. CONVOY BRIEF / DE-BRIEF

(1). All convoy personnel will receive a convoy pre-brief and de-brief. The pre-convoy brief will consist of MSR (Main Supply Route) status, enemy sightings/actions close to our AO (Area of Operations) or on the routes of concern; this will be coordinated through the S4. The convoy de-brief will consist of receiving any SPOT REPORTS, minefield sightings, mass gatherings of local residents any possible terrorist threats to 399th CSH personnel mentioned in the (BUB) Battle Update Brief. Any other information and intelligence pertinent to the 399th CSH and 399th CSH higher and subordinate unit operations will be reported also.

5. REPORTING PROCEDURES. All intelligence information will be forwarded to the CSB / Higher headquarters. Any other intelligence information will be forwarded to the units that require it.

6 BURN BASKET. A Burn Basket will be used to destroy all classified or sensitive documents. The S2 and Force Protection OIC will decide where the burn basket will be placed… It must be placed in an inconspicuous place. The S2 will determine when the documents will be destroyed throughout the deployment.

ANNEX D (CONVOY OPERATIONS) TO 399th CSH TACSOP

This annex prescribes convoy procedures and checklists for use by all Hospital Personnel.

Convoy Checklist:

Convoy Frequency:MEDEVAC:Command Frequency:Admin Log Frequency:Convoy Commander:Convoy NCOIC:________________________

1. Convoy Commander/NCOIC ensures the following prior to movement:

a. Conducts Recon (Minimum Map Recon)

b. Identifies location of friendly units

c. Identifies control measures (Check Points, SP, RP, etc)

d. Conducts radio checks

e. Ensure the vehicles are fueled

f. Coordinates maintenance / towing support

g. Ensures PMCS is completed on vehicles & trailers

h. Identifies Combat Lifesavers / medic support requirements

i. Ensures the vehicles are dispatched

j. Ensures Load Plans are followed (spot check)

k. Develop order of march

l. Identifies and complies with local, state, or country traffic laws7. COMMUNICATION SECURITY (COMSEC)

(1). The hospital C-E section or NCOIC. Coordinates C- activities ofsubordinate, attached and supporting units.

m. Ensure that all drivers had adequate rest appropriate for the length ofmission

(2). Distribution of SOI’s are found within the ANCD.(3). Communications must always be maintained with higher HQ’s.(4). Radio listing silence will be in effect in the AA during tactical operations,unless otherwise directed.

2. Convoy Commander Gathers the Following Information:

a. Route Brief from S-2.

b. Maps & strip Maps for vehicles.

c. Convoy Signs and Flags.


C-4

ANNEX D (CONVOY OPERATIONS) TO 399th CSH TACSOP ANNEX D (CONVOY OPERATIONS) TO 399th CSH TACSOP

d.

e.

f.

g.

h.

Combat Lifesaver and Combat Lifesaver Bags.

Sensitive Item Serial Numbers.

Frequencies and Call Signs.

Names of Personnel in the Convoy.

Bumper Numbers of all Vehicles in the Convoy.

i.

j.

k.

l.

Battle Drills.

Radio Frequencies (Convoy, Command, MEDEVAC).

Actions upon departure.

Actions upon arrival.

5. Vehicle Checklist:

3.

i. Road March Credit Number if applicable. a.

b.

Operator’s Name.

Vehicle Commander’s Name.Convoy Commander Briefs:

a.

b.

c.

d.

Mission.

Threat / Risk Assessment.

Route(s) speed limit /catch-up speed.

Interval between vehicles.

c.

d.

e.

Section / Unit.

Mission.

Vehicle commander and operators completes the following prior to

movement:

(1) Receive mission brief from the convoy commander.e. Communication procedures to include frequencies and call signs.

(2) Complete risk assessment.f. Rest Stops / Refuel Points /

Rally Points / Link-up Points / (3) Top-off vehicle and fuel cans / fuel spout on hand.g. Security and PMCS procedures.

(4) PMCS completed (supervisor verified).h. Uniform / Force Protection Level.

(5) First aid kit and fire extinguisher serviceable, and on hand.4.__________________________________Convoy Commander’s Checklist:a. Mission brief.

(6) Clean windshield, mirrors, lights, and reflectors.

(7) BII on hand and mission capable.b. Force protection brief.

(8) 3 days supply of water.c. Weather route condition.

(9) 1 case of MRE.d.

e.

f.

Combat Lifesaver / Medic Support with bag.

PMCS.

Strip map.

(10) Sleeping bag / Kit On Hand.

(11) Vehicle dispatched.

(12) Received ADEQUATE REST to conduct Mission (8 Hour Rest).g. Actual map.

6. Breakdown Procedures:h. Fuel, Water, MRE.

D-23 D-3

a. Notify convoy commander.

b. Remove vehicles from roadway.

c. Exit vehicles from passenger side if unsafe to do so from driver’s side.

d. Set up warning triangles.

e. DO NOT stand behind or In front of vehicles.

f. DO NOT attempt BDAR (Battle Damage Assessment and Repair).

7. MEDEVAC REQUEST Procedures:

a. Line 1: Location of pick-up site (Grid Coordinate).

b. Line 2: Frequency Call Sign, and suffix (applies to POC at Pick-up Site).

c. Line 3: # of patients by precedence (A-None, B-Urgent, C-Priority, D-Routine).

d. Line 4: Special Equipment Required (A-None, B-Hoist, C-Extraction Equipment, D-Ventilator.

e. Line 5: # of Patients by Type (L-Litter, A-Ambulatory).

f. Line 6: Security of Pick-up Site (Wartime) (N-No Enemy Troops, P-Possible Enemy Troops; E-Enemy Troops in Area.

g. Line 7: Method of Marking Pick-up Site (A-Panels; B-Pyrotechnic, C-Smoke; D-None.

h. Line 8: Patient Status (A-U.S. Military; B-Civilian; C-Non U.S. Military; D-Non U.S. Civilian; E-Enemy POW).

i. Line 9: NBC Contamination (Wartime) (N-Nuclear; B-Biological; C-Chemical).

j. Line 10: Terrain description.ANNEX D (CONVOY OPERATIONS) TO 399th CSH TACSOP

8. CONVOY OPERATIONS SAFETY INSPECTION CHECKLIST

Date of Convoy

Convoy Commander NCOICRoute/Map reconnaissance completed:

Name/Rank:_____________________________Date:____________________

Hazard Inventory Sheet completed and identified all known hazards. Yes ____ No ____

Overall Risk Assessment for this convoy operation.

Extremely High ____ High ____ Medium ____ Low ____

Approving authority: Name/Rank

Signature___________________________________________________

6. Briefing completed to include (but not limited to) the following:

a. Strip maps of entire route distributed to each vehicle/TC? Yes ____ No ____

b. Time line for main events (report time, arms room, line-up, departure, etc. ) Yes ____ No ____

c. Verify crew selection (least experienced drivers paired with most experienced). Yes ____ No ____

d. Speeds on highways. Yes ____ No ____

e. Catch-up speeds Yes ____ No ____

f. Emergency actions (lost, accident, break down procedures) Yes ____ No ____

g. Scheduled rest stops (proposed times and places) Yes ____ No ____


D-24 D-5

h. TC assigned for each vehicle (h) Change routine (Periodic routine change of scheduledYes ____ No ____ LOGPAC).

i. Use of seat belts. Yes ____ No ____

j. Ensure the driver has had adequate rest/sleep, and does not appear to be tired. Yes ____ No ____

k. Daily maintenance checks and services completed. Yes ____ No ____

l. Other safety issues.

Convoy Commander Signature

7. Convoy Briefing

a. Situation:(1) Enemy(2) Friendly(3) Support units

b. Mission: (Who, What, Where, When, and Why)(1) Type of cargo(2) Origin(3) Destination(4) Info on civilians(5) Information on enemy

8. Execution: (General Organization of Convoy)(1) Time schedule(2) Routes / convoy speed / catch-up speed(3) Vehicle measures(4) Accidents(5) Vehicle breakdown procedures(6) drills (i.e. Roll-over Drills

9. Convoy Drills(a) Fuel(b) Water(c) Ammo(d) Commo(e) Towbar(f) MP’s(g) Alt route

D-6

9. Action on Contact(1) Day(2) Night(3) Rehearsals

5. Service Support (Administrative and Logistics)(1) Personnel(2) Billeting(3) Class I(4) Class II(5) Class III(6) Class V

10. Command and Signal(1) Location of convoy commander(2) Designation of assistant convoy commander(3) Serial commander’s responsibilities(4) Hand and arm signals(5) Radio frequencies and call signs

(a) Convoy commander(b) Assistant convoy commander(c) Military Police(d) Higher HQ(e) MEDEVAC(f) Safety:

1. Route / Road Conditions2. Hazards of Route and Weather Conditions

8. Upon Mission Completion, the Convoy Commander will:a. Report to Higher HQ (Battle CPT) of closure onto destinationb. Ensure all vehicles are topped offc. Account for sensitive itemsd. Ensures after operations PMCS is performed and completed; report all

deadlines and deficiencies to maintenancee. Ensure all government and personnel equipment is securedf. Mission AAR

D-7


Convoy Clearance Checklist

Convoy number:___________ Date:

Reason for convoy:

Personnel going:

Vehicles going:

Time leaving:___________ Time Returning:_______________________________

S2 Brief:__________________________________________________________Battle Captain’s Approval:

______________________--------------------------------------------------------------------------

----------------------------------

S2 initial’s:_________ Battle CPT’s initial’s:___________________

Motor pool's initial’s:_____________________________________

*Battle CPT has final approval for anyone leaving the compound.

1. GENERAL: This Annex standardizes the procedures to be used by the 399th Combat Support Hospital (CSH) to reduce casualties, damage, and interruption of operations caused by an NBC attack.

2. REFERENCES: AR350-41, FM3-4, FM3-5, FM3-100, FM3-3, FM8-9, FM3-101, and FM 3-11.

3. ORGANIZATION.

a. NBC defense is a command responsibility; the normal chain of command will apply.

b. The Hospital Commander will appoint an NBC control party consisting of an NBC Defense Officer (School Trained), NBC NCO (54B), and a NBC decontamination specialist (54B).

c. OIC / NCOIC will appoint an NBC Defense teams to include:

d. Chemical/Radiological Detection and Survey team, and a unit decontamination team.

e. Patient decontamination teams, consisting of 10 personnel per team.

f. Chemical/Radiological Detection and Survey Team will consist of an NCOIC, ANCOIC and a minimum of 10 team members. Team members will be trained to conduct Chemical/Radiological recon and survey operations.

g. Unit decontamination team will consist of an NCOIC, ANCOIC and a minimum of 35 team members. Team members will be trained to conduct limited decontamination operations as directed by the NBC officer.

h. Patient decontamination team will consist of two NCOIC, two ANCOIC and a minimum of two 10-person teams. Team members will be trained to conduct patient decontamination operations.

i. When possible, NBC school trained personnel should be appointed to NBC defense teams.

4. RESPONSIBILITIES

a. Hospital Commander:

(1) Proficiency of the hospital in all aspect of NBC defense.(2) Designation and control of the Mission Oriented Protective Posture

(MOPP) for operations in a chemical environment consistent with the mission, the temperature, and the recommendations from the battalion NBC NCO.

b. Hospital NBC NCO is responsible for:

D-8 E-1

ANNEX D (CONVOY OPERATIONS) TO 399th CSH TACSOP ANNEX E (NBC) TO 399th CSH TACSOP

(1) Receive, prepare, correlate, and disseminate information on enemy NBC attacks.

(2) Consolidate battalion radiation status. Report to division as required.

(3) Provide recommendations concerning MOPP levels appropriate for enemy threat and tactical situation.

(4) Recommend employment of supporting NBC recon, smoke, and decon units.

(5) Report NBCDE and personnel shortfalls to the division chemical

section. (6) Provide NBC inputs to plans, orders, and SOPs.

c. Individuals are responsible for:

(1) Knowing the proper procedure for individual protection from NBC attack.

(2) Knowing the proper procedure for masking, and skin/equipment decontamination.

(3) Recognizing standard NBC Alarms and actions to be taken.(4) Recognizing the signs and symptoms of chemical agent attacks

and applying appropriate protective measures.(5) Recognizing standard NATO contamination markers.(6) Having the knowledge and proficiency to accurately submit an NBC I

report (observers Initial Report)

d. The Chemical /Radiological Detection and Survey NCOIC

(1) Ensure the readiness of all equipment and personnel assigned to the Chemical/Radiological Detection and Survey team.

(2) Conduct Chemical/Radiological surveys IAW the FM 3 -5.(3) Mark all contaminated areas with the appropriate NATO marker.

e. Patient Decon Team NCOICs.

(1) Ensure the readiness of all equipment and personnel assigned to the patient decon teams.

(2) Conduct patient decon operations IAW current doctrine.(3) Advise the BN NBC NCO on all aspects concerning patient

decontamination.

f. Unit Decon Team NCOIC

(1) Ensure the readiness of all equipment and personnel, assigned to the unit decon team.

(2) Perform detailed troop decontamination operations IAW FM 3-5.(3) Perform equipment decontamination IAW FM 3-5.ANNEX E (NBC) TO 399th CSH TACSOP

5. ALARMS AND WARNING SYSTEM

a. Communications personnel will immediately notify the Hospital NBC NCO of any NBC reports received in the TOC.

b. The hospital warning system for NBC attack consists of the M8AI Alarm, three short horn blasts, metal on metal, hand and arm signals, and the verbal "gas" warning announced over the public address system.

c. Upon attack, the communications section will initiate a ring down to all sections notifying each of the attack.

d. The signal for "All Clear" will be the verbal command “All Clear”; only the Hospital Commander will initiate the signal.

e. The Communications Section will initiate a ring down to notify all sections of the "All Clear" only when ordered to do so.

6. NBC Warning and Reporting Formats

a. NBC-1 (Observer's Report). All units observing an NBC attack will submit this report. Only unit NBC defense teams format NBC-I Reports. This ensures that the content of the report in known to the Commander by his representative. The first time a NBC weapon is observed, an initial report will be submitted as quickly as possible with all available information and with a FLASH precedence. A follow-up report will be submitted with an IMMEDIATE precedence as soon as additional information is available. Refer to GTA 3-6-8 for NBC-1 Report format.

b. NBC-2 (Evaluated Data). This report will be used by higher HQ and the NBCC and only after sufficient data to identify the type, location and yield of an attack has been relayed to higher HQ Data from later NBC- I reports on an attack may be consolidated and used to prepare an NBC-2 report. The NBC-2 report is then transmitted to higher HQ and subordinate in place of a number of NBC- 1 reports.

c. NBC-3 (Immediate Warning of Expected Contamination). The report will be used to disseminate detailed fallout predictions and warning of expected toxic/contamination. The report is based on an NBC evaluation of NBC-1 and/or NBC-2 reports of an NBC attack.

d. NBC-4 (Reconnaissance, Monitoring, and Survey Results). When any unit detects NBC contamination through monitoring or reconnaissance, this information is reported using an NBC-4 report. Separate NBC-4 reports are collected then plotted on the tactical map to determine where the hazard exists. If monitoring information is incomplete, a survey may be directed if it is needed.

E-2 E-3

ANNEX E (NBC) TO 399th CSH TACSOP ANNEX E (NBC) TO 399th CSH TACSOP

e. NBC-5 (Area of Actual Contamination). NBC-4 reports are consolidated b. Procedures for conducting chemical survey:to prepare an NBC-5 report. NBC-5 reports are usually prepared by the NBCC.Because of the nature of the report, it is best sent as an overlay. The 399th CSH (1) Move into area in MOPP4 and establish security.will use the NBC-5 overlay when planning operations. (2) Conduct a survey of a minimum of 200 meters.

(3) Check for vapors and liquid contamination.f. NBC-6 (Report of Detailed Information on Chemical or Biological Attacks).

This report summarizes information concerning a chemical or biological attack and is prepared at battalion level. It is used as an intelligence tool to help determine enemy future intention. The NBC 6 report is submitted to higher headquarters only when requested.

7. ALERT PROCEDURES:

a. The 399th Combat Support Hospital NBC control party will establish communication no later than H+2 hours within the area of operation.

b. Individual protective mask and accessories (Nerve Agent Antidote Kit (Mark l) will be issue upon orders of the commander, 399th CSH.

c. 1 individual pack will be issue per individual.

8. Individual will assume MOPP level IV unless other-wise notified. (All convoys, personnel will assume MOPP Level IV).

9. Individuals will replace C2 canister filters with contingency stock replacement.

10. M40 accessories will be store within the mask carrier.

11. Radiac instrument and chemical agent decon equipment will be issued. The chemical agent alarm will be employed when applicable.

12. Provisions will be made for moving all other NBC equipment and materials to the unit field location within 24 hours of the time the unit deploys.

13. CONSIDERATIONS DURING FIELD DEPLOYMENT.

c. Conduct unmasking procedures, if required.

d. Procedures for conducting radiological survey and monitoring procedures, if required.

(1) Employ radiological survey and monitoring team to insure that the area is free from radiation.

(2) RAD survey and monitor team equipment should consist of the following: IM93, IM9, UDR 13,and AN/VDR 2 Radiac set.

(3) Procedures for conducting radiological survey will consist of taking readings with the VDR 2 Radiac set at pre-selected locations.

e. All sections will sign for their section assigned NBC equipment.

14. NBC DEFENSE MEASURES:

a. NBC warning and reporting system consists of a series of NBC reports and perimeter NBC warning equipment and devices.

b. All soldiers should understand the NBC I Report. It is known as the Observer Report. It goes from the soldier in the field to the President.

c. NBC perimeter defense: Consist of the M22 Chemical Alarm System. The system is employed as follows:

(1) Place no more than 150 meters upwind of the farthest position.(2) Never place the M488 more than 400 meters from the M42 Alarm

unit.(3) The optimum distance between detectors is 3 00 meters.(4) The NBC perimeter warning system can also consist of any devises

designed to warn personnel of possible NBC hazards.

a. The following is a list of task to accomplish to insure that the area is freeof chemical contamination. Chemical detection team should be equipped with thefollowing equipment:

d. Recognizing NBC hazards: Munitions, low bursting, air bursting, andground bursting.

(1) M8A1 chemical agent alarm. e. Types of agents:(2) M256A1 chemical detection kits.(3) Chemical Agent Monitor (CAM), if authorized. (1) Nerve agent(4) M8 and M9 chemical detection paper. (2) Blood agent

(3) BlisterANNEX E (NBC) TO 399th CSH TACSOP ANNEX E (NBC) TO 399th CSH TACSOP


E-28 E-5

15. First-aid and treatment for agents. (i)(j)

Initiate unmasking procedures when applicable.Submit NBC- I report ASAP.

a. Employment of agent on the battlefield.(4) Procedures in the event of a Nuclear Attack

(1) Persistent agent.(2) Non-persistent agent. (a) Take cover.

16. Protection from NBC hazard consists of MOPP4 and decontamination(b)(c)

Shield eyes and cover exposed skin.Remain prone until the blast effects have subsided.

techniques and procedures. (d) Decon as required (shake and brush).(e) Chemical/Radiological Survey Team assembles on NBC NCO

a. Three levels of decon:

(1) Immediate decon. (2) Operational decon. (3) Thorough decon.

b. Actions before an NBC attack Actions

before a chemical attack

(a) Alert hospital of potential attack.(b) Increase level of MOPP to meet threat.(c) Cover any exposed mission essential equipment.(d) Ensure that all patients have protective mask.(e) Initiate continuous monitoring.(f) The NBC NCO will provide further guidance as

required.

Actions before a nuclear attack.

(a) Alert hospital of potential attack.(b) Secure all loose equipment.(c) Vehicles are placed in defilade as best as possible.(d) Communications equipment is disconnected (except for one

radio-one radio will remain in operation at all times.)(e) Antennas are disassembled.(f) The NBC NCO will provide further guidance as required.

(3) Procedures during an NBC attack.

(a) Procedures during a chemical attack(b) Mask and give alarm.(c) Seek overhead cover.(d) Mask all patients.(e) Assume MOPP IV.(f) Individual decon operations begin.(g) Chemical/Radiological Survey Team assembles on NBC NCO

in vicinity of the TOC.(h) Continue the mission.

(1)

(2)

E-29

in vicinity of the TOC.(f) Continue the mission.(g) Submit NBC-1 report to higher HQ.

(5) Procedures after an NBC attack:

(a) Continuous monitoring and survey.(b) Post contaminated areas (if applicable).(c) Radiation exposure guidance established.(d) Filter elements will be changed ASAP.(e) Coordinate for decontamination support as required.

c. Procedures in the Event of a Biological Attack: The most effective defense against the effects of a biological attack is proper sanitation and hygiene. Biological agents must have a host - the soldier - to be effective. The individual soldier must be aware of standard sanitation and hygiene procedure and must conform to these standards. Immunizations and other protective measures will not insure a reduction in the number of casualties if the soldier does not maintain himself and his area of operation in a sanitary manner.

(1) Procedures in the event of an imminent biological attack

(a) Assemble and brief NBC monitoring and decontamination teams.

(b) Treat all cuts, wounds, or other areas of the body suspect susceptible to infection or infectious diseases.

(c) Cover all food and water.(d) Increase vector control programs.(e) Don protective mask with hood and cover all exposed areas of

the body i.e., roll sleeves down, button jackets at collar and cuff, blouse boots and jackets.

(f) Continue the mission.

(2) Actions during the attack:

(a) Mask when attacked by low flying aircraft, artillery, mortar or rackets which have no visible effect or other strange objects which produce an aerosol spray or low order detonation.

E-7

(b) Continue the mission. (4) When crossing a contaminated area, a conscious effort must bemade to limit the amount of dust produced.

17. NBC CONVOY OPERATIONS (5) Upon clearing the area, personnel and equipment should be testedfor radiological contamination (AN/VDR-2).

a. React to a chemical attack.

(1) Mask and sound alarm. (three short horn blasts, repeated several

(6) Decontaminate as required (shake, brush, wash).

18. INDIVIDUALS WILL MASK WHEN:

times).(2) Assume maximum protective posture (MOPP IV).(3) Depart the area as quickly as possible.(4) Test for contamination. (CAM, M8AI alarm, M256 Kit, M9, M22

paper)

a. Any artillery, mortar, rocket, or enemy aircraft or munitions. Land nearthe unit’s position, and have a smaller than expected yield or produces smoke ormist. Or any enemy aircraft that spray a mist or fog as it fly’s over.

(5) Coordinate for decon support. (if required)(6) When safe, the Convoy Commander will initiate unmasking

b. Smoke or mist of an unknown source arrives in the area.

c. A chemical attack is suspected for any other reason.

d. Prior to entering an area known to be or suspected or being

procedures.

b.

(7) Continue the mission.(8) NBC-1 report is submitted to higher HQ.

React to nuclear attackcontaminated with a chemical agent.

e. For no obvious reason, personnel exhibit any of the following(1) When alarm is sounded. symptoms:(2) Vehicles placed in defilade to the extent possible.(3) Personnel take maximum cover. (1) A runny nose, drooling, involuntary urination and defecation.(4) Personnel remain under cover until "All Clear" is given. (2) A feeling of chocking and tightness in the chest or throat.(5) NBC-1 report is submitted to higher HQ. (3) Dim of vision and difficulty in focusing the eyes on close objects.

(4) Irritation of the eyes. (Dilation of the pupils)c. Crossing chemically contaminated areas. (5) Difficulty breathing, discoloration of skin, lips and fingernails.

(1) Assume MOPP IV prior to entering area.(2) Coordinate with HQ for decon support upon clearing area.(3) Close all windows and doors.(4) Move across area slowly limiting dust particles.(5) Use the shortest and the most convenient route through the

contaminated area.(6) Test crossing area for contamination with (CAM, M22 Alarm, M256

Kit, M9 and M8 paper).(7) Decontaminate if necessary. (IAW FM 3-5).(8) When determined to be safe, initiate unmasking procedures.(9) Replace mask canister filter element.

d. Crossing radiological contaminated areas.

(1) Advance party will survey the area to determine the extent of radiological contamination.

(2) Before crossing the area all personnel should assume MOPP IV, to avoid breathing dust particles.

(3) Provide maximum amount of shielding.

19. GENERAL: When the threat of chemical attack is low, personnel wear amounts of protective clothing and equipment that will not cause heat stress under the existing temperature and humidity. The level of MOPP or amount of protective clothing and equipment worn by unit personnel is a command decision based on the threat of chemical attack and the unit mission. Identification of personnel in NBC over garments: 399th CSH with personnel wearing NBC over garments will wear tape above the left upper pocket with the individuals rank and last name clearly printed on it. Any durable/flexible tape will do (i.e., pressure sensitive but not masking tape).

a. MOPP and Work Rates. The following table indicated the level of MOPP compatible with various work rates at given temperatures:

WORK RATE BELOW 70 DEG 70 DEG - 85 DEG ABOVE 85DEGWBGT WBGT WBGT WBGT

HEAVY MOPP II MOPP II MOPP IMODERATE MOPP IV MOPP II MOPP IILIGHT MOPP IV MOPP III MOPP II

E-9


E-31

decontamination is required and the priorities will be determined by the

22. MAINTENANCE AND STORAGE OF NBC SUPPLIES AND EQUIPMENT.

a. Protective masks canister filters will be changed as the situation dictates.

(1) Canisters will be obtained from the NBC NCOIC.

(2) The Hospital Pharmacy will maintain nerve agent antidote. They will be issued on order of the Hospital Commander.

(3) Equipment operators are responsible for the proper maintenance of the given equipment. The NBC NCOIC will supervise operations to ensure that proper maintenance is being accomplished.

(4) The NBC NCOIC is to be notified in the event that any NBC equipment becomes inoperable.

b. Replacement criteria for canister filter elements

(1) C2 Canister filter elements will be changed IAW TM 3-4240-339-10.

(2) Canister element will be replaced if:

(a) They have been exposed to direct attack with chemical-biological agents.

(b) Canister is cracked or dented on the seem or has a holes.(c) Excessive breathing resistance is experienced and visual

inspection reveals that the canister is clogged with dust.(d) Threads on canister are damaged, loose particles rattle or dust

falls out when canister is shaken.(e) In a tactical situation, all unserviceable filter elements

(contaminated or uncontaminated) will be disposed of by crushing the connectors and burying the elements under at least six (6) inches of dirt.

E-11


E-32

Commander.b. WBGT indicates Wet Bulb Globe Temperature. WBGT is approximately

MOPPEquip-ment

MOPPReady

MOPPZero

MOPP1

MOPP2

MOPP3

MOPP4

MaskOnly

MASK Carried Carried Carried Carried Worn1 Worn WornOver-garments

Ready3 Available4

Worn1 Worn1 Worn1 Worn

Overboots Ready3 Available4

Available4

Worn Worn Worn

Gloves Ready3 Available4

Available4

Available4

Available4

Worn

HelmetProtectiveCover

Ready3 Available4

Available4

Worn Worn Worn

ChemicalProtectiveOver -garments2

Ready3 Available4

Worn2 Worn2 Worn2 Worn2

In hot weather, coat or hood can be left open for ventilation.The CPU is worn under the BDU (primarily applies to SOF, armor vehicle crewmen).Must be available to the soldiers within two hours. Second set available in 6 hours.Within arms reach of soldier.

equal to degrees Fahrenheit.

c. MOPP Levels. The following table indicates the level of MOPP and what will be worn

20. DECONTAMINATION:

a. Individual. Individuals will decontaminate themselves, weapons, and personal equipment when required without orders and continue their mission.

b. Team Operated Equipment. Member of teams assigned to a piece of equipment will decontaminate using appropriate decontaminates IAW appropriate TM and continue their mission.

c. Vehicle. Vehicle operators will temporarily decon essential parts of the vehicle with the M13 decontamination apparatus.

d. Unit. The Hospital Commander will designate equipment and areas to be decontaminated by the Unit Decontamination Team and will establish priorities for the decontamination.

21. PRIORITIES FOR DECONTAMINATION: Decontamination priorities will be dictated by the specific mission and situation at the given time that

ANNEX F (PERSONNEL AND ADMINISTRATION) TO 399TH COMBAT SUPPORT HOSPITAL TACSOP

1. PURPOSE. This annex establishes responsibilities, policies, and procedures governing personnel functions and programs for the 399th Combat Support Hospital during wartime, contingency operations, and exercises simulating combat conditions.

APPENDIX 1 (ADMIN SERVICES AND PERSONNEL SERVICE SUPPORT) TO ANNEX F (PERSONNEL AND ADMINISTRATION) TO 399th CSH TACSOP

1. PURPOSE. This appendix establishes policy and procedures for admin services and personnel service support during wartime, contingency operations, and exercises simulating combat conditions.

2. SCOPE. Applies to all Hospital units and attachments.2. RESPONSIBILITIES.

a. Hospital S1 is responsible for the following:

(1) Report replacement requirements to Higher HQ.(2) Orient, equip, assign replacements; update databases.(3) Provide UMR, AAA-162, and Battle Roster to Higher HQ for review;

reconcile internal strength.(4) Correlate Hospital strength management information.(5) Execute SIDPERS, DEERS, UMR, and other admin transactions.(6) Collects and forwards casualty reports; monitors next of kin letters;

maintains soldier spouse/family information.(7) Delivers/redirects mail.(8) Directs Hospital distribution, information management and courier

OPs to Higher HQ.courier service to the Group ALOC once per day.(9) Requests field Finance support from Group.(10) Maintains Hospital publications account.(11) Process OERs, NCOERs and Awards for companies.(12) Perform personnel and administrative services.(13) Coordination with G1/S1 for all reporting requirements.

b. Companies are responsible for the following:3. ADMIN SERVICES.

(1) Publications and forms. Units will deploy with adequate reference material, publications and forms to last at least 30 days after deployment. Units with reproduction capability may also produce DA and theater blank forms as needed. Hospital S1 is responsible for updating the pinpoint distribution address for pubs for an overseas deployment that exceeds 5 months.

(2) Reproduction Service. The Hospital S1 will coordinate reproduction requirements thru Corps for documents that exceed internal capabilities.

(3) Courier Service. The Hospital S1 will operate a courier service to the Brigade TOC and ALOC. Companies are responsible for establishing a once a day courier service to the Hospital ALOC. The Brigade courier will go to the Hospital on an emergency basis to dispatch items that are critically time sensitive.

(4) Classified documents. Documents will be handled IAW requirements outlined in Annex C.

4. PERSONNEL SERVICE SUPPORT.

F-1 F-34-1

(1) Report replacement requirements to Hospital S-1. a. Awards.(2) Orient, equip, assign replacements; update databases.(3) Comply with H-Hour Sequence reporting and formats per Appendix (1) Wartime criteria are established in AR 600-8-22.

3. (2) Hospital S-1 will forward awards requiring Higher HQ’s, approval to(4) Collect and forwards casualty reports; monitor spouse/family the Higher HQ’s ALOC.information (3) Award recommendations for KIAs/MIAs will be initiated NLT 30

Delivers/redirects mail.Maintain strict accountability of unit personnel and exact location. Submit OERs, NCOERs, and Awards in a timely manner.

days after determination of individual status.

b. Elimination’s, separations, retirements.

(1) Officer elimination’s continue IAW AR 635-100. Provisions of AR 635-120 may be suspended.

APPENDIX 1 (ADMIN SERVICES AND PERSONNEL SERVICE SUPPORT) TO ANNEX F (PERSONNEL AND ADMINISTRATION) TO 399th CSH TACSOP

(2) Admin discharges for enlisted personnel will continue under AR 635-100 unless otherwise directed.

(3) Statutory retirements continue to be processed. Voluntary length of service retirements may be suspended.

(4) ETS may be suspended under "Stop Loss."

c. Leave. Leave policy will be published by the Hospital IAW Group policy. Emergency leaves can continue, however, the length of leave may be restricted. For announced major field training exercises, soldiers will not take ordinary leave.

d. Promotions. Current policies and procedures remain in effect until notified of changes by higher HQs. Promotion boards and ceremonies will be conducted in the field as required.

5. DATA BASE MANAGEMENT (SIDPERS).

a. Prior to overseas deployment, PSB will provide the Hospital an extract of their database. The database will be updated by the Hospital using SIDPERS III. Once SIDPERS processing support is available, PSB will update the database.

b. PSB will announce the implementation of functional requirements associated with maintaining essential wartime SIDPERS data elements.

c. Data base splits will only be implemented upon instruction from Corps.

6. MANIFESTS. Units prepare manifests as possible, using EXCEL, in alphabetical order, by unit, by plane or shipload and an organic TALCE representative will approve manifest. Each manifest will include soldier's name, rank, SSN, UIC, weight, PMOS.

APPENDIX 2 (CASUALTY MANAGEMENT AND OPERATIONS) TO ANNEX F (PERSONNEL AND ADMINISTRATION) TO 399th CSH TACSOP

1. Purpose. To establish standards and procedures for casualty management and operations during wartime, contingency operations, and exercises simulating combat conditions.

2. Scope. Applies to all Hospital units and attachments.

3. General. Methods and standards for reporting battle and non-battle casualties are prescribed in FM 12-6 and AR 600-8-1. In the event that a unit submits an exercise/simulated casualty report, the words "EXERCISE, EXERCISE, EXERCISE, SIMULATION ONLY" will be clearly marked on the report.

a. Casualty reporting.

(1) Casualty feeder reports. Prepared in triplicate using DA Forms 1156 (Casualty Feeder Report) and 1155 (Witness Statement). If no forms are available, use any paper - do not delay the report for lack of a form. The company retains the 2nd copy of these forms.

(2) Unit Feeder report. Companies transmit DA Form 1156 and 1155 to BDE by a letter of transmittal entitled "Unit Feeder Report." Hospital will transmit to the PSB. The unit feeder report is formatted as follows:

(a) Control number(b) Name(c) SSN(d) Status (KIA, MIA, etc)

4. Unit feeder reports are assigned alphanumeric control numbers in a single consecutive series each calendar year (i.e. B01 = battle casualty #1; NB01 = non-battle casualty #1; A01 = allied casualty #1). The unit nomenclature will precede the control number (i.e. 163rdNB01 is the first non-battle casualty report from 163rd MI).

(1) VIPs, war correspondents, Red Cross personnel and other civilian personnel supporting US Forces will be reported under the same procedures listed above. The report will show the service or agency to which the individual belongs, if known.

(2) Allied personnel are reported under the same system; control number contains the letter A.

F-1-2 F-2-1

APPENDIX 2 (CASUALTY MANAGEMENT AND OPERATIONS) TO ANNEX F (PERSONNEL AND ADMINISTRATION) TO 399th CSH TACSOP

(3) Each TOC maintains an alphabetical master casualty file (card or folder) to provide ready reference for all information concerning casualties, to facilitate verification of reports and to prevent duplicate reports.

(4) Letters of Sympathy. Letters of sympathy will be prepared within 24 hours at Company level (by company commander), and forwarded to Hospital S-1 within 30 hours. Hospital forwards through Corps casualty reporting channels immediately. Hospital S1 will follow-up with BDE S1 to ensure graves registration and official notification of next of kin.

(5) Disposition of Remains and Personnel effects will be conducted. IAW AR 638-40, AR 638-1 and Corps' directives. Hospital S1 will coordinate w/Hospital S4 to ensure Casualty Assistance Officer performs military and civilian clothing inventory and military equipment inventory in garrison and in the field.

(6) Determination of Line of Duty Status. All battle and non-battle casualty line of duty determinations/investigations will be completed IAW AR 600-32.

(7) Casualty Mail. See Postal Operations appendix.

APPENDIX 3 (PERSONNEL AND ADMINISTRATION REPORTS) TO ANNEX F (REPORTS) TO 399TH COMBAT SUPPORT HOSPITAL TACSOP

1. Purpose. To provide report formats for use by 399th CSH S1, assigned units and attached units.

2. Scope. Applies to all Hospital units and attachments. Reports are submitted during tactical deployments.

3. Administrative instructions.

a. Report times per paragraph 3E. Annex L Reports Matrix. Report formats paragraph 3E, Appendix 3, TABS A - I.

b. Company reports are submitted to CDR, 399th CSH, ATTN: S1.

c. Transmission is by fax, CT, courier. Casualty SPOTREPS and SIRs may be sent by MSE phone.

d. Completed strength reports are classified SECRET; SIRs classified IAW regulation.

e. Units are required to submit the following reports to the Hospital S1 in the BN ALOC at 0500 and 1700Z throughout the deployment.

(1) PERSITREP (TAB A)(2) BN PRR Feeder (TAB B)

F-2-2 F-37-1

TAB A (PERSITREP Instructions) TO APPENDIX 3 (PERSONNEL AND ADMIN REPORTS) TO ANNEX F (REPORTS) TO 399th CSH TACSOP

1. Reports will be numbered sequentially each day starting with 001. Supplemental PERSITREPS during the same day will use the number plus an alpha character (001A). A change in strength 10% or greater or changes that drop the unit’s P-rating should be reported immediately.

2. Part I. A is the consolidated totals for the reporting unit. Definitions: a. OPR

STR - The “foxhole” strength. Actual strength on hand in the unit.

TAB B (HOSPITAL FEEDER REPORT FOR PRR) TO APPENDIX 3 (PERSONNEL AND ADMIN REPORTS) TO ANNEX F (REPORTS) TO 399th CSH TACSOP5. PERSITREP FORMAT

SUBJECT: PERSITREP NUMBER________________________________AS OFDTG________________________________________________FROM:TO:

STRENGTH TOTALS.First listing in report table is for operational strength from the previous reporttable is for operational strength from the previous report. The last listing in thetable is for the current operational strength.

b. REPL - replacements/gained personnel.c. Other - All other gains (recovered personnel, hospital returnees and

CONSOLIDATED

BY UNIT.

personnel returned from AWOL etc.). REMARKS.d. KIA - Killed in Action.e. MIA - Missing in Action.f. DNBI - Disease and Non-Battle Injuries (not available for duty). Include

PROJECTED STATUS:

all personnel evacuated for medical treatment. 24 HOURS 48 HOURS 72 HOURS 96 HOURSg. WIA - Wounded in Actionh. Admin - All administrative losses (reassigned, discharged, AWOL,

confinement etc.). METHODOLOGY:

Attachments and Detachments:i.j.

CSG - Civilian Support GroupLN - Local National

3. Part I. B is a by-unit breakout of the categories listed in I.A. The Hospital will list companies. Include attachments as a sub-unit listing. The total in this section should equal the total from Part I. A. Brigade reports Battalion consolidated figures from Part I. A.

4. Part II Remarks

a. Companies are not required to complete Part II. A. The Hospital does this using the MCS tables. The Hospital will use para D., Miscellaneous, to comment on significant projected changes. The entries are “G” (green) for no impact on unit mission; “A” (amber) for some impact on unit mission; “R” (red) for mission impossible due to personnel, and “B” for unit incapable of action.

b. Attachments and detachments: Note the units that are attached and detached.c. TPFDL gains. Only reported if a reserve TPFDL unit arrives with flow of forces.

F-3-A-38 F-3-B-1

TPFDL Gains:

Miscellaneous: (include remarks on significant personnel matters, extraordinary changes in reported figures, highlight units P3 or below).

TAB B (HOSPITAL FEEDER REPORT FOR PRR) TO APPENDIX 3 (PERSONNEL AND ADMIN REPORTS) TO ANNEX F (REPORTS) TO 399th CSH TACSOPINSTRUCTIONS:

FROM_______________________________________________________

TO__________________________________________________________

PFF FEEDER #___________________________________________________________________________________________________(NUMBERSEQUENTIALLY)

AS OF DTG

CHANGE IN FORCE STRUCTURE:

TAB B (HOSPITAL FEEDER REPORT FOR PRR) TO APPENDIX 3 (PERSONNEL AND ADMIN REPORTS) TO ANNEX F (REPORTS) TO 399th CSH TACSOP66F 66H 66N 67OTHER

O1-O3 O4-O6SSI REQ ASGN REQ ASGN

70B 70E 70F 70H 70 K OTHER

UNIT GAINEDOFF WO ENL

GAINED FROM Warrant Officer Status (list all MOS' and specialties; must use 5 digit code)

UNIT (S) LOST_______________________________________(FOR UNITS REASSIGNED IN THEATER)

OFF WO ENL LOST TO

UNIT ZEROED OUT_(DUE TO CASUALTIRS, REORG)OFF WO ENL GAINED FROM

Officer status (list all specialties and MOS')O1-O3 O4-O6

SSI REQ ASGN REQ ASGN

56A 60A 66C

66E F-3-B-2 F-3-B-3

MOS REQ ASGN

210A 760A OTHER

TAB B (HOSPITAL FEEDER REPORT FOR PRR) TO APPENDIX 3 (PERSONNEL AND ADMIN REPORTS) TO ANNEX F (REPORTS) TO 399th CSH TACSOPEnlisted Status (list all MOS' and specialties):

E1-E4 E5-E6 E7-E9MOS REQ ASGN REQ ASGN REQ ASGN

00Z 09B 13B 31F 31U 52C 52D 54B 57E 63B 63J71G 71L 71M 75B 75F 75H 76J 77F 91A 91B 91C 91D 91E 91K 91M 91P 91Q 91S 91V 91X 92A 92Y OTHER

REMARKS:

F-3-B-4

APPENDIX 4 (POSTAL OPERATIONS) TO ANNEX F (PERSONNEL AND ADMINISTRATION) TO 399TH COMBAT SUPPORT HOSPITAL TACSOP

1. Purpose. To provide administrative information regarding postal operations for field and combat deployments.

2. General.

a. Field Deployment. Postal services continue daily. Units deploy with trained mail officer and postal clerk. Units will provide certified mail couriers to pick up mail from delivery points. Units must be prepared to execute alternate plan for mail pick up and delivery if Hospital S-1 support becomes unavailable.

b. Combat Deployment and Pre-deployment Procedures.

(1) Units notify installation postal office in writing of the upcoming deployment and the last date of mail pick up.

(2) Units provide a roster of deploying personnel to installation postal. In addition, DA Form 3955s must be turned-in for all personnel, to include non-deploying soldiers. If a unit deploys entirely, then a copy of the complete directory file will be turned in to installation postal prior to deployment.

(3) If there is a Rear Detachment, it will be responsible for providing trained mail handlers and processing/forwarding mail for the deployed unit. If there is no rear detachment, the Hospital S-1 will coordinate with installation postal for mail processing procedures.

(4) Prior to deployment, unit mail officers will request that installation postal conduct a closeout inspection. Mail rooms will be emptied of all mail, will be locked, and then sealed by installation postal.

c. Combat Deployment--Operations.

(1) Corps AG coordinates with the theater PERSCOM to ensure corps and theater postal operations are synchronized.

(2) Hospital S1 receives the APOs for the unit(s) from BDE AG. APOs will be based on fixed sites, area sites and servicing postal company locations. Hospital S1 will disseminate APO to subordinate units.

3. Each company will maintain a directory file on all unit personnel.

4. Mail will be secured and delivered IAW postal regulations.

5. Free mail from soldiers in theater may be limited to personnel letter mail, post cards, and sound recorded correspondence of 11 ounces or less, and may be sent to the U.S., a U.S. possession or any Military Post Office (APO/FPO).

F-4-1APPENDIX 4 (POSTAL OPERATIONS) TO ANNEX F (PERSONNEL AND ADMINISTRATION) TO 399TH COMBAT SUPPORT HOSPITAL TACSOP

The word "Free" must be handwritten in the upper right corner. The upper left

corner must contain the Rank, Name, SSN, and complete mailing address of the soldier. Free mail may not be registered, insured or certified. Free mail privileges will be announced by Corps after approval by Congress.

6. If free mail is not authorized, postage stamps may be sold in theater. If stamps are not available, mail requiring postage will be accepted without postage, rated postage due, and forwarded to CONUS.

a. Casualty Mail.

(1) Commanders are responsible for the prompt forwarding of mail for unit personnel who become casualties. Under no circumstances will mail for battle or non-battle casualties be returned directly to the sender.

(2) Mail received for an individual who is KIA, MIA, captured, POW or interned will be endorsed "Search", initialed, dated and dispatched to the Corps Personnel Operations Center (CPOC) for verification before being returned to senders.

APPENDIX 5 (PUBLIC AFFAIRS) TO ANNEX F (PERSONNEL AND ADMIN) TO 399TH COMBAT SUPPORT HOSPITAL TACSOP

1. Purpose. To outline public affairs responsibilities for combat operations and exercises simulating combat operations.

2. Scope. Applies to all Hospital units and attachments.

3. General.

a. The Hospital Public Affairs Officer will be appointed by the Hospital Commander prior to deployment and serve as a Special Staff Officer on the Battalion Staff. The Hospital PAO will have sole release authority for the command, to include photographs, histories, or journals while deployed in a combat zone. All use of personal digital cameras within the hospital perimeter must be authorized in writing prior to use or they will be confiscated at no cost to the government.

b. Media Relations. The Hospital PAO coordinates media events thru the Brigade PAO to the Corps and/or theatre PAO. Corps and/or theatre PAO provides guidance regarding the release of information to the media. Corps and DA will normally publish guidance concerning the following sensitive topics:

(1) Release of information IRT KIA, MIA, POW, and WIA soldiers.

(2) Unit locations and status.

(3) Deployment schedules and preparations.

c. Community Relations. The Hospital PAO will work with the Brigade/MEDCOM PAO to ensure all necessary coordination is made with the civilian populace to include utilization of radio, television, and print mediums.

d. Command Information. The Hospital PAO coordinates with Brigade/MEDCOM PAO for newspapers and fact sheets, and ensures dissemination throughout the command. The Hospital PAO coordinates with units and family chains of concern and publishes monthly family bulletins/command information papers. The Hospital PAO prepares a hospital capability flier for press and VIPs, establishes a hospital tour route, and prepares hospital soldiers in dealing with the media.

e. Field Press Censorship (FPC). Requests to invoke are forwarded to the Brigade S1. The Secretary of Defense, with Presidential approval, may invoke FPC. Provisions of AR 360-65 apply.

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APPENDIX 5 (PUBLIC AFFAIRS) TO ANNEX F (PERSONNEL AND ADMIN) TO 399TH COMBAT SUPPORT HOSPITAL TACSOP

f. Photographic/Audio Visual Support. Historical or documentary photo support is requested through Hospital PAO to Brigade PAO to TASC as appropriate. Unit film processing will be requested through the Brigade PAO to TASC. All photographs will be reviewed by the PAO prior to dissemination through email, hard copy, or any other means. (S-6 will assist with internal photo support).

g. Historical Information. The Hospital PAO will serve as the hospital historian and coordinate directly with OTSG, AMEDD C+S, and USARC for historical guidelines and theatre requirements. He will ensure that a daily log is maintained for SIG ACTS IRT Hospital activities and personnel. The Hospital PAO will coordinate with the Hospital S6 to ensure that both SIPR and NIPR accounts with all daily briefings are backed up monthly for historical purposes and turned-in to USARC Historian upon redeployment to CONUS. The Hospital PAO will maintain copies of all personal journals, conduct interviews, and publish a captioned photo -journal for collective submission to USARC within 30 days of redeployment.

APPENDIX 6 (LEGAL) TO ANNEX F (PERSONNEL AND ADMIN) TO 399th COMBAT SUPPORT HOSPITAL TACSOP

1. Purpose. To prescribe policies and procedures concerning legal support and actions during wartime, contingency operations, and exercises simulating combat conditions.

2. General.

a. Legal activities, investigations, and actions continue during deployments, wartime, and exercises. Commanders at all levels are responsible for ensuring the lawful and orderly conduct of assigned and attached personnel.

b. Commanders who exercise general, special or summary courts-martial jurisdiction before deployment, continue to exercise the same jurisdiction except as modified by operational plans and orders.

c. Authority of commanders to impose punishment under Article 15, UCMJ, remains in effect.

d. The Corps Commander reserves imposition of punishment of Article 15, UCMJ, on officers. Recommendations to impose such punishment will be forwarded through command channels through the Brigade Commander, to Commander, III Corps, ATTN: SJA, using DA Form 5109-R (Request to superior to exercise Article 15, UCMJ, Jurisdiction).

e. Claims.

(1) Each unit appoints a Claims Officer prior to deployment.(2) Claims will be processed IAW AR 27-20 and AR 27-40.

f. Foreign Criminal Jurisdiction. Except in territory under military occupation by the United States, and unless modified by international treaty (i.e. SOFA) members of the U.S. Armed forces are subject to all of the laws of the territory in which they are located. Criminal instances involving soldiers who violate foreign criminal laws will be reported immediately through the Brigade S1 to the commander.

g. The Law of War and provisions of the Geneva Convention remain in effect. All individuals have the responsibility to report apparent violations of the Law of War through command channels. Prior to a combat deployment, soldiers will receive a Law of War briefing. Request for SJA support will be forwarded to the Brigade S1.

h. All requests for legal assistance will be forwarded to the Hospital S1.

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ANNEX G (SUPPLY ABD SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide basic supply procedures for requesting, storing, issuing and reporting of supplies and equipment, less Class X. To provide procedures for biomedical and unit equipment maintenance, nutrition care operations, laundry and bath, gray water, solid, and hazardous waste disposal, and management of remains.

2. SCOPE: Applicable to all units assigned, attached, or OPCON to the 399th Combat Support Hospital (CSH) in a field environment.


(3) Medical supply operations (all Class VIII including blood).

(4) Property Book operations (Class VII) and unit supply tracking (Class II, IV, V, VII) in support of the HHC.

c. Hospital Maintenance / Utility Officer: Responsible for direct supervision of the following services.

3. REFERENCES: (1) Non-medical organizational maintenance.a. AR 40-6 1b. AR 190-11 (2) Supply tracking of Class IX and Class III (bulk and packaged)c. AR 190-51 request / turn-in procedures.d.e.f.g.h.i.j.k.l.

AR 210-130SUPPLY UPDATE 14FORSCOM Reg 700-2FORSCOM Reg 700-3399th CSH Medical Supply External SOP399th CSH Medical Maintenance External SOP399th CSH Medical Supply Internal SOP399th CSH Medical Maintenance Internal SOP399th CSH Logistics SOP (Garrison)

(3) Maintenance and power aspects of laundry and bath operations.

(4) Power distribution planning and supervision (distribution isphysically laid out utilizing the unit supplied power team) to the hospital and livingareas.

(5) Environmental control in the hospital.

d. Medical Maintenance Officer: Responsible for organizational biomedical4. RESPONSIBILITIES:

a. Chief, Supply & Services Division (C, S&SD) / S4: Has overall staff responsibility for the Hospital Supply & Services Division to include:

(1) Supply operations for all classes of supply, less Class X.

(2) Service operations to include biomedical and unit equipment maintenance, laundry and bath, foodservice and nutrition care, and waste (solid, water, hazardous) disposal.

(3) Directly responsible for the management of remains, including morgue operations. (With administrative assistance from the PAD section).

(4) Water and electrical distribution within the hospital.

(5) Transportation operations

b. Assistant Chief, Supply and Services Division / AS4: Responsible for direct supervision of the following services.

(1) Laundry and bath operations.

(2) Waste disposal (gray water, bio-medical and hazardous waste, and solid).

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equipment, services and repairs.

(1) Certification and calibration of all medical equipment prior to use.

(2) Maintenance and maintenance support coordination.

e. HHC Supply: Responsible for unit supply operations to include:

(1) Maintenance of a 10-day basic load of expendable office, cleaning, and personal supply items (Class II, VI and SSSC). Responsible for coordination with the S4 for resupply support from supporting units.

(2) Maintenance of expendable/durable document register for Classes II, III and IV.

(3) Hospital Arms Room Operations.

5. GENERAL:

a. This annex is organized into a series of appendices which detail general information, specific references and procedures for the operation of the Supply and Services section hospital, as well as other logistics procedures.

b. REPORTS: Required reports are discussed in ANNEX (Reports) to this TACSOP.

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c. APPENDICES:APPENDIX 1: Class I: SubsistenceAPPENDIX 2: Class II & IV: Secondary Items/Barrier Material APPENDIX 3: Class III: Petroleum, Oil and Lubricants APPENDIX 4: Class V: AmmunitionAPPENDIX 5: Class VI: Hygiene & Comfort Items APPENDIX 6: Class VII: Major End Items APPENDIX 7: Class VIII: Medical Supply APPENDIX 8: Biomedical Equipment Maintenance APPENDIX 9: Unit Maintenance Operations APPENDIX 10: Laundry and BathAPPENDIX 11: Management of Remains APPENDIX 12: Water DistributionAPPENDIX 13: Waste DisposalAPPENDIX 14: Blood Component Resupply

APPENDIX 1 (CLASS I: SUBSISTENCE) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for the request, receipt, and accountability of Class I subsistence.

2. REFERENCES: AR 30-1, AR 30-18, AR 40-5, AR 710-2, DA PAM 710-2-1, FM 1-23, FM 21-10, FM 29-3-1, FM 29-147, TM 8-500, TM 8-501, TM 10-104, TM 10-412, TM 10-418 and TB 740-10.

3. RESPONSIBILITIES:

a. Chief, Supply and Services / S4 will maintain oversight of the NCD during all planning and execution operations.

b. DIETITIAN / FOOD SERVICE OFFICER: Responsible for quantitative and qualitative input to the Hospital Food Service Sergeant. Insures that all subsistence is stored and prepared JAW references. Ensures all Class I information and status is passed to the S4 as required.

c. HOSPITAL FOOD SERVICE SERGEANT: Directly responsible for forecasting, requesting, storing, securing, preparing and distributing substance, for both patients and hospital staff.

4. GENERAL:

a. Authorized Rations: Field Ration A, Field Ration T, Meal Ready To Eat (MRE), and Medical Rations B

b. One ration cycle consists of breakfast, lunch and supper.

(1) Normal cycle for combat operations will be A-M-A for hospital staff.(2) All attempts will be made to prepare A ration meals when available,

and T rations will be utilized as required.

c. The Troop Issue Support Activity (TISA) maintains and rotates thehospital’s 10-day basic load of rations. Upon alert, the hospital draws basic load.

d. The Hospital Food Service Sergeant establishes the Class I account. Class I supplies are requested, received, transported, and stored by food service personnel. A dedicated vehicle is designated to transport rations. For the purpose of sanitation, the vehicle is kept clean and covered at all times.

e. Ration forecasts are submitted to the TISA NLT 65 days prior to the start of any tactical operations. Ration requests (DA Form 3294-R) are submitted NLT 30 days prior to the tactical operation, for headcounts less than 400 and 60 days prior for headcounts greater than 400. Changes to the ration request may be submitted up to 3 days prior to the issue date.

f. Rations for EPWs, displaced civilians or refugees consist of the standard T ration or MREs supplemented by perishables. Requests for prisoner rations are submitted the same way as patient and staff rations requests. 399th CSH S-2/S-3 will provide headcount numbers to the NCD for EPWs.

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APPENDIX 2 (CLASS II/IV: SECONDARY ITEMS/BARRIER MATERIAL) TOANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for requisitioning Class II (SecondaryItems) and Class IV (Barrier Material) supplies.

APPENDIX 3 (CLASS III: PETROLEUM, OIL, LUBRICANTS) TO ANNEX G(SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for the request of Class III (Petroleum,Oil and Lubricants) items.

2. REFERENCES: AR 700-84, AR 710-2, DA Pam 7 10-2-1, and CTA 50-900. 2. REFERENCES: AR 703-1, AR 710-2, and DA Pam 710-2-1.


a. S4: Responsible for submitting non-expendable Class II and all Class


a. S4: Responsible for establishment of a 10 day basic load of Class III.IV supply requests. Coordinates for the support of unit Class II supply requirements.

b. UNIT SUPPLY SERGEANTS: Responsible for requesting expendable and durable Class II supplies when a valid requirement exists. Responsible for development and stockage of a 10 day Class II basic Load. This stockage accompanies the hospital on all tactical operations and missions. Responsible for monitoring stockage levels of Class II expendable/durable supplies.

c. GENERAL:

(1) The Chief, Supply and Services and/or Asst. C, S&S establishes accounts at supporting Class II and Class IV supply points.

(2) Class II (Secondary Items)

(a) Unit supply personnel submit requests for expendable/durable Class II supplies to the supporting SSA. Requests for non-expendable Class II supplies are submitted to the PBO.

(b) The S-4 forwards valid requests for non-expendable Class II supply items to the SSA.

(c) Unit supply personnel receive, transport, store, and distribute Class II supplies. Upon receiving non-expendable supplies, unit supply personnel submit copies of receipt documents to the PBO within 24 hours of receipt.

(3) Class IV (Barrier Materials)

(a) S4, in conjunction with the hospital operations office (S-3) and security personnel forecast Class IV requirements. The S4 supplies the barrier material to the hospital defense coordinator.

(b) The S-4 coordinates with supporting supply units to fill all requisitions.

(4) The PBO submits valid requests for non-expendable Class IV supplies to the SSA.

Maintains supervision of all Class III operations.

b. HOSPITAL MAINTENANCE/UTILITY OFFICER: Responsible for establishing Class III accounts.

(1) Requests, receives, transports, stores and distributes Class III (as needed within the hospital).

(2) Responsible for monitoring stockage levels of Class III and submitting Class III supply requests to the supporting unit.

(3) Ensures the S4 in immediately informed of all Class III issues, levels, and changes.

4. GENERAL:

a. The hospital maintains a 10-day basic load of Class III (P) on hand if tactically feasible.

b. Whenever possible, Class III (B) supplies are delivered by the supporting petroleum unit. The maintenance officer is notified if delivery cannot be accomplished, and immediately notifies the S4.

c. The Maintenance Officer submits written requests to the supporting unit for Class III (B). The requests contain nomenclature, unit of issue, quantity, and national stock number of required supplies.

d. Unit Maintenance ensures that they properly mark all vehicles and storage areas. Ensures all issues are properly recorded.

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APPENDIX 4 (CLASS V: AMMUNITION) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for the request, receipt and accountability of Class V (Ammunition).

2. REFERENCES: AR 19-49, AR 55-355/FD Supp, AR 75-1, AR 190-1 1, AR 710-2, DA Pam 710-2-1, FORSCOM Reg 700-2, FORSCOM Reg 700-3, FORSCOM Reg 700-8, TM 9-1300-20-0, TM 9-1300-214 and TM 9-11305-200.


a. PROPERTY BOOK OFFICER (PBO). Responsible for maintaining property book accountability for a 10-day basic load of ammunition in the event of deployment. Maintains the Class V document register during deployment.

b. S-3: Maintains the Class V document register for training ammunition. Submits training ammunition requests to the 43D Group Ammunition Officer. Updates the DA Form 581 (Requests for Issue and Turn-In of Ammunition) with the Class V basic load at least annually.

c. S-3: Responsible for estimation of Class V requirements.

d. Unit Commanders receive guidance from S-3 and supervises unit supply in the request, receipt, storage and distribution of ammunition. During transport of ammunition, vehicles must have applicable explosive hazard placards on all sides of the vehicle.

APPENDIX 5 (CLASS VI: HYGIENE AND COMFORT ITEMS) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for the requesting, receiving and distributing Class VI.


a. UNIT SUPPLY SERGEANT: Request Class VI “sundry packs” as required. Receive Class VI and distribute to all section NCOICs.

b. SECTION NCOICs: Upon receipt of sundry packs from unit supply, distribute to soldiers and patients, as needed. Ensure that all soldiers are informed about availability of sundries and have the opportunity to get necessary supplies.

c. INDIVIDUAL SOLDIERS: Deploy with enough Class VI supplies (toothpaste, feminine hygiene products, writing paper, shoe polish, etc.) to sustain you for at least 30 days.

3. GENERAL:

(1) Sundry packs are not issued during field exercises. Soldiers deploy on field exercises with sufficient hygienic and comfort items to sustain them for the duration of the exercise.

(2) The government does not provide cigarettes or alcoholic beverages. Soldiers may be able to purchase these items in some theaters of operation.

(3) The S4 establishes an account at the supporting Class VI point. If the Class VI is co-located at the Class I point, the Hospital Food Service Sergeant will transport pre-coordinated Class VI supplies during regular Class I re-supply operations.

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APPENDIX 6 (CLASS VII: MAJOR END ITEMS) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for the request, receipt, and accountability of Class VII (Major End Items).

2. REFERENCES: AR71O-2, DA Pam 710-2-1 and MTOE O8OLFCO4FC1 193 EDATE 16DEC92.


a. S-4/Chief S&S: Ensures that all Class VII supplies are on hand or on valid request. Requests any Class VII equipment lost, damaged, or destroyed. Coordinates evacuation or destruction of any excess and non-repairable Class VII equipment.

b. UNIT COMMANDER: Prepares relief documents for loss, damaged or destroyed equipment. Forwards relief documents to the C, S&S.

c. The PBO maintains the non-expendable document register.

4. GENERAL:

a. The PBO establishes accounts at supporting Class VII supply points.

b. Requests for Class VII supplies are generated from daily Battle Loss Reports and existing authorization documents.

c. The PBO requests Class VII supplies directly from the supporting supply points.

d. The PBO receives, coordinates for technical inspection and issue, and maintains accountability for Class VII equipment.

APPENDIX 7 (CLASS VIII: MEDICAL RESUPPLY) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide the responsibilities and procedures necessary for customers to obtain supplies and services from the 399th Combat Support Hospital (CSH) Medical Supply Section in a tactical environment. It also provides customers with an understanding of the system behind the procedures to plan and request logistics support.

2. REFERENCES: TCAM User’s Guide.


a. MEDICAL SUPPLY OFFICER (MSO) / Assistant S4: Supervises the operation of the Medical Supply Section.

b. MEDICAL SUPPLY SERGEANT: Requests all Class VIII supplies required by the hospital. Maintains the Class VIII document register. Resupplies all hospital sections with Class VIII supplies. Supervises the operations of the Medical Supply section. Ensures all appropriate quality assurance measures are taken. Ensures security of Note R + Q supplies maintained in the Medical Supply section and/or ensures accountability of R&Q’ s are transferred to pharmacy.

c. SECTION NCOICs: Responsible for monitoring on hand levels of Class VIII within their sections. Responsible for filling out Class VIII supply requests.

d. Medical supply will go to each section inside the hospital three times each day to pick up reorder requests.

4. RECEIVING MEDICAL SUPPLIES: Supplies are issued only to personnel authorized by the requesting section. This will be verified by utilizing DA Form 1687.

a. Request for potency and dated (P&D) medical supplies must be approved by the Chief Nurse and the Chief, Supply and Services.

b. Request for control substances (Note R&Q items) are only accepted from the Pharmacy section.

c. Syringes, needles, and items, which contain needles, are considered controlled items due to their potential for abuse. These items are secured at all times.

d. Categories of specially Handled Medical Supplies include:

(1) Vault (controlled) items(2) Secure storage items(3) Refrigerated (Reefer) items(4) Frozen items

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APPENDIX 7 (CLASS VIII: MEDICAL RESUPPLY) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

e. Dental Customers are the only customers authorized to order precious metals.

f. Medical Supply will deliver supplies. The following procedures will take place:

(1) Upon delivery, receiving sections will inventory supplies received on a copy of the issue document. The delivery person retains the original Customer Issue Document and the section will retain one copy as a receipt document.

(2) In the event that immediate receipt validation cannot be done, return the completed original Customer Issue Document to Medical Supply by COB the day following the delivery.

(3) Partial Issues: It may be necessary to issue only a part of the quantity originally requested or only part of the items listed on a Customer Issue Document.

(a) Partial issue - receipt of a requested quantity will be clearly noted by a circle around the requested quantity and the actual number issued written above the circled requested quantity.

(b) The quantity not issued will be reversed out of TAMMIS, or the document will be issued as a partial issue with the balance due- out remaining active.

g. Issue of Specially Handled medical Supplies: Sections will be telephonically instructed to report to the Medical Supply tent for issue of specially handled medical supplies.

h. TURN-IN MEDICAL SUPPLIES

(1) When a customer/section determines that expired or excess supplies are on hand, they will turn in these supplies to Medical Supply.

(2) DA Form 2765-1: DA Form 2765-1 (Request for Issue Turn-In) serves as the official turn-in document for serviceable supplies in full unit of issue.

(3) DA Form 3161: DA Form 3161 (Request for Issue or Turn-In) formatted as a Destruction certificate. It serves as the official turn-in document for unserviceable items.

i. Blood Management

(1) S-4 would establish a contract with supporting MEDLOG BN and/or DLA.

(2) 399th CSH Blood Bank personnel will submit a request to Medical Supply. Medical Supply will forward the request to the MEDLOG and contact DLA for pick up or delivery of blood or lab supplies.

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APPENDIX 8 (BIOMEDICAL EQUIPMENT MAINTENANCE) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide policies and procedures for the repair and preventive maintenance of biomedical equipment.

2. REFERENCES: AR 40-61, AR 700-138, AR 220-1, AR 710-2, DA PAM 710-2-1, DA PAM 7338-750-1, TM 38-750-2, TB MED 521, SB 8-75 series, and manufacturer’s literature for individual equipment items.


a. S4: Provides overall staff supervision of medical equipment maintenance operations.

b. PROPERTY BOOK OFFICER: Ensures that all medical and nonmedical equipment authorized on the MTOE is on hand or on valid request. Responsible for turn-in and replacement of medical and non-medical equipment.

c. MEDICAL SUPPLY SECTION: Responsible for requesting Class VIII medical equipment repair parts as required by the Medical Maintenance section.

d. MEDICAL MAINTENANCE OFFICER: Responsible for overall supervision and facilitation of Medical Maintenance operations.

e. MEDICAL MAINTENANCE NCOIC: Ensures that all medical equipment is properly maintained, repaired, and replaced when necessary. Maintains required historical records for each piece of equipment. Identifies and maintains required PLL and sufficient bench stock. Ensures required services are performed IAW the service schedule.

f. MEDICAL MAINTENANCE REPAIRMEN: Provide unit level maintenance support to all elements of the 399th CSH. Will ensure that all patient care equipment is fully mission capable to support its intended use. Support will include all aspects of unscheduled services such as repairs, installations, acceptance evaluations and inspections, quality assurance testing, special operational surveys as required by accreditation agencies, equipment removal, and disposal classification.

g. MOTOR MAINTENANCE SECTION: Responsible for requesting Class IX medical equipment repair parts as required by the Medical Maintenance Section.

h. SECTION NCOICS: Ensures assigned medical equipment is operational and all required supplies, accessories and operators manuals are on hand for each medical equipment item. If equipment requires repairs or calibration, section NCOs call the Medical Maintenance Section and initiates a maintenance request (DA Form 2407). Section NCOICs maintain copies of operator PMCS (DA Form 2404) and copies of maintenance requests (DA Form 2407) for all assigned equipment. Section NCOICs train and supervise equipment operators in the operation and preventive maintenance, checks and

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APPENDIX 8 (BIOMEDICAL EQUIPMENT MAINTENANCE) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

services of all assigned medical equipment. They are familiar with the problems of electrical, fire, ionizing radiation, and other potential hazards that may develop in medical equipment.

i. X-RAY NCOIC: Responsible to coordinate a Radiation Protection Officer Survey for all x-ray units after units have been calibrated by Medical Maintenance.

j. Medical Maintenance will coordinate for the forward support from a MEDLOG Battalion for TMDE and repair parts.

k. Medical Maintenance will recommend equipment priorities to the Hospital Commander for reporting and maintenance.

APPENDIX 9 (MOTOR MAINTENACE OPERATIONS) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. Purpose: To establish the 399th Combat Support Hospital’s concepts, objectives, responsibilities, and policies pertaining to the supervision and accomplishment of organizational maintenance of vehicles and equipment.

2. General:

a. The mission of the 399th Combat Support Hospital requires that all assigned equipment and vehicles be ready for immediate deployment.

b. This SOP is tactically oriented. Subjects not covered in this annex will be covered in the Primary maintenance SOP.

3. Responsibilities:

a. Chief, Supply and Services / S-4: Responsible for maintaining oversight of all maintenance functions and procedures.

b. Hospital Maintenance Officer:

(1) Monitors equipment status for serviceability and availability.(2) Coordinates with the AS4 / PBO for maintenance requirements of

turn in and lateral transfer actions.(3) Ensures the immediate update to the ALOC of any changes in

equipment status or serviceability, along with the consumption rates and current status of Class III and IX.

(4) Coordinates with supporting units for supply of Class III (bulk and packaged) and Class IX, in addition to all direct support (DS) maintenance operations.

(5) Supervises recovery, and evacuation of equipment, components, and parts, and HAZMAT.

c. Company Commander:

(1) Assignment of equipment operators and assistant operators.(2) Establishment of supervision and unit preventive maintenance

checks and services (PMCS).(3) Conducting periodic inspections and visits, as appropriate, to

determine the adequacy of unit maintenance operations.

d. Battalion Motor Sergeant:

(1) Implements all maintenance shop operations.(2) Schedules and manages all daily work rotations in accordance with

mission requirements.

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APPENDIX 9 (MOTOR MAINTENACE OPERATIONS) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

4. Procedures

a. Dispatching:

(1) Vehicles will be dispatched on a continuous basis during tactical operations

(2) The assigned driver will or assistant driver will notify the dispatcher (TAMMS clerk) that their vehicle requires dispatch. The dispatcher will ensure that the operator is licensed by checking his or her OF-346 (license) to make sure that the operator is indeed qualified to operate the requested equipment.

(3) The dispatcher will give the operator a DA Form 2404 to conduct a PMCS while preparing the dispatch.

(4) The operators will PMCS the vehicle. The operator or mechanic will repair the faults if possible. The Commander or his/her designated representative will decide whether or not to “circle X” and faults.

(5) Vehicles will not be locked in a tactical environment when they are inside the hospital perimeter.

(6) Operators will complete an accident reports (SF91 and DD Form 518) in case of an accident. The completed DD Form 518 will given to the other operator and one will also be received. The appropriate supervisor and company commander will be notified as soon as possible. The SF 91 will be given to the dispatcher.

b. Evacuation for maintenance or repair, which is beyond the capability of the unit, will be done in accordance with the Direct Support’s guidelines.

All PMCS will be turned into the HMT / HMS, to delegate workload.

HMT / HMS will delegate and allocate mechanics based on the priority of the equipment.

Cannibalization of equipment or controlled exchange will be controlled by the HMT / HMS and the commanders.

Unrepairable ECU’s will be traded out with floats from the motor pool. All unrepairable ECU’s will be turned into maintenance.

APPENDIX 10 (LAUNDRY AND BATH) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide the hospital with policies and procedures to be followed in the conduct of Laundry Operations.

2. REFERENCES: FM 10-280.


a. Chief, Supply and Services(C, S&S): Responsible for the staff supervision of field laundry operations.

b. LAUNDRY & BATH (L&B) NCIOC: Responsible for the operation of laundry equipment and linen exchange.

c. MAINTENANCE / UTILITY OFFICER: Responsible for ensuring the maintenance of laundry equipment. Responsible for providing water support to the laundry.

d. UNIT FIRST SERGEANT: Responsible for designating detail (5 person) to support layout of water lines. These personnel are the water team.

4. GENERAL:

a. Laundry unit will be set up and mission capable on day 1 of hospital establishment. Hours of operation and services provided by the Laundry & Bath section are set by the C, S&S and are dependent on mission.

b. Soiled hospital clothing and linen is inventoried, sorted, consolidated and transported to the laundry by medical personnel in large plastic bags or trash cans, based on availability. Linen and hospital clothing is sorted by type (i.e., sheets, pillow cases, gowns). Contaminated linen and hospital clothing is placed in clearly marked bags by the user prior to turn-in.

c. Laundry and Bath personnel receive soiled clothing and linen on a DA Form 1974 (Laundry list), or DA Form 2886 (laundry List for Military personnel). These forms serve as a receipt to the user.

d. Clothing and linen is available for pick-up by the user NLT 24 hours after turn-in. The user presents the receipt, and is issued clean clothing and linen.

e. Laundry and Bath personnel only handle contaminated hospital linen and clothing while wearing protective gloves, clothing and a mask.

f. Clean hospital linen is stored and transported to minimize the possibility of contamination.

g. The user turns in hospital linen requiring sterilization to Central Material Services (CMS) after laundering.

G-9-2 G-10-1APPENDIX 11 (MANAGEMENT OF REMAINS) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for the management of remains of deceased patients and staff.


a. MORTUARY AFFAIRS (MA) TEAM (not organic to the hospital): Responsible for processing of remains and transport of remains and personal affects to the nearest Causality Collection Point. The preferred method for control and evacuation of remains is to have a MA Team co-located with the hospital.

b. PATIENT ADMINISTRATION SECTION (PAD): Responsible for reporting patient deaths through personnel channels. Responsible for inventorying and storing all deceased patient personal effects and turning over to the MA Team when available. Responsible for notifying C, S&S that remains need to be picked up.

c. PERSONNEL ACTION CENTER (PAC): Responsible for casualty reporting in event of death or injury of a unit member.

d. HHC SUPPLY: Responsible for storing and safeguarding deceased patient and staff weapons and protective masks. Responsible for inventorying and processing personal effects of deceased staff

e. S-4/CHIEF, SUPPLY & SERVICES: Responsible for running a temporary collection point (morgue) when a MA Team is not co-located with the hospital. Responsible for turning over remains.

3. GENERAL:

a. PROCESSING PATIENT REMAINS AND PERSONAL EFFECTS:

(1) A patient enters the hospital. His personal effect are collected, inventoried and stored by PAD. PAD turns in the patient’s weapon and mask to unit supply.

(2) The patient dies. The attending physician notifies PAD. The body is sealed.

(3) PAD reports the death through personnel channels. PAD notifies Supply & Services that remains need to be picked up.

(4) The sealed remains and sealed personal effect are picked up by a detail designated by the HHC first sergeant and placed in the temporary collection point. The remains are accompanied by identification (i.e., ID tags, ID card, or DD Form 565 (Statement of Recognition) and an inventory of personal effects. Valuables remain in PAD until the remains are transferred to the collection point. References FM 10-63/FM 10-63-1.

G-11-1

APPENDIX 11 (MANAGEMENT OF REMAINS) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

(5) The remains are logged in on DD Form 1077, (Register of Remains) and stored in the temporary morgue designated by the C, S&S. The temporary morgue will be a refrigerated van or, weather dependent, a MILVAN.

(6) When remains are picked up MA, all personal effects (to include valuables) are also turned over. A listing of remains is made on DD Form 1075 (Convoy list of Remains). The remains are logged out on DD 1077 and one copy of DD Form 1076 (Inventory) accompanies the remains. The MA driver/clerk must sign the DD Form 1075 before leaving the collection point.

(7) The file copy of DD Form 1076 is attached to the file copy of the DD Form 1075 and kept at the temporary collection point.

b. PROCESSING STAFF REMAINS AND PERSONAL EFFECTS:

(1) A unit member dies. PAC reports death through casualty notification channels. PAC notifies the Chief, S&S that remains need to be picked up.

(2) Unit supply takes possession of the soldier’s weapon and protective mask. Unit supply inventories and stores the soldier’s personal effects.

(3) All other procedures are stated in paragraph 3a (4-7) above.

G-11-2APPENDIX 12 (WATER DISTRIBUTION) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for water distribution within the 399th CSH.


a. Laundry and Bath Section: Responsible for the planning of water distribution, layout of water lines, setup of water blivets and pumps.

b. Water Team: Designated by the Unit Commander. Provides assistance to the L&B section in the layout of water lines.

3. GENERAL

a. Water distribution will start after TEMPER tentage is set up.

b. During cold weather, heat tape will be used on all couplings and connections to prevent freezing and cracking of the metal.

c. Water will be circulated constantly by pumps to prevent freezing.

d. Laundry and Bath will coordinate with the field sanitation team to test water daily, and before any water is resupplied to water trailers or water blivets for chlorine residual and chemical contamination. Proper chlorine residual levels will be established before download of water from water trucks.

APPENDIX 13 (WASTE DISPOSAL) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for the disposal of waste produced within the 399th Combat Support Hospital.


a. C, S&S: Overall staff responsibility for the collection, segregation, disposition and/or destruction of all types of waste.

b. Infectious Disease Control Officer: Designated by the hospital commander to establish infectious disease control procedures that preclude the spread of infection within the hospital and prevent spread of disease outside the facility. Works closely with the MSO for the removal of Medical Waste. Responsible for supervision of hospital wards and sections in use of 5 gallon wastewater cans,

c. Medical Supply Officer: Responsible for the supervision of the removal and/or disposal or destruction of medical waste.

d. Medical Supply NCO: Responsible for the disposal of medical waste.

e. Food Service NCO: Responsible for the disposal of waste produced by the Nutrition Care Division (Field Kitchen), and maintenance of a hospital trash collection site. Also responsible for maintaining proper sanitation of the wastewater sump used by NCD.

f. Laundry and Bath (L&B) NCO/ Water Team NCO: Responsible for the setup and monitoring of the gray water return system (weather permitting), and sump maintenance for laundry, bath and waste water systems.

3. WASTEWATER DISPOSAL

a. GENERAL: For purposes of this SOP, the gray water return system for DEPMEDS is designed for use in a warm weather climate. Due to the fact that water does not flow continuously through the gray water system, it will likely freeze during cold weather.

(1) When the gray water system is in use, wastewater lines will be hooked up to sinks and/or ISO’s by the water team.

(2) A large sump must be dug using engineer assets for the wastewater collection. If possible, host nation sewer systems should be planned for and used.

(3) When the wastewater system is not available, 5 gallon cans clearly marked “wastewater only” will be used and drained in the wastewater sump by the producers of the waste (individual wards and sections).

(4) Sinks and ISO’s will not drain wastewater to the immediate exterior of shelters. This creates pooling of wastewater throughout the hospital area and a likely source of infection. If wastewater lines are not available, five gallon

G-12-1 G-13-1


“wastewater only” cans will be used and drained in the central sump as necessary.

(5) If field showers are available, wastewater must be collected appropriately and disposed of in the sump or sewer system (when available). The L&B personnel in charge of the showers are responsible for the collection and disposal of field shower wastewater.

(6) NCD will dispose of wastewater in the proper manner JAW FM 21-10/21-10-1. Soakage pits, grease traps must be used to maximum extent possible.

(7) Hospital field sanitation teams must ensure wastewater runoff and disposal procedures are enforced.

4. MEDICAL / INFECTIOUS WASTE DISPOSAL

a. GENERAL: Medical waste collection and segregation is the responsibility of the ward or section that generates the waste. In turn, each section will deliver its waste to a central point designated by the MSO for medical waste consolidation, disposal, and destruction. There are six types of medical waste requiring specific handling and disposal techniques.

(1) Isolation Waste: Generated by patients who are isolated to protect others from highly communicable diseases. It includes all discarded materials contaminated with blood, excretions, exudates, or secretions.

(2) Microbiological Waste: Comes from cultures and stocks of infectious agents from laboratory elements, such as specimens or discarded vaccines from treatment areas.

(3) Blood and Blood Products: Results from the use of all blood and blood-related products, including blood bags, blood tubes, and material contaminated with blood.

(4) Contaminated Sharps: Includes, but not limited to, needles and syringes, pipettes, glass tubes, scalpel blades. Unused sharps should be considered just as dangerous as used sharps as the puncture hazard remains.

(5) Surgical Waste: Material contaminated as a result of surgical procedures. Includes soiled dressings, used sponges, soiled surgical drapes, etc.

(6) Pathological Waste: Comprised of tissue, organs, body parts, and fluids removed during surgical procedures.

b. Medical Waste Handling and Transport Procedures(1) Proper handling and segregation of medical waste from general

waste at the point of generation are the keys to an effective hospital waste program.

(2) Personnel transporting and disposing of medical/infectious waste must wear disposable masks, rubber aprons, and gloves.

(3) Infectious waste is collected in double-lined impervious containers with tight fitting lids, if available; otherwise double plastic bags (red in color, if available) are used. These containers and bags are clearly marked “infectious


waste. Bags will only be filled to two-thirds capacity, have their tops overlapped, and will be sealed with tape to ensure liquid waste does not leak.

(4) Sharps are placed in rigid, clearly marked, and puncture resistant containers.

(5) Medical waste will be stored only in designated areas, either secured or under direct physical control.

(6) Medical waste will be removed from point of generation at least once a day.

(7) Blood, blood products, and semisolid waste are placed in unbreakable capped or stoppered containers.

(8) Transport of medical waste within the hospital is in rigid, leak proof containers, marked and used exclusively for its transport. Vehicles used to transport medical waste should not be used to transport rations, clean laundry, or medical supplies. Before a vehicle is used for another purpose after transporting medical waste, it must be thoroughly cleaned with 5% chlorine solution.

5. Disposal of Medical Waste

a. GENERAL: Depending on the command policy within a theater of operations, type and quantity of waste, and availability of disposal facilities and engineer support, a variety of options exists. Every effort should be made to ensure the safest and most complete method of medical waste disposal is used.

b. Depending on host nation (I-IN) environmental laws and regulations, field expedient methods of medical waste disposal are not permitted. Thus, it might be necessary to contract for the disposal of medical waste or haul to a fixed medical facility with incineration capability.

c. Some types of medical waste (especially in small quantities) can be rendered nonpathogenic by autoclave (steam sterilization). Consult the TM for the autoclave for detailed information.

d. Incineration (controlled) is the method of choice for most types of medical waste. An inclined plane incinerator (see FM2 1-10-1) is a field expedient option when no other option is available. Thorough consideration must be given to this option as it involves open air burning.

e. Disposal by burying is a last resort for medical waste disposal. Engineer support is required when this option is chosen and waste must be covered immediately after disposal. Close coordination with preventive medicine personnel and HN authorities is essential.

6. HUMAN WASTE DISPOSAL

a. GENERAL: Human waste (feces and urine) disposal is essential toprevent disease spread, especially in the hospital environment. All human waste

G-13-2 G-13-3


must be disposed of in a manner consistent with command policy and proper field sanitation procedures.

b. RESPONSIBILITIES:

(1) C, S & S: Maintains overall staff responsibility for: providing human waste disposal facilities; coordinating for engineer support as necessary for construction of facilities, contracting for portable chemical latrine services through I-IN.

(2) Hospital (PM) Field Sanitation Officer/Team(s): Responsible for the calculation of number of latrines required; construction of field latrine facilities according to JAW FM 21-1 0!-l; monitoring of facilities for cleanliness, handwashing supplies, etc.

(3) Unit Commander: Responsible for designating and training the hospital field sanitation team(s).

(4) General:

(a) Ambulatory patients will use the same latrines as hospital staff. Non-ambulatory patients require use of bedpans and urinals.

(b) The number of latrines provided will be based on unit/staff strength and anticipated patient loads.

(c) When bedpans are used, proper sanitation measures must be enforced both in disposal (if plastic bedpans are used) and cleaning/sanitizing (if metal bedpans are used).

7. GENERAL/SOLID WASTE DISPOSALa. GENERAL: General Waste includes all waste not specifically classified

as medical hazardous waste. It includes such items as paper and plastic products, garbage (generated by the dining facility), and scrap material.


(1) S-4/C, S&S: Responsible for designating a central solid waste collection point; coordinating daily trash run or pickup (if applicable), burn, or burial; coordinating for engineer support as necessary; coordinating location of FIN sanitary landfills when available.

(2) Unit Commander / First Sergeant: Responsible for designating trash detail and coordinating appropriate trash vehicles.

(3) PM/Field Sanitation Officer/Team(s): Responsible for monitoring trash pits/sites for rodents, arthropods and general sanitary conditions.

(4) The NCD will recommend a central point for collection of trash generated by dining facility operations to the C, S&S.

(a) If burial is permitted, engineers will dig a trash pit for burial of solid waste, which must be at least 30 meters from the dining facility. Normally, one garbage pit is required per 100 soldiers per day (See FM 21-10-10).

(b) Vehicles used to transport solid waste may not be used for transporting rations or medical supplies.

G-13-4APPENDIX 13 (WASTE DISPOSAL) TO ANNEX G (SUPPLY AND SERVICES) TO THE

399th CSH TACSOP

(c) If trash is going to be hauled off to a sanitary landfill rather than burned, the HHC Commander will designate trash detail, vehicle(s), and trailer(s) as necessary.

8. HAZARDOUS WASTE

a. GENERAL: Used POL products are classified as hazardous waste as well as various batteries, acids, and chemicals.


(1) S-4/C, S&S: Responsible for coordinating RN hazardous waste disposal contract services;

(2) POL NCOIC: Responsible for setting up POL recycle/collection point.

(3) HOSPITAL MAINTENANCE OFFICER: Responsible for coordinating with DS for disposal of hazardous wastes; monitoring of maintenance operations for spillage; coordinating spill prevention training.

(4) Any hazardous wastes generated will be taken (by the customer/generator of the waste) to a central collection point designated by the HMO.

(5) As the waste accumulates or in anticipation of a hospital relocation, the BMO will coordinate with DS units for disposal of hazardous waste. If DS cannot support this disposal, the C, S&S will contract with RN for disposal of hazardous waste.

(6) Hazardous waste collection and disposal must be in compliance with RN environmental codes and regulations.

(7) Spill kits will be on hand during transfer of POL products.(8) Fuel can storage points will be dug in, lined with plastic (or other

impermeable material) and marked with engineer tape.(9) Any waste that cannot be identified will be handled as hazardous

waste.

G-13-5

APPENDIX 14 (BLOOD RESUPPLY) TO ANNEX G (SUPPLY AND SERVICES) TO THE 399th CSH TACSOP

1. PURPOSE: To provide procedures for blood resupply within the 399th Combat Support Hospital.

ANNEX H (PATIENT ADMINISTRATION) TO THE 399th CSH TACSOP

1. Purpose. To establish policies, responsibilities and procedures governing medical services support for Patient Administration Division (PAD) during wartime, contingency operations, and exercises simulating combat conditions.

2. RESPONSIBILITIES:2. Scope. Applies to all assigned and attached units.

a. HOSPITAL LABATORY OJC: Responsible for storing, processing, andquality control of blood/blood products within the hospital. Responsible for 3. General.forecasting blood needs based on patient load and anticipated casualties.Submits blood requests to the MSO for resupply. a. SRP

b. MSO/Medical Supply NCO: Responsible for coordination with lab for blood needs and forwarding blood requests to the supporting MEDLOG BN.

3. GENERAL:

a. Blood shipped into the theater of operations will be packed RBCs only. Frozen plasma and platelets are also available. Blood planning factors are as fol lows:

b. RBC - *4 units for each wounded in action (WIA) and each nonbattle injury (NBI) casualty initially admitted to a hospital Frozen Plasma 0.08 units for each hospitalized WJA or NBI Frozen Platelet 0,04 units for each hospitalized WIA or NBI Concentrate.

c. For blood planning purposes, only count the WIA or NBI once in the system, not each time the patient is seen or admitted.

(1) It is estimated that the CSH will require 113 units of blood per day (with storage capability of 160 units). Emergency blood collection capability exists in the CSH, but blood collection in the theater is governed by command policy. It must be noted that no serological testing of donor units is possible in the CSH.

(2) Lab will submit daily blood requirements to medical supply, which will forward the request to the blood bank platoon of the supporting MEDLOG BN.

(3) Emergency blood resupply requests will be conducted on air ambulance backhaul when available.

(1) SRP support is requested by units through the S-3 tasking NCO, 399th Combat Support Hospital.

(2) PAD will request medications for immunizations through Medical Supply NCOIC prior to SRP.

(3) Unit tasked for shot team will request supplies needed for shots and HIV through Medical Supply NCOIC prior to SRP.

b. EVACUATION

(1) Health service support is based on the principle that medical units (higher echelon) are responsible for evacuating patients from supported units. Patient transport means will be dependent upon the seriousness/demands of their wounds or injuries.

(2) Patients will be moved no further to the rear than necessary to obtain medical care and be then be returned to duty. The S-3/MRO/AELT will publish current evacuation policy as received from G-3/Corps for deployments.

(3) EPW patients will be evacuated through medical channels with the same priorities as U.S. patients. The capturing unit is responsible for providing an armed guard until relieved by MP personnel. EPW patients will not be evacuated in the same vehicle as U.S. or Allied patients, and must be searched prior to evacuation.

(4) Aeromedical evacuation will normally be determined by necessity to ground evacuation, the medical needs of the patient(s), tactical operating constraints or Airspace management criteria. Precedence for air ambulance evacuation is as follows:

(a) URGENT: required immediately to save life, limb, or eye sight. (within 4 hours)

(b) PRIORITY: required within 24 hours(c) ROUTINE: required within 72 hours.

(5) The patient’s protective mask will accompany them during evacuation. All other Equipment, i.e. TA-50 and weapon, will remain with the soldier’s unit.

G-14-1 H-1

(6) Army aeromedical evacuation is the primary means for urgent andpriority casualties. Ground evacuation should be exploited for routine andambulatory casualties.

5. Surgical beds operational6. Surgical beds occupied7. NP beds operational8. NP beds occupied(7) Nine line MEDEVAC request will be used for evacuations

(a)(b)

LocationRadio Frequency, call sign, and suffix

e. Patients requiring evacuation

(c) Number of patients (1) Medical ambulatory(d) Special Equipment (2) Medical litter(e) Number of Patients by type (3) Surgical ambulatory(f) Security (4) Surgical litter(g) Method of Marking PZ (5) NP ambulatory(h)(i )

Patient Nationality and StatusNBC Contamination

(6) NP litter

c. MORTUARY AFFAIRS

(1) Mass and hasty burials are not authorized.(2) Handle remains:

(a) PAD will contact S-4 after completion of all paperwork. Hospital medical personnel will deliver the casualty to the Medical Supply reefer van.

(b) Medical Supply personnel will receive and verify the casualty. The casualty is stored in the medical supply reefer until the casualty is turned over to graves registration.

(3) Units are responsible for evacuating remains to mortuary affairs

f. Report total numbers of patients in the following categories: Allied, POW’s, DAC, LN. Comment on special in flight requirements

g. Send admission, transfer, and discharge of allied personnel (recurring) to S-3. As of 2400 hours due by 0700. Format:

(1) Unit name, with nationality designation(2) Report number, Date Time Group (DTG)(3) Identify each patient by number (Charlie one, Charlie two, etc.) the

following information for each patient: nationality, name, rank, service number, unit (if known); diagnosis (including SI/VSI and comment on loss of limb or eye); disposition (admitted, transferred, discharged, died); date of disposition; gaining organization.

collection point.(4) Remains will not be transported with Class 1 or medical evacuees.(5) Decontaminate remains, if required, prior to evacuation.

d. MASCAL

(1) Detail a PAD clerk to each treatment area to collect necessary datafor admission:

(4) Enter total number of allied patients reported.

h. Send POW/EPW in Medical Treatment Facilities Report (recurring) toBN S-3. As of 2400 hours due by 0700 and 1900. Format:

(1) Unit name, with nationality designation(2) Report number; DTG(3) Identify each patient by number (as stated above) the same as

(a) Maintains a roster of all individuals processed and theirdisposition.

(b) Secures all personal property of MASCAL patients admitted fortreatment; inventories personal effects of the dead.

Allied

i. Send Medical Situation Report (recurring) to BN S-3. As of 2400 hoursdue by 0700 and 1900. Format:

(c) Prepares for increased patient evacuation workload. (1) Patient Status(d) Maintains accurate bed status records. (2) Previous patient census(e) Establish folders for individual patients. (3) Number of patients admitted(f) Send Medical Regulating Report to BN S-3 (4) Number of patients evacuated

1. As of 2400 report due by 0700 (5) Number of patients returned to duty2. Format of Bed Status Report: (6) Number of patients died3. Medical Beds operational (7) Number of patients remaining

ANNEX H (PATIENT ADMINISTRATION) TO THE 399th CSH TACSOP ANNEX H (PATIENT ADMINISTRATION) TO THE 399th CSH TACSOP

H-2 H-56

4. Medical Beds occupied (8) Number of beds available

j. Unit Status (after initial report, submit changes only)

(1) Location (6 digit grid coordinate)(2) Number of beds operating(3) Time operational

k. Anticipated moves (report as necessary)

(1) Anticipated closing time(2) Anticipated new location

l. Problem Areas (Report in narrative format as appropriate hospitalization, evacuation, Personnel shortages, contagious diseases, treatment of NBC casualties, MASCAL Situations.)

1. Ammunition and Weapons handling procedures

a. Weapons will be tagged using the same number assigned to the patient.b. Weapons will be cleared by armor or personnel designated by CSM and

placed in location designated as weapons holding area.c. AMMO will be turned over to the armor and stored.

2. TRAC2ES.

a. TRAC2ES will also allow reports to be received and sent to the Medical Regulating Office via Diskette, tape or modem.

b. TRAC2ES will be used to generate the Manifest for Air/Ground Evacuations.

c. TRAC2ES will be used to generate 24 hours Ward Reports,

Recapitulation Reports, and Bed status Reports.

d. TRAC2ES will be used to report casualty and personnel tracking

e. TRAC2ES will be used for Admissions and Dispositions of all patients to include:

(1) Patients Record Management (Inpatient Treatment Record Cover Sheet) IPTRCS

(2) Patient Status Management: Update patient’s condition and there location within the facility.

(3) Produce ward report, VSI, SI/SC rosters, Alpha roster of patients(4) Make corrections to previous reports.(5) Produce command interest reports (i.e. VIP)

3. Medical Evacuation will done by completed PMRC Form 7a Mass Patient Movement Request (MPMR) manually and forwarding the form to the Medical Regulating Office who will then forwarded the form to GPMRC (Scott AFB) requesting patient movement. GPMRC will regulate the patient by working with the Air Force to determine the best airlift for the patients.

4. The Chief Patient Administration Division is overall responsible for ensuring the Patient Administration Division is functional and operating 24 hours.

4. The Patient Administration NCOIC will be responsible for the collection of all Casualty Feeder Cards. Witness Statement Cards, and insure they are forwarded to the S-1.

a. Ensuring all reports or accurate and correct.b. 24 hours Ward Reports, Recapitulation Reports and Bed status Reportc. Tracking Admissions and Dispositions status of patientsd. Generating Manifest for Air/Ground Evacuations for submission to the

MRO.e. Submitting reports to the Medical Regulating Office (S-3) by 0700hrs

and 1900hrs.

6. The Medical Regulating Office will be responsible for:

a. Medical Evacuation Air/Ground.b. Coordination between the GPRMC/Air Force using TRANSCOM

Command and Control Evacuation System (TRAC2ES) or email.c. Collecting reports from Patient Administration Division and briefing the

Commander.

H-4 H-5

ANNEX H (PATIENT ADMINISTRATION) TO THE 399th CSH TACSOP ANNEX H (PATIENT ADMINISTRATION) TO THE 399th CSH TACSOP

1. Purpose. To provide guidance to personnel assigned to the Hospital Services

2. Reference. 399th CSH Clinical Services SOP.

3. Duties of ANC Officers.

a. Chief Nurse, Hospital Service (AR 40-6):

(1) Responsible to the Hospital Commander for standards of nursing care and the organization, direction, supervision, training, and effective utilization of nursing service personnel.

(2) Responsible to the Chief of Professional Services to plan and collaborate efforts for nursing services to reach common goals.

(3) Maintains liaison with the Chiefs of other hospital services in the interest of patient welfare, effective management, coordination of activities and accomplishment of the stated policies of the hospital.

(4) Keeps open an effective communication channel with registrar to increase the effectiveness of nursing service and patient administration.

(5) Evaluates the operation of the nursing service against the established standards for patient care, goals, objectives and other indices an a continuous and timely basis, taking corrective actions as required to maintain or alter these performance criteria.

(6) Evaluates qualifications and determines assignments of all professional nursing personnel according to nursing requirements.

b. Night Nursing Service Supervisor: Responsible to Chief Nurse, Hospital Service for the standards of nursing care, effective utilization of personnel, and rendering reports as appropriate relative to patients and nursing service personnel. Responsible to designated or appropriate medical officer for reporting the needs and conditions of patients IAW established hospital policies.

c. Head Nurse of Ward and Specialty Area:

(1) Responsible to Chief Nurse for maintaining the established standards of nursing care and implementation of overall nursing service policies and procedures; to include but not limited to the full utilization, evaluation, and education and training of personnel, maintenance of clinical functional patient environment.

(2) Responsible to appropriate medical officer to plan and collaborate efforts for effective nursing support of medical plans and policies for patient care and treatment.

(3) Plans and coordinates with appropriate medical officers the activities required to meet patient physical, emotional, social and spiritual needs and ensure that these services are provided.

(4) Each Ward Head Nurse is responsible for planning, organizing and developing additional Ward SOPs as required for ensuring that the unit and Hospital Services SOPs are followed.

(5) Responsible for a continuous evaluation of all patient care rendered to patients and for seeking ways to improve the care given.

d. Duty Nurse: Responsible to the head nurse for nursing care duties and responsibilities assigned to them. In the absence of the head nurse or supervisor, assumes their duties and responsibilities.

e. Chief Operating Room Nurse:

(1) Responsible to the Chief, Surgical Service for the organization of the operating rooms, for the provision of nursing service support for the surgical procedures done in the operating rooms, supplies and equipment necessary for the accomplishment of the surgical mission of the hospital in conjunction with the assistance of the NCOIC of the duty area.

(2) Responsible to the Chief Nurse, Hospital Service for the standards of nursing care provided and the implementation of overall Hospital Service policies.

(3) Responsible for the administration and operation of Central Material Service as (CMS) indicated in TM 8-275, as permitted by tactical mission.

f. Nurse Anesthetist:

(1) Responsible to the Chief, Surgical Service for the provision of Nurse Anesthetist support for the surgical unit. Administers anesthesia to patients, observes patient’s conditions and takes measures as indicated. Maintains as accurate supply of anesthesia drugs and ensures maintenance and availability of equipment. Maintains proper records.

(2) Actively participates in the development of post-operative nursing protocols and SOPs IAW anesthetic techniques being utilized.

(3) Monitors immediate post-operative nursing care and compliance with SOPs correcting deficits as required.

g. Responsible to the Chief Nurse, Hospital Service for the standards of nursing care provided and the implementation of overall nursing service policies.

h. Duties of enlisted personnel:

(1) Chief Wardmaster: Responsible to Chief Nurse, Hospital Servicefor job performance of enlisted personnel assigned to nursing service. Duties-and responsibilities are to include, but not limited to:

(a) Evaluates the quality and quantity of nursing care administered by para-professional personnel. Acts as liaison between professional and para-professional personnel.

(b) Supervises the overall cleanliness, sanitation, order and maintenance of supplies and equipment in the nursing areas. Makes frequent

ANNEX I (HOSPITAL SERVICES) TO THE 399th CSH TACSOP ANNEX I (HOSPITAL SERVICES) TO THE 399th CSH TACSOP

I-1ANNEX I (HOSPITAL SERVICES) TO THE 399th CSH TACSOP

checks on facilities and areas designated for disposal of wastes. Takes any necessary corrective action.

(c) Responsible for all para-professional nursing personnel in regard to uniform, courtesy, personal hygiene and availability for duty. Provides counseling and recommends disciplinary measures as required.

(d) Interprets hospital and nursing policies and Army regulations for enlisted personnel.

(e) Coordinates with the First Sergeant concerning duty rosters to avoid conflict in the assignment of personnel.

(f) Reviews duty schedules to ensure effective coverage of wards.(g) Reviews fire and Emergency Operations Plans (EOP) and

individual’s ability to understand the SOP.(h) Monitors professional growth of assigned personnel to ensure

proper utilization and professional advancement in keeping with soldiers’ time in grade. Make selections for schools, recommends awards and advises Chief Nurse of all enlisted concerns.

(2) Wardmaster:

(a) Responsible to head nurse and Chief Wardmaster for assigned ward personnel. Ensures safe and effective care of patients and implementation of hospital and nursing service policies.

(b) Prepares time schedules.(c) Assigns routine ward duties.(d) Orders and maintains supplies.(e) Affects the pick up of drugs from pharmacy and supplies from

CMS.(f) Make frequent rounds in ward, notifies nurse of any new

admissions, change in condition of patients, any unusual occurrences.(g) Maintains order and discipline.(h) Assigns duties to able ambulatory patients.(i) Responsible for ward sanitation.(j) Monitors routine preventive maintenance of all ward

components while in garrison. Replaces or repairs all defective items. Rotates stockages and maintains control and accountability of all hand receipted items.

(k) Trains ward personnel in basic tasks required to maintain ward operations and critical support tasks in event of power failure, fire, etc.

(l) Responsible for personnel accountability.

(3) Practical Nurse/Patient Care Assistant: Responsible to Wardmaster, Ward Nurse and Chief Wardmaster for performance of duties.

(a) Promptness on duty, good personal hygiene, and a neat and clean appearance are essential.

(b) Performs duties as directed. These will include: admission, transfer, and discharge of patients, measure/record TPR’S, blood pressure, feed patients, bathe patients, bed making, linen exchange, pre and post operative

care, observation of patients, securing supplies, ward cleanliness, waste disposal and all other duties as assigned.

I-3

ANNEX I (HOSPITAL SERVICES) TO THE 399th CSH TACSOP ANNEX I (HOSPITAL SERVICES) TO THE 399th CSH TACSOP

I-3

1. Purpose: To establish procedures to be followed when the incoming patients load is determined to exceed the efficient capability of the Emergency Treatment Section (for the present EMT configuration, this would be approximately 8 or more patients, dependent on patient acuity).

**NOTE: The Hospital Commander (or his designee) and the Chief Physician maintain the authority to declare a MASCAL.

2. Procedures:

a. Chain of notification

(1) TOC will notify the hospital CDR of impending patient load.

(2) Hospital CDR will notify the DCCS and the Chief Nurse who in turn will initiate their alert notification chain.

(3) TOC will have the responsibility of initiating a MASCAL scenario by notification to base camp over the PA loudspeaker system.

(4) Each OIC/NCOIC will maintain a roster of personnel assigned to their sections for MASCAL purposes. Identified missing personnel will immediately be reported to TOC and/or Chief Nurse.

b. Orientation of Personnel

(1) All medical MOS’s will report immediately to their assigned MASCAL section.

(2) Non-medical MOS will report to either their assigned MASCAL section or their company command tent (for unassigned personnel).

(3) Personnel not reporting to their section will be identified to the TOC.

c. Triage/Sorting of Patients

(1) The principle of triage or the sorting and assignment of treatment priorities to various categories of wounded will be utilized. The principle of providing the greatest amount of care for the largest number of soldiers will be exercised.

(2) The physician in charge of the MASCAL will perform initial triage. This will later be developed in the concept of operations.

(3) Patient Categories/Location of Category AreasANNEX J (MASCAL) TO THE 399th CSH TACSOP

(a) Immediate - Severe, Life - Threatening wounds that require emergency intervention if death is to be prevented.

1. PAD immediately assigns patient a red ID band with number.

2. Treatment initiated in Operating Room or EMT area as directed by MASCAL Triage physician.

3. Held in that area until transferred to another area as directed by MASCAL Triage physician/OlC triage team.

(b) Delayed - Casualties that can tolerate delay prior to operative intervention without unduly compromising the likelihood of a successfully outcome.

1. PAD provides patient a yellow ID band with patient number.

2. Directed by MASCAL Triage Physician to pre-op area, ICU, ICW or Operating Room.

3. Remain in pre-op wards until directed by MASCAL triage physician or ward OIC. Name, injury and patient location added to OR staging board within pre-op area.

(c) Minimal - Casualties with wounds that are so superficial that they require no more than cleaning, minimal debridement and general first-aid.

1. PAD provides patient with a green ID band with number.

2. Directed by MASCAL triage physician to identified area; ICWs. Ward personnel initiate treatment and report to PAD final disposition after determination by primary physician.

3. Remain in manpower pool as directed by ward/area OIC to assist with more seriously injured personnel.

(d) Expectant - Casualties that have wounds so extensive that even if they were the sole casualty and had benefit of optimal medical resources their survival would be unlikely.

1. PAD provides patient with a black ID band with number.

2. Directed by MASCAL triage physician to identified care

ANNEX J (MASCAL) TO THE 399th CSH TACSOP ANNEX J (MASCAL) TO THE 399th CSH TACSOP

J-4 J-2

area; Med Supply/Interchange area. Chaplain and/or chaplain assistant will assist in area.

(e) Chemically Contaminated Patients - See Chemical Decontamination SOP

d. Concept of Operation

(1) Upon notification of a MASCAL, TOC will notify Hospital CDR and sections as indicated in Appendix A. Only the hospital CDR (his designated representative) or the MASCAL triage physician may declare or terminate a MASCAL.

(2) Personnel will report immediately to their assigned duty sections.

(3) Patients already in hospital will be consolidated within their ward areas to open blocks of beds dedicated to MASCAL patients. ICU patients will be assessed using the ICU patient acuity system (Appendix D) and either remains in ICU or moved to an open ICW bed.

(4) Sections Operational Policy:

(a) Triage/EMT Services Area:

1. Triage team with MASCAL chests will report to the Triage tent with 4 litter teams. As patients are brought from Helipad or arrive in ambulances, each patient will be triaged by the MASCAL triage physician, preferably inside Triage tent with overflow outside tent and EMT area. During limited visibility, (night operations), triage can be accomplished within EMT Services; this decision will be made by the triage physician. An ID band will be placed on an upper limb by PAD liaison and directed to the appropriate areas as designated by the triage officer.

2. Patients declared DOA by Physician will be triaged to expectant area.

3. In the triage area only lifesaving procedures will be initiated as directed by the MASCAL Triage Physician. All clothing will be cut off except for ID tags. Chemical masks will remain with patients at all times. Two teams as outlined in Appendix B will be utilized in triage area to carry out orders of the MASCAL Triage physician.

4. Field medical cards will be the preferred method of documentation in this area. If the patient does not arrive with field medical card, one will be initiated by treatment team within the triage area.

5. Lab work is discussed in LAB concept of operations (Appendix E)

(b) Immediate Area (EMT)

J-3ANNEX J (MASCAL) TO THE 399th CSH TACSOP

1. Patients requiring further immediate treatment (beyond initial lifesaving measures performed in triage area) and overflow from triage area will be sent to the immediate area as directed by MASCAL Triage Physician.

2. Personnel who report to EMT Trauma area immediately coordinate transfer of MASCAL supplies to this area and ready trauma stations for resuscitation efforts. The physician team leader of each trauma station will direct further resuscitative measures and lab work.

3. A member of the anesthesia department and respiratory therapist will be utilized to perform lifesaving airway management and respiratory treatments.

4. Patients will remain in this area until the physician team leader completes the initial resuscitation and either stabilizes for transfer to an appropriate area (e.g. OR, X-ray, pre-op), or obtains an immediate OR table for life saving surgical intervention.

(c) Operating Room, CMS, Anesthesia Teams

1. Two operating rooms will be utilized. OR physicians will report to OR as directed by MASCAL Triage physician.

2. One 66E will report to EMT Trauma area to assess requirements and will notify OR staff of initial incoming patients ASAP.

3. The trauma stations within EMT may be utilized as an immediate operating table if deemed necessary by physician team leader.

4. OR concept of operation is found in Appendix E.

patients.5. Initially the ICU will be utilized for all post-operative

6. For ICU’s concept of operation see Appendix E.

7. Patients already admitted to hospital requiring intensivecare will be reassessed and moved to an ICW if possible.

8. Intermediate Care areas will be utilized if surgical patient load is such that ICU cannot safely provide patient care or for delayed patients requiring surgery.

(d) Delayed Area

1. Initially Intermediate Care Wards I and II will be utilized for patients in delayed category. If situation dictates Intermediate III (minimal care) will also be utilized as a delayed patient area.

ANNEX J (MASCAL) TO THE 399th CSH TACSOP ANNEX J (MASCAL) TO THE 399th CSH TACSOP

ANNEX J (MASCAL) TO THE 399th CSH TACSOP

2. Wards concepts of operations are found in Appendix E.

(e) Minimal Care Areas

1. Intermediate Care Ward III (minimal care) will preferably be utilized as an overflow area for Intermediate Care Wards I and II.

2. If the situation permits, all minimal care patients will be quickly treated by assigned personnel and returned to the hospital labor pool.

3. Treated Minimal Care patients may be utilized by Chief Nurse/NCOIC of labor pool for duty as deemed necessary if the situation calls for more manpower.

(f) Expected Area

1. All patients in this category will be directed through EMT Services to the Medical Supply interchange area. An Army Nurse (AN) officer and a 91B/C will be stationed in this area to provide patient pain relief, patient care as deemed necessary. A Chaplain and/or chaplain assistant will also assist in providing patient comfort.

2. As situation permits, expectant patients will be re-triaged at an appropriate time by the MASCAL Triage Physician.

(g) DOA Area: All patients pronounced DOA by physician will initially be taken to a refrigerated van or designated overflow area (GP small) until Graves Registration personnel are available for body retrieval.

(h) Combat Stress Patients

ANNEX K (REPORTS) TO THE 399th CSH TACSOP

1. PURPOSE: This annex lists reports required to be submitted to this headquarters during deployments or field exercises.

TITLE AS OF/DUE BY PREPARED BY

b. Personnel ReportsPERSTAT 0600 0700PERSPOT EVENT ASAPWitness Statement EVENT ASAP --DA Form 1155Casualty Feeder Rpt --DA Form 1156

1. Will initially be triaged to the minimal care (ICW III) area. Assistance provided by psych tech and chaplain assistant.

d. Miscellaneous Reports Sector Sketch Closure Report

ARRIVAL +2 Hours HHC CDRArrival + 30 Minutes Convoy CDR

2. May be utilized as labor pool as appointed by the NCOIC of Combat Stress Patients.

(i) Litter Bearers: SGM or Company 1SG will identify and collect all available non-medical MOS’s as litter bearers. These personnel will report to their company command tent for assignment.

e. Supply and Material ReportsLOGSTAT Any Change Immediately

2. Report Formats:

a. SALUTE Report

(1) Send to: BNS-2(2) Prepared by: Witness(3) As of: Event (DTG)(4) Due by: ASAP(5) Format:

(a) Salute Report #_______(b) S - Size of Enemy Unit

J-5 K-1

a. Operations ReportsSALUTE EVENT ASAP WITNESSSensitive Item Report 0500/1700 0600/1800 CO/DET CDRSPOTREP EVENT ASAP WITNESSINTSUM 1700 1900 S-2Effective Downwind Msg EVENT ASAP HIGHER HQNBC-1 Report EVENT ASAP WITNESS

c. Medical ReportsMED / SITREP 2400 0700DBPRSR 2400 0700Medical Reg Rpt 2400 0700Admission, Transfer 2400 0700 & Discharge of Allied PatientsPrisoners of War in MTF 2400 0700Special Telegraphic EVENT ASAP Report of Selected Diseases

PAD DON PAD PAD

PAD DON

CO CDR CO CDR WITNESS

EVENT ASAP WITNESS

(c) A - Activity(d) L - Location(e) U - Enemy unit, if known(f) E - Equipment Noted(g) Response / reaction of observing unit

b. Sensitive Item Report (Recurring)Send to: TOCPrepared by: By each ward/sectionAs of: 0500, 1700 dailyDue by: 0600, 1800 daily(a) Format:

1. Weapons by type2. # AUTH # ON HAND # ACCOUNTED FOR3. M164. 9mm5. Sensitive Items

(i) Night Vision Goggles (NVGs)(ii) Signal Operating Instructions (SOIs)(iii) KIK- 13s(iv) PROTECTIVE MASKS

6. Commander’s Signature

c. SPOT Report(1) Send to: BN S-2(2) Prepared by: Witness(3) As of: EVENT (DTG)(4) Format:

(a) Friendly KIA(b) Friendly WIA(c) Friendly MIA(d) Friendly damaged, destroyed or captured equipment(e) Enemy KJA(f) Enemy WIA(g) Enemy damaged, destroyed or captured equipment

d. Intelligence Summary (Recurring)(1) Send to: S-2, Headquarters Unit(2) Prepared by: 1900 daily(3) As of: 1700 daily(4) Due by: 1900 daily(5) Format:

(a) Summary of enemy activity for the period(b) Ground activity(c) Enemy front line trace(d) Potential targets for deep / nuclear attack(e) NBC activities(f) Air activity(g) Other

K-2ANNEX K (REPORTS) TO THE 399th CSH TACSOP

(h) Personnel and equipment losses1. Personnel KIA / WIA2. # of EPWs3. Equipment destroyed / captured

(i ) New obstacles / barriers(j) New identifications

1. Units2. Personalities

(k) Enemy activity(l) Enemy capabilities / vulnerabilities(m) Weather and terrain effects(n) Conclusions

e. Effective Downwind Message(1) Send to: NBC NCO(2) Prepared by: NBC Officer of Headquarters Unit(3) As of: EVENT(4) Due by: ASAP(5) Format

(a) Z - DTG at which real wind are measured(b) A - Effective wind direction from grid north and kilometers per hour

(KPH) (for less than 2KTS)(c) B - Effective wind direction from grid north and KPH(for 2-5KTS)(d) C - Effective wind direction from grid north and KPH (for 5-3OKTS)(e) D - Effective wind direction from grid north and KPH (for 30-100KTS)

(f) E - Effective wind direction from grid north and KPH (for 100-3OOKTS) 1 MT)

(h) PREVAILING SURFACE WINDS: Effective wind direction from grid north and kilometers per hour (for chemical agent vapor hazard travel)

3. 4. 5. 6.unable to see crater, submit “UNKNOWN.)

(b) Provide the following information for a follow-up nuclear report:1. B - Position of observer (grid location)2. C - Direction of attack (degrees from observer)

3. D - DTG of detonation

ANNEX K (REPORTS) TO THE 399th CSH TACSOP ANNEX K (REPORTS) TO THE 399th CSH TACSOP

(1) (2) (3) (4)

(g) F - Effective wind direction from grid north and KPH (for 300KTS -

f. NBC-1 Report(1) Send to: BNNBCNCO(2) Prepared by: Observer(3) As of: Event (DTG)(4) Due by: ASAP(5)

(a)Format:

Provide the following information for an initial nuclear report:1. B - Position of observer (grid location)2. C - Direction of attack (degrees from observer)

D - DTG of detonationH - Type of burst (surface, air unknown)J - Flash to bang time (second)K - Crater presents or absent and the width (meters); (if

K-9

4. H - Type of burst (surface, air, unknown)5. U - Cloud width at H+5 minutes after burst (If unable to

obtain Line U, submit Line M.)6. M - Cloud bottom angle or cloud height, top or bottom at

H+10 minutes after the burst (degrees, mils, meters or feet)(c) Provide the following information for Report of Radiation Dose

Rate measurements (NBC-4):1. Q - Location of reading (UTM or place)2. R - Dose rate (CGY/hr) and the word “initial,” “increasing,”

“seak,” or “decreasing,” as appropriate.3. S - DTG of reading4. Provide the following information for a chemical or

biological attack:5. B - Position of observer (grid location)6. C - Direction of attack (degrees from observer)7. D - DTG of attack8. F - Area attacked (actual or estimated)9. G - Means of delivery (if known)10. H - Type of agent, if known, and type of attack (chemical

or biological)11. I - Type and number of munitions or aircraft12. S - Date and time contamination was initially detected

Personnel Status Report (PERSTAT)(1) Send to: BN S-l(2) Prepared by: Chief Ward Master(3) As of: 0600 daily(4) Due by: 0700 daily(5) Format:

(a) PART I - PERSONNEL DAILY SUMMARY1. AUTH ASSG TDY KIA MIA LOSS TOTAL LOSS GAINS2. COMMISIONED3. WARRANT4. ENLISTED5. TOTAL

(b) PART II- PERSONNEL REQUIREMENT REPORT1. SSI I PMOS ASI GRADE RQMT2. TOTAL3. PART II- REMARKS

h. Personnel SPOT Report(1) Send to: BN, S-1

(a) Prepared by: Chief Ward Master(b) As of: EVENT (DTG)(c) Due by: ASAP(d) Format - This report is used when PDY strength drops below

75% of authorized strength.

1. Authorized strength (OFF / WO / ENU / TOT)2. PDY strength (OFF / WO / ENU / TOT)

3. Reason for decline4. Requests or recommendations

i. Medical Situation Report (Recurring) (1) Send to: S-3(2) Prepared by: PAD(3) As of: 2400(4) Due by: 0700(5) Format:

(a) Patient Status1. Previous patient census2. Number of patients admitted3. Number of patients evacuated4. Number of patients returned to duty5. Number of patients died6. Number of patients remaining7. Number of bed available

(b) b. Unit Status (after initial report, submit changes only)(c) Location (6 digit grid coordinate)(d) Number of beds operating(e) Time operational(f) Anticipated Unit Moves (report as necessary)(g) Anticipated closing time(h) Anticipated new location(i) Medical Logistics (status reported as DOS in categories

provided by the Corps Surgeon)(j) Problem Areas. (Report in narrative format as appropriate

hospitalization, evacuation, personnel shortages, contagious diseases, treatment of NBC casualties, MASCAL situations.)

(k) Reintegration hospitals for Allied patients. (After initial report, submit changes only.)

Daily Blood / Plasma Request and Status Report (Recurring)(1) Send to: S-3(2) Prepared by: DON(3) As of: 1200(4) Due by: 0700(5) Format:

(a) Reporting unit and location (grid coordinate)(b) DTG at end of reporting period(c) Total number of blood units on hand by A, B, 0 Group and Rh type and

beginning of report period.(d) Total number of group and type CF blood units received during report

period.(e) Total number, group and type of blood units issued during the initial

report period.(f) Total number, group and type of blood units on hand at end of report

period.

K-5


g.

K-10


(g) Number, group and type of blood units to expire within sevendays or less.

(h) Total number, group and type of blood units requested fromhigher echelons for the next 24 hours.

of limb or eye); disposition (admitted, transferred, discharged, died); date ofdisposition; gaining organization.

(d) Enter total number of allied patients reported

(i) Estimate of total number, group and type of blood units to be m. POW in Medical Treatment Facilities Report (Recurring)requested from higher echelons for the next seven days. (1) Send to: BNS-3

(j) Total number, group and type of plasma received during the (2) Prepared by: PADreport period. (2) Total number, group and type of plasma on hand at the end of (3) As of: 2400the report period. (3) Total number, group and type of plasma from higher (4) Due by: 0700echelons for the next 24 hours. (5) Format:

Medical beds operationalMedical beds occupiedSurgical beds operationalSurgical beds occupiedNP beds operationalNP Beds occupiedPatients requiring evacuationMedical ambulatoryMedical litterSurgical ambulatorySurgical litterNP ambulatoryNP litterRemarks (report hospital location initially, and then onlychanges)

(p) Report total numbers of patients in the following categories: Allied, POWs, DAC, UN Comment on special in-flight requirements

l. Admission, Transfer, and Discharge of Allied Personnel (Recurring)(1) Send to: BNS-3(2) Prepared by: PAD

(3) As of: 2400(4) Due by: 0700(5) Format:

(a) Unit name, with nationality designation(b) Report number; DTG(c) Identify each patient by number (Charlie one, Charlie two, etc.)

the following information for each patient: nationality, name, rank, service number, unit (if known); DOD: diagnosis (including SI / VSI and comment on loss

(a) Unit name, with nationality designation(b) Report number; DTG(c) Identify each patient by number (Charlie one, Charlie two, etc.)

the following information for each patient: nationality, name, rank, service number, unit (if known); DOD: diagnosis (including SI / VSI and comment on loss of limb or eye); disposition (admitted, transferred, discharged, died); date of disposition; gaining organization.

(d) Enter total number of POW patients reported

n. Special Telegraphic Report of Selected Diseases(1) Send to: BNS-3(2) Prepared by: DON(3) As of: EVENT(4) Due by: ASAP(5) Format:

(a) All medical treatment facilities will submit reports JAW AR 40-418. Including:

1. Meningococcal infections2. Heat, solar and cold injuries (hospitalized only)3. Viral hepatitis (Type A and B)4. Malaria5. Outbreaks of occupational illness6. Diseases of animals

o. Closure Report(1) Send to: TOC(2) Prepared by: Convoy CDR(3) As of: Arrival at destination(4) Due by: ASAP(5) Format:

(a) Number of personnel(b) # of vehicles(c) # of COMSEC items by type(d) # of sensitive items by type (NVG5, weapons, etc.)(e) # of weapons by type

p. LOGSTAT 1

K-7

(k) Remarks: Comment on delivery services, status of storage capabilities, unit movement, excess blood, etc., as appropriate.

k. Medical Regulating Report(1) Send to: BNS-3(2) Prepared by: PAD(3) As of: 2400(4) Due by: 0700(5) Format:

(a) Bed status(b) (c) (d) (e) (f) (g) (h) (i ) (j) (k) (l) (m ) (n) (o)

K-11

g. Safety (Accidents and Concerns):AFZC-Y-C-OPS

Date:

MEMORANDUM THRU Commander, Area Support Group

FOR Commander,

SUBJECT: 399th CSH JRTC SITUATION REPORT #____

1. Previous 24 Hours.

a. Personnel

(1) 399th CSH personnel in theater: ____

(2) Red Cross Messages: ___.

(3) Personnel Issues:

(4) Redeployments: ___.

(5) Soldiers in Baynes-Jones Army Hospital: ___.

b. Intel ligence.

c. Operations (timeline).

4. Point of contact is CPT Lambert.d. Logistics. (1) Significant issues:

e. Public Affairs: / Civil Affairs:

f. Information Management:


K-12 K-9

2. Current Situation a. Patients Treated: Real:

MILES: ____

b. Other KIA: DOA: Real MEDEVACs:

3. Next 24 Hours.

a. Personnel.

(1) Expected Arrivals: .

(2) Expected Redeployments:_______.

b. Intelligence.

(1) Significant Weather:

(2) Other:

c. Operations.

AMY J. LAMBERT CPT, MS Operations Officer


J RTC 04-03

DTG:

Subject: Red Cross Messages, Emergency Redeployment, Medical Redeployment, Soldiers in the Hospital.

RED CROSS MESSAGE


0100 hours. If a training event terminates prior to this time, a report will be submitted NLT 2 hours after the termination of training. SITREPS are to be consolidated at the BATTALION level, where appropriate, and submit a copy to the G-3 OPCEN. G-3 Fax: 6-5825. G-3 24-hour phone: 6-3400. The required formal is as follows:

CDR’S Down-Range Training Daily SITREP

Last Name First N Uni Da Rece Delive DeliveredLINE 1.

T DispositiDate / Time Gr1.

2.3 . LINE 2.

ReportingUnit

4.5 . LINE 3. CP Location: (Range /

LINE 4. CDR’s Overall Assessment

A. Training conducted 1ast 24 hours:

Last Name First Na Unit D a Depart EV Reason1 . C. # Firing Runs Execute2. D # Crews Qualified:3. .

4. E. Personnel Qualified:

5. F. # Crews Remaining t

G. #Alibi’s:

Commander’s Comments:LINE 5. RED #1 REPORT, Personnel On-Hand: OFFICERS____ WO____

ENLISTED_ Hours:

ort Last 24 Hours:24 Hours:

LINE 9. BLUE #3 REPORT, Weapons / Sensitive Items Inventory Complete: YES or NO

LINE 10. Training to be Conducted Next 24 Hours:

All units conducting training on any range or training area are required to submit a Commander’s Down-Range Training Daily SITREP to the OPCEN, NLT

K-10 K-11

399th Combat Support Hospital

oup

Training Area / Grid)

B.EMERGENCY REDEPLOYMENTS # Rounds Fired:

Last Name Un Da Facili Reason 1.2.

d:

o Qualify:

MEDICAL REDEPLOYMENTSLast Name First N Uni D Dep

TimEVA Reason

LINE 6. Training Issues Last 24

1. LINE 7. Maneuver Damage Rep2.

LINE 8. Training Accidents Last

SOLDIERS IN HOSPITALDisposition

LINE 11. Training Issues Next 24 Hours:

ANNEX L (AUTOMATION) TO THE 399th CSH TACSOP

1. Purpose. This SOP annex establishes the tactical standard operation procedures for automated information system staff, commanders, and computers users. It establishes services and support available to the 399th Combat Support Hospital while deployed and/or at field training exercises with or without a signal support element.

2. General. For standardization of supported and/or unsupported tactical Local Area Network (LAN) and automated information systems operation procedures used by the 399th CSH for pre-deployment and deployment. Included is technical support provided to the unit communications section in regard to troubleshooting and programming the laptop computer attached to the RH 5800H Harris~ High Frequency Radio running Microsoft~ Windows NT 4.0 Server operating system.

3. Duties and Responsibilities.

a. Health Service System Manager (S-6 IMO)

(1) Ensure that procedural and security provisions outlined in the Automated Information Systems Processing Unclassified Information SOP are adhered to.

(2) Establish Carson LAN accounts/email accounts and ensure accounts are current prior to deployment for command and staff personnel.

(3) Function in an advisory capacity to Hospital Commander and staff on LAN, computer automated communications and databases, i.e., TAMMAS, ULLS.

(4) Facilitate, monitor, and log all flow/reports through established networks, i.e., LAN, MC4, NIPRnet/email, TAMMAS, ULLS.

(5) Maintain liaison with higher command, regulatory, and adjacent units, regarding automated communication issues.

(6) Establish, maintain, monitor, and supervise LAN and networked systems. Exercise operational control over the automation information system section and staff.

(7) Establishment and update Local Area Networkaccreditation when required IAW DOD Standard 5200.28. System(s) accreditation is required for all networks established in garrison and also while in the field.

ANNEX L (AUTOMATION) TO THE 399th CSH TACSOP

(8) Plan and arrange for Mobile Subscriber Equipment (MSE) signal support, Small Electronic Node van (SEN van), and Network Encryption System (NES) services far in advance of deployment. Support units depending on originating location may pack and ship equipment 3 to 6 months prior to training exercises and/or deployments.

(9) Liaison and arrange for Signal support at Core Support Battalion (CSB) levels. Establish point-of-contacts. Coordination with supporting unit’s higher command element is required to allow for tasking(s). This action requires letter(s) of justification and close progress monitoring. Automation, Radio, and Telephone communication requirement requests may be combined and submitted together.

(10) Coordinate with 399th CSH Department of Nursing to locate support elements in relation to hospital setup design and provide diagram of automation plan (external and internal). Establish shortest route to signal support Small Electric Node (SEN) van. Limit on RG-58 co axle is 185 meters before signal loss.

(11) Research and purchase equipment needed prior to deployment. Obtain information from signal support element on equipment upgrade requirements, if needed.

(12) Plan for all situations. Purchase and pack accordingly to provide for backup systems.

(13) Establish internal POP email service within deployed hospital, if requested. This will require computer networking using hubs and RJ-45 cable.

(14) Provide intelligence reports to S-2 by establishment of a Tactical Wide Area Network (TAC WAN). This is only possible when supported by SEN van. This requires creation of email account to receive unclassified TAC WAN information. Computer(s)/hard drives connected to network must be wiped clean before removal/redeployment.

(15) Establish internet/email when requested. This action is only available through signal support’s SEN van and Network Encryption System (NES). Email can also be established using dial up internet/email via TSACS service, only if phone drops/equipment supports digital data transfer. Coordination between unit communications section and automation is a “must” for requesting required services.

(16) Hand receipts all accountable equipment moving in and out of the automation section.

L-1 L-2

b. Information System Team Chief (S-6 NCOIC).

(1) Ensure all procedural and security provisions outlined in the Automated Information Systems Processing Unclassified Information SOP are adhered to.

(2) Coordinate with Terminal Area Security Officers (TASOs) for establishment of new accounts and training while deployed.

(3) Establish packing list of required tools, software, and hardware needed for mission accomplishment for pre-deployment and deployment.

(4) Pack computer(s) and required equipment in an approved manner as not to cause damage due to shock and/or water.

(5) Configure email and TSACS profiles. Update existing TSACS profiles prior to deployment.

(6) Provide training and support to TASOs in areas of maintenance, software installs, profile creation, printer install andtroubleshooting. Ensure data base systems are updated before deployment by school trained user/ operators i.e., TAMMIS, ULLS

(7) Support hard wiring of hospital LAN and computer connections.

(8) Provide technical support for client network component with troubleshooting, software, hardware, and TCP/IP configurations.

(9) Support shared resources such as printers and provides share file/folders capabilities to specified areas of the hospital, such as the TOC/ALOC.

(10.) Provide backup for all share folders/files on a specified periodic basis.

(11) Establish POP email network when requested.

(12) Inform all users that all computers/hard drives connected to signal support SEN and NES equipment must be wiped clean after use and before redeployment, prior to connection to network.

(13) Responsible for clearing computer hard drives prior to redeployment.

(14) Provide technical support for RH 5800H Harris~ High Frequency Radio laptop running Windows~ NT 4.0 server operating system.

c. Company and Detachment Commanders.

(1) Ensure all personnel are familiar with and adhere to the provisions outlined in the Automated Information System SOP.

(2) Ensure logons are by authorized users IAW AR 380-19.

(3) Identify computer users with the need-to-have for LAN, email, TSACS profile setups.

(4) Ultimately responsible for safeguarding all COMSEC material in their respective units.

(5) Evaluates COMSEC incident reports.

(6) Ensure IMO notification and approval before movement of LAN components to new location(s).

d. Terminal Area Security Officers (TASO)

(1) Responsible for all duties, as described in TASO SOP. SEE: Terminal Area Security Officer SOP, Annex E of 399th CSH Automated Information Systems Processing Unclassified Information SOP.

4. Pack, stock, and maintain forms needed for operations as TASO while deployed.

e. Computer Operators/Users.

(1) Remain in compliance with requirements outlined in Security Brief SOP, IAW AR 380-19.

(2) Safeguard user password; update when prompted.

(3) Inform supervisor/TASO/IMO of any malfunctions, deficiencies, viruses, and unauthorized computer access.

(4) Safeguard COMSEC material.

L-4

ANNEX L (AUTOMATION) TO THE 399th CSH TACSOP ANNEX L (AUTOMATION) TO THE 399th CSH TACSOP

L-15

4. Tactical. Internal and external services available to and/or provided in pre-deployment/deployment situations will vary based on mission requirements, available support, and/or command requested services.

a. Staging Areas (Pre-deployment)

(1) Dial-up internet/email will be provided via TSACS accounts, given phone lines that support digital data transfer. Accounts must be established/updated prior to deployment.

(2) Setup of shared resources such as printers/share folders can be established in areas like the hospital TOC/ALOC.

(3) Computer troubleshooting and software support will be provided in pre-deployment areas. Support equipment and software should be hand-carried to ensure availability before arriving at deployment location.

b. Field Hospital LAN

(1) When requested, provide internal and/or external communication within the hospital by authentication through LAN primary domain controller server using Microsoft~ Windows NT 4.0 server operation system, network interface cards, hubs, and RJ-45 category 5 cable (plenum grade).

(2) When requested/supported, provide external internet/email service to hospital staff via SEN/NES equipment.

(3) Provide dial-up internet/email service via TSACS account(s), when supported by digital phone drops. Training areas located on Ft Carson no longer support digital service.

(4) Where external email is not available, an internal “POP” email service can be provided to allow email communication between hospital computers. This is accomplished by using Microsoft programs, network interface cards, hubs, and RJ-45 cable networking.

(5) When/where signal support is provided, thinnet co axle RG-58 cable with BNC connectors, terminators, hubs (RG-58/RJ45) will be used to interface with signal SEN/NES equipment. Maximum distance for RG-58 cable is 185 meters.

(6) A tactical WAN can be provided in a signal supported environment. This is accomplished after connection to SEN equipment with the creation of an email account/profile and new IP address configuration on the

connected computer. This will allow reception of unclassified intelligent reports distributed among the wide area network; information utilized by hospital S-2 staff.

(7) Once a network of any type is established i.e., Microsoft~ Windows NT server, peer-to-peer using Windows family logon), shared resources such as printers, file, and folds can be provided. Shared resources are very useful in areas such as the hospital TOC/ALOC.

(8) Hubs will be mounted to temper frames near power outlets avoiding traffic, shock, water, and sunlight.

(9) Any cable that is installed external and/or internal should be done in a manner not to expose position(s) of vital command posts to opposition forces. I.e., TOC, ALOC.

` (10) RG-58 cable should be installed in areas free of motorized traffic, buried if possible. RG-58 cable is easily damaged and cut. This should be considered in location of support elements and in hospital setup planning.

(11) Computer troubleshooting, connections and software support will be provided.

(12) Hardware such as printer and computers will be provided by the users and is not the responsibility of the automated information management to provide such items, unless prior arrangement has been made.

c. Harris~ High Frequency Radio (RH 5800H) Support.

(1) Reference manufacturer manual(s) and 399th CSH tactical communication SOP for operation.

(2) Establishment of small LAN is possible using the attached laptop computer utilizing Microsoft~ Win NT 4.0 server operation system. The Harris radio has the capability of sending email to other established LAN locations. The size of files sent over high frequency is limited using the Harris~ encryption program. Caution should be used in sending large file attachments. Sending large files other than simple mail transfer protocol (SMTP) can take several minutes, hours, keeping the radio “keyed”. This action may cause damage and/or will prevent other voice/digital communications.

(3) Communication plan(s) must be established prior to deployment and should include all net members. This is done by and/or in junction with 399th CSH Communication staff.

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(4) Technical support will be provided in regards to the Harris~ laptop computer in areas of troubleshooting, programming, and plan configuration.

d. General LAN Information and possible LAN types available while deployed.

(1) Connection and networking of computer(s) to SEN equipment. The number of computers connected should be limited. All computers/hard drives connected must be cleared before re-deployment. This requires planning, time, and implementation by IMO staff to clear and then re-install all lost programs and data. One computer connection could be utilized to access Internet, send and receive external email.

(2) Connection and networking of computer(s) to Harris~ laptop computer. This network is limited to LANs built around issued and staffed radio systems. Requires planning, programming, and issue of NCS plans to net members. This LAN will not give the user Internet or external communication other than the mentioned. It is limited to file size data transfer.

areas.

(6) Disconnect power supply to computers before removal of covers for servicing, to avoid electrical shock.

(7) Installation of RG-58 cable will avoid roads and heavy foot traffic areas.

(8) Placement of the HF Radio antenna will be away from populated areas. Do not allow personnel within 100 feet while transmitting. “High Voltage” warning signs will be positioned around the antenna in plain view.

(9) White engineer tape will be placed on antenna support lines to avoid personnel injury.

(10) Do not touch or allow touching of antenna resistors; may cause shock and/or burns.

(3) Connection and networking of computer(s) using pear-to-pear. This connects local computers/users within a small area. Utilizes Microsoft~ program and does not require a server. Hard drives and printers can be shared using this type of network.

(4) Connection and networking of computer(s) usingMicrosoft~ Windows NT server operating system with authentication to a primary domain controller. IP addresses must be issued and configured for each connected computer.

e. Safety.

(1) All equipment will be grounded in accordance with the manufacturer’s technical manual instructions.

(2) All LAN components will utilize UPS surge protection.

(3) LAN component will be shielded from water and moisture to avoid electrical shock and/or equipment damage.

(4) Avoid excessive extension cords and overloading power

supply. (5) Avoid cord and cable “trip wires” in traveled paths and

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ANNEX M (COMMUNICATION) TO THE 399th CSH TACSOP

1. PURPOSE: To provide guidance and procedures for the use of Communications equipment within the Hospital

2. GENERAL: Policies and Procedures are applicable to all units assigned or attached. All Signal assets of assigned or attached units are under the technical control of the Operations Officer and respond to the operational requirements of the Hospital Commander.

3. FUNCTIONAL AREAS:

a. Message Center Operations.

1) Communications personnel will operate the Hospital Message Center under the supervision of the Communications Chief. All message traffic will be properly numbered and logged prior to being distributed.

2) All incoming messages will be provided to the Operations section to ensure proper assignment of priority and distribution.

3) Outgoing messages will be sent by the most secure and reliable means as mission allows. The originator of outgoing messages will be notified once the message has successfully been transferred.

4) Messenger service within the Hospital will be based on mission and priority.

5) Information Program. Ensures that an active program is conducted and coordinated with higher headquarters.

b. Wire Operations.

1) The communications section will install Wire systems for Telephone traffic. Systems will include both Internal Net via organic switchboards, and External Mobile Subscriber Equipment (MSE) Net utilizing assets provided by supporting Signal units.

2) Internal landlines will be connected to the switchboards located in the TOC. Guard points and fighting positions will be “hot-looped” to speed in QRF/Force Protection information.

3) The Operations Officer will dictate priority of MSE circuits. Circuits may be available on a limited basis only. The Communications section will coordinate with the Signal support unit on location Node Center/SEN van, and the number of circuits available. MSE users will perform Affiliation/Disaffiliation functions with the SEN van. Instructions on these procedures will be posted at each MSE terminal.

4) Public Address (PA) systems will be installed on the Hospital perimeter to act as an Early Warning device. Internal PA system speakers will be installed throughout the Hospital as mission permits.

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ANNEX M (COMMUNICATION) TO THE 399th CSH TACSOP

c. FM Communications. (SINCGARS)

1) SINCGARS will operate in Frequency Hopping and Cipher Text (FH/CT) mode at all times. All COMSEC and Radio Data will be loaded using a current Automated Net Control device (ANCD). Vehicle and Base Station systems will not be left unattended when filled with COMSEC.

2) All stations will conduct a radio check with the NCS prior to departing the local area.

3) Operators will not adjust net Ids, COMSEC Keys, and SINCGARS Time unless directed to do so by Communications personnel.

d. UHF Communications. (AN/PRC-127)

1) At no time will individuals re-program frequencies or operate on unauthorized channels.

2) AN/PRC-127s are NON-SECURE Radios. NO classified information will be passed over UHF Nets. Proper Radio procedures and Call Signs will be used at all times by all users.

e. Communications Security (COMSEC) Information.

1) Suspected or actual COMSEC Compromises will be reported via the fastest possible secure means to the S-2 or Communications Chief. Reports will be forwarded to the next higher S-6/SIGO for evaluation and action. Include the following information when reporting:

Line 1 – Reason for suspected CompromiseLine 2 – Equipment CompromisedLine 3 – Information CompromisedLine 4 – Time of CompromiseLine 5 – Actions taken after Compromise

2) A Company or platoon level compromise can be recovered from without affecting Nets higher than Battalion level. These compromises are minimal and can be worked around if reported immediately. One of the following actions will take place upon direction of the NCS:

a) “STRIKE” will be used to switch to an Alternate Net ID. A number to identify a pre-designated Net ID will follow the codeword STRIKE. STRIKE 1 and STRIKE 2 Net Ids will be identified in the SOI or published within the Signal annex supporting the mission. STRIKE 3 will be used to notify all stations to return to original Net ID. It will be used as follows: “ALL STATIONS, STRIKE AT THIS TIME, OVER”.

b) “LIGHTNING” will be used to announce Julian Date change. Date change will be specified in the Signal Annex supporting the mission. It will be used as follows: “ALL STATIONS, LIGHTNING

AT THIS TIME, OVER”.

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3) Either of the above methods can be used as a quick fix until operations allow the Hospital to use Electronic Data Transfers or manual exchange of COMSEC Keys. The preferred means is a Manual dissemination of COMSEC or SINCGARS Data.

4) Complete SOI/ANCDs will not be taken forward of the Hospital (i.e. FLAs and LOGPACs do not carry ANCDs with them). Hand written extracts consisting of Call Signs, frequencies, and Challenge/Password are limited to two (2) days of material and must be clearly marked with Classification information. ANCDs used in a fixed location must be secured at all times. ANCDs may be secured to a member of the TOC during displacements.

5) Compromise Avoidance Measures – DO NOT HESITATE TO ZEROIZE YOUR EQUIPMENT. Compromises on your part affects the Hospital and could possibly affect the whole Corps Communications net. It is easier to recover from a Zeroized Radio or ANCD than from a compromise. NEVER leave COMSEC equipment unattended while filled. Load Net Ids of “999” into unused channels of your SINCGARS. Maintain Net discipline and always think SIGSEC and OPSEC when transmitting.

f. Safety.

1) Always allow for twice the height of an Antenna from power lines while emplacing the mast sections. Helmets must be worn during Antenna erection and recovery. Antennas can cause RF burns if you are too close during transmissions, so stay clear

2) Communications equipment and power supplies will be grounded in accordance with appropriate Technical Manuals. Failure to do so may result in shock or possibly death.

3) Batteries contain Corrosive material that may cause serious injury. Do not crush, puncture, mutilate, or disassemble batteries. Return all batteries to Communications personnel for proper disposal.

Hospital Command/Staff ElementsCommander VIPERCSM / 1 SG GATORDCCS EAGLEDCHS / Chief Nurse OWLExecutive Officer BOAS-1 Possum 1S-2 Possum 2S-3 Possum 3S-4 Possum 4TOC Toad 1ALOC Toad 2NBC NCO SKUNKCommo PARROTCWM RAVENEMT CROW

CHAPLAIN Motor pool

STORK BEAVER

Unit fixed Call Signs HHCA CompanyB Company223rd Med Det (PM)

2nd FST

JACKLE WOLF COYOTE MOUSE RABBIT

ASSISTANT NCOIC DRIVER RTO

A N D R

Combat Stress Control Ground Ambulance Air AmbulanceDentalVeterinary Detachment EngineersMed Log

M-4M-19

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