Главная Manuals FM 3-11.34 MULTISERVICE TACTICS, TECHNIQUES, AND PROCEDURES FOR INSTALLATION CBRN DEFENSE (NOVEMBER 2007)
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Table B-1. Sample ESF Manager Roles (continued)
ESF
Name
ESF Manager Roles
No. 3
Public works and
• Request and monitor the deployed damage assessment
engineering
team when requested by the IC.
• Ensure water and utilities are available for incident site
support
• Ensure that environmental expertise/technical assistance is
available for the IC.
• Ensure additional follow-on support is available if required.
• Request follow-on elements from installation or civilian
sources
• Report public works and engineering activities to the EOC.
• Strategically plan for future phases.
No. 4
Firefighting
• Request augmentation or mutual aid assistance before fire
service capabilities are exhausted.
• Per IC request, activate MOAs/MOUs with
local/state/federal/HN fire and search and rescue assets for
augmentation, not previously activated.
• Monitor and obtain expendable equipment status from ICP.
Request additional equipment as needed.
• Strategically plan for future phases.
No. 5
Emergency
• Manage the overall operation of the EOC
Management
• Provide direct support to the EOC director
• Submit incident situation reports to Higher HQs through the
Installation Commander
• Ensure the control and protection of classified material.
• Keep detailed records/logs of decisions and events.
• Coordinate support from additional response elements with
local civilian Emergency Management Official .
• Review and comment on incident lessons learned/after
action reports.
• Strategically plan for future phases.
No. 6
Mass care,
• Arrange for mass care.
housing, and
• Arrange disaster housing for displaced persons.
human services
• Arrange for human services.
• Strategically plan for future phases.
No. 7
Resource
• Arrange resource support (e.g., facility space, office
Support
equipment and supplies, and contracting services).
• Strategically plan for future phases.
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Table B-1. Sample ESF Manager Roles (continued)
ESF
Name
ESF Manager Roles
No. 8
Public health and
• Ensure emergency medical services are available, as
medical services
necessary.
• Report potential BW incidents to higher HQ.
• Request assistance from outside sources, such as the
CDC, to confirm diagnosis and to control the further spread
of disease.
• Ensure medical intelligence officer or NCO is available to
provide medical intelligence information if needed.
• Advise the IC/EOC/ICP on the status of medical treatment
activities.
• Coordinate with local medical forces for mutual assistance
requirements on scene; activates appropriate procedures if
during non-duty hours.
• Serve as a liaison with the installation medical facility for
on- and off-installation medical needs.
• Strategically plan for future phases.
• Establish contact with the MCC, Local EOCs and Higher
HQ.
• Ensure medical personnel are available to provide technical
medical information and advice to the IC, including
information on physiological effects of contamination.
• Coordinate with local hospitals for bed availability.
• Establish reach-back guidance and support from
USAMRIID, USAMRICD, AFRRI, USACHPPM, and CDC.
• Establish contact with local, municipal, state, and federal
public health agencies, as required.
• Establish contact with state/regional/local public health
laboratories for LRN support, as needed
• Strategically plan for future phases.
No. 9
Urban search
• Activate the Urban Search And Rescue Team
and rescue
• Dispatch team when requested by IC.
• Strategically plan for future phases.
No. 10
Oil and HAZMAT
• Activate installation Oil and HAZMAT resources and deploy
response
to incident site when requested by IC
• Request from local civilian agencies/higher HQ
augmentation if the CBRN/HAZMAT team capabilities are
exceeded.
• Strategically plan for future phases.
No. 11
Agriculture and
• Advise the IC on natural and cultural resources, and
natural resources
protection/restoration of historic properties.
• Strategically plan for future phases.
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B-3
Table B-1. Sample ESF Manager Roles (continued)
ESF
Name
ESF Manager Roles
No. 12
Energy
• Deploy a damage assessment team when requested by the
IC.
• Ensure backup power is available to the incident site.
• Provide functional expertise and assistance to the
CBRN/HAZMAT team, as required.
• Determine the need for additional follow-on support.
• Assist with coordination among the IC, ICP, EOC, and other
civil and/or military authorities involved with the response.
• Strategically plan for future phases.
No. 13
Public safety and
• Monitor incident site perimeter/cordon security. Deploy
security
additional forces as requested by the IC/ICP.
• Coordinate additional civilian Law Enforcement support as
needed or requested by the IC/ICP.
• Ensure safety of emergency responders and public through
monitoring incident situation. Draft and provide safety
notices for EOC Director’s approval.
• Ensure personnel in the immediate area are aware of any
potential hazards coming from the site.
• Monitor individual equipment items status, especially during
CBRNE incidents. Request additional equipment and
vehicles to meet the needs of incident site security
personnel for sustained operations through the recovery
phase.
• Request augmentation support from the EOC Director; e.g.
Installation commander approval needed to obtain non-
emergency responder personnel support to maintain
incident site perimeter/cordon security.
• Monitor safe routes and advise emergency responders of
recommended/needed changes to those routes.
• Coordinate installation entry requests with appropriate
control centers, agencies, and ESFs.
• Strategically plan for future phases.
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Table B-1. Sample ESF Manager Roles (continued)
ESF
Name
ESF Manager Roles
No. 14
Long-term
• Conduct a social and economic community impact
community
assessment.
recovery and
• Recommend long-term community recovery assistance to
mitigation
states, local governments, and private organizations and
individuals that reside on the installation or are affected by
an installation related disaster.
• Conduct mitigation analysis and program implementation.
• Alert and notify a SJA EOC representative to proceed to the
incident site or designated assembly point and report to the
IC.
• Determine whether claims should be activated.
• Provide advice and assistance to the installation
commander, EOC, IC, and ICP members (as appropriate)
on all legal issues arising from incident and the response,
including issues associated with establishing an NDA;
providing military support to civil authorities; and providing
support to civil authorities.
• Provide advice and assistance to responding security
forces, as appropriate, including advice on chain of
custody/evidence preservation issues.
• If claims teams are mobilized, prepare estimates of
damage and injuries, dollar estimates of third party-damage
(if possible), Report the status of funds available at the
installation, and determine potential need for advance
payment and additional JA manning.
• If appropriate, establish a temporary claims office in
proximity to the incident site and advertise the location,
operating hours, and availability of advance payments.
• Strategically plan for future phases.
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B-5
Table B-1. Sample ESF Manager Roles (continued)
ESF
Name
ESF Manager Roles
No. 15
External affairs
• Coordinate with Installation Operations Center (IOC) or
Emergency Operations Center (EOC), ICP, and IC for
probable timing and location of the establishment of the
public information facility.
• Activate the press center, as directed by the EOC Director
or Installation Commander. Coordinate installation access.
• Ensure Public Affairs representation at the Joint Information
Center, if established.
• Coordinate liaison with media representatives to provide
accreditation, mess facilities, billeting, transportation, and
escorts, as authorized and appropriate.
• Ensure PA liaison and spokesperson is available to the
Incident Commander in order to respond to public requests
for information.
• Coordinate media access regarding the incident.
• Coordinate and monitor movement of news media
personnel ensuring press passes, escorts, etc. are
available.
• Coordinate media requests for photographs, interviews,
and biographical and other data.
• Answer community concerns and deal with the news media
at the incident site. Recommend and coordinate an
emergency information line/rumor control line.
• Prepare, coordinate, and disseminate public information
alerts.
• Ensure information for public dissemination is reviewed for
compliance with security and policy requirements.
• Coordinate all public information drafts with the installation
commander or the commander’s designated representative.
• Obtain approval from the installation commander for news
releases; the release of photographs of suspects, victims,
and the immediate scene; interviews with anyone other
than the commander; and direct communication with press
personnel and suspects.
• Make news release(s) available.
• Report the facts concerning the CBRN incident/attack, the
government investigation, apprehension of terrorists,
recovery operations, and other stories of interest to the
public, as appropriate.
• Strategically plan for future phases.
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Appendix C
INSTALLATION CBRN CHECKLISTS
1.
Background.
This appendix addresses two areas. First, installation CBRN checklists and the
described actions are provided. The checklists support furnishing an integrated,
cross-functional response. Second, this appendix describes representative coordination
and information activities that should occur between the installation and tenant and
transient units on an installation.
2.
Checklists
The CBRN checklists are separated into the following categories:
•
Planning and Preparing (see Table C-1). The planning and preparing
checklists are combined into one table, as planning and preparatory
actions overlap.
•
Response (see Table C-2, page C-4).
•
Recovery (see Table C-3, page C-6).
Table C-1. Planning and Preparatory Actions
Individuals
Attend Level I AT training course and ensure that accompanying dependents 14 years or older
attend course prior to leaving CONUS.
Train to proficiency on all individual CBRN protection tasks.
Leaders (All)
Attend Level II/III AT training course, as appropriate.
Ensure personnel immunizations are up-to-date.
Reinforce individual CBRN survival tasks through continuous training.
Collective (Unit, Team, or Cell)
Participate in CBRN emergency response exercises.
Prepare and maintain personnel, equipment, and supplies fully capable of performing required tasks
associated with CBRN/TIM event activities.
Identify CBRN response augmentees in the unit/team/cell by name and have them participate in
exercises with the supporting element, as required.
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C-1
Table C-1. Planning and Preparatory Actions (continued)
Installation Commander
Attend Level III/IV AT training course, as appropriate.
Ensure that responsibilities, resources, and requirements are identified for a successful installation
CBRN emergency response plan. Review the CBRN emergency response program and plans at
least annually to ensure compliance with standards.
Ensure that the installation CBRN emergency response plan addresses security and/or possible
evacuation of DOD personnel and their dependents.
Authorize and direct an evaluation of the CBRN response program to be conducted in order to
establish a baseline for the installation. Ensure that the evaluation identifies equipment, personnel,
training, exercise requirements, and MAAs needed to coordinate additional response capabilities
from local/state/federal/HN organizations
Ensure that a CBRN exercise is conducted annually using realistic CBRN scenarios to validate the
CBRN emergency response plan.
Designate an emergency disaster planning officer with CBRN emergency response program
management responsibilities.
Align installation exercise and training schedules with local/state/federal/HN CBRN exercises.
Coordinate CBRN emergency efforts on the installation with local/state/federal/HN emergency
responders to ensure interoperability.
Direct and ensure that a viable health protection program is established, equipped, and trained.
Direct and ensure that MOAs are coordinated with local/state/federal/HN authorities and that
cohesive working relationships are established and maintained through training and sharing of
information.
Review MOAs annually to ensure that local/state/federal/HN sufficiency exists in meeting agreed-
upon installation emergency response needs.
Review SOFAs and other international agreements affecting CBRN responses and
local/state/federal/HN emergency response capabilities.
Installation IOC/EOC Director
Ensure that the installation CBRN emergency response CONOPS includes the establishment of an
ICS.
Determine a primary and backup location for the IOC/EOC. Incorporate collective protection
systems in facility.
Identify primary and alternate IOC/EOC personnel.
Establish operating procedures for the IOC/EOC, including duties and responsibilities of staff,
communication, reports, and timelines for notification to higher HQ.
Establish and maintain current emergency response notification rosters, including rosters of all off-
post response agencies. Brief the installation commander on all changes to the rosters.
Establish and ensure the implementation of automated CBRNWRS using preformatted or
preaddressed messages for local/state/federal/HN reports. Ensure that personnel are trained on
CBRNWRS and networks.
Develop a CBRN emergency response plan that integrates facilities, equipment, training, personnel,
and procedures for crisis management and response operations into a comprehensive effort
designed to provide the appropriate protection to personnel and critical missions on the installation.
Develop a system for rapid distribution of available CBRN/TIM escape masks to all personnel
(military, civilian, dependent) on the installation.
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Table C-1. Planning and Preparatory Actions (continued)
Installation IOC/EOC Director
Integrate response functions into the CBRN emergency response plan, including preparedness,
public affairs, legal counsel, public works and safety, chaplain services, mortuary affairs, and
resource management.
Utilize the most current TIC information from ITF-25 and ITF-40 and site surveys to determine
installation priorities for protection from TIM.
Annually identify the full range of known or estimated terrorist capabilities and the possibility of
nonhostile incidents for use in conducting VAs and planning countermeasures.
Examine the CBRN emergency response programs and assess written plans and programs
designed to support preincident planning, emergency response, medical needs, equipment, law
enforcement, training, intelligence support, security, and postincident response.
Examine the availability of resources to support plans as written and the frequency and extent to
which CBRN emergency response programs have been exercised. The assessment should
determine the status of formal and informal agreements with supporting organizations using an
MOU, MOA, inter-service support agreement, host-tenant support agreement, etc.
CBRN VAs should address the IOC, fire and emergency services, medical services,
CBRN/HAZMAT team, law enforcement and security personnel, and bomb technicians.
Ensure that CBRN VA includes an inventory of assets on the installation and resources available
through mutual-aid assistance with outside communities.
Include participants from all emergency-response functions on the installation and whenever
possible, appropriate local/state/federal/HN organizations in exercises.
Incorporate lessons learned from installation emergency response CBRN exercises into the overall
installation FP plans.
Identify responsibilities, resources, and requirements needed for successful execution of the
installation CBRN emergency response program and integrate these into the plan.
Collect and prioritize installation CBRN emergency response resource requirements for the POM
submission.
IOC/EOC CBRN Cell
Coordinate storage, issue, movement, and maintenance of installation CBRN equipment and
supplies.
Conduct periodic inventories of CBRN response equipment.
Ensure that installation emergency response equipment is interoperable with equipment used by
local/state/federal/HN mutual-aid partners according to DODI 2000.18, whenever possible.
Ensure that a personnel identification and accountability system is established for all response
teams to operating at the incident site.
Monitor CBRN/perimeter surveillance devices according to the installation emergency response
plan.
Incident Commander/On-Scene Commander
Attend the IC course.
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Table C-2. Response Actions
Individuals
Watch for CBRN attack indicators.
Minimize skin exposure.
Proceed immediately to designated shelters and/or assume and maintain MOPP as directed.
Check self/assets for contamination.
Report in for personnel accountability.
Listen for instructions.
Operationally decontaminate self/assets.
Leaders (All)
Disseminate threat and emergency action information, protective measures, and other incident
information.
Direct the covering of mission-essential equipment.
Protect facilities by closing all windows and outside air intake, turning off ventilation systems, etc. at
the time of attack and implementing single-entry procedures.
Maintain a log of events to document emergency response actions.
Collective (Unit, Team, or Cell)
Initiate personal protection and accountability measures.
Assemble and dispatch unit personnel, as required.
Installation Commander
Initiate increased FPCONs, as necessary.
Monitor all on-scene actions.
Ensure that local/state/federal/HN officials are notified and updated as the situation requires.
Determine if a public health emergency exists on the installation, based on information provided by
the PHEO. If it does determine whether the emergency powers listed in paragraphs 4.6. and 4.7.,
DODD 6200.3, should be implemented.
Decide if and when evacuation of installation facilities is appropriate.
Authorize requests for augmentation, as necessary.
IOC/EOC/CBRN Cell
Activate the IOC/EOC alert procedures and installation alert rosters and recall procedures for the
various emergency response teams.
Set up an incident information center for coordination.
Establish and maintain communications with the IC and other responders.
Obtain the initial report from responders and determine the location of the incident.
Track and plot initial incident information on an installation map.
Integrate information from CBRN/HAZMAT team, medical, security, and intelligence assets.
Track and maintain the status of the situation, including record event casualty summary, damage
summary, weather status, evacuation status, area closing status, shelter facility status, resources or
equipment status, medical facility (base and local) bed availability, and the status of response to
contracts or agreements for services.
Activate the installation warning systems. Notify the base populace by emergency alert system or
MARS, radio or television, mass notification systems within buildings, the ‘Big Voice’ outdoor sirens,
or other predetermined means in order to direct proper procedures to avoid the incident site (by
either evacuating or SIP).
Establish and maintain communication links with higher, lateral, and lower elements.
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Table C-2. Response Actions (continued)
IOC/EOC/CBRN Cell
Activate appropriate elements of the MAAs and monitor augmentation from civilian and military
forces.
Notify the appropriate EOD control center of the need for EOD support, if required. Coordinate with
the transportation representative to provide movement of EOD personnel with special EOD tools
and equipment to the incident site by the most rapid transportation mode available, to include
military and commercial charter aircraft.
Receive and send orders, information, reports, and requests pertinent to the incident to subordinate
commands/agencies, higher HQ, and outside civilian agencies. Serve as the central tasking office
for all internal and external taskings regarding the incident.
Issue changes to the FPCON level as directed by the IC.
Maintain an incident log.
Continuously monitor with CBRN/perimeter surveillance devices according to the installation
emergency response plan.
Provide COP to the installation commander, IC, other installation offices, and local/state/federal/HN
agencies, as required.
Track response assets and effectively manage resources.
Request additional resources to support response through recovery, as necessary.
Incident Commander/On-Scene Commander
Locate and assess the incident site.
Assume command of on-scene operations and perform IC duties until relieved of duties (after
security and response forces have neutralized all hostile force terrorist activity).
Establish assembly areas for the incident response team members in a controlled environment and
ensure that initial preparation of the incident and team-leading procedures are conducted.
Mark contaminated areas to prevent casualties and the spread of the hazard.
Determine the initial cordon size, based on the type and quantity of material involved at the incident.
Identify safe routes for follow-on forces
Assemble and account for all incident response team members and augmentees.
Establish and ensure that all responders operating in the contaminated areas have the appropriate
protective clothing and equipment available and are trained and medically cleared to respond.
Notify all nonessential personnel to evacuate from the incident site.
Ensure that personnel working at the incident site understand all safety procedures for work-rest
regimes and protective measures against climatic conditions. Ensure that personnel have adequate
food and water and are aware of the location and use of sanitary facilities.
Ensure that comprehensive control, decontamination, and medical intervention activities are in place
prior to any response team entry into the contaminated area.
Advise team members to look out for secondary devices such as IEDs/booby traps.
Determine if the incident is a crime scene and initiate procedures to preserve evidence, if required.
Establish initial hot, warm, and cold zones.
Conduct contaminated casualty extraction, in coordination with installation fire and emergency
services. Provide triage and emergency medical service, if required.
Search for secondary devices in coordination with EOD.
Detect CBRN hazards.
Identify the CB agent.
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C-5
Table C-2. Response Actions (continued)
Incident Commander/On-Scene Commander
Collect aerosol, environmental, plant/animal, and medical samples.
Prepare and forward samples to the laboratory for further analysis and identification.
Establish exposure limits and stay times in the area for wearing protective equipment based on
agent type, concentration (if known), and ambient temperature. Rotate personnel based on
exposure levels and stay times.
Conduct a survey to analyze agent transfer and spread.
Submit incident SITREPs to IOC/EOC.
Maintain continuous communication with the IOC/EOC and provide updates as the situation
changes.
Transfer control of the site to the lead agency, as directed. Provide a detailed SITREP to include
the product released, operations taken or in progress, call signs, all resources on site, additional
resources on call or enroute, and any other considerations.
Ensure the control and protection of classified material.
Keep detailed records of decisions and events.
Accurately record HAZMAT exposure for personnel. Keeping accurate records enables the tracking
of long-term health effects on those exposed to HAZMAT.
Coordinate support from additional response elements through higher HQ.
Coordinate with augmentee personnel, follow-on elements, and others who will provide support at
the incident site.
Coordinate with the relieving IC when he arrives at the incident scene. Brief the new IC on the
situation, including the organization under IC control.
Table C-3. Recovery Actions
Individuals
Avoid potentially contaminated surfaces and areas.
Obtain and report observations and evidence of an attack.
Provide input, as required, to incident AARs.
Return IPE to a ready status in anticipation of another attack.
Leaders (All)
Ensure that unmasking procedures are carried out according to the SOP.
Monitor personnel for unusual physical conditions or symptoms.
Document exposures.
Collective (Unit, Team, or Cell)
Ensure that personnel, equipment, and supplies are prepared to perform required tasks associated
with another CBRN/TIM event.
Develop and provide input to incident lessons learned/AARs.
Installation Commander
Oversee recovery operations on the installation.
Review and approve necessary reports following the incident, including lessons learned and AARs.
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Table C-3. Recovery Actions (continued)
Installation IOC/EOC/CBRN Cell
Coordinate activities of follow-on elements.
Monitor recovery operations and support the needs of the installation commander.
Coordinate input to the incident lessons learned/AAR.
Write the installation AAR based on input from various functional areas.
Incident Commander/On Scene Commander
Assess the incident site for any remaining hazards and determine the mitigation actions needed.
Advise the IOC/EOC and installation commander.
Provide HAZMAT support to the IOC/IC through recovery.
Develop and provide input to incident AARs.
Individuals
Report unusual physical conditions or symptoms.
Leaders (All)
Monitor personnel for unusual physical conditions or symptoms.
Document exposures.
Collective (Unit, Team, or Cell)
Reconstitute unit/team/cell personnel, equipment, and supplies until fully capable to perform the
required tasks associated with CBRN/TIM event activities.
Installation Commander
Oversee recovery and reconstitution operations on the installation.
IOC/EOC CBRN Cell
Ensure that installation emergency response equipment is decontaminated or replaced.
Ensure that CBRN filters are replaced after exposure.
3.
Installation Tenant and Transient Unit Coordination
Maintaining effective coordination and liaison between the installation, tenant,
and transient units is the responsibility of all those concerned. This appendix addresses
a representative list of information and coordination measures that a tenant or
transient unit should share with an installation on a mutual basis.
a.
Common Considerations. Adequate preparation and coordination is key
to the success of the liaison and coordination activity between the installation and a
tenant or transient unit. Coordination must be an integral part of the planning process,
and the tenant and transient units must fully understand the installation commander’s
emergency response plan. Common understandings between the installation
commander and tenant and transient units include the following:
(1)
Understanding each mission, the coordination and liaison
functions, the commander’s expectations, and the specific responsibilities between
various organizations on the installation.
(2)
Becoming familiar with potential issues of the installation (e.g.,
shortage of first responder resources), including specific issues and CBRN information
requirements for the installation staff.
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C-7
(3)
Knowing the current installation situation (e.g., threat level,
CBRN VA, and emergency response capabilities), including the respective
organizational commander’s intent, commander’s critical information requirements
(CCIRs), and the commander’s CONOPS.
(4)
Coordinating with each other to determine if there are any special
requirements, including CBRN equipment, operations security (OPSEC) applicable to
the mission, arrangements for communications and transportation, credentials for
identification, appropriate security clearances or documents, or any peculiar
requirements (language, interpreter, customs, etc.) associated with multinational units,
if applicable.
(5)
Understanding the communications connectivity and software
requirements for CBRN warning and reporting.
(6)
Becoming familiar with capabilities, the emergency response plan,
and SOPs.
(7)
Exchanging information on national customs and procedures, if an
assignment requires becoming a tenant or transient on an allied HQ installation.
(8)
Preparing command-specific capabilities and limitations briefings
(including such topics as combat readiness factors, personnel strengths, logistics
considerations, and map overlays) for mutual presentation.
b.
Installation Coordination With a Tenant or Transient Unit. Upon arrival
at an installation, the tenant or transient unit CBRN representative should proceed to
the HN OPCEN. Specific coordination measures and information exchange that the
installation should provide to the tenant or transient unit may include operational,
intelligence, and logistics information (see Figure C-1).
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•
Reviewing during- and postattack actions, checklists, plans, and concepts, such as—
9 Postattack reconnaissance.
9 Installation sector/control zones, boundaries, and transition point locations.
9 Decontamination points and tenant/transient unit responsibilities.
9 Contamination avoidance checklist items, such as sheltering locations for equipment.
9 Contamination control areas and TFAs.
9 FHP actions (e.g., patient decontamination responsibilities).
9 Casualty handling.
9 The processing of contaminated remains and hazardous wastes.
9 The replacement of personnel.
•
Reviewing the implement blackout procedures for areas, sectors, facilities, buildings, airfields, vehicles,
flashlights, aircraft, weapons systems, etc.
•
Reviewing quarantine, ROM, and isolation plans.
•
Planning for the integrated use of CBRN reconnaissance, surveillance, and monitoring assets, to include
detectors and detector teams.
•
Planning for integrated dispersal or sheltering of critical equipment and vehicles, such as—
9
Aircraft and weapons systems.
9
Maintenance equipment.
9
Fire and crash vehicles and systems.
9
Base recovery equipment and systems.
9
Security equipment, vehicles, and systems.
9
Casualty and patient care medical equipment.
9
Fuel trucks.
9
Munitions trailers.
9
Generators.
9
Special-purpose vehicles.
9
CBRN reconnaissance team vehicles.
9
EOD vehicles.
9
Ambulances.
Figure C-1. Sample Installation-Level CBRN Coordination With a Tenant
or Transient Unit
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C-9
•
Reviewing the plan for Dispersal or sheltering of personnel, to include—
9 Leadership.
9 Intelligence support.
9 Installation recovery teams (EOD, medical, CBRN reconnaissance, damage assessment, etc.).
9 Security teams.
•
Identifying installation actions with respect to dispersal, issue, or shelter-critical supplies, to include—
9 Food.
9
Water.
9
Medicine, CBRN pretreatment drugs, prophylaxis medications, antidotes, and other medical supplies, as
directed.
9
CBRN prophylaxis, as directed.
•
Providing information on the installation’s exposure control systems.
•
Providing guidance on when to administer pretreatments, prophylaxis, and antidotes.
•
Providing information on what resources (if available) can be allocated for protecting and hardening CBRN C2
centers, CCAs, and sites where CBRN assets have been dispersed.
•
Providing information on the installation’s cover, concealment, and deceptions operations, as required, to
include—
9 Smoke and obscuration.
9 Camouflage netting.
9 Decoys.
9 Radar reflectors.
9 Other systems and methods.
Figure C-1. Sample Installation-Level CBRN Coordination With a Tenant
or Transient Unit (continued)
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•
Allocating resources to support hardening or splinter-protect vital assets using steel bin revetments,
sandbags, earth berms, concrete revetments, or other expedient methods, to include—
9
C4I systems, operations, and centers.
9
COLPRO facilities.
9
Utility generation and distribution systems.
9
War reserve materiel.
9
POL storage and distribution points.
9
Munitions storage, assembly, and loading assets and centers.
9
Supply storage.
9
Medical facilities.
9
CCAs.
•
Providing assistance, if required, on inspecting all CBRN equipment, such as—
9
CBRN detection and COLPRO systems.
9
IPE.
9
Decontamination.
9
CCAs and contamination avoidance gear.
•
Providing information on the MOPP guidance (e.g., should MOPP gear be immediately available?).
•
Briefing units on CCA and casualty collection point locations.
•
Briefing units on contaminated waste disposal locations according to applicable environmental
considerations and procedures.
•
Briefing units on preparing shelters and COLPRO facilities for occupancy and operations.
•
Briefing units on reporting shelter status (stocking, number of personnel, and problems) to command
centers
•
Providing information on duress codes, if applicable.
•
Providing guidance on pre-positioning CBRN detection equipment and activating detection systems, such
as—
9
M8 paper on facilities, vehicles, revetments, bunkers, defensive fighting positions, etc.
9
M9 tape on chemical-protective overgarments.
9
Detector kits at designated locations (with designated teams).
9
Other CB detection equipment at designated locations.
Figure C-1. Sample Installation-Level CBRN Coordination With a Tenant
or Transient Unit (continued)
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C-11
•
Implementing exposure control systems.
•
Identifying CBRN defense required capabilities for assigned missions.
•
Preparing sample evacuation plans.
•
Exercising contingency plans.
•
Determining the locations of all known nuclear facilities and radioisotope resources (e.g., hospitals and
clinics with nuclear medicine capabilities and industries with isotopic weld-testing sources).
•
Determining the locations of hospitals, clinics, and MTFs.
•
Determining what radiation detection equipment is within the AO and to whom it belongs (commercial
vendor, government, government agency, or HN).
•
Determining the distribution of military radiation measuring instruments to deploying units.
•
Determining the disposition of specialized radiation survey teams; identifying the contractual expertise
available to negotiate any required civil medical or technical support.
•
Determining if friendly or enemy equipment and ammunition containing DU or other radioactive
materials are likely to be present.
•
Determining the locations and functions of high-priority TIM facilities and associated chemical product
lines and storage.
9
What are the operational levels, security, and infrastructure associated with these TIM facilities.
9
What storage volumes are associated with these TIM facilities?
9
What possible or potential environmental contamination exists?
9
What hydrological, MET, and topographical geospatial data exist for these facilities?
•
Determining the local hazard management procedures and identifying civilian agencies responsible for
handling incidents.
•
Determining what local hazard identification labeling and placarding systems exist.
•
Determining the status of the distribution of military CBRN detection equipment to deploying units.
•
Determining the disposition of specialized CBRN and TIM reconnaissance teams and equipment.
•
Determining the disposition of IPE and CPE.
•
Identifying the need for special or modified CBRN or TIM detection equipment or protective
equipment.
Figure C-1. Sample Installation-Level CBRN Coordination With a Tenant
or Transient Unit (continued)
c.
Tenant or Transient Unit Coordination With the Host Installation. Upon
arrival at an installation, the tenant or transient unit CBRN representative should
proceed to the host installation OPCEN. Specific coordination measures and
information exchange that the tenant or transient unit should provide to the
installation may include operational, intelligence, and/or logistics information. See
Figure C-2.
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6 November 2007
•
Providing information and status on the unit CBRN defense capabilities and functions to include—
9
Available equipment and supplies that could have a dual-purpose capability (e.g., pumps) and
could be used for CBRN defense.
9
Personnel resources.
9
Specialist personnel (e.g., CBRN specialists).
9
Decontamination capability.
9
CBRN reconnaissance capability.
9
Biological defense (detection, protection, and decontamination) capabilities.
9
Medical capabilities (prophylaxis and support).
9
Engineer capabilities (equipment).
9
Individual protection capabilities.
9
Collective protection capabilities.
9
Fire fighting and specialized emergency support.
9
Unit mobility status.
•
Providing information on the ability of unit communications to integrate with the installation CBRNWRS.
•
Providing information on the unit mission and schedule (e.g., how long will the unit be at the host
installation).
•
Providing information on the unit emergency response plan.
•
Providing information on unit POCs and functions.
•
Providing information on security capabilities.
•
Providing information on mass-casualty management capabilities.
•
Providing information on response-time ability (e.g., ability to respond with an emergency team).
•
Providing information on the unit’s ability to contribute resources to the installation emergency response
plan.
•
Identifying unique service tactics, techniques or procedures that will require familiarization training for
tenant or transient unit personnel from the host installation.
Figure C-2. Tenant or Transient Unit Level CBRN Coordination With an Installation
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Appendix D
FORCE HEALTH PROTECTION CAPABILITIES, RESTRICTIONS,
AND CONSIDERATIONS
1.
Background
FHP at installations may be provided by an MTF established in permanent
structures (garrison-type organizations, ports, and airfields) or deployable FHP units.
At CONUS locations, the primary source of FHP is the garrison organization with
deployable FHP units assisting. At OCONUS locations, a combination of deployable
units and garrison organizations serves as the primary FHP provider.
2.
Preventive Medicine and Public Health Services
Preventive medicine (PVNTMED), public health services and other specialized
teams, perform a variety of tasks in support of CBRN defense of installations. personnel
perform a variety of tasks in support of CBRN defense of installations. In some cases,
PVNTMED and public health services personnel may be requested to collect
environmental samples for identification of CBRN contamination or risk assessment. In
such cases, presumptive identification procedures are conducted by the collectors or by a
designated laboratory. Chain of custody is established for the samples and the samples
are forwarded by courier to the supporting laboratory. See Multiservice Tactics,
Techniques, and Procedures for Chemical, biological, radiological, and nuclear (CBRN)
Reconnaissance, Multiservice Tactics, Techniques, and Procedures for Biological
Surveillance, FM 4-02.7, and FM 4-02.17 for detailed information. In cases where other
groups/personnel are designated to obtain CBRN samples, PVNTMED/public health
services personnel must be coordinated with it, in order to ensure that medical and
OEH requirements are met. This includes involvements in final clearance level decision-
making. The following describe key tasks that are direct medical and OEH
responsibilities of PVNTMED/public health services.
a.
Medical Surveillance. Medical surveillance is the ongoing daily
systematic collection, analysis, and interpretation of data derived from instances of
medical care or medical evaluation and the reporting of population-based information
for characterizing and countering threats to a population’s health, well being, and
performance. Preattack/pre-event medical surveillance data collected provides a
baseline for disease and nonbattle injury (DNBI) rates for the area. This baseline data
provides essential information concerning which diseases are endemic to the area and
the expected rates of illnesses. This can help medical personnel rule out endemic disease
from diseases caused by an intentional BW event or determine whether increased rates
of illness might be associated with chemical or radiological exposures. After an
attack/event, or when a spike in illness above the baseline occurs, PVNTMED/public
health services personnel must begin collecting data on: the numbers, signs, and
symptoms of affected and unaffected persons; the possible source of the illness; and the
movement of personnel. They analyze the data and prepare recommendations about
how the commander can best reduce the effects of the attack/event and prevent new
casualties. See DODD 6490.2 and DODI 6490.3 for medical surveillance requirements.
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See JP 4-02 and FM 4-02.17 for detailed information regarding the conduct of medical
surveillance activities.
b.
Occupational and Environmental Health (OEH) Surveillance. OEH
surveillance is the regular or repeated collection, analysis, archiving, interpretation,
and dissemination of OEH-related data for monitoring the health of, or potential health
hazard impact on, a population and individual personnel, and for intervening in a
timely manner to prevent, treat, or control the occurrence of disease or injury, when
necessary. Collection of OEH data on service members potentially exposed to CBRN
agents/weapons is required for ensuring their continued care for post-exposure illnesses.
Specifically, this includes documentation of the levels/durations of (unprotected)
exposure to the specific CBRN hazard as well as any other existing hazards associated
with are pollution or occupational exposures. Determination of baseline data regarding
environmental pollution and unique occupational exposure should be coordinated
through environmental or industrial hygiene personnel. If civilians are exposed to the
agent/weapon at the site, similar documentation is necessary to ensure their medical
needs are identified. See DODD 4715.1E, and DODI 6055.1 for OEH surveillance
requirements and FM 4-02.17 for detailed information on the conduct of the OEH
program. See DJSM-0612-03, Memorandum on Improving Occupational Health
Surveillance (OEHS) Reporting and Archiving. Ensure that all significant action and
associated items (response, documentation) are completed according to JCS Memo,
MCM-0026-02 (Chemical Warfare Agent Exposure Planning Guidance) and JCS Memo,
MCM-0006-02 (Documentation). Ensure that ASTM standards are met for
environmental health surveillance assessments.
c.
Casualty Prevention. Personnel whose primary duty involves responding
in a CBRN environment should be issued the appropriate medical countermeasures.
Issue of medical countermeasures should be consistent with theater policy. Based on the
threat, nerve agent antidotes, blocking agents, vaccinations, and antibiotics can be
provided to personnel. FM 4-02.7 provides additional information.
d.
Water Surveillance. PVNTMED and public health services personnel
conduct surveillance of water supplies on a continuous basis before, during, and after a
CBRN event to ensure that the water is safe for consumption. Surveillance includes the
source, treatment, and distribution system. If CBRN contamination is found, samples
are collected, chain of custody is established, and the samples are forwarded by courier
to the supporting laboratory. Analyses may include water and ice samples. The water
production and treatment personnel are advised of the findings with recommendations
on how to best render the supply safe for use. See FM 4-02.7 and FM 4-02.17 for
additional information.
e.
Food Service Surveillance. Food-service surveillance (during and after a
CBRN event) is critical in ensuring that personnel have a safe food service facility and
food source. The facility must be thoroughly inspected for possible contamination.
Should contamination be found, veterinary personnel should be contacted for evaluation
of the food supplies and determination of food safety. The facility must be closed and
thoroughly decontaminated before proceeding to prepare and serve food to supported
personnel. See FM 4-02.7, FM 4-02.17, and FM 4-02.18.
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f.
Waste Disposal (Liquid and Solid) Monitoring. PVNTMED and public
health services personnel should ensure that wastes are properly collected, stored, and
disposed of to mitigate potential exposures and safety hazards to military or civilian
personnel. This may include making recommendations as to criteria for identifying
hazardous waste, should a CBRN event occur (see FM 4-02.7 and FM 4-02.17 for
additional information).
3.
Laboratory Support
Laboratory support for processing specimens and samples may come from a
variety of sources. Initial sample/specimen processing and presumptive identification
will normally be performed by sample/specimen collection personnel and laboratory
personnel near the incident site. The laboratory may be a DOD, local, regional, state,
HN, or coalition force facility. The use of the test results from these facilities (especially
HN and coalition force facilities) may be limited and they must be validated by a
nationally recognized reference laboratory (e.g. USAMRIID, CDC, NMRC) for
confirmatory identification and definitive characterization of the agent/material. The
presumptive identification and/or field confirmatory identification by supporting
laboratories provide leadership with valid information that can be used to initiate
protective, preventive, and initial casualty care procedures. However, definitive
identification and characterization may be required for forensic and retaliatory actions.
a.
Clinical Laboratory. MTF personnel collect appropriate clinical specimens
from affected and suspected personnel for laboratory testing. The organic clinical
laboratory within Services’ hospitals may be capable of performing presumptive
identification or field confirmatory identification, if laboratory equipment is available
(i.e., JBAIDS). Chain of custody is initiated by MTF personnel, and the specimens are
referred to reference (confirmatory) laboratories for confirmatory testing. If required,
reference laboratories will send isolates to LRN national laboratories for definitive
(forensic) characterization. Clinical laboratories are not designed to be testing sites for
environmental samples. Generally, public health laboratories are the preferred locations
for environmental testing.
b.
Laboratory Response Network (LRN). The LRN is a multilevel system, in
CONUS and some OCONUS laboratories, that is designed to link front-line hospital and
state public health microbiology labs with federal and military reference labs supporting
advanced capabilities in testing human, veterinary, food, and environmental samples.
Medical labs participating in the LRN employ common SOPs and reagents to process
and identify potential BW threat agents. Upon obtaining a presumptive identification,
clinical laboratories at community hospitals, referred to as LRN Sentinel labs, refer
presumptively identified isolates to LRN reference laboratories for confirmatory
identification. Upon confirmation of the identification at LRN reference labs, the
samples/specimens may then be referred to LRN national laboratories for forensic
testing and definitive characterization. The Food Emergency Response Network
(FERN), which has a similar multilevel system as LRN, tests food and bottled water for
CBRN threats.
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D-3
c.
Other Non-DOD Laboratories.
(1)
CDC. The CDC is a nationally-recognized reference laboratory
providing definitive identification of suspect biological agents. The CDC is available to
support installation leadership with a broad-spectrum of laboratory support.
(2)
HN. HN laboratory support may be provided through mutual
agreements. However, the level of laboratory support may be limited and the laboratory
personnel may not have up-to-date technology and training.
(3)
Coalition Force. Presumptive identification of possible CBRN
agents/material may be provided by coalition forces laboratory personnel. Again, their
level of training and status of their equipment may be limited.
d.
Other DOD Laboratories.
(1)
USAMRICD. USAMRICD can provide laboratory support for the
identification of chemical warfare (CW) agents from human specimens and technical
guidance on prevention, protection, and medical management of CW agent injuries.
(2)
AFRRI. AFRRI can provide technical and laboratory support for
nuclear and radiological incidents or events. They can provide identification on the type
of radiological hazard that exists and provide recommendations on shielding, hazard
levels, and preventive measures. However, their laboratory support capabilities are very
limited.
(3)
Area Medical Laboratory (AML). The AML is a deployable USA
medical laboratory that can provide presumptive and confirmatory identification of
suspect CBRN agents/material. The AML has the capability to detect multiple
biomarkers in a suspect sample/specimen; thus, providing positive identification of the
agent. See FM 4-02.12 and FM 4-02.7 for more information.
(4)
USAMRIID. USAMRIID is the DODs highest national reference
laboratory for performing definitive identification of biological agents. USAMRIID can
also provide technical guidance on prevention, protection, and medical management of
BW agent injuries and infectious diseases.
(5)
US Army Center for Health Promotion and Preventive Medicine
(CHPPM). CHPPM can provide technical and laboratory support for TIC and provides
health risk assessment SME for CW, TIC, biological and radiological hazards on behalf
of the US Army Office of the Surgeon General. The website is http://www.chppm.com.
(6)
Navy Environmental and Preventive Medicine Unit (NEPMU).
The NEPMU and the Navy Disease Vector Ecology Control Center (NDVECC) are
strategically located at installations around the world to meet FHP requirements and to
perform confirmation identification of samples/specimens. Forward-Deployable
Preventive Medicine Units (FDPMUs) have deployable teams with the capability of
performing field confirmatory identification of samples/specimens.
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(7)
Navy Environmental Health Center (NEHC). The NEHC provides
functional oversight of the laboratory services associated with field activities.
(8)
NMRC. NMRC is a premier research organization that is one of
DOD’s nationally recognized reference laboratories that can provide definitive
identification of biological agents. The Biological Defense Research Directorate (BDRD)
of the NMRC serves as a national resource providing testing and analysis for the
presence of anthrax and other potential biological hazards.
(9)
USAF Institute for Occupational Health. USAF Institute for
Occupational Health (radiochemistry laboratory) can provide definitive identification of
radiological samples. The website for the radio-chemistry laboratory is:
(10)
USAF Bioenvironmental Engineer (BEE) Units. USAF
bioenvironmental engineer units can provide field confirmatory identification of CBR
agents.
(11)
USAF Biological Augmentation Team (BAT). The BAT can provide
commanders with field confirmatory identification with rapid, specific pathogen
identification.
(12)
Homeland Defense Laboratory Response Team (HLD-LRT). The
USAF’s HLD-LRT can provide rapid identification of potential biological agents. This
resource is available at select USAF bases in CONUS and their equipment and
protocols are similar to the BATs.
(13)
The DOD food Analysis and Diagnostic Laboratory (FADL) and
Veterinary Laboratory Europe. These laboratories have specific methodologies for
testing food, bottled water, and commercially procured ice; they can provide technical
and laboratory support in identification of pathogens, adulterants, and certain CBRN
agents. The FADL can provide laboratory support in identification of animal/zoonotic
diseases. These laboratories are accredited by the American Association for Laboratory
Accreditation; the FADL is a member of the FERN laboratory network. The FERN
website is http://vets.amedd.army.mil/vetlab.nsf.
4.
Veterinary Medical Care
The US Army Veterinary Corps, under the direction of the Secretary of the Army
and supervision of the Surgeon General of the Army, is the DOD executive agent for
veterinary service for all the Services. Under CBRN conditions, veterinary service
personnel will monitor food and bottled water for contamination (food safety and food
security); provide veterinary PVNTMED; and provide veterinary medical care for
government owned animals. For additional information regarding policies and
capabilities, refer to MEDCOM REG 40-28 and MEDCOM PAM 40-13. On USAF bases,
public health personnel perform food surveillance and bioenvironmental engineering
personnel perform sampling for health risk assessment. In USN operations, PVNTMED,
and other medical personnel may be required to perform food surveillance and sampling
operations. See FM 4-02.7 and FM 4-02.18 for additional information.
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D-5
a.
Food Safety and Food Security. Whether in garrison or in a deployed
environment, constant protection of food supplies is critical to the operation. Veterinary
personnel monitor the food (including food-producing animals) for possible CBRN
contamination and provide recommendations on how to best decontaminate it or if it
must be destroyed. The operational commander has the ultimate responsibility for
deciding if the food will be decontaminated or destroyed using risk assessments
described in paragraph 3-10, FM 4-02.18.
b.
Veterinary Medical Care. The CBRN environment may limit the level of
care that can be provided for government owned animals. Veterinary personnel must
locate an area outside the contaminated environment to provide essential care and
decontamination. Veterinary personnel may also be called upon to provide care to
privately owned pets and food-producing animals.
c.
Veterinary PVNTMED. Veterinary personnel are responsible for
performing investigations of unexplained animal deaths to include livestock and
wildlife. They also monitor and evaluate safety of animals exposed to CBRN agents or
TIM. Samples and specimens collected from animals will be forwarded to a supporting
laboratory for testing; however, the veterinary unit may posses some organic testing
capabilities for presumptive identification. In addition, the disposition of dead animals
found on a military installation is an installation engineering directorate responsibility
and is accomplished according to local policy and directives. Federal, state, and local
health hazard standards, including environmental restrictions regarding the animal’s
disposal, will be the minimum standards.
5.
Mass Casualty Management
Mass casualty (MASCAL) management requires greater numbers of medical
treatment personnel to provide emergency care. A MASCAL situation exists when the
number of patients requiring care exceeds the capabilities of available medical
personnel or resources. In either situation the medical responders must make snap
decisions on how to best manage the casualties to provide the best care for the greatest
number. When the casualties do not have PPE, they must be removed from the
contaminated area as quickly as possible. This must be balanced with a realization that
failure to decontaminate the patient could potentially expand the area of contamination
exponentially.
a.
On-Scene Initial Treatment.
(1)
Initial treatment for a MASCAL situation at the incident scene
requires triage procedures be performed rapidly to determine if patients require
emergency medical treatment before decontamination or if they can survive
decontamination before receiving treatment. Patients should be medically stable before
undergoing patient thorough decontamination; those not wearing MOPP ensemble may
have a greater exposure to the agent and may require more medical attention. Medical
care before decontamination might consist of emergency treatment to control
hemorrhage or restore breathing, which could include the administration of antidotes
(see FM 4-02.7, FM 4-02.33, FM 4-02.283, FM 8-284, FM 8-500, and ERG 2004 for
detailed information on treatment procedures). All patients must be monitored and
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provided care during the decontamination process to ensure that no further injury is
caused by the decontamination process.
(2)
The on-scene initial treatment for deployed forces or on a military
installation is provided by the organic or supporting FHP personnel. On-scene initial
treatment is usually provided by local, state, or federal medical responders at incidents
off the installation. When an MOU is in place FHP personnel may provide the initial
treatment for off installation incidents.
b.
Patient Movement. Patient movement in a tactical situation is managed
by the supporting FHP organizations. In a MASCAL situation involving civilian
casualties, local civilian authorities normally manage patient movement operations.
Patient movement on an installation is managed by EMS. See JP 4-02, FM 4-02.7, FM
8-10-6, FM 8-500, ERG 2004, and service/local command guidance for specific patient
movement procedures.
6.
Casualty Collection Points
Casualty collection points are established on the downwind side of the incident
area and at the periphery of the warm zone. Medical personnel are located in these
areas to begin triage and EMT to stabilize the patient for gross decontamination.
7.
Medical Evacuation
One of the first considerations following a CBRN attack is to determine to what
extent evacuation assets will be committed to contaminated areas. If personnel are to be
sent into contaminated areas to evacuate casualties, some type of exposure guide must
be established and followed. Every effort should be made to limit the number of assets
and people that become contaminated, to include protecting medical personnel and
evacuation crews from exposure to CBRN agents as much as possible.
a.
Medical Evacuation. This is the process of moving patients from the point
of injury to an MTF, or between two MTFs using vehicles, aircraft, or watercraft that
are designed and staffed for this purpose. As a general rule, the unit will decontaminate
casualties before they are presented to the MTF or entered into the aeromedical
evacuation systems. Medical evacuation differs from casualty transportation in that en
route care is provided during medical evacuation. See JP 4-02, FM 8-10.6, and FM 4-
02.7 for detailed information.
b.
Nonmedical Vehicles With En Route Care. When the number of patients
exceeds the capabilities of supporting ambulances, nonmedical vehicles (e.g., flat bed
trucks, school buses, public transit buses, helicopters, and private boats) may be
employed for patient evacuation purposes. Medical personnel provide en route care to
the patients. However, the level of care that can be provided may be limited due to the
way patients are loaded onto the vehicle. See JP-4.02 and FM 8-10.6 for additional
information.
c.
Transportation Without En Route Care. When patient movement needs
cannot be met with medical and nonmedical evacuation vehicles equipped with en route
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D-7
care, patients may be transported on any vehicle of convenience. See FM 8-10.6 for
additional information.
d.
Preparation of the Patient for Evacuation. Preparation of the patient
should include initial emergency treatment and decontamination/removal of gross
contamination. In the battle area, those in MOPP should remain in their protective
ensemble which can be grossly decontaminated (patient operational decontamination)
before they are loaded on to “dirty” evacuation assets for movement to a facility that has
adequate resources to perform a thorough decontamination. Previously decontaminated
patients, who are no longer wearing MOPP, must be protected from contaminated
patients through the use of a patient protective wrap (PPW). In a civilian setting gross
decontamination assets may travel to the casualty collection point where patients will
have clothing removed and skin decontaminated before being loaded onto evacuation
vehicles. See FM 4-02.7 and Multiservice Tactics, Techniques, and Procedures for CBRN
Decontamination for detailed information.
e.
Preparation of the Medical Evacuation Vehicle. When contaminated
patients are to be evacuated, the vehicle should be prepared for the mission.
Preparation may include placement of plastic sheeting or blankets, under the litters to
keep liquid and solid contamination off the inside of the vehicle. Also, the crew must be
protected against the agent/material; they should be in the appropriate level of
MOPP/EPA PPE.
NOTE: Potentially contaminated evacuation assets should be marked in a
manner to indicate that they are dirty evacuation assets and the type of
contamination they may contain (e.g., chemical, biological, radiological).
These assets should only be used for incident response until decontaminated.
See Multiservice Tactics, Techniques, and Procedures for CBRN
Decontamination for additional information.
f.
Aeromedical Evacuation. Externally contaminated patients and those
infected with critical list agents will not be transported onboard AMC or AMC-procured
aircraft without first being decontaminated. AMC/CC is the waiver authority to this
policy. The transport of biologically contagious patients will need international
clearances to fly over some countries.
8.
Quarantine/Restriction of Movement
On an installation, restriction of movement procedures, including quarantine,
may be necessary to prevent or reduce person-to-person transmission of communicable
diseases following a BWA attack or a naturally occurring disease pandemic. The
command surgeon or medical treatment facility commander/PHEO recommends these
procedures. The installation commander directs their enforcement. The duration of such
controls is determined by the period of time that personnel remain contagious. See
DODD 6200.3, FM 4-02.33, and FM 8-284 for detailed information.
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9.
Patient and Medical Staff Protection
Essential to patient care is providing protection for patients and medical
personnel from the effects of CBRN agents.
a.
During the Evacuation. Patient protection during evacuation can be
provided by use of the vehicle onboard collective protection (COLPRO) system, MOPP,
the patient protective wrap, plastic sheeting, blankets, or other barrier material.
Selecting routes that do not require movement through the downwind hazard area is
also critical for crew and patient protection.
CAUTION
Do not place a contaminated patient into the Patient Protective Wrap (PPW) or other impermeable
material. To do this will create a vapor seal which will increase absorption of the vapors through the
contaminated patient’s skin. The PPW is designed to be a protective overgarment for the thoroughly
decontaminated patient who must be transported across a contaminated or potentially contaminated
environment.
b.
In the Hospital. Patient protection in fixed facilities without collective
protection systems/equipment requires innovative procedures. Expedient patient
protection may be provided by covering them with sheets, blankets, or plastic sheeting,
and providing forced airflow over their face. The forced airflow can reduce the amount of
chemical/biological agent that is inhaled.
c.
Medical Staff PPE. The MOPP ensemble is the standard IPE provided to
warfighters by theater combatant commanders in an operational environment.
However, when non-military first response and recovery operations are involved,
personnel must use federal OSHA levels of protection. When TIM are involved
(especially TIC), personnel may require OSHA Level A, B or C protective ensembles or
the use of National Institute for Occupational Safety and Health (NIOSH)-approved
respirator with appropriate filter. See DODI 6055.1, Multiservice Tactics, Techniques,
and Procedures for Chemical, biological, radiological, and nuclear Protection,
Multiservice Tactics, Techniques, and Procedures for Chemical, biological, radiological,
and nuclear Vulnerability Assessment, FM 3-11.24, FM 4-02.7, FM 8-500, and ERG 2004
for descriptions of MOPP and OSHA protective equipment and requirements.
10.
Combat and Operational Stress Control
Combat and operational stress control (COSC), also referred to as "mental health
services," is critical in managing the stress concerns/conditions of service members and
civilians that are affected by CBRN attacks/events (see FM 4-02.51).
a.
In garrison, the primary care/response to COSC will be provided by
organic MTF mental health personnel or mental health personnel in direct support of
the MTF. When deployable COSC unit personnel are available, they may augment and
support the MTF staff in the management of combat and operational stress reaction
(COSR).
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D-9
b.
When operating in a deployed environment and under the threat of or
under actual CBRN conditions, service members will be at a high risk of suffering
COSR conditions. The invisible, pervasive nature of these agents/weapons creates a
high-degree of uncertainty and ambiguity, presenting fertile opportunities for false
alarms, mass panic and other maladaptive stress reactions. Therefore, medical
personnel, commanders, and leaders must take actions to prevent and reduce the
numbers of COSR cases in this environment. For detailed information on COSC see FM
4-02.7, FM 8-51, and FM 4-02-51.
11.
Hospital Requirements
Installation based hospitals and deployable hospitals alike require early
planning for preparation and receipt of CBRN patients. The patients may self-evacuate
to the facility or may be evacuated to the facility before being decontaminated.
Therefore, all hospitals in the vicinity of a CBRN event must be prepared to receive
contaminated patients.
a.
Contamination Control. Contamination control is critical to a successful
medical response to a CBRN event. One patient contaminated with CB material could
render the MTF unusable and contaminate the medical staff, thus disabling the medical
staff from providing essential care to the victims of the incident. Key considerations
include the following:
(1)
Contamination should be removed from patients and medical
items as close to the incident site as possible.
(2)
Any individuals arriving at the hospital contaminated with a
CBRN agent that were not decontaminated at the incident site must be decontaminated
before admission into the medical facility (see paragraph 13.a.).
(3)
The patient decontamination point(s) at an MTF should be clearly
marked and operated with an established protocol to include addressing the use of
detection equipment to verify decontamination and methods to control/collect
decontamination water as appropriate (should be coordinated with local water
treatment facility and environmental personnel).
(4)
Lifesaving measures take priority over radiological
decontamination, but in the case of less severe injuries, every effort should be made to
decontaminate radiologically contaminated patients prior to entering the hospital.
Concerns about the spread of radioactivity, (i.e., radioactive contamination or possible
contamination of medical personnel) should be attended to after the patient has been
stabilized.
b.
Facility Security/Entry and Exit Control. Planning must include lock
down procedures for the facility. Entry into the medical facility during and after a
CBRN incident must be controlled by security personnel. If security personnel, not
assigned to the hospital, will be used to provide hospital security, this should be noted
in pre-event planning. Entry/exit should be limited to one or two doorways near patient
hospital decontamination areas, with all other entrances secured and monitored. If the
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6 November 2007
facility is collectively protected and COLPRO is activated, then these entry/exit areas
must be doors that have air locks and positive pressure to limit the entry of outside
airborne contamination. See FM 4-02-7 for detailed entry/exit procedures.
c.
Hospital Triage/Emergency Treatment Area (Decontamination Zone). The
MTF should have medical personnel stationed between the evacuation vehicle arrival
area and the hospital decontamination area. This hospital triage and emergency
treatment area allows arriving patients to be re-triaged and provide medical
stabilization while they await decontamination outside the hospital. Medical personnel
in this area will determine which arriving patients have priority for decontamination at
the designated hospital decontamination area.
d.
Emergency Room Care. Emergency room personnel must be trained in
procedures for providing emergency care to patients arriving from a CBRN event site.
Patients may be suffering from the effects of the CBRN agent, conventional injuries,
COSR, or a combination of these injuries/effects. Provision of care for these patients
requires emergency room personnel to be trained in conventional injury care and
treatment of CBRN effects. Emergency room personnel must also ensure that any
patient or individual from the incident site are decontaminated prior to allowing their
entry into the facility.
e.
Inpatient Care. Inpatient care during and after a CBRN event requires
not only care for their injuries/illnesses, but also protecting the patient from exposure to
the CBRN effects. Patients in the fixed facility may be exposed due to the lack of
COLPRO. When COLPRO is not available, wrapping a clean or decontaminated patient
in blankets, sheets, etc and providing filtered fresh air to the face, mouth, and nose or
administering oxygen through a face mask can greatly reduce the effects of many CB
agents. The best protection is provided by COLPRO systems/equipment or individual
PPE.
f.
Infection Control. Infection control within the MTF is critical, especially
when patients with contagious/infectious biological agent effects are admitted to the
facility. Isolation/quarantine of affected patients is critical. The medical staff providing
care to these patients should be limited in numbers and must apply standard, airborne,
and contact precautions. See FM 4-02.33 and FM 8-284 for additional information.
12.
Collective Protection
The provision of COLPRO in a fixed facility is possible. However, plans and
improvements to the structure must begin long before any incident occurs to ensure
survivability/protection of the hospital staff and patients.
a.
Employment of the Chemically Protected Deployable Medical System
(CPDEPMEDS) in a field environment is described in Multiservice Tactics, Techniques,
and Procedures for Chemical, biological, radiological, and nuclear Protection and FM 4-
02.7. However, these systems may be employed in support of a response to a CBRN
event at an installation. The CPDEPMEDS is classified as a deployable system, but the
time required to establish/disestablish this system, makes it basically an installation.
See TM-10-5410-283-14P for detailed information on this system.
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b.
Collectively Protected Expeditionary Medical Support (CPEMEDS) and
Deployable Medical System (DEPMEDS) are joint programs to integrate
environmentally controlled COLPRO into already fielded USA and USAF field hospitals
in order to sustain medical operations in a CBRN contaminated environment for 72
hours. The M28 Simplified CPE has been integrated into the Army DEPMEDS and the
Air Force EMEDS field hospitals.
c.
The chemical biological protective shelter (CBPS) system is a deployable
medical shelter system used by the battlefield medical treatment facilities and the
forward surgical team. When available, they may be employed at an installation as a
temporary shelter when the fixed facility becomes contaminated. However, the numbers
of patients and staff that can occupy these systems are limited. When employed at the
installation, only those patients who cannot be otherwise protected from the CBRN
contamination should be placed inside these systems. See TM 10-5410-228-10 for
detailed information and FM 4-02.7 for additional information on employment of these
systems.
d.
The M20 Simplified CBRN Collective Protection Equipment may be
employed in rooms of opportunity or tents to provide COLPRO. However, this system
only provides ambient temperature filtered ventilation. Newer versions of the M20 to
include M20A1 are currently being fielded. See Multiservice Tactics, Techniques, and
Procedures for Chemical, biological, radiological, and nuclear Protection and TM 3-
4240-288-12&P for additional information.
13.
Decontamination
a.
Patient Decontamination. Decontamination of patients is critical to
reduce the CBRN effects on them and to protect rescuers and medical personnel from
cross contamination, or in the case of chemical agents from off gassing of vapors.
Patients who were wearing protective garments when they were exposed to an agent
may not need the extensive skin decontamination required for those who wore no
protective equipment. When MOPP/IPE is worn, it is important to remove the
overgarment carefully to reduce the spread of contaminant. In any case, clothing should
be removed and the patient thoroughly decontaminated before he is allowed into a toxic-
free MTF. For specific decontamination procedures see FM 4-02.7, FM 8-500, and ERG
2004. Consideration must be given to the placement of decontamination points to reduce
the spread of contamination adjacent to fixed MTFs. Newly fielded decontamination
equipment will require planning and training to be used effectively to decontaminate
casualties. Principles presented in FM 3-11.5 remain valid for fixed-side patient
decontamination and for newly fielded decontamination systems.
b.
Facility Decontamination. Decontamination may require temporary
closure of the MTF. Biological contamination may require labor-intensive
decontamination procedures. Contamination with liquid or dry chemical agents will
require decontamination of contaminated surfaces and sampling/analyses to ensure
there are no residual toxic vapors. Areas contaminated only by vapors from patient
clothing need only be well ventilated by fans to remove contaminated air from the area
but would still need to be sampled to verify vapors have dissipated. Radiological
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contaminants, radioactive dust, should be carefully wiped up or removed with a high-
efficiency particulate air (HEPA) filter vacuum or other procedures which limit dust
movement. The area can then be carefully checked with a detection device until no
contamination is detected. The confidence with which an area is determined to be
adequately decontaminated and “cleared” for reuse will be somewhat limited by reliance
on real-time detectors. Real-time detectors include M8/M9 paper for surface liquid and
several vapor detectors. The levels of detection are not necessarily no-effects levels.
Unfortunately, the alternative, using laboratory analyses, would likely result in
significant time delays. Therefore, facilities should include in their plans, specific
identification of equipment to be used to verify decontamination/clear areas along with
the explanation of the levels of detection offered by the equipment and the degree of
protection offered by these levels. Plans should identify additional steps to be taken to
verify clearance (e.g., follow-up laboratory analyses). This documentation will be critical
for documentation of overall exposures to facility personnel and patients.
c.
Medical Equipment Decontamination. Most medical equipment is not
hardened or protected and cannot be decontaminated using standard decontaminants;
therefore, replacement items must be available. Weathering may be used as a method
for decontamination of medical equipment contaminated with liquid chemical agent
only if no replacement is available and other decontamination methods would damage
the equipment. Washing can be used if it does not damage the components, and the
decontaminant used is not harmful to the material. Hypochlorite will corrode metal
components. Equipment should be thoroughly disassembled during decontamination
and should not be used inside a medical facility until it has been thoroughly
disassembled and cleaned and its cleanliness can be verified with a detection device. (As
indicated previously, however, the use of real-time equipment to verify adequate
decontamination has significant limitations.) Medical supplies that are not packaged in
metal or other impermeable containers and become contaminated must not be used in
patient care. The outside of protected containers of medical supplies can be
decontaminated and the contents can be used in patient care. See FM 4-02.7 for
additional information.
d.
Ambulance Decontamination. Decontamination of ambulances requires
special considerations due to the fact that onboard medical equipment will most likely
require replacing. Also, ambulances will be in such great demand that decontamination
may have to be delayed until all patients have been evacuated. Operator
decontamination should be performed to reduce the level of contamination in the patient
transport area. See FM 4-02.7 and FM 8-10-6 for additional information.
14.
Medical Logistics
Medical logistics (MEDLOG) personnel must be prepared to provide logistical
support in preparation for and in response to a CBRN incident/event. Medical treatment
personnel and MTFs may have a limited stock of pharmaceuticals, blood and blood
expanders, medical equipment, and other Class VIII supplies on hand. However,
resupply must be readily available for continuous response to the incident. The Army
has CM sets positioned and maintained at strategic locations and are readily available
within 24 to 48 hours after a CBRN incident. CM sets provide additional supplies to a
CBRN incident to allow MTFs sufficient time to establish a resupply chain through the
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D-13
normal prime vendor system. Sources of supply and critical materiel to support a CBRN
incident must be identified in advance in order to expedite the resupply chain. For
additional information on MEDLOG see JP 4-02.1 and FM 4-02.1.
a.
Pharmaceuticals and Blood. Antidotes, pretreatments, therapeutics,
barrier creams, blood and blood expanders must be available before a CBRN event
occurs. Advance planning for critical materiel is a key element of MEDLOG
preparedness. See JP 4-02 and FM 4-02.1 for detailed information on MEDLOG
operations. See FM 4-02.33, FM 4-02.283, FM 8-284, and FM 8-500 for detailed
information on essential pharmaceuticals.
b.
Medical Equipment. Most medical equipment is not protected or hardened
against CBRN contamination. MTF personnel and supporting units must be prepared to
address contaminated or damaged equipment caused by a CBRN event. Alternative or
noncontaminated equipment must be provided for use in patient decontamination and
treatment operations.
c.
Nonmedical Equipment. The nonmedical equipment that is required to
provide a FHP response and patient care may include such items as garden hoses,
shower heads mounted on pipe stands, disposable gowns, soap, wash cloths, household
bleach, and bath towels for patient decontamination at the receiving MTF. High-test
hypochlorite (HTH) or household bleach can be used to clean the patient equipment. See
FM 4-02.7 and FM 8-500 for patient decontamination procedures. PPE for medical staffs
must be provided including MOPP and/or EPA Levels A, B, C, and D ensembles,
depending on the operational environment. Protective material such as tarpaulins and
rolls of plastic material for covering supplies that cannot be stored inside containers or
buildings may also be needed. The improvised air-lock frame is constructed of wood,
pipes, or other similar material. The cover and outside door is constructed of the
tarpaulin or plastic material and placed over the frame.
15.
Incident Installation Medical Support
Organic medical personnel on the installation or designated medical personnel
from another installation provide medical support at the incident site on the
installation. The installation fire department or emergency medical services will
normally provide medical evacuation from the incident site to the MTF. When on
installation emergency medical services are not available, memorandums of agreement
may be established with the off installation emergency medical services for provision of
these services. Deployable medical evacuation assets may also be employed in patient
evacuation.
16.
Reach-Back
When local FHP capabilities cannot meet incident support requirements, reach-
back organizations/agencies should be employed to fill the gaps. Reach-back support
may be obtained from various sources. See FM 3-11.21, FM 3-11.4, and FM 8-42 for
detailed information. Examples include the following:
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a.
DOD Organizations. DOD organizations include, but are not limited to,
USAMRIID, USAMRICD, CHPPM, NMRC, or the AFRRI. See FM 4-02.7 for detailed
information.
b.
Other Federal Agencies. Federal agencies may include the CDC, FEMA,
OSHA, DHS and EPA.
c.
Local/State Organizations. Local/state civilian organizations may include
law enforcement, public health, medical clinics, hospitals, fire departments, and
emergency medical services.
d.
Host Nation Support (HNS). HNS may include law enforcement, public
health, medical clinics, hospitals, fire departments, and emergency services. However,
their medical treatment standards and pharmaceuticals may not meet US standards.
Therefore, memorandums of understanding/agreements should be developed to ensure
that their medical support meets US standards.
17.
Medical Planning Considerations.
There are multiple planning considerations to support operational planning.
These considerations include—
•
Receipt of contaminated self-evacuees.
•
Recognition of biological outbreaks.
•
Alternate treatment or isolation sites.
•
Hospital evacuation.
•
Training of patient care providers and nonmedical augmentees.
•
Replacement of sick medical care providers.
•
Ensure plan nesting with installation plan.
•
Provision of a common operational picture.
•
Logistical disruption.
•
Facility security.
•
Decontamination operations.
•
Medical information/patient tracking.
•
Integration with supporting medical facilities NDMS/MOV.
•
Concept of operations for the entire installation AO.
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Appendix E
COLLECTIVE PROTECTION AND IN-PLACE PROTECTION
NOTE: For additional information on how to use and install COLPRO and SIP,
see Multiservice Tactics, Techniques, and Procedures for Chemical, biological,
radiological, and nuclear Protection and the Unified Facilities Criteria.
1.
Collective Protection
a.
COLPRO is protection provided for personnel to carry out functions
without being restricted by protective clothing. JP 1-02 describes COLPRO as facilities
or systems equipped with air filtration devices and air locks to provide personnel with a
toxic-free environment for performing critical work and obtaining rest and relief in
order to sustain combat operations. COLPRO is provided through a facility or the
integral portion of equipment design, whereby individuals or groups may be afforded
protection.
b.
The term COLPRO applies to: buildings, facilities, or ships modified to
afford protection; pieces of equipment (in their entirety or in part); or vehicles designed
to provide CBR protection. COLPRO usage is characterized by the requirement of an
individual or group to execute specific actions, such as donning or doffing equipment,
entering a facility, or closing openings in order to derive the benefits of COLPRO.
c.
COLPRO provides a safe environment for individuals to carry out tactical
functions such as weapons employment, medical care, C2, and communications without
being restricted by wearing the full set of CBRN protective clothing. MTTP for
Multiservice Tactics, Techniques, and Procedures for Chemical, biological, radiological,
and nuclear Protection, provides a detailed discussion on COLPRO.
d.
Ideally, COLPRO provides a temperature-controlled, contamination-free
environment to allow personnel relief from continuous wear of PPE. The basic concept
for most facility COLPRO solutions is to provide overpressure, filtration, and controlled
entry and exit. Maintaining a higher internal air pressure than external pressure and
filtering incoming air prevents contaminated external air from infiltrating the shelter.
The result is a TFA where personnel can operate without protective equipment. One or
more self-purging airlocks provide controlled entry and exit.
e.
In addition to mission critical sustainment, COLPRO supports two
mission sustainment areas that quickly erode in a CBR environment: personnel rest
and relief (breaks and sleeping), and work relief (C2, medical treatment, MOPP
recovery time after maximum work effort). Each installation must assess COLPRO
requirements based upon the likely threats and mission requirements. Specific
COLPRO solutions may include a mixture of permanent, mobile or transportable, or
expedient or temporary COLPRO systems.
f.
The provision of COLPRO in an installation is possible. However, plans
and improvements to the structure must begin long before any incident occurs to ensure
survivability/protection of the occupants. Representative COLPRO capabilities are
identified below.
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E-1
(1)
Employment of the CPDEPMEDS in a field environment is
described in Multiservice Tactics, Techniques, and Procedures for Chemical, biological,
radiological, and nuclear Vulnerability Assessment and FM 4-02.7. However, these
systems may be employed in support of a response to a CBRN event at an installation.
Though the CPDEPMEDS is classified as a Level III and Level IV deployable system,
the time required to establish/disestablish this system associates this as an installation
asset (see FM 4-02.7 and FM 4-02.10 for detailed information on this system).
(2)
The CBPS system is a deployable medical shelter system used by
the Level I and Level II MTFs and the forward surgical team. When available, they
may be employed at an installation as a temporary shelter when the installation
becomes contaminated. However, the numbers of patients and staff that can occupy
these systems are limited. When employed at the installation, only those patients that
cannot be otherwise protected from the CBRN contamination should be placed inside
these systems. See FM 4-02.7 for additional information on employment of these
systems.
(3)
The M20 simplified CBRN COLPRO equipment may be employed
in rooms of opportunity or tents to provide COLPRO. However, this system only
provides ambient-temperature filtered ventilation (see Multiservice Tactics, Techniques,
and Procedures for Chemical, biological, radiological, and nuclear Protection and TM 3-
4240-288-12&P for additional information).
2.
In-Place Protection
a.
Use in-place protection, according to the guidelines in Table E-1 when
evacuation may cause greater risk than remaining in place or when successful
evacuation cannot be conducted.
b.
In-place protection may not be the option of choice if the toxic vapors are
flammable, the hazard is persistent, or buildings cannot be closed tightly. Although
vehicles are not as effective as buildings, vehicles can offer some protection for a short
period when the windows are closed and the ventilating system is shut off.
c.
Warn personnel that are protected in place to stay clear of the windows
due to the danger of glass and projectiles in the event of a fire or explosion. Maintain
some form of communications with in-place protected personnel and advise them of
changing conditions. Communications are a psychological lifeline for personnel cut off
from freedom of movement and information.
d.
Paragraph 3 provides detailed options for developing a form of an in-place
protection program.
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FM 3-11.34/MCWP 3-37.5/NTTP 3-11.23/AFTTP(I) 3-2.33
6 November 2007
Table E-1. General Protection-In-Place Options
Protection-In-Place Options
For This
Use These Items:
With This Guidance:
Function:
•
Place plastic around inside of windows and
doors.
•
Close holes and windows with plywood; seal
using items shown and duct tape.
•
Plastic Canvas
•
Spray foam into doorways and windows,
•
Plastic Sheeting
overlapping all sills and openings. Foam spray will not
Sealing Air
•
CBRN-PC
work well on overhead horizontal surfaces.
Infiltration
•
Foam-In-Place
•
Spray foam into all air intakes and exhausts.
Points
•
Gasket forming
•
Cut and fit plastic as necessary; use duct tape to
materials (silicon, rubber
hold in place.
gaskets, foam sealing materials)
CAUTION
Turn off HVAC systems before sealing
air intakes/exhausts.
•
Cut plastic sheet, plastic canvas, and CBRN-PC
•
Plastic Sheet
1.5 times taller and wider than the individual using it. Use
•
Plastic Canvas
as cover to provide protection-in-place for personnel
•
CBRN-PC
caught in the open.
•
Military/Civilian Wet
Individual
•
Make rain suits/ponchos part of daily work
Weather Gear/Rain Suits
Covers
uniform, use in conjunction with plastic sheet, plastic
(Rubber)
canvas, and CBRNPC.
•
Ponchos
•
Pre-position MCHT and TEMPER throughout
•
MCHT
installation, concentrate on areas with few approved
•
TEMPER
shelters, but high personnel concentrations.
•
Plastic Sheeting
•
Plastic Coated Canvas
•
Cut and fit as necessary, use duct tape to hold in
•
CBRN-PC
place.
Materiel
•
Large Area Shade
•
Place covered material under shade systems or
Covers
Systems
shelters for additional protection.
•
Large Area
Maintenance Shelter
•
Place CONEX/MILVAN at regular intervals
around installations. Attach plastic sheet/CBRN-PC to
front of CONEX/MILVAN of sufficient size to cover the
•
CONEX
opening and to act as a liquid barrier. Attach weight (piece
•
MILVAN
of wood/iron bar, etc) to bottom edge of plastic to hold in
Shelters
•
MCPS
place when being used.
•
MGPTS
•
Erect MCPS/MGPTS at specified intervals
(based on personnel concentrations).
•
Use these measures in conjunction with
individual and materiel covers.
•
Move operations to upper floor/levels.
• Plastic Sheeting
•
Block entryways and openings with multiple
Vertical
• Plastic Coated Canvas
sheets of plastic. Place a plastic sheet at foot of stairs,
Separation
• CBRN-PC
another partway up the stairs, a third at the top of the
stairs, etc.
CAUTION
The duration of protection using these measures is not
quantified and is provided for emergency situations only. This
table does not preclude using other expedient measures
afforded by available materials and common sense.
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FM 3-11.34/MCWP 3-37.5/NTTP 3-11.23/AFTTP(I) 3-2.33
E-3
3.
Shelter In Place
a.
Using Shelter in Place (SIP). SIP is a means to providing low-cost, short-
term protection against the effects of CBRN agent or the accidental or deliberate release
of TIM. The purpose of SIP is to make a shelter out of the place you are in and
protecting yourself until help arrives.
(1)
SIP uses the indoor atmosphere to separate you from airborne
hazards outside. Personnel are still potentially in the danger area, but are protected by
the barrier created by the shelter. Speed is essential for SIP to work, the quicker
actions are taken, the less likely airborne contaminants will enter.
(2)
Protection diminishes over time. SIP is only for a short duration,
roughly 2 hours or less. During wartime, this method is used to limit the entry of
airborne contamination when other protection is unavailable. Under emergency
conditions, it may provide limited protection to unprotected personnel or casualties that
cannot wear the protective mask. A building can provide substantial protection if the
air is filtered, temporarily interrupted, or reduced. Interrupting air flow is the principle
used in SIP, and shutting down a building’s HVAC and closing outside openings reduces
the potential hazard. The concept assumes that the techniques can be applied rapidly,
require little or no specialized training, and use common skills and supplies. Specific
methods will vary based on the building or area to be protected and the ability to
provide advanced warning to the occupants. Establishing SIP procedures for an
installation requires planning and preparatory actions. The information provided in the
following paragraphs outlines basic steps that can be used to support SIP planning.
Key elements in the planning process include:
•
Identifying space for SIP.
•
Preparing and maintaining SIP kits.
•
Establishing and practicing SIP procedures.
•
Coordinating and assisting the training and exercising of SIP
procedures.
•
Determining the appropriate criteria to determine when SIP is
necessary. This should be balanced with potential hazards
associated with this COA (such as preventing access to medical
and other potentially needed resources; exposure buildup of carbon
dioxide and/or heat that cause headaches/mild illness or
weakness—people in poorer health are especially vulnerable to
these risks.
NOTE: the buildup of carbon dioxide can result in some mild effects such as
headaches and weakness or fatigue. These effects are transient for short-term
exposures, but monitoring of carbon dioxide levels is advisable to ensure
serious life-threatening levels are not reached. Use of generators or propane
heaters should be avoided inside shelters, as these can increase toxic levels.
(3)
Identifying a building for use to support SIP will consider the
following facility requirements. For example, the ideal building should be:Concrete.
•
Multistory.
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6 November 2007
•
Equipped with air handlers located on the roof.
•
Energy efficient.
•
In a remote location.
•
On a hill.
•
Upwind side of the base.
•
Away from the installation perimeter.
•
Equipped with an emergency power supply.
•
Equipped with filtered air.
Further, the rooms identified for SIP should be on an upper floor; possess no windows,
provide a communications capability, and be accessible during duty hours and at a
central location.
b.
Estimating SIP Requirements. Estimating space requirements involves
factors such as, the number of personnel that require shelter, available square footage,
and air requirements.
(1)
Computing Square Footage for SIP. Determining the approximate
square footage for SIP includes estimating the total floor space required, the estimated
available air and air requirements. A representative computation for determining
square footage for a SIP requirement is identified below.
•
Step 1. Determining Floor Space.
o
Current guidance allows for 10 f2 per person for SIP.
o
Determine the area (f2) of a SIP room by multiplying the
length (l) by the width (w). (l) (w) = f2
•
Step 2. Determining Air Available. Determine cubic feet (f3) of a
SIP room by multiplying (l) by (w) by Height (h). (l) (w) (h) = f3
•
Step 3. Determining Air Requirements.
o
A person generally requires 16.2 f3 of air per hour while at
rest.
32.3 f3 to protect for minimum of 2 hours.
o
Double the amount to 64.6 f3 for planning purposes and
safety concerns due to heat and humidity build up, activity
level of people, and the cautions of using the minimum air
requirements (64.6 f3).
NOTE: The buildup of carbon dioxide will cause some headaches. This is
acceptable for a short duration.
NOTE: People with poor health may become casualties to the heat, carbon
dioxide buildup, or from the tight quarters.
(2)
Sample SIP Room Calculation.
•
Step 1. Determine Floor Space.
o
Measurement Example: 20 x 20 x 7.5
6 November 2007
FM 3-11.34/MCWP 3-37.5/NTTP 3-11.23/AFTTP(I) 3-2.33
E-5
o
Area = 400 f2
o
(Using floor space per person requirement of 10 f2)
o
Divide 400 f2 by 10 f2 = 40 people have room for SIP
•
Step 2. Determine Air Available. Cubic feet of air = 3,000 f3
•
Step 3. Determine Air Requirements. Divide 3,000 f3 by: 64.6 f3 =
46 people have enough air for two hours. Use the lowest number of
people from steps 1 and 2. This is your “maximum occupancy (i.e.,
40 people have room for SIP)”.
o
Walk through potential SIP rooms. Look at actual floor
space available by taking into account furnishing such as
cabinets, cubicles and desks and the mission.
o
Determine how many people can be realistically sheltered.
This is your “planned occupancy”.
SIP must be accomplished within minutes to be of
use.
The larger the SIP room, the longer it will take to
seal.
Saving lives has a higher priority than comfort.
Unrealistic cramping of personal space becomes an
issue before problems with breathable air arise.
c.
Establishing an SIP program. Setting up an installation SIP program
will be an effort that should include installation and tenant unit personnel. Table E-2
provides a list of sample steps that should be considered for establishment of a SIP
program.
E-6
FM 3-11.34/MCWP 3-37.5/NTTP 3-11.23/AFTTP(I) 3-2.33
6 November 2007
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