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Flashcards in Army Health System Deck (40)
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1
Q

Army Health System (AHS)

A

The AHS is a complex system of systems that is interdependent and interrelated and requires continual planning, coordination, and synchronization to effectively and efficiently clear the battlefield of casualties and to provide the highest standard of care to our wounded or ill Soldiers.

2
Q

Medical Regulating

A

Medical regulating is designed to ensure the efficient and safe movement of patients. It is a system that entails identifying the patients waiting evacuation, locating the available beds, and coordinating the transportation means for movement.

3
Q

Casualty Collection Point (CCP)

A

A location that may or may not be staffed, where casualties are assembled for evacuation to a medical treatment facility.

4
Q

Ambulance Exchange Point (AXP)

A

A location where a patient is transferred from one ambulance to another en-route to a medical treatment facility. This may be an established point in an ambulance shuttle or it may be designated independently. Also called AXP.

5
Q

Definitive treatment

A

refers to the final role of comprehensive care provided to return the patient to the highest degree of mental and physical health possible. It is not associated with a specific role or location in the continuum of care; it may occur in different roles depending upon the nature of the injury or illness. (FM 4-02)

As a general rule, no role of care will be bypassed except on grounds of medical urgency, efficiency, or expediency. The rationale for this rule is to ensure the stabilization/survivability of the patient through tactical combat casualty care (TCCC), and far forward resuscitative surgery is accomplished prior to movement between medical treatment facilities (MTFs) (Roles 1 through 3).

6
Q

The Principles of Army Health System

A

Conformity, Proximity, Flexibility, Mobility, Continuity, Control

7
Q

Conformity

A

Conformity with the operation order (OPORD) is the most basic element for effectively providing AHS support. In order to develop a comprehensive concept of operations, the medical commander must have direct access to the operational commander. AHS planners must be involved early in the planning process to ensure that we continue to provide AHS support in support of the Army’s strategic roles of shape, prevent, LSCO, and consolidate gains. Once the plan is established it must be rehearsed with the forces it supports. In operations with a preponderance of stability tasks, it is essential that AHS support operations are in consonance with the combatant commander’s (CCDR’s) area of responsibility (AOR) engagement strategy and have been thoroughly coordinated with the supporting assistant chief of staff, civil affairs (CA)

8
Q

Proximity

A

Proximity is to provide AHS support to sick, injured, and wounded Soldiers at the right time and the right place and to keep morbidity and mortality to a minimum. AHS support assets are placed within supporting distance of the maneuver forces which they are supporting, but not close enough to impede ongoing operations. To support the operational commander’s plan, it is essential that AHS assets are positioned to rapidly locate, acquire, treat, stabilize, and evacuate combat casualties. Peak workloads for AHS resources occur during combat operations.

9
Q

Flexibility

A

Flexibility is being prepared to, and empowered to, shift AHS resources to meet changing requirements. Changes in plans or operations make flexibility in AHS planning and execution essential. In addition to building flexibility into the OPLAN to support the commander’s scheme of maneuver, the medical commander must also ensure that he has the flexibility to rapidly transition from one level of violence to another across the range of military operations. As the current era is one characterized by persistent conflict, the medical commander may be supporting simultaneous actions characterized by different decisive actions, such as offensive, defensive, or stability tasks. The medical commander exercises his command authority to effectively manage his scarce medical resources so that they benefit the greatest number of Soldiers in the AO. For example, there are insufficient numbers of FSTs or FRSDs to permit the habitual assignment of these organizations to each BCT. Therefore, the medical commander, in conjunction with the command surgeon, closely monitors these valuable assets so that he can rapidly reallocate or recommend the reallocation of this lifesaving skill to the BCTs in contact with the enemy and where the highest number of Soldiers will potentially receive traumatic wounds and injuries.

10
Q

Mobility

A

Mobility is the principle that ensures that AHS assets remain in supporting distance to support maneuvering forces. The mobility, survivability (such as armor plating), and sustainability of AHS units organic to maneuver elements must be equal to the forces being supported. Major AHS headquarters (HQs) in EAB continually assess and forecast unit movement and redeployment. AHS support must be continually responsive to shifting medical requirements in an OE. In noncontiguous operations, the use of ground ambulances may be limited depending on the security threat in unassigned areas and air ambulance use may be limited by environmental conditions and enemy air defense threat. Therefore, to facilitate a continuous evacuation flow, MEDEVAC must be a synchronized effort to ensure timely, responsive, and effective support is provided to the tactical commander. The only means available to increase the mobility of AHS units is to evacuate all patients they are holding. AHS units anticipating an influx of patients must medically evacuate patients they have on hand prior to the start of the engagement.

11
Q

Continuity

A

Continuity in care and treatment is achieved by moving the patient through progressive, phased roles of care, extending from the POI or wounding to the CONUS-support base. Continuity of care refers to an attempt to maintain the role of care during movement at least equal to the care provided at the preceding facility. (FM 4-02) Each type of AHS unit contributes a measured, logical increment in care appropriate to its location and capabilities. In recent operations, lower casualty rates, availability of rotary-wing air ambulances, and other mission, enemy, terrain and weather, troops and support available, time available, and civil considerations (METT-TC) factors often enable a patient to be evacuated from the POI directly to the supporting CSH or hospital center. In more traditional operations, higher casualty rates, extended distances, and patient condition may necessitate that a patient receive care at each role of care to maintain his physiologic status and enhance his chances of survival. The medical commander, with his depth of medical knowledge, his ability to anticipate follow-on medical treatment requirements, and his assessment of the availability of his specialized medical resources can adjust the patient flow to ensure each Soldier receives the care required to optimize patient outcome. The medical commander can recommend changes in the theater evacuation policy to adjust patient flow within the deployed setting. A major consideration and an emerging concern in future conflicts is providing prolonged care within all roles of care when evacuation is delayed. The Army’s future OE is likely to be complex and challenging and widely differs from previous conflicts. Operational factors will require the provision of medical care to a wide range of combat and noncombat casualties for prolonged periods that exceed current evacuation planning factors

12
Q

Control

A

Control is required to ensure that scarce AHS resources are efficiently employed and support the operational and strategic plan. It also ensures that the scope and quality of medical treatment meets professional standards, policies, and United States (U.S.) and international law. As the AHS is comprised of 10 medical functions which are interdependent and interrelated, control of AHS support operations requires synchronization to ensure the complex interrelationships and interoperability of all medical assets remain in balance to optimize the effective functioning of the entire system. Within the AO, the most qualified individual to orchestrate this complex support is the medical commander due to his training, professional knowledge, education, and experience. In a joint and multinational environment it is essential that coordination be accomplished across all Services and unified action partners to leverage all of the specialized skills within the AO. Due to specialization and the low density of some medical skills within the MHS force structure, the providers may only exist in one Service (for example, the United States Army has the only veterinary corps officers in the MHS).

13
Q

MEDICAL FUNCTIONS

A

 Medical command and control.
 Medical treatment (organic and area support).
 Hospitalization.
 Medical Evacuation (to include medical regulating).
 Dental services.
 Preventive medicine services.
 Combat and operational stress control (COSC).
 Veterinary services.
 Medical logistics (to include blood management).
 Medical laboratory services (to include both clinical laboratories and environmental laboratories).

14
Q

Medical command function

A
Medical command
Communications and computers
Task-organization
Medical intelligence
Technical supervision
Regional focus
15
Q

Medical treatment

A
First aid
Tactical combat casualty care
Forward resuscitative surgery
Routine sick call
Patient holding
Casualty prevention measures
Medical evacuation
Physical therapy
16
Q

Hospitalization function

A
Essential care
Triage and emergency care
Outpatient services
Inpatient care
Clinical Laboratory and blood banking
Radiology
Physical therapy
Medical logistics
Emergency and essential dental care
General and specialty surgery
Anesthesia service
Pharmacy
Nutrition care
Behavioral health
Patient administration services
Consultation
17
Q

Medical evacuation function

A

Acquire and locate
Treat and Stabilize
Intra-Theater Medical Evacuation
Emergency movement of medical personnel, equipment, and supplies

18
Q

Medical logistics function

A

Medical materiel procurement
Class VIII management and distribution
Medical equipment maintenance and repair
Optical fabrication and repair
Blood management (distribution)
Centralized management of patient movement items
Health facilities planning and management
Medical contracting support
Hazardous medical waste management and disposal
Production and distribution of medical gases

19
Q

Preventive dentistry

A

Conduct periodic examination of Soldiers’ teeth, gums, and jaw
Classify Soldiers’ dental conditions in the dental classification system and determine Soldiers’ dental readiness status
Provide training to Soldiers and units on measures to take to mitigate the adverse impact of dental threats

20
Q

Dental services function

A
Comprehensive dental care
Operational dental care
Emergency dental care
Essential dental care
Oral maxillofacial surgery
21
Q

Preventive medicine function

A
Disease prevention and control
Field preventive medicine
Environmental health
Occupational health
Health surveillance and epidemiology
Soldier, Family, community (public) health, and health promotion
Preventive medicine toxicology
Preventive medicine laboratory services
Health risk assessment
Health risk communication
22
Q

Combat &operational stress control function

A

Implement combat and operational stress control plan/program
Perform combat and operational stress control unit needs assessment
Conduct traumatic event management for potentially traumatic event
Screen and evaluate Soldiers with maladaptive behaviors to rule out neuropsychiatric/ behavioral health conditions
Conduct combat and operational stress restoration and reconditioning programs to include warrior resiliency training
Perform command-directed evaluation for Soldier’s behavioral health status
Screen patients with potential behavioral health issues for signs/symptoms of mild traumatic brain injury

23
Q

Behavioral health/neuropsychiatric treatment

A

Identify and diagnose be-havioral health/neuropsychiatric disorder/disease
Stabilize patient

24
Q

Veterinary services function

A

Animal medical care
Food protection
Veterinary public health

25
Q

Veterinary services treatment

A
Preventive care
Sick call
Combat casualty care
Military and contract working dogs hospitalization
Medical evacuation
26
Q

Medical laboratory services function

A

Analytical, investigational, and consultative capabilities
Special environmental control and containment
Data and data analysis
Medical laboratory analysis
Deploy modular sections or sectional teams

27
Q

Clinical laboratory services

A

Analysis of medical specimens

Blood-banking services

28
Q

OPERATIONAL CONTROL AND TACTICAL CONTROL

A

Commanders establish the operational control (OPCON) and tactical control (TACON) command relationships by placing a subordinate unit under the command of another organization for a specified period of time. The OPCON is the authority to perform those functions of command over subordinate forces involving organizing and employing commands and forces, assigning tasks, designating objectives, and giving authoritative direction necessary to accomplish the mission. The TACON is a command authority over units made available for tasking that is limited to the detailed direction and control of movements or maneuvers within the operational area necessary to accomplish missions or tasks assigned. The commander establishes these command relationships in an OPORD issued to the subordinate commander and specifies the duration of the relationship in the order. Unless specifically stated in the OPORD, these command relationships do not include ADCON authority and responsibility for the gaining command. Once the duration of the relationship has lapsed, the unit returns to its parent unit.

29
Q

Medical Evacuation

A

System that provides the vital linkage between the roles of care necessary to sustain the patient during transport

Accomplished by providing enroute medical care which enhances the individual’s prognosis and reduces long-term disability

Medical Evacuation occurs at the tactical, operational, and strategic levels and requires the synchronization and integration of service component medical evacuation resources

30
Q

Theater Evacuation Policy

A

Establishes, in number of days, the maximum period of non-effectiveness (hospitalization and convalescence) that patients may be held within the theater for treatment

Established by the Secretary of Defense, with the advice of the JCS, and upon the recommendation of the combatant commander

Does not mean the patient will be held in theater for the entire time

Patients not expected to RTD in time will be treated, stabilized, then evacuated out of theater as soon as medically feasible

31
Q

Short theater evacuation policy

A

Fewer hospital beds required in the theater
Greater number of beds required CONUS
Creates large demand for intra-theater Air Force evacuation resources
Increases requirements for replacements

32
Q

A longer theater evacuation policy

A

Greater accumulation of patients and a demand for a larger AHS structure in the theater
Increases the requirements for hospitals, engineer support, and all aspects of base development for the AHS
Greater proportion of patients returned to duty within the theater, reduces the loss of experienced manpower
Longer intra-theater evacuation policy may decrease demand on evacuation assets and system

33
Q

OPERATIONAL ENVIRONMENT

A

The future operational environment (OE) and our forces’ challenges to operate across the range of military operations represents the most significant readiness requirement. The logic chart (Figure 1-2) begins with an anticipated OE that includes considerations during LSCO against a peer threat. Next, it depicts the Army’s contribution to joint operations through the Army’s strategic roles. Within each phase of a joint operation, the Army’s operational concept of unified land operations guides how Army forces conduct operations. In large-scale ground combat, Army forces combine offensive, defensive, and stability tasks to seize, retain, and exploit the initiative in order to shape OEs, prevent conflict, conduct large-scale ground combat, and consolidate gains. The philosophy of mission command guides commanders, staffs, and subordinates in their approach to operations. The mission command warfighting function enables commanders and staffs of theater armies, corps, divisions, and brigade combat teams (BCTs) to synchronize and integrate combat power across multiple domains and the operational environment. Throughout operations, Army forces maneuver to achieve and exploit positions of relative advantage across all domains to achieve objectives and accomplish missions.

34
Q

Combat Lifesaver

A

The combat lifesaver is a nonmedical Soldier selected by his unit commander for additional training beyond basic first aid procedures. A minimum of one individual per squad, crew, team, or equivalent-sized unit should be trained.

35
Q

Medical logistics

A

Provides Class VIII management, requisitioning, and resupply as well as maintenance on medical equipment. Coordinates with supporting medical logistics company and medical detachment (blood support) for required external medical logistics support.

36
Q

Principles of the Army Health System

A

Mobility, proximity, conformity, continuity, and control (FMPC3).

37
Q

Army Health System

A

A component of the Military Health System that is responsible for operational management of the health service support and force health protection missions for training, predeployment, deployment, and postdeployment operations. Army Health System includes all mission support services performed, provided, or arranged by the Army Medicine to support health service support and force health protection mission requirements for the Army and as directed, for joint, intergovernmental agencies, coalition, and multinational forces. Also called AHS.

38
Q

Force Health Protection

A

Force health protection are measures that promote, improve, or conserve the behavioral and physical well-being of Soldiers comprised of preventive and treatment aspects of medical functions that include: combat and operational stress control, dental services, veterinary services, preventive medicine, and laboratory services. Enabling a healthy and fit force, prevent injury and illness, and protect the force from health hazards.

39
Q

Medical Regulating

A

Medical Regulating
(1) Medical regulating is the actions and coordination necessary to arrange for
the movement of patients through the roles of care and to match patients with an MTF that
has the necessary HSS capabilities and available bed space.
(2) The factors that influence the scheduling of PM include:
(a) Patient’s medical condition (ability to withstand evacuation).
(b) Tactical situation.
(c) Availability of evacuation means.
(d) Locations of MTFs with special capabilities or resources.
(e) Current bed status of MTFs.
(f) Surgical backlogs.
(g) Number and location of patients by diagnostic category.
(h) Location of airfields, seaports, and other transportation hubs.
(i) Communications capabilities (to include radio silence procedures).
(3) Execution of the medical regulating process at the tactical level is a function
of the HQ responsible for coordinating patient evacuation from POI to a Role 2 or higher
MTF. This task is often executed by the responsible HQ through the formation of a patient
evacuation coordination cell (PECC).
(4) Execution of the medical regulation process at the operational level, from
MTF to MTF, is conducted by the responsible United States Transportation Command
(USTRANSCOM) PM requirements center, in conjunction with the guidance and direction
of the affected CCDR

40
Q

Roles of veterinary services in a deployed environment

A

Roles of veterinary services in a deployed environment (includes: 64A (veterinarian), 68T, 68R, and 68S)
Veterinary care for military working dogs and other government-owned animals and veterinary preventive medicine capabilities pertaining to zoonotic disease transmissible to man.
Medical services provided in the internment facility, to include
Veterinary support (food inspection and quality assurance, veterinary preventive medicine, and animal medical care).
Mission: The veterinary mission is to execute veterinary service support essential for (FHP) and to project and sustain a healthy and medically protected force; train, equip, and deploy the veterinary force; and promote the health of the Soldier.Primary Task/Purpose:
Animal medical care Provide medical care for military working dogs and other government-owned animals.Food protection Ensure quality, food safety, and food defense of food sources for deployed forces.Veterinary preventive medicine Reduce transmission of zoonotic diseases transmissible to man.
Capabilities and dependencies
Veterinary support for zoonotic disease control, investigation and inspection of subsistence, and animal medical care.
Deployment support – falls under chief of staff section
Veterinary services personnel serve as the commander’s principal consultant and the command’s technical advisor for veterinary activities and employment of veterinary assets. This section provides technical supervision of food inspection, animal medical care, and veterinary preventive medicine support. The U.S. Army is the Executive Agent for veterinary services for all Services (DODD 6400.4) (with the exception of food inspection operations on USAF installations). Refer to Table 11-1 for information on veterinary services primary tasks.