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FM 4-02.6
APPENDIX E
RECORDS AND REPORTS
Section I. PATIENT ACCOUNTABILITY
E-1. General
a. Individuals entering the medical treatment chain must be accounted for at all times. Prompt
reporting of patients and their health status to the next higher headquarters is necessary for the maintenance
of a responsive personnel replacement system and the Army Casualty System. Patient accountability and
status reporting is required to—
• Provide the commander with an accurate account of personnel losses due to medical
causes (enemy action and related battlefield losses and DNBI).
• Verify personnel replacement requirements.
• Assist the command surgeon in the preparation of the CHS estimate and plan.
• Alert PVNTMED personnel to the medical threat in a given AO.
b. Patient accountability and status reporting in the AOE division is depicted graphically in
Figure E-1.
This paragraph implements STANAG 2132 and QSTAG 470.
E-2. United States Field Medical Card
a. The FMC (DD Form 1380) is used to record data similar to that recorded on the inpatient
treatment record cover sheet and Standard Form (SF) 600, Chronological Record of Medical Care. The
FMC is used by BASs, clearing stations, and nonfixed troop or health clinics working overseas, on
maneuvers, or attached to commands moving between stations. It may also be used to record an outpatient
visit when the health record is not readily available at an MTF. The FMC is used in the TO during times of
hostilities. It also may be used to record carded for record only cases.
b. The FMC is made so that it can be attached to a casualty. The cards are issued as a book, with
each card set consisting of an original card and a pressure sensitive paper duplicate.
c.
Medical treatment facilities initiating the SF 600, having received a patient with an initiated
DD Form 1380, will attach this form to the SF 600 to remain as a permanent record of the patient
(Appendix K).
d. For additional information on the preparation and use of this card, refer to AR 40-66 and
FM 8-10-6.
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FM 4-02.6
Figure E-1. Patient accountability and status reporting in the AOE division.
E-3. Daily Disposition Log
a. The Daily Disposition Log (DDL) (Figure E-2) is maintained by Echelons II MTFs. The
information from this log is extracted, when required, and provided to the S1, (Adjutant [US Army]) or
supported unit requesting the information. The DDL is also the primary source document for information
needed in the preparation of the Casualty Feeder Report (DA Forms 1155/1156), Patient Summary Report
(PSR), and the Patient Evacuation and Mortality Report (PE&MR).
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FM 4-02.6
b. The DDL does not lend itself to transmission. However, the information may be extracted and
provided via courier or electronic means to agencies responsible for preparing consolidated reports and/or
casualty feeder reports.
Figure E-2. Example Daily Disposition Log.
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FM 4-02.6
E-4. Patient Summary Report
The PSR is a weekly report (Figure E-3), compiled as of 2400 hours, Sunday. It is prepared by Echelons I
and II MTFs and is submitted to respective surgeons as shown in Figure E-1, usually on each following
Monday. The command surgeon can, however, dictate the frequency of submission to meet command
requirements.
Figure E-3. Example Patient Summary Report.
E-5. Patient Evacuation and Mortality Report
The PE&MR (Figure E-4) is prepared by Echelons I and II MTFs. It is disseminated as shown in Figure E-1.
The PE&MR primarily serves as a medical spot report. The frequency of this report is established by the
command surgeon.
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FM 4-02.6
Figure E-4. Example Patient Evacuation and Mortality Report.
Section II. BLOOD MANAGEMENT REPORT
E-6. General
This section provides a format for the required report for requesting blood support. Echelon II MTFs may
only request Group O red blood cells. The report in this appendix, therefore, only discusses this limited
support. For additional information on the complete blood report submitted by Echelons III and IV MTFs,
refer to Joint Publication 4-02.1.
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FM 4-02.6
E-7. Blood Management Report
Depending on the tactical situation and the command policy, the blood management report may be
transmitted by voice or written means (transmitted electronic message, telephonically, or by courier). A
sample written message format is contained in Figure E-5. A sample voice message format is contained in
Figure E-6.
Figure E-5. Sample written format for blood report.
Figure E-6. Sample voice message format.
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FM 4-02.6
APPENDIX F
THE BRIGADE SUPPORT MEDICAL COMPANY
Section I. ORGANIZATION AND MISSION
F-1. Organization Capability and Functions
a. The BSMC, TOE 084108F300, is assigned to the BSB of the IBCT and its overall mission is to
provide Echelon II CHS to all IBCT units operating within the brigade AO. The company also provides
Echelon I CHS on an area basis to all IBCT units that do not have organic medical assets. The company
provides C2 for its organic elements and OPCON of medical augmentation elements. The BSMC locates
and establishes its company headquarters and a brigade clearing station/MTF in the BSA. The BSMC will
normally be augmented with a surgical capability provided by a FST.
b. The BSMC is organized (Figure F-1) into a company headquarters, a PVNTMED section, a
MH section, a treatment platoon, and an evacuation platoon. The company performs the following functions:
• Emergency medical treatment and ATM for wounded, and DNBI patients.
• Sick call services.
• Ground ambulance evacuation from supported units.
• Operational dental treatment that includes emergency and essential dental care.
• Class VIII resupply and medical equipment maintenance support.
• Limited medical laboratory and radiology services.
• Outpatient consultation services for patients referred from Echelon I MTFs.
• Patient holding for up to 20 patients.
• Reinforcement/regeneration of maneuver battalion medical platoons.
• Preventive medicine consultation and support.
• Combat and operational stress control support.
• Mass casualty triage and management.
• Patient decontamination (see FM 8-10-7).
c.
The BSMC is dependent on—
• Appropriate elements of the IBCT for legal, finance, and personnel and administrative
services.
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FM 4-02.6
• The headquarters and distribution company (TOE 43106F0), BSB for food service support
and religious support.
• The brigade support company (TOE 43107F300), BSB for unit maintenance support.
• The FST (TOE 08518LA0) for surgical support as an early entry element into the AO.
• A MEDLOG activity that could be either Joint CONUS-based (United States Army
Medical Supply Agency) or a corps MEDLOG company (TOE 08488A0), MEDLOG battalion (corps) for
optometry, medical resupply, and medical equipment maintenance and repair.
• Either a Joint or Army blood support detachment (TOE 08489A0), MEDLOG battalion
for blood support.
• The MDT (TOE 085390AA0), or a subelement thereof, for reach-back telemedicine/
teleconsultation capabilities to national assets in CONUS or sustaining base.
• The forward support medical evacuation team (FSMT) from the medical company air
ambulance (UH 60) (TOE 08447L20) for timely aeromedical evacuation within the IBCT AO.
• An air evacuation liaison team (AELT) and a mobile aeromedical staging facility for
providing medical evacuation support from the AO.
• Onshore- or offshore-based hospitalization support for the IBCT soldiers.
Figure F-1. Brigade support medical company, brigade support battalion.
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FM 4-02.6
F-2. Augmentation
a. It is essential that the BSMC be augmented with a FST as part of the early entry medical
support for the IBCT, especially if it is a forced entry. When the BSMC is augmented with a corps FST
(TOE 08518LA0), the BSMC commander will insure that the unit is provided the following support:
• Limited clinical laboratory and radiology services.
• Electrical power generation.
• Patients administration and arrangement for medical evacuation.
• Patient holding when required.
b. Based on METT-TC and the dispersion of IBCT units, conditions and availability of trafficable
road networks within the AO, medical evacuation by air ambulance will be the preferred method for
evacuating patients. Therefore, it is essential that an FSMT augment the BSMC medical evacuation
capabilities during early entry or as part of early follow-on support elements. Reach-back capabilities
provided by the MDT will link the BSMC with the sustaining base. This reach-back capability is invaluable
for medical consultation/telementoring and coordination for CHS requirements. Other CHS augmentation
support, such as the Theater Army Medical Laboratory, PVNTMED, and veterinary support, will be
METT-TC-dependent and requested as required. Essential support to the BSMC must include proximate
Echelon III hospitalization, a 44-bed early entry module of an 84-bed CSH or an offshore naval hospital
afloat can provide this capability. Echelon III-level support may also be provided by USAF hospitalization
capability, HN, and allied and/or coalition forces.
c.
Upon arrival and subsequent breakup of the combat service support company’s (TOE
63591FA) command section, the treatment team of this unit will be assigned to augment the BMSC. This
PA-led high mobility multipurpose wheeled vehicle (HMMWV)-based treatment team will be placed OPCON
to the BSMC treatment platoon. It will be employed in direct support of IBCT CS/CSS units.
Section II. COMPANY HEADQUARTERS ORGANIZATION
AND FUNCTION
F-3. Company Headquarters
a. The company headquarters section provides C2 for the company and attached units. It pro-
vides unit-level administration, general supply, and NBC operating support. It also provides CHL support
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FM 4-02.6
and operates a supply distribution point of Class VIII push-packages for supported medical units and com-
bat lifesavers operating in the IBCT AO. The company also provides unit-medical equipment repair
capability.
b. The company headquarters section (Figure F-2) is organized into a command element, a
supply element, and a support operations element consisting of unit decontamination, NBC, and a small
arms repair capability. For communications, the company establishes an FM and AM radio net and a wire
net (refer to FM 8-10). For communications, automation, and navigational capability, it employs the
following assets:
• Frequency-modulated radios, single-channel ground and airborne radio system
(SINCGARS) (AN/VRC 89-F and AN/VRC 90-F), for C2 and an AM, AN/VRC0-213, radio for reach-
back operations communications capability with supporting medical elements at EAB.
• The FBCB2 System for situational understanding.
• The MC4 capability (when fielded) with laptop computers for functional area operations
and medical information management.
• Enhanced Position Location Reporting System-user unit employed in conjunction with
SINCGARS and FBCB2 to facilitate MC4 requirements.
• An AN/VSX-4 transponder (battlefield combat identification system [BCIS]) for fratricide
avoidance (when issued).
• An MTS control station (when issued) for tracking and messaging forward deployed
medical elements.
F-4. Command Element
The command element is responsible for providing billeting, security, training, administration, and discipline
for assigned personnel. This element provides C2 of its assigned and attached personnel. It is typically
staffed with a company commander, an XO, and a 1SG.
NOTE
Currently, medical company commanders’ positions are documented
05, AMEDD immaterial, meaning any qualified AMEDD officer can
assume command. When the medical company commander is not a
physician, medical decisions and technical supervision are performed
by the treatment platoon leader. The treatment platoon leader’s
position should always be filled by a physician.
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FM 4-02.6
Figure F-2. Company headquarters section depicting personnel, major equipment,
and communications/automation enablers.
F-5. Logistics Elements
The logistics elements include a general supply element, a CHL element, and a medical equipment
maintenance element. These elements provide Class VIII resupply, medical equipment repair, general
supply, and armorer support for the BSMC’s organic platoons/sections and attached medical units.
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FM 4-02.6
a. Unit Supply Element. The unit supply element is responsible for managing, requesting,
receiving, issuing, storing, and maintaining all classes of supplies and turn-in supplies and equipment for
the company. It also employs the ULLS/S4 for automated supply activities. The unit supply sergeant
coordinates all general supply, equipment requirements, and actions with the XO and the logistics support
operations officer of the BSB support operations section.
b. Combat Health Logistics Element. The CHL element establishes the CHL distribution point
and manages Class VIII. The MEDLOG sergeant of this element coordinates CHL requirements through
the BSMC XO with the HSMO of the BSB support operations section and the BSS.
(1) The CHL element fills Class VIII requisitions for supported units and the BSMC. It
issues Class VIII supplies to all treatment elements of the company, monitors the expirations of perishable
medications, and requisitions accordingly. When blood/blood products are received at the BSMC, they are
distributed to the treatment platoon (area support squad medical laboratory element) for storage, managing,
monitoring and further distribution. The treatment platoon is responsible for the preparation of the blood
situation report.
(2) Blood and blood products for the supporting FST will be issued directly to that unit for
use, management, and reporting,
(3) The BSMC CHL element and the BSB HSMO will use the Combat Service Support
Control System (CSSCS), the FBCB2 system radios, telephones, and facsimile (FAX), and the GCSS-A for
requisitioning and monitoring Class VIII requirements for the IBCT and its supporting medical augmentation
elements. In the future, a Defense Medical Logistics Standard SupportAmplitude-Modulated (DMLSS-
AM) functional module of the TMIP/MC4 systems. When the TMIP/MC4 becomes available, it will serve
as a reach-back CHL capability for the IBCT. This element employs the FBCB2 and uses the tactical
internet to intercept CALL FOR SUPPORT (medical) traffic.
c.
Medical Equipment Maintenance Element. The medical equipment maintenance element
provides operational and unit-level medical equipment maintenance for the BSMC and all other medical
elements of the IBCT.
Section III. EMPLOYMENT OF THE MEDICAL COMPANY
F-6. Establishment of the Company Headquarters
a. In establishing the company headquarters, the command element must ensure that communi-
cation is established with the units within the BSB and BSA. All security precautions and requirements must
be met according to BSB and BSA operating procedures. Only essential equipment is set up to support the
medical company operations. If the failure to camouflage endangers or compromises tactical operations,
the camouflage of the MTF may be ordered by a commander of at least brigade level or equivalent (refer to
STANAG 2931). Dispersion of shelter systems and equipment is accomplished to the maximum extent
possible.
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FM 4-02.6
b. The command element supervises the establishment of the company. The commander monitors
all elements as the company sets up. He ensures the BSMC is established according to the unit layout and
the TSOP. The XO and the 1SG assist the company commander. The XO supervises and monitors the
establishment of the company area for compliance with the BSB TSOP and IBCT guidance. The XO
coordinates with supporting units/elements for support requirements. Both the commander and XO should
interface with supported units as soon as possible.
c.
The 1SG focuses his attention toward ensuring all unit security requirements are accomplished.
The 1SG supervises the establishment of the company headquarters and the troop billeting areas. He
monitors field sanitation team activities. The operations element assists in establishing the company
headquarters. The NBC NCO supervises the company NBC team by monitoring its activities and use of
unit NBC-monitoring equipment. He coordinates with other BSB units and monitors the placement of early
warning devices for the detection of chemical agents. He supervises and monitors unit personnel for
compliance with correct wear of MOPP clothing and equipment according to the current MOPP level and
TSOP.
d. Unit personnel set up communications equipment and establish the NCS for the company.
They establish contact with the battalion headquarters and with supporting and supported units. Unit
personnel also establish the internal wire communications net. They connect to the MSE area system at the
wire subscriber access point operated by the area support signal element.
e.
The logistics element establishes the unit supply for the company and establishes a Class VIII
supply distribution point for all medical elements operating in IBCT battle space. This element ensures all
supplies are secured, properly stored, and protected from the environment and establishes the unit POL and
water points.
F-7. Preventive Medicine Section
The PVNTMED section (Figure F-3) assigned to BSMC has primary responsibility for supervising the
unit’s PVNTMED program as described in FM 4-02.17. The section is primarily responsible for identifying
medical threats and occupational and environmental health hazards, assessing the health risk associated with
these threats, and recommending protective measures.
a. The PVNTMED section provides advice and consultation in the areas of health threat
assessment, force health protection, environmental sanitation, epidemiology, sanitary engineering, and pest
management. Through routine surveillance, they identify actual and potential health hazards, recommend
corrective measures, and assist in training IBCT personnel in disease prevention programs
b. Functions of the PVNTMED section include—
• Assisting the commander in preparing staff estimates by identifying the medical threat
and risk assessments.
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FM 4-02.6
• Assisting the higher headquarters in determining requirements for medical intelligence
assessments, particularly with respects to TIM and disease prevalence.
• Assisting units in the training of PVNTMED measures (PMM) against heat and cold
injuries, as well as food-, water-, and arthropodborne diseases.
• Coordinate with supporting veterinary teams for conducting and implementing food
safety and quality assurance surveillance and assisting in foodborne and zoonotic disease surveillance and
control.
• Monitoring the brigade immunization program.
• Monitoring and approving the health-related aspects of water and ice sources, to include
production, distribution, and consumption.
• Conducting occupational and environmental health hazard surveillance of the unit’s AO
and initiating preemptive occupational and environmental health preventive measures.
• Conducting epidemiological investigations of disease outbreaks and recommending PMM
to minimize their effects.
• Collecting and shipping samples/specimens to the supporting medical laboratory to rule
out or confirm presence of a medical threat.
• Coordinating for NBC reconnaissance vehicle to assist with environmental monitoring to
verify presence of toxic industrial material.
• Conducting limited entomological investigations and coordinating control measures.
• Monitoring environmental and meteorological conditions, assessing their health-related
impact on operations, and recommending PMM to minimize heat or cold and high altitude injuries.
• Training unit field sanitation teams for assigned or attached units IAW FM 21-10-1 and
assessing their effectiveness.
• Conducting surveillance of all assigned and attached brigade units to ensure field sanita-
tion procedures are implemented and to identify any existing or potential medical threats.
• Monitoring disposal practices/facilities for all classes of waste in the AO.
Additional information pertaining to PVNTMED staff and specific functions is discussed in Chapter 3 and
in FM 4-02.17. The PVNTMED section is deployed BSMC’s FM command net. For a communications,
automation, and navigational capability, PVNTMED section employs the following assets:
• An FBCB2 system for situational understanding and functional area operations.
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FM 4-02.6
• An EPLRS used in conjunction with SINCGARS radio and FBCB2 system to facilitate
the MC4 requirement.
• An AN/VRC 90-F for area communication. The PVNTMED section is employed in the
BSMC command net and has the capability to interface other FM nets as required.
• An MC4 capability with a laptop computer for CHS functional area operations and
medical situational understanding and medical surveillance reporting.
• An AN/VSX-4 transponder (BCIS) for fratricide avoidance (when issued).
Figure F-3. Preventive medicine section depicting personnel, major equipment, and
communications/automation enablers.
F-8. Employment of the Preventive Medicine Section
a. Preventive medicine activities begin prior to deployment to minimize DNBIs. Actions taken
include—
• Supporting command awareness of potential medical threats and occupational and
environmental health hazards and implementation of appropriate protective measures.
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FM 4-02.6
• Ensuring the deployment of a healthy and fit force.
• Monitoring the command’s immunization status (see AR 40-562).
• Monitoring water supplies, to include NBC contamination.
• Monitoring the status of individual and small unit PMM (see FM 21-10).
• Monitoring against heat and cold injuries, occupational and environmental health hazards,
NBC/TIM contamination of water, and food-, water-, and arthropodborne diseases (see FM 4-02.17).
• Ensuring unit training in PVNTMED to countering the medical threat.
• Monitoring the use of prophylaxes such as antimalarial tablets.
• Monitoring, analyzing, and reporting medical surveillance information.
b. Effective PVNTMED operations are characterized by preemptive actions. Lack of or delay in
implementing preemptive actions can significantly impact on the deployment forces’ ability to accomplish its
assigned mission.
c.
Preventive medicine support operations are prioritized based on the mission, medical threat,
medical surveillance, occupational and environmental health hazard surveillance, and assessment of data
collected (through monitoring, inspecting, and reporting observations).
d. Preventive medicine assistance is requested through the brigade surgeon’s section or the BSB
support operations section. Preventive medicine missions received by the BSB will be coordinated with the
BSS for establishing its priority. The brigade surgeon will establish priorities and coordinate PVNTMED
section support. The BSS submits the request to the brigade S3 and it tasks the BSB with the support
mission. The request for support is sent to the BSB support operations section/combat health support cell
HSSO. The HSSO keeps the BSB and BSMC commanders informed on any tasks with a high priority.
Upon receipt of the mission, the BSMC commander will accept or reject the mission based on current
capabilities and other METT-TC factors. Coordination is required with the BSS when these tasking cannot
be accomplished or accomplished in a timely manner, or if corps augmentation support for PVNTMED is
required. Since priorities change on a daily basis, any PVNTMED support missions not accomplished must
be coordinated with the BSS to ensure priorities have not changed.
F-9. Mental Health Section
a. The MH section (Figure F-4) consists of a behavioral science officer and a MH specialist.
They are responsible for assisting commanders in controlling combat and operational stress through sound
prevention programs. The COSC team operates under the direction of the BSMC commander and provides
brigade-wide MH services. See FM 8-51 for details on COSC duties. The behavioral science officer and
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FM 4-02.6
MH specialist are especially concerned with assisting and training warfighter small-unit leaders, to include
members of unit ministry teams, members of forward deployed medical platoons/sections, and medical
treatment personnel of BSMC.
Figure F-4. Mental health section depicting personnel, major equipment, and
communications/automation enablers.
b. The BSMC MH section provides training and advice in the control of stressors, the promotion
of positive combat/operation stress behaviors, and the identification, handling, and management of
misconduct stress behavior and BF soldiers. It coordinates COSC training for supported units. The section
collects and records social and psychological data and counsels personnel with personal, behavioral, or
psychological problems.
c.
The company MH section uses the brigade clearing station as the center for its operations, but
is mobile throughout the AO. The section’s priority functions are to promote positive stress behaviors,
prevent unnecessary evacuations, and coordinate RTD, not to treat cases. Through the treatment and
ambulance platoon leaders and company commander, the section keeps abreast of the tactical situation and
plans and projects requirements for COSC support when units are pulled back for rest and recuperation.
For definitive information on COSC operations, see FMs 8-10, 8-51, and 22-51. The MH section will be
employed in the BSMC’s command net (refer to Appendix I). For communications, automation, and
navigational capability, the MH section employs the following assets:
• An FBCB2 system for situational understanding in functional area operations; this asset
is employed in the tactical internet to respond to CALL FOR SUPPORT (medical) traffic.
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FM 4-02.6
• An EPLRS used in conjunction with the SINCGARS radio and the FBCB2 system to
facilitate MC4 for managing medical information.
• An AN/VRC 90-F for area communications. The MH section is employed in the BSMC
command net and has the capability to interface with other FM nets as required.
• An MC4 capability (when fielded) with a laptop computer for CHS functional area
operations and medical situational understanding.
• A transponder (BCIS). for fratricide avoidance (when issued).
• A Defense Advanced Global Positioning System Receiver (DAGR) (when issued) for its
vehicle.
d. Functions of the IBCT BSMC mental health section include—
• Conducting surveys and evaluating data to assess unit cohesion and other factors related
to prediction and prevention of both BF casualties and misconduct stress behaviors.
• Identifying and resolve organizational behavioral and social environmental factors that
interfere with combat readiness.
• Monitoring indicators of dysfunctional stress in units.
• Providing consultation and triage as requested for soldiers exhibiting signs of combat
stress or neuropsychiatric disorders.
• Coordinating mental health and stabilization support for soldiers and for their families
from Army and civilian community support agencies.
• Providing counseling to soldiers experiencing emotional or social problems.
• Assisting in the evaluation of command referred emotionally and mentally impaired
soldiers according to Department of Defense Directives (DODDs) 6490.1, Mental Health Evaluation of
Members of the Armed Forces and 6490.5, Combat Stress Control Program.
• Conducting critical-event debriefings/diffusings following traumatic events within the
IBCT.
• Coordinating and/or assisting with getting commanders and their staffs involved in after
action briefings led by unit and small group leaders.
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FM 4-02.6
• Providing stress management training to commander, leaders, and individuals for
recognizing and coping with excessive stress to include leader’s actions for resolving stress related problems
and individual actions for coping with excessive stress.
• Providing COSC consultation services for unit commanders and feedback on the status of
morale, unit cohesion, and adverse trends in their units. Provide recommendations for prevention or
actions required to ensure positive mission-oriented motivation of unit members and unit cohesion.
• Conducting and oversee a three-day unit restoration program for IBCT soldiers ex-
periencing BF or other stress related disorders as required according to FM 8-51.
• Developing TSOPs and TTPs to facilitate the timely acquisition, treatment, disposition
and or RTD of IBCT soldiers with BF or other stress related disorders.
• Ensuring patient encounters are recorded in the soldier’s individual HREC and CEMRs
in the field. The governing regulation is AR 40-66.
• Providing predeployment briefings, postdeployment debriefings, and reunion briefings,
for IBCT personnel and family support groups.
• Providing COSC training and consultation to IBCT medical personnel.
• Providing mental health support in garrison for unit soldiers and families by working
with unit commanders, chaplains, and other medical personnel or if the mission permits, to augment home
station community mental health activity.
• Providing consultation, training, and support to the brigade’s Alcohol and Drug Pre-
vention and Control Program.
• Maintaining technical and tactical proficiency by participating in CME activities, and
ARTEP/Common Task Test related training.
e.
Mental health assistance is requested through the brigade surgeon’s section or the BSB support
operations section. Mental health missions received by the BSB will be coordinated with the BSS for
establishing its priority. The brigade surgeon will establish priorities and coordinate mental health section
support. Mental health support request within the brigade are submitted to the BSS. The BSS submits the
request to the brigade S3 and it tasks the BSB with the support mission. The request for support is sent to
the BSB support operations section/combat health support cell HSSO. The HSSO keeps the BSB and
BSMC commanders informed on any tasks with a high priority. Upon receipt of the mission, the BSMC
commander will accept or reject the mission based on current capabilities and other METT-TC factors.
Coordination is required with the BSS when the requested mental health support cannot be provided or
accomplished in a timely manner, or if corps augmentation support for mental health is required. Since
priorities change on a daily basis, any tasking mission not accomplished must be coordinated with the BSS
to ensure priorities have not changed.
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FM 4-02.6
Section IV. THE TREATMENT PLATOON
F-10. General
The treatment platoon (Figure F-5) contains a treatment squad, an area support treatment squad, an area
support squad, and a patient-holding squad. The treatment squad includes two treatment teams to provide
Echelon I area support and augmentation support to IBCT maneuver battalions, as required. Each of the
treatment teams has a HMMWV ambulance (with trailer) to transport the team and its equipment. The area
support treatment squad is comprised of two treatment teams that operate and provide continuous coverage
for the clearing station. The area support squad provides operational dental care, as well as limited clinical
laboratory and x-ray support to the brigade. The patient-holding squad provides a patient-holding facility
capability of 20 cots. Its primary function is to hold patients awaiting evacuation out of the brigade’s AO; a
secondary function is to hold soldiers who are expected to RTD within 72 hours. The area support
treatment squad, the area support squad, and the patient-holding squad are the elements required to establish
the brigade clearing station of which the treatment platoon is responsible for operating. The clearing
station/MTF receives, triages, treats, and determines the disposition of patients based upon their medical
condition. This platoon provides professional services in the areas of minor surgery, internal medicine,
general medicine, and general dentistry. In addition, it provides patient holding, basic laboratory procedures
for blood cell counts, urinalysis, and microbiology, and radiological services. When patients are able to
RTD after having received treatment, the MTF coordinates with the brigade S1, who in turn contacts the
respective unit to pick up the soldier, or follows brigade standing operating procedures (SOP). The
treatment platoon also serves as the alternate CP for the BSMC.
Figure F-5. Treatment platoon.
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FM 4-02.6
F-11. Treatment Platoon Headquarters
The treatment platoon headquarters (Figure F-6) element directs, coordinates, and supervises platoon
operations based on the IBCT CHS plan. The headquarters element directs the activities of the BSMC’s
clearing station and monitors Class VIII supplies, blood usage, and inventory levels, and keeps the
commander informed. The headquarters element is responsible for the management of platoon operations,
OPSEC, communications, administration, organizational training, supply, transportation, patient account-
ability and statistical reporting functions, and coordination for patient evacuation. For communications, the
headquarters employs an FM radio for C2, and is employed in the BSMC command and internal wire net.
It also employs an MC4 (laptop computer) capability for patient accounting and reporting. The platoon and
its treatment teams also employ an MC4 device to initiate/update the electronic information carrier (EICs).
The platoon headquarters is responsible for supervising the treatment platoon support activities. The
platoon establishes an NCS and is employed in the BSMC’s command net (See Appendix I and Figure I-3)
For communications, automation, and navigational capability, the treatment platoon headquarters employs
the following assets:
• Two FBCB2 systems for functional area reporting and situational understanding. The platoon
headquarters employs FBCB2 and uses the tactical internet applique, to intercept CALL FOR SUPPORT
(medical) traffic.
• Two EPLRS used in conjunction with the SINCGARS radio supporting FBCB2 and MC4
requirements.
• Two AN/VRC 89-F for C2 communications with supporting air ambulances. The treatment
platoon establishes a platoon NCS and is employed in the BSMC command FM net.
• An MC4 capability (when fielded) with two laptop computers for CHS functional area
operations and medical situational understanding.
• An AN/VSX-4 transponder (BCIS) for fratricide avoidance (when issued).
• A DAGR for its vehicle.
F-12. Treatment Squad
The treatment squad (Figure F-7) provides emergency and routine sick call treatment to soldiers assigned or
attached to supported units. This squad is deployed in DS of CS/CSS units. When positioned with the
BSMC, the treatment squad personnel work in the clearing station. The treatment squad/team must be
prepared for short-notice, forward deployment; therefore, personnel, MESs, and vehicles must be in a state
of readiness. The squad has the capability to split and operate as separate treatment teams (Teams A and B)
for limited periods of time. While operating in these separate modes, they may operate up to two aid
stations. For communications, automation, and navigational capabilities, this squad is employed in the
platoon headquarters FM net and employs the following assets:
• An MC4 capability (when fielded) with four laptop computers for CHS functional area
operations and medical situational understanding.
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FM 4-02.6
• Two FBCB2 systems for situational understanding and functional area operations. This
element employs the FBCB2 and uses the tactical internet applique, to intercept CALL FOR SUPPORT
(medical) traffic.
• Two EPLRS used in conjunction with SINCGARS radio supporting FBCB2 and MC4
requirements.
• Team A employs an AN/VRC 89-F and Team B employs an AN/VRC 88-F for communi-
cations with supported and supporting elements. The squad is employed in the treatment platoon’s FM net.
• A transponder (BCIS) for fratricide avoidance; one per team (when issued).
• When issued, two DAGR (one for each vehicle).
• Two GPS.
Figure F-6. Treatment platoon headquarters depicting personnel, major equipment, and
communications/automation enablers.
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FM 4-02.6
Figure F-7. Treatment squad depicting personnel, major equipment, and
communications/automation enablers.
F-13. Area Treatment Squad
The area treatment squad (Figure F-8), along with the area support squad and patient-holding squad, form
the brigade clearing station (Echelon II MTF). The area treatment squad is the base medical treatment
element of the clearing station and does not deploy from the BSMC. The squad provides routine sick call
services and initial resuscitative treatment (ATM and EMT) for supported units. For communications, the
squad employs FM radios and is deployed in the BSMC’s radio and internal wire communications nets.
Teams of this squad operate their radios on the treatment platoon FM net (see Appendix I). For
communications, automation, and navigational capabilities, this squad employs the following assets:
• Two FBCB2 systems for situational understanding and functional area operations. These two
teams employ the FBCB2 systems and use the tactical internet to facilitate the displacement of the clearing
station and to intercept and respond to CALL FOR SUPPORT (medical) traffic.
• Two EPLRS used in conjunction with SINCGARS radio supporting FBCB2 and MC4
requirements.
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FM 4-02.6
• Team A employs an AN/VRC 89-F and Team B employs an AN/VRC 88-F for communi-
cations with supported and supporting elements. The squad is employed in the treatment platoon FM net.
• An MC4 capability (when fielded) with four laptop computers (two per team) for CHS
functional area operations and medical situational understanding.
• Two AN/VSX-4 transponder (BCIS) for fratricide avoidance (when issued).
• Two GPS.
NOTE
This squad, because it operates the brigade clearing station, is not
used to reinforce or reconstitute other medical units. It is not used as
part of the area damage control team.
Figure F-8. Area treatment squad depicting personnel, major equipment, and
communications/automation enablers.
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FM 4-02.6
F-14. Area Support Squad
The area support squad (Figure F-9) includes the dental, medical laboratory, and field x-ray capability. It
provides for basic services commensurate with Echelon II medical treatment. The area support squad is
typically staffed with a dental officer
(63A00), a dental specialist (E4, 91E10), a medical laboratory
sergeant (E5, 91K20) and medical laboratory specialist (E4, 91K10), a radiology sergeant (E5, 91P20) and
a radiology specialist (E4, 91P10). The dental officer supervises the activities of the area support squad.
The area support squad is employed in the treatment platoon FM net (see Appendix I). For communications,
automation, and navigation, this squad employs the following assets:
• An AN/VRC 89-F for communications with supporting air and ground ambulances.
• An MC4 capability (when fielded) with one laptop computer for CHS functional area operations
and medical situational understanding.
• One AN/VSX-4 transponder (BCIS) (when issued) for fratricide avoidance; one per vehicle.
NOTE
This squad is not used to reinforce or reconstitute other medical units.
It is also, it is not normally used on the area damage control team.
a. Dental Element.
(1) The dental element provides operational dental care which consists of emergency dental
care and essential dental care intended to intercept dental emergencies. This also includes dental consultation
and x-ray services.
(2) Operational dental care is the care given for the relief of pain, elimination of acute
infection, control of life-threatening oral conditions
(hemorrhage, cellulitis, or respiratory difficulty);
treatment of trauma to teeth, jaws, and associated facial structures is considered emergency care. It is the
most austere type of care and is available to soldiers engaged in tactical operations. Common examples of
emergency treatment are simple extractions, antibiotics, pain medication, and temporary fillings. Essential
care includes dental treatment necessary for prevention of lost duty time and preservation of fighting
strength. Soldiers in dental Class 3 (potential dental emergencies) should be provided essential care as the
tactical situation permits (refer to FM 4-02.19 for a detailed discussion on dental operations).
b. Medical Laboratory Element. The medical laboratory element performs clinical laboratory
and blood banking procedures to aid physicians and PAs in the diagnosis, treatment, and prevention of
diseases and other medical disorders. Laboratory functions include performing laboratory procedures
consistent with the Echelon II treatment capabilities. This element is responsible for storing and issuing
blood (liquid red blood cells).
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FM 4-02.6
c.
Radiology Element. The radiology element operates x-ray equipment consistent with the
Echelon II treatment capabilities. It is capable of both plane film and regional digital radiography. With the
augmentation of the MDT, this element will also have a reach-back telemedicine capability to request and
acquire digital radiographic diagnostic assistance. The section performs routine clinical radiological
procedures to aid physicians and PAs in the diagnosis and treatment of patients. Specific functions
performed by this element include—
• Interpreting physicians’ orders, applying radiation and electrical protective measures,
operating and maintaining x-ray equipment, and taking x-rays of the extremities, chest, trunk, and skull.
• Performing manual and automatic radiographic film processing (darkroom) procedures.
• Assembling x-ray film files for the patients remaining within the brigade, or arranging
for such film to accompany those patients who are evacuated out of the AO.
• Assisting the NBC NCO with radiological monitoring, surveying, and documentation
procedures.
• Operating and maintaining the assigned generator.
Figure F-9. Area support squad, depicting personnel, major equipment, and
communications/automation enablers.
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FM 4-02.6
F-15. Patient-Holding Squad
a. The patient-holding squad (Figure F-10) operates the patient-holding facility of brigade clearing
station. The holding facility is staffed and equipped to provide care for up to 20 patients. Normally, only
those patients awaiting evacuation or those requiring treatment of minor illness or injuries and who are
expected to RTD within 72 hours are placed in the patient-holding area. The medical-surgical nurse
assigned to the patient-holding squad provides nursing care supervision and is responsible for the operation
of the holding facility. Since Echelon II facilities, such as the BSMC, do not have an admission capability,
patients may only be held at this facility and are not counted as hospital admissions.
Figure F-10. Patient-holding squad, treatment platoon depicting personnel,
major equipment, and communications/automation enablers.
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FM 4-02.6
b. The patient-holding facility also serves as a patient-overflow recovery area for the FST. If
recovery and RTD is not expected within 72 hours, then the patients are sent to an Echelon III hospital.
NOTE
The IBCT commander on advice of the brigade surgeon, may extend
this period up to 96 hours under certain battlefield conditions.
c.
For communications, automation, and navigational capabilities, this squad is employed in the
treatment platoon’s FM net and employs the following assets:
• An FBCB2 system for situational understanding and functional area operations.
• An EPLRS used in conjunction with SINCGARS radio and the FBCB2 system to facilitate
MC4 requirements.
• An AN/VRC 88-F employed in the treatment platoon FM net.
• When fielded, an MC4 capability with a laptop computer for CHS functional area
operations and medical situational understanding.
• An AN/VSX-4 for fratricide avoidance.
• One DAGR for its vehicle, when issued.
F-16. Employment of the Treatment Platoon
a. The treatment platoon establishes its elements using the BSMC layout plan. The platoon
headquarters element supervises the establishment of platoon operations. The platoon leader directs set-up
operations and supervises the displacement of treatment squads/teams, when necessary. The field medical
assistant assists the platoon leader in supervising establishment operations and coordinates the displacement
of treatment squads/teams with company headquarters and supported units. He ensures all platoon elements
perform PMCS on their assigned equipment and reports any deficiencies that are not correctable to the
platoon leader, who reports them to the company commander.
b. The area treatment squad establishes all treatment areas as directed by the treatment platoon
leader. This DS treatment team from the area support treatment squad is tasked with providing medical
support for the company until the clearing station is established.
c.
The dental treatment facility is established within the clearing station/MTF. The dental
officer supervises the placement of dental supplies and equipment within the dental treatment area.
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FM 4-02.6
d. The laboratory element and the radiology element are established within the clearing station/
MTF area. Precautions for operating radiological equipment must be observed. Radiation hazard areas
adjacent to the x-ray facility must be clearly marked and blocked so that personnel are prevented from
crossing too closely to the facility.
e.
The patient-holding squad sets up the patient-holding facility, which is an integral part of the
clearing station. The treatment platoon leader, based on troop concentration and casualty estimates,
determines the number of cots to set up. If the commander directs that less than 20 cots are to be set up, this
may dictate that only one general-purpose large tent be erected. Water, latrine, and a handwash area should
be established for the convenience of those patients being held at this facility.
Section V. THE EVACUATION PLATOON
F-17. General
The evacuation platoon (Figure F-11) performs ground evacuation and en route patient care for the supported
units. The evacuation platoon consists of a platoon headquarters, a GS evacuation section, and a DS
evacuation section. The platoon employs five HMMWV evacuation squads (or ten ambulance teams).
Figure F-11. Evacuation platoon, brigade support medical company.
F-18. Evacuation Platoon Headquarters
a. The evacuation platoon headquarters (Figure F-12) element provides C2 for platoon operations.
It maintains communications to direct ground ambulance evacuation of patients. It provides ground
ambulance evacuation support for the maneuver battalions of the supported brigade combat team and to
units operating in the BSA. It also provides ground ambulance support to other units receiving area medical
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FM 4-02.6
support from the BSMC. Further medical evacuation to Echelon III hospitals is the responsibility of the
next higher echelon, to include ground and air evacuation. Personnel assigned to the evacuation platoon
headquarters include the platoon leader and platoon sergeant.
Figure F-12. Evacuation platoon headquarters depicting personnel, major equipment,
and communications/automation enablers.
b. The evacuation platoon headquarters element directs and coordinates ground evacuation of
patients. This element supervises the platoon and plans for its employment. It establishes and maintains
contact with supported units and forward deployed treatment squad/teams of the BSMC. The platoon
headquarters element performs route reconnaissance and develops and issues all necessary route and
navigational information, to include strip maps, maps, graphic control measures, and any other pertinent
information. If possible, the information is provided via the FBCB2 system to all ambulance teams. The
platoon headquarters element also coordinates and establishes AXPs for both air and ground ambulances, as
required. The EVAC platoon establishes an NCS for its EVAC teams. For communications, the platoon
headquarters employs—
• An AN/VRC 89-F for C2. It is employed in the BSMC’s command net and establishes a
platoon net for connectivity with forward deployed evacuation squads.
• An FBCB2 system for situational understanding and functional area operations. The
platoon employs the FBCB2 system and uses the tactical internet applique to intercept CALL FOR SUPPORT
(medical evacuation) traffic.
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FM 4-02.6
• An EPLRS used in conjunction with the SINCGARS radio supporting FBCB2 and MC4
requirements.
• An MC4 (when fielded) capability with a laptop computer to facilitate functional area
requirements.
• When issued, an AN/VSX-4 transponder (BCIS) for fratricide avoidance.
• A DAGR navigational device for its vehicle.
F-19. Evacuation Squads
a. The evacuation squads (Figures F-13 and F-14) provide ground evacuation of patients from
supported units to the brigade clearing station/BSMC MTF. The evacuation squads consist of five emergency
care sergeants and fifteen ambulance aides/drivers. Evacuation squad aide/evacuation personnel perform
EMT, prepare patients for evacuation, and provide en route care for patients they evacuate. They also
operate and maintain assigned radios and other CE equipment. Evacuation platoon personnel maintain and
perform PMCS on assigned ambulances and associated equipment. Evacuation squad personnel maintain
supply levels for the ambulance MESs. They ensure that appropriate property exchange of medical items
(such as litters and blankets) is made at sending and receiving MTFs (Army only). Ambulance teams
maintain situational understanding and use all available navigational tools to ensure quick and secure
evacuation of patients.
b. For communications, each ambulance team/evacuation squad is employed in the platoon FM
net. Each team employs the following communications, automation, and navigational equipment:
• An AN/VRC 90-F radio with the capability to monitor supported units FM radio nets.
• An FBCB2 system for situational understanding and functional area operations. Elements
also employ the FBCB2 system and use the tactical internet applique to intercept and respond to CALL FOR
SUPPORT (medical evacuation) traffic.
• An EPLRS, used in conjunction with SINCGARS radio and the FBCB2 system, to
facilitate MC4 and operational area requirements.
• An MC4 capability (when fielded) with a laptop computer to facilitate functional area
operations activity.
F-25
FM 4-02.6
Figure F-13. Direct support evacuation squad depicting personnel, major equipment,
and communications/automation enablers.
F-26
FM 4-02.6
Figure F-14. General support evacuations squad depicting personnel, major equipment,
and communications/automation enablers.
F-27
FM 4-02.6
F-20. Employment of the Evacuation Platoon
Each ambulance team carries an on-board MES designed for medical emergencies and en route patient care.
Ambulances either deploy forward to support maneuver battalions’ BASs or with treatment squads/teams of
the BSMC at AXPs. The evacuation platoon leader and platoon sergeant conduct reconnaissance of the area
of support to establish primary and alternate evacuations routes, to verify locations of supported units, and
to field site ambulance teams as necessary. The platoon leader and platoon sergeant coordinate support
requirements with supported units for ambulance platoons placed in DS. Evacuation platoon personnel
obtain appropriate dispatch and road clearances prior to departing company or supported unit areas. The
platoon leader ensures that maps, graphic control measures, and all available information is provided to
platoon personnel. If time and fuel permit, the platoon leader or platoon sergeant may take ambulance
drivers on a rehearsal of the evacuation routes. The platoon leader/sergeant coordinates/establishes AXPs
as required by the medical evacuation mission. The ambulances are usually positioned forward with the aid
stations of maneuver battalions/squadrons. The DS ambulances normally evacuate patients from the aid
stations back to the AXPs where patients are placed in either a ground or air ambulance for further medical
evacuation back to the BSMC. The GS ambulances are used for area support missions. Evacuation platoon
personnel assist with establishment of the BSMC and provide available personnel as tasked by the 1SG. For
definitive information on medical evacuation operations, see FMs 8-10-6 and 8-10-26.
Section VI. COMBAT HEALTH LOGISTICS SUPPORT FOR
THE BRIGADE COMBAT TEAM
F-21. Overview
a. The BSMC has limited Class VIII/blood management capability. During deployment,
lodgment, and early buildup phases, the BSMC operate from planned, prescribed loads and from existing
pre-positioned stocks identified in applicable contingency plans. The Strategic Logistics System for Class
VIII is operated within CONUS by US Army Medical Materiel Agency (USAMMA) and the Defense
Logistics Agency (DLA) depot system. If USAMMA coordinates Class VIII support of the AO, it is done
with the designated medical C2 unit that is deploying and with the defense logistics activity of the Joint
headquarters. This support consist of procurement and shipment of preplanned medical supply packages in
support of the BSMC, medical platoon/section of IBCT maneuver battalion and other supporting medical
elements. If home station MEDLOG activities provides the initial Class VIII supply/resupply, this is
preplanned and prepackaged Class VIII materiel tailored to meet the need of the IBCT. Class VIII packages
will be scheduled based on projected casualty estimates and may be adjusted based on the Class VIII supply
requirements identified by the BSS and availability of platforms for shipment. While resupply by
preconfigured Class VIII packages is intended to provide support during the initial phase, continuation on
an exception basis may be dictated by operational needs. Planning for such a contingency must be
coordinated with the BSS and the HSMO of the BSB support operations section. The MEDLOG packages
should continue until line item requisitioning can be established. A combination of line item requisitioning
and preplanned Class VIII packages could be the resupply method. All IBCT medical units will deploy with
enough supplies to support a 96-hour self-sustainment mission within the AO.
F-28
FM 4-02.6
b. Resupply of the BSMC will be conducted by electronic requisitions sent to the supporting
MEDLOG activity. This could be either a Joint, Army, or home station MEDLOG activity (Reach). If the
BSMC is supported by a corps MEDLOG company, requisitions will be sent to that supporting MEDLOG
company. Class VIII resupply will flow via the battlefield distribution system. It is important to note that if
required, BSMC/BSB HSMO has the authority/capability to order directly from any supply support activity
(SSA) located geographically in the operational area. The release orders for materiel will be processed by
the MEDLOG company and shipped by the fastest appropriate transportation system to the IBCT. Corps-
level DS medical units/elements will forward Class VIII requisitions through the BSMC CHL element.
c.
Unique to the IBCT is the range and complexity of CHL support. The probability of corps-
level CHS (surgery, hospitalization, intensive care, and extensive blood usage) within the IBCT footprint
will result in a significant increase in the variety and urgency of medical supplies and equipment. Priority
of transportation of critical Class VIII materiel will have to be recognized and supported throughout the
distribution system. Blood support to the operation will follow the same procedures.
F-22. Health Service Materiel Officer
a. The HSMO of the BSB support operations section oversees and manages the Class VIII supply
system in the IBCT. The HSMO will coordinate all Class VIII requirements for the IBCT with the
supporting MEDLOG activity as appropriate. The HSMO tracks critical Class VIII shortages and in
coordination with the BSMC and the BSS, recommends the priority for their requisition and delivery. The
HSMO also coordinates for the disposition of captured enemy medical materiel. The HSMO and the BSS
together manage all CHL issues and operations within the IBCT.
b. Management of the IBCT Class VIII authorized stockage list (ASL) is the responsibility of the
HSMO as directed by the brigade surgeon. The ASL will be maintained and published by the HSMO.
Changes, additions, and deletions to the ASL will be forwarded through the HSMO, with final approval
authority being the brigade surgeon. The BSMC CHL element is responsible for physical control,
maintenance, and supply operations associated with the ASL.
F-23. Functional Combat Health Logistics Module Business Systems
Class VIII automation management in the IBCT is accomplished by medical units/elements through the use
of the software application of the TMIP/MC4 system (when fielded). The TMIP/MC4 system provides
division/brigade medical units/elements a direct link with the supporting MEDLOG activity.
F-24. Class VIII Requisitioning in the Brigade
a. Routine (Nondigital). Routine requisitions for Class VIII supplies are submitted to the BSMC
using a DA Form 2765-1, Request for Issue or Turn-in, for each item or TSOP. The BSMC may fill these
requests or forward them to the supporting MEDLOG activity. The BSMC coordinates the delivery of
Class VIII supplies to the requesting unit through the BSB support operations section (HSMO) or issues the
F-29
FM 4-02.6
items through supply point distribution. Class VIII deliveries coordinated through the support operations
section will be included in the daily LOGPAC deliveries. Requisitions may also be sent via FBCB2,
SINCGARS, or by using a sneaker net method (placing the requisitions on a floppy disk and having it hand-
carried to the BSMC). Prior to deployment, medical platoon personnel should know the Class VIII
requisitioning requirements and procedures.
b. Digital Request. When fielded, the CHL module of TMIP/MC4 will be used by Echelon II
and below medical units/elements found at division- and brigade-levels. The maneuver battalion medical
platoon and the BSMC will use this system for digital requisition of Class VIII materiel. The CHL
functional module of TMIP/MC4 system is capable of assemblage management, to include replenishment
and quality control for all MESs for all medical unit/elements. The MC4/TMIP system will also be used for
individual line-item requisitioning and employ automated receipt updating to expedite issue. The reports
section of the CHL functional module of the MC4/TMIP will produce equipment on hand (EOH) percentages
that are used in unit status reporting.
c.
Emergency Request. Emergency requisitions for Class VIII supplies are sent to the BSMC via
radio, telephone, or hand delivered. Any item not filled is immediately forwarded to the supporting
MEDLOG activity. The BSMC’s CHL element in coordination with the HSMO will expedite handling of
this request to ensure tracking of critical Class VIII items and timely delivery. All emergency requests
received by the MEDLOG activity are processed for shipment by the most expedient transportation available.
Delivery of emergency requests will be by the most expedient mode of transportation, based on METT-TC
factors.
F-25. Medical Maintenance
Medical maintenance will consist of operator-/user-level maintenance. See FM 4-02.1 for additional
information. Medical platoon personnel will exercise their responsibilities by performing operator PMCS.
This includes maintaining equipment by performing routine services like cleaning, dusting, washing, and
checking for frayed cables, loose hardware, and cracked or rotting seals. In addition, medical platoon
personnel will—
• Perform equipment operational testing.
• Replace operator-level spares and repair parts that will not require extensive disassembly of
the end item, critical adjustment after the replacement, or extensive use of tools.
The HSMO coordinates medical equipment replacement requisition with the supporting MEDLOG activity.
F-26. Property Exchange
When patients are evacuated to and from the BSMC, property exchange will occur between the BSMC’s
ambulances and the supporting or supported elements to prevent unnecessary depletion of items. Whenever
a patient is evacuated from one MTF to another or is transferred from one ambulance to another, medical
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FM 4-02.6
items of equipment (casualty evacuation bags [cold weather-type bags], blankets, litters, and splints) remain
with the patient. To prevent rapid and unnecessary depletion of supplies and equipment, the receiving
Army element exchanges like property with the transferring element. This reciprocal procedure will be
practiced to the fullest extent possible through all phases of evacuation from the most forward element
through the most rearward hospital.
F-27. Delivery of Class VIII Supplies
a. Class VIII and blood to the BSMC will be shipped from the supporting MEDLOG activity to
the BSMC via the battle distribution system.
b. Delivery of Class VIII supplies to requesting medical elements in the IBCT is accomplished by
LOGPACs. Shipment of Class VIII resupply from the BSMC is coordinated with the BSB support operations
section and the BSS. Working through the HSMO of the BSB support operations section, the BSMC
MEDLOG element ensures requested Class VIII is shipped via LOGPAC to the appropriate unit. In some
cases, delivery of medical materiel within the IBCT may also be achieved through use of the directed Class
VIII resupply using returning air or ground backhaul resources that are returning to an IBCT unit.
Emergency Class VIII resupply will be processed for shipment by the most expedient means available.
Based on casualty estimates, medical push-packages may be pre-positioned with maneuver battalion medical
platoons or with the BSMC. Figure F-15 provides an overview of Class VIII requisitions and resupply flow
at Echelon I.
F-28. Blood Management
Blood for the IBCT is only used at Echelon II MTFs (BSMC and FST). The brigade surgeon determines
blood requirements. Only packed liquid red blood cells are expected to be available to the brigade. Blood
products are shipped directly to the BSMC by the blood support detachment of the MEDLOG battalion.
The BSB HSMO coordinates with the blood support detachment for blood requirements. Shipment of blood
from EAB to the IBCT is coordinated by the blood support detachment with the EAB MCO/movement
control center. It is then transported to the requesting MTF by dedicated medical vehicles (air and ground).
The blood support detachment notifies the BSB HSMO when blood is shipped. Emergency resupply can be
accomplished by air ambulances from the medical battalion, evacuation, or by medical personnel on
nonstandard medical transports. See FMs 8-10, 8-10-9, and 8-55 and TM 8-227-12 for definitive information
on blood management.
F-31
FM 4-02.6
Figure F-15. Overview of Class VIII resupply at Echelon I.
F-32
FM 4-02.6
APPENDIX G
TACTICAL STANDING OPERATING PROCEDURE
G-1. General
This appendix provides a sample TSOP format for a medical company. The information on the clinical
aspects of the treatment and evacuation elements can be included in the TSOP or prepared separately as a
clinical standing operating procedure (CSOP) (Appendix H). This sample TSOP should not be considered
as all-inclusive. However, this information and the unit mission training plan are good starting points for
developing the TSOP. It may be supplemented with information and procedures required for operating
within a particular command.
G-2. Purpose of the Tactical Standing Operating Procedure
The TSOP prescribes policy, guidance, and procedures for the routine tactical operations of a specific unit.
It should cover broad areas of unit operations but be sufficiently detailed to provide newly assigned
personnel the guidance required for them to assume their new positions. A TSOP may be modified by
TSOPs and OPLANs/OPORDs of higher headquarters. It applies to a specific unit and all subordinate units
assigned and attached. Should a TSOP not conform to the TSOP of the higher headquarters, the higher
headquarters’ TSOP governs. The TSOP should be periodically reviewed and updated as required.
G-3. Format for the Tactical Standing Operating Procedure
a. There is not a standard format for all TSOPs; however, it is recommended that the unit’s
TSOP follow the format used by its higher headquarters. The TSOP can be divided into sections (specific
functional areas or major operational areas). The TSOP can contain one or more annexes, each of which
may have one or more appendixes. The appendixes may each have one or more tabs. Appendixes can be
used to provide detailed information on major subdivisions of the annex and tabs can be used to provide
additional information (such as report formats or area layouts) addressed in the appendix.
b. Regardless of the format used, the TSOP should follow a logical sequence in the presentation
of material. As a minimum, it should discuss the—
• Chain of command.
• Major functions and staff sections of the unit.
• Operational requirements.
• Required reports.
• Necessary coordination with higher and subordinate elements for mission accomplish-
ment.
• Programs (such as command information, PVNTMED measures, and CSC).
• Other relevant topics.
G-1
FM 4-02.6
c.
Pagination of the TSOP can be accomplished by starting with page 1 and numbering the
remaining pages sequentially. If the TSOP is subdivided into sections, annexes, appendixes, and tabs, a
numbering system that clearly identifies the location of the page within the document can be used. Annexes
are identified by letters and are listed alphabetically. Appendixes are identified by numbers and arranged
sequentially within a particular annex. Tabs are identified by a letter and are listed alphabetically within a
specific appendix. After numbering the initial sections using the standard numbering system (sequentially
starting with page 1 through to the end of the sections), then beginning with the annexes and their
subdivisions, they are numbered as the letter of the annex, the number of the appendix, the letter of the tab,
and the page number. For example, page 4 of Annex D is written as “D-4”; page 2 of Appendix 3 to
Annex D is written as “D-3-2”; page 5 of Tab A to Appendix 3 of Annex D is written as “D-3-A-5”. This
system of numbering makes the pages readily identifiable as to their place within the document.
d. In addition to using a numbering system to identify specific pages within the TSOP, descriptive
headings should be used on all pages to identify subordinate elements of the TSOP.
(1) The first page of the TSOP should be prepared on the unit’s letterhead. The remaining
pages of the major sections should include the unit identification in the upper right hand corner of the page
(for example:
“____Medical Company”).
(2) A sample heading for an annex is:
“ANNEX C (Administration and Personnel) to
____Medical Company.”
(3) A sample heading for an appendix is:
“APPENDIX 2 (Personnel Management) to
ANNEX C (Administration and Personnel) to ____Medical Company.”
(4) A sample heading for a tab is:
“TAB A (Award Recommendations) to APPENDIX 2
(Personnel Management) to ANNEX C (Administration and Personnel) to ____Medical Company.”
e.
As the TSOP is developed there may be an overlap of material from one annex to another.
This is due in part to similar functions that are common to two or more unit elements. Where overlaps
occur, the material presented should not be contradictory. All discrepancies will be resolved prior to the
authentication and publication of the TSOP.
G-4. Sample Tactical Standing Operating Procedure (Sections)
The information contained in this paragraph can be supplemented. It is not intended to be an all-inclusive
listing. Different commands will have unique requirements that need to be included.
a. The first section of the TSOP identifies the unit that developed it.
(1) Scope. This document establishes and prescribes procedures to be followed by the
designated unit and its assigned, attached, or OPCON units/elements.
(2) Purpose. This document provides policy and guidance for routine tactical operations of
this unit and its assigned, attached, or OPCON units.
G-2
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