Medical Aspects of Chemical Warfare (2008) - The Black Vault

Field Management of Chemical CasualtiesFig. 14-1. The pillars of force health protection.Reproduced from: US Department of Defense. Health Service Support in Joint Operations. Revision, Final Coordination. Washington,DC: DoD; 2005. Joint Publication 4-02: I-9.SERVICE-SPECIFIC OPERATIONS FOR FIELD MANAGEMENT OF CHEMICAL CASUALTIESLand-Based ForcesLand-based forces are comprised primarily of USArmy and Marine Corps (USMC) personnel, landbasedNavy personnel in support of land forces, andAir Force personnel in support of air operations andland forces. Land-based forces include all levels of HSS.HSS units from all services plan and train for chemicalagent incidents in advance. In joint operations, all ofthe services move battlefield casualties through thetaxonomy of care (Figure 14-2), with various servicecomponents having responsibility for particular treatmentfacilities as dictated by the Joint Task Force (JTF)commander.The first responder capability (level I) for Armyland-based forces at the point of injury incorporatesself and buddy aid care. Units also have combat medicsor treatment squads that provide first aid. Unique tothe Army at this level is the combat life saver, a soldierwith first-aid training. These individuals are capable ofassisting the medic in field care of injured soldiers. Thebattalion aid station (BAS) is also part of this capability.Stabilization and emergency treatment for a limitednumber of contaminated casualties can be achievedat the BAS depending on its available resources to decontaminatethe patients before admission to the BAS.Casualties with injuries that require further treatment,or who cannot be managed at the BAS, are evacuated tothe area support medical battalion or to units capableof forward resuscitation care (FRC), which includeforward surgical teams. Forward surgical teams cannotoperate in a chemical environment unless supportedby a unit such as the division clearing station, whichprovides the capability to decontaminate patients. 3The operational tempo may not allow for the thoroughdecontamination of patients by first responders (levelI) or units with an FRC capability (level II); therefore,medical facilities serving in a theater hospital capability(level III and IV) must be prepared for the triageand decontamination of contaminated casualties whoare transported dirty (without thorough decontamination)to their facilities. The combat support hospital isthe Army theater hospital asset that provides surgicalcare, laboratory services, and stabilization of chemicalcasualties. Army field medical facilities can be chemicallyhardened with chemically resistant inner tent487