|
|
|
FM 4-02.6
(2) When processing individuals for deployment, the MTF and dental treatment facility
(DTF) will audit each individual’s HREC or CEMR and record essential health and dental care information
on DD Form 2766. If a HREC or CEMR is not available, DD Form 2766 will be completed based on
individual interviews and any other locally available data. A HREC may not be available for most
Individual Ready Reserve, Individual Mobilization Augmentees, and retired personnel because these HRECs
may remain on file at the Army Reserve Personnel Command (ARPERSCOM) or the VA.
(3) Upon notification of deployment, all military personnel will complete DD Form 2795.
(a) The individual being screened will fill out the section entitled Demographics on
page 1, and the section entitled Health Assessment on page 2. These sections are self-explanatory.
(b) The health assessment administrator will fill out the boxed area on page 1 entitled
Administrator Use Only, and will answer the user’s questions on filling out the form. The administrator will
document the deployment location as well as the completion date of the pre-deployment evaluation on DD
Form 2766, Block 11, Pre-/Post-Deployment History. This does not apply to classified operations.
(c) The health care provider will fill out the section entitled Pre-Deployment Health
Provider Review on page 2.
(d) A copy of the form will be filed on the fastener inside the DD Form 2766 folder;
one copy will remain in the HREC, and the original form will be sent to the Army Medical Surveillance
Activity, ATTN: MCHB-TS-EDM/Deployment Surveillance, Building. T-20, Room 213, 6825 16th Street
NW, Washington, DC 20307-5000.
(4) Department of Defense Directive 6490.2 and Department of Defense Instruction (DODI)
6490.3 state that to the extent applicable, medical surveillance activities will include essential DOD civilian
and contractor personnel directly supporting deployed forces, consistent with plans established under DODIs
1400.32 and 3020.37. If DD Form 2795 is used for civilians, a copy of the form will be filed on the
fastener inside the DD Form 2766 folder; one copy will remain in the CEMR, and the original form will be
sent to the Army Medical Surveillance Activity.
(5) If the deployed individual is taking part in a classified operation, the pre-deployment
evaluation (DD Form 2795) is still required, but the form will be maintained only in the personnel folder.
(6) The completed DD Form 2766 and a copy of any printout from an automated immuni-
zation tracking system will be provided to the individual’s command, or to the individual if he or she is an
individual replacement, and then handed off to the MTF in the AO responsible for providing primary
medical care to that individual. That MTF will maintain the DD Form 2766 as an outpatient field file for
reference as needed. The MTF will ensure that the ABO/Rh blood type from a verified blood bank typing
is recorded in Block 10. The field file will consist of, in part, DD Form 2766, DD Form 2795, and possibly
DD Form 2766C, DD Form 2796, SF 600, SF 558 (Medical Record-Emergency Care and Treatment),
SF 603 (Health Record-Dental), or DD Form 1380. These forms will be filed on the fastener inside
the DD Form 2766. For detailed information on how to complete the DD Form 1380, see Appendix C, FM
8-10-6.
K-2
FM 4-02.6
(7) If DD Form 2766 is not available, the individual’s field file may be managed as a “drop”
file (forms not attached) and integrated into the DD Form 2766 when it is available.
b. Forwarded Deployed Force. If time permits, follow guidance in a(1), (2), and (3) above. If
not, consolidate HREC in-country and process when time permits.
c.
Limited Contingency Operations. Retain the HREC at the MTF and DTF providing primary
care. If the servicing primary care facility closes, forward the HREC to the MTF or DTF indicated by the
servicing MEDDAC and dental activity. If full mobilization occurs, follow guidance in a(1), (2), and (3) above.
d. Units That Do Not Process Through a Mobilization Station. Units that do not process through
a mobilization station before deployment or otherwise do not have access to an MTF or DTF will follow the
procedures in b above.
K-3. Use of Field Files/DD Form 2766
a. If a member’s primary MTF changes, the field file/DD Form 2766 should be moved to the
gaining MTF.
b. If a member requires admission to the hospital, every attempt will be made to forward the field
file/DD Form 2766. The file will be returned to the member’s primary MTF if disposition is RTD.
K-4. Storage of Health Records and Civilian Employee Medical Records
Forward deployed (Echelon I and Echelon II) MTFs will secure field chest or field file containers in
quantities sufficient for the troop and civilian employee population supported. They will maintain the DD
Form 2766 for each individual receiving primary medical care from their MTF.
K-5. Establishment and Management of the Field File in the Operational Area
a. A DD Form 2766 and the medical records identified above will be maintained by medical
companies operating an Echelon II MTF or the medical platoon/section that operates an Echelon I MTF, or
will be handed off to the MTF providing their primary care.
b. Supported units will be required to provide the primary care MTF a battle roster of personnel
assigned. This roster should be provided when personnel assignment changes are made or upon request.
c.
The MTF, when possible, will attempt to ensure that the HREC or CEMR accompanies the
medically evacuated individual.
d. If an individual’s primary MTF changes, the HREC or CEMR will be transferred to the
gaining MTF.
K-3
FM 4-02.6
e.
If an individual requires hospital admission, every attempt will be made to forward the HREC
or CEMR to the admitting hospital.
f.
When the MTF determines that an individual was evacuated without the DD Form 2766 and
other medical records in the file, then the individual’s DD Form 2766 and other medical records are
forwarded to the medical C2 headquarters responsible for regulating patients out of the AO. The medical
C2 headquarters forwards the outpatient field file to the hospital where the patient was evacuated. The
hospital patient administration section will attach the file to the inpatient chart and the file is evacuated with
the patient out of the AO or theater.
K-6. Health Assessments after Deployment
a. All military personnel will complete DD Form 2796 prior to leaving the AO.
(1) The individual being screened will fill out the section entitled Demographics on page 1
and the section entitled Health Assessment on page 2. These sections are self-explanatory.
(2) The health assessment administrator will fill out the boxed area on page 1 entitled Admin-
istrator Use Only and will answer the user’s questions on filling out the form. The administrator will
document the deployment location (if this information is missing) and the completion date of the post-
deployment evaluation on DD Form 2766, Block 11, Pre-/Post-Deployment History. This does not apply to
classified operations.
(3) The health care provider will fill out the section entitled Post-Deployment Health Provider
Review on page 2.
b. If a situation does not allow this health screening prior to departure, the individual’s commander
will ensure that the health assessment is completed and submitted to the local MTF commander within 30
days of the individual’s return. The local MTF commander will ensure that a procedure is in place for
submitting the original DD Form 2796 to the Army Medical Surveillance Activity and for filing a copy in
the HREC.
c.
If the DD Form 2796 is completed prior to leaving the AO, a copy of the form will be filed in
the DD Form 2766 folder until it can be integrated into the HREC. The original DD Form 2796 will be
submitted to the Army Medical Surveillance Activity, ATTN: MCHB-TS-EDM/Deployment Surveillance,
Building. T-20, Room 213, 6825 16th Street NW, Washington, DC 20307-5000.
d. The post-deployment assessment of Reserve Component personnel must be completed prior to
release from active duty if not completed before redeployment. Reserve Component personnel who have
been deployed will also complete DD Form 2697 (Report of Medical Assessment) according to AR 40-501.
Reserve Component personnel who are called to active duty but never actually deployed will only complete
DD Form 2697.
e.
If DD Form 2796 is used for civilians, the form will be completed prior to leaving the AO. If
a situation does not allow this health screening prior to departure, the individual’s commander will ensure
K-4
FM 4-02.6
that the health assessment is completed within 30 days of the individual’s return. If the DD Form 2796 is
completed prior to leaving the AO, a copy of the form will be filed in the DD Form 2766 folder until it can
be integrated into the CEMR. The local commander will ensure that a procedure is in place for submitting
the original DD Form 2796 to the Army Medical Surveillance Activity and for filing the copy in the CEMR.
f.
If the deployed individual is taking part in a classified operation, the post-deployment evaluation
(DD Form 2796) is still required, but the form will be maintained only in the personnel folder.
K-7. Field Record Administration after Hostilities Cease
a. Field files/DD Form 2766 will be integrated with the HREC or CEMR after demobilization at
the home station or at mobilization stations.
(1) On return to the MTF (post-deployment), forms, such as SF 600, will be removed from
the DD Form 2766 folder and placed with the other SF 600 in the medical record.
(2) DD Form 2795 and DD Form 2796 will be removed from the DD Form 2766 folder and
placed as shown in Figures 5-1, 5-2, or 7-1 of AR 40-66. If a previously photocopied DD Form 2795 is
contained in the record, only one of the DD Forms 2795 will be kept; the other will be removed and
shredded.
(3) The photocopies of the DD Form 2766 and DD Form 2766C will also be removed and
shredded when the originals are placed back into the record. Field files/DD Form 2766 will be forwarded
to ARPERSCOM for those members who’s HREC is maintained at ARPERSCOM.
b. Each CONUS MTF must request records from ARPERSCOM for those members who remain
on active duty and are assigned for support upon demobilization.
c.
Field files will be integrated with the HREC maintained at home station or mobilization
station. Field files will be forwarded to Army Reserve Personnel Center (ARPERCEN) for members who’s
HREC is maintained at ARPERCEN.
d. Each CONUS MTF must request records from ARPERCEN for those soldiers who remain on
active duty and are assigned for support upon demobilization.
K-5
FM 4-02.6
APPENDIX L
CLINICAL GUIDELINES FOR COMBAT CASUALTY CARE
Section I. CLINICAL GUIDELINES FOR PHYSICIAN-LEAD, PHYSICIAN
ASSISTANT-LEAD, AND NURSING-LEAD TREATMENT MODULES
L-1. General
a. This appendix provides guidelines for use of personnel providing combat casualty care within
the medical company. It focuses on the clinical aspects of the unit’s operations.
b. The phased concept of combat casualty care, unique to war, permits the medical company, an
Echelon II MTF, to do what must be done to render casualties transportable to an Echelon III MTF for
continued treatment, or to treat and care for them for a limited period of time until they are able to RTD.
L-2. Field Surgeon (62B00 MC)
The credentialed physician (field surgeon) commanding trauma treatment elements examines, diagnoses,
and treats or prescribes course of treatment for the initial phase of battlefield disease and injury. He
provides resuscitative and definitive care for injured and wounded soldiers within the capability of the unit’s
medical element. This physician is also credentialed in Advance Trauma Life Support (ATLS®). Accord-
ingly, he establishes and practices techniques and procedures in accordance with ATLS® protocols. The
field surgeon also provides guidance to assigned clinical personnel and ensures the efficacy of their capability
in handling the sick and wounded/trauma casualty. He also ensures his team readiness and continued
training in tactical emergency medical care.
L-3. Physician Assistant (65D00 SP)
Physician assistants leading emergency medical treatment elements are ATM certified. The ATM is
composed of ATLS® and military specific/unique ATM and resuscitative skills. They practice techniques
and procedures in accordance with established ATM protocols. The PA also provides clinical guidance to
assigned medical personnel and insures the efficacy of their capability in handling of the sick and wounded/
trauma casualty.
L-4. Medical-Surgical Nurse (66H00 AN)
The medical-surgical nurses leading patient holding elements provide professional nursing care and health
care promotion for the assigned unit and the broader military community. Their responsibilities include
ambulatory, medical-surgical, emergency, and critical care nursing. The medical-surgical nurse duties
include supervision of holding squad personnel and technical training for 91W personnel of the unit. The
medical-surgical nurse also provides nursing care for those patients that overflow the FST’s recovery area.
L-1
FM 4-02.6
L-5. Forward Surgical Team
This physician-lead 20-person Echelon II trauma treatment module employs three clinical functional areas:
triage-trauma management, surgery, and recovery.
Section II. HEALTH CARE SPECIALISTS TREATMENT AND
EVACUATION MODULES
L-6. The 91W Health Care Specialist
Health care specialists assigned to treatment teams, holding squad, and ambulance teams of the medical
company/troop serve as integral members of the warfighting team by combining the skills of soldier and
medical caregiver. The 91W performs emergency and evacuation care under the medical direction of a
physician or other credentialed providers. Serves as a clinical technician in inpatient and outpatient areas of
MTFs. Performs basic force health protection care for individual soldiers and small units. Is trained for
combat and other operational environments. Conducts casualty triage and provides medical care for
patients in all operational environments to include enroute care during ground and air ambulance evacuations.
The 91W is certified to the national standards of emergency medical technician-basic (EMT-B) and
augmented by the national EMT-intermediate curriculum.
L-7. Core Competencies of the 91W
The 91Ws of medical company/troop must be trained/credentialed in several areas of core competencies.
These core competencies are examples of specific skills that establishes the scope and depth of clinical
practice that are outlined in Tables L-1 through L-3 below.
Table L-1. Core Competency for Emergency Medical Care
CORE COMPETENCY IN EMERGENCY CARE FOR THE 91W IS INCLUSIVE OF THE FOLLOWING:
• BATTLEFIELD AND OPERATIONAL FOCUS
• FAR FORWARD PRIMARY CARE
• SKILLS TO SUPPORT UNIT READINESS AND OPERATIONAL NEEDS
• SKILLS IN CONTEXT OF TACTICAL/OPERATIONAL ENVIRONMENT
EXAMPLES:
A. ALL EMT-BASIC SKILLS
1. ABCs (AIRWAY, BREATHING, CIRCULATION), CPR (CARDIOPULMONARY RESUSCITATION), OXY-
GEN THERAPY, SUCTION, AND SO FORTH.
2. BLEEDING CONTROL, BANDAGING, SPLINTING
3. BLS (BASIC LIFE SUPPORT) CARE FOR A BROAD ARRAY OF EMERGENCIES
4. DOCUMENTATION OF MEDICAL CARE
L-2
FM 4-02.6
Table L-1. Core Competency for Emergency Medical Care (Continued)
B. ADVANCED AIRWAY MANAGEMENT (INTUBATION, CRICOTHYROTOMY)
C. DECOMPRESSION OF TENSION PNEUMOTHORAX
D. VASCULAR ACCESS: INTRAVENOUS, INTRAOSSEOUS
E. FLUID RESUSCITATION
F. NBC MEDICAL PROCEDURES
G. LIMITED MEDICATIONS
1. CONTROLLED MEDICATIONS (SUCH AS MORPHINE)
2. CEPHALOSPORIN (ANTIBIOTIC)
3. ATROPINE (NERVE AGENT ANTIDOTE)
4. PRALIDOXIME (NERVE AGENT PROPHYLAXIS)
5. NITRITES, SULFATES (CYANIDE ANTIDOTE)
6. ALBUTEROL (PULMONARY AGENTS)
7. EPINEPHRINE, BENADRYL (ANAPHYLAXIS)
8. OTHER MEDICATIONS AT THE DISCRETION OF THE ATTENDING PHYSICIAN
H. ASSIST WITH AND MAINTAIN MEDICAL INTERVENTIONS INITIATED IN ECHELONS I, II, AND III DURING
TRANSPORTATIONS. ASSIST IN THESE PROCEDURES:
1. NASOGASTRIC INSERTION
2. FOLEY CATHETER INSERTION AND MAINTENANCE
3. CHEST TUBE(S) INSERTION AND MAINTENANCE
I. TRIAGE/MASCAL
J. ALL EMERGENCY CARE SKILLS ARE TRANSFERABLE TO INPATIENT/PATIENT HOLDING SETTING
Table L-2. Core Competency for Primary Medical Care
CORE COMPETENCY IN PRIMARY CARE FOR THE 91W IS INCLUSIVE OF THE FOLLOWING:
• SICK CALL NEEDS OF FAR-FORWARD UNITS
• ACUTE DENTAL, PSYCHOLOGICAL, AND OTHER PRIMARY CARE NEEDS
• PROTOCOL-DRIVEN COMMON FIELD CLINICAL PROBLEMS
EXAMPLES:
A. HEADACHE, COUGH, SORE THROAT AND OTHER MINOR COMPLAINTS
B. SPRAINED ANKLE, BRUISES, CUTS AND OTHER MINOR INJURIES
C. MINOR WOUND CARE AND CLOSURES (STAPLES/SUTURES)
D. LIMITED OVER-THE-COUNTER (OTC) MEDICATIONS
1. ACETAMINOPHEN (HEADACHE)
2. IBUPROFEN (ACHES AND PAINS)
3. ANTACIDS (DYSPEPSIA)
4. KAOPECTATE (DIARRHEA)
5. BENADRYL (ITCH)
6. CALAMINE LOTION (POISON IVY)
7. OTHER AVAILABLE OTC MEDICATIONS APPROVED BY A PHYSICIAN
E. REHABILITATION OF HEAT EXHAUSTION, FATIGUE, COLD EXPOSURE, AND SO FORTH
F. ASSIST PHYSICIAN/PA IN SICK CALL PROCEDURES
G. APPROPRIATE DOCUMENTATION (PATIENT CHARTING AS APPROPRIATE)
H. CONDUCT BASIC AMBULATORY CARE—TRIAGE
L-3
FM 4-02.6
Table L-3. Core Competency for Medical Evacuation
CORE COMPETENCY IN PATIENT EVACUATION AND RETRIEVAL FOR THE 91W IS INCLUSIVE OF THE FOLLOWING:
• EXTRACTION OFF THE BATTLEFIELD
• EXTRICATION FROM ALL TYPES OF COMBAT VEHICLES AND AIRCRAFT
• ONGOING EVACUATION CARE
• REQUESTING AIR/OR GROUND EVACUATION
EXAMPLES:
A. EXTRACTION OFF THE BATTLEFIELD
B. MANUAL AND LITTER CARRIES
C. EVACUATION PLATFORM LOADING/UNLOADING
D. EXTRICATION FROM VEHICLES/AIRCRAFT
E. OPERATING TACTICAL GROUND AMBULANCES (TRACKED AND WHEELED)
F. BASIC EN ROUTE MEDICAL CARE ONGOING FOR UP TO 48 HOURS
G. APPLICATION OF TACTICAL MEDICAL EVACUATION PROCEDURES AND RADIO COMMUNICATIONS
L-8. Medical Training
Tables L-4 through L-6 contains the critical tasks to be used by the commander in the development of unit
medical training program for assigned or attached 91W personnel. The training will be conducted under the
auspices of a licensed physician. The 91W will be certified to the national standards of EMT-B and
augmented by the national EMT-intermediate curriculum. The commander (medical company/troop) will
coordinate with the senior medical officer for consultation as needed, supervision of the unit’s continuing
education program, and to serve as the medical liaison between the unit and other services/facilities.
Table L-4.
91W10/20 Critical Task List
1. PERFORM AN INITIAL CASUALTY ASSESSMENT
TRAUMA/MEDICAL ASSESSMENTS (RESPONSIVE AND UNRESPONSIVE), BOTH ADULT AND PEDIATRIC (VS),
HISTORY (HX), SUBJECTIVE OBJECTIVE PROCEDURE NOTES, AUSCULTATE BREATH/BOWEL SOUNDS, MENTAL
STATUS, GLASGOW COMA SCALE, PRIORITIZE INJURIES OF INDIVIDUAL CASUALTY/PATIENT, COMPLETE
SPECIFIC FORMS
2. PERFORM ONGOING CASUALTY MANAGEMENT
VS DEFICITS AND TX, ONGOING MEDICAL MANAGEMENT IN BOTH LIMITED AND UNLIMITED RESOURCE
ENVIRONMENTS, PROVIDE CARE FOR COMPLICATIONS WITHIN AIR/GROUND EVACUATIONS, TRIAGE
CASUALTIES
3. PERFORM A CASUALTY RESUSCITATION
UNRESPONSIVE AND RESPONSIVE CASUALTIES, CARDIOPULMONARY RESUSCITATION (CPR), AIRWAY
ADJUNCTS, AIRWAY DEVICES, ADMINISTRATION OF OXYGEN (O2), HEAD POSITIONS, COMPLETE SPECIFIC
FORMS
L-4
FM 4-02.6
Table L-4.
91W10/20 Critical Task List (Continued)
4. ESTABLISH AN AIRWAY
ESTABLISH AIRWAY, USING AIRWAY ADJUNCTS, CONFIRM PLACEMENT, USE AMBU BAG AND TRACHEAL
SUCTION AS REQUIRED. USE MEDICATIONS FOR CONTROL OF THE INTUBATED PATIENT
5. MANAGE AN AIRWAY
FOCUSED ASSESSMENT, ADMINISTRATION OF O2 MASKS, PULSE OXIMETER, SUCTIONING, INTUBATION
6. TREAT A CASUALTY FOR A BURN INJURY
FOCUSED ASSESSMENT (BURN SURFACE AREA/DEPTH), AIRWAY MANAGEMENT, STABILIZING TX, PAIN
MANAGEMENT, WOUND CARE. (INCLUDE KNOWLEDGE ON CHEMICAL AND ELECTRICAL BURNS), PREPARE
FOR EVACUATION
7. TREAT A CASUALTY FOR A MAXILLOFACIAL AND NECK INJURY
FOCUSED ASSESSMENT, AIRWAY MANAGEMENT, MANAGE AREA-SPECIFIC BLEEDING, TX TEETH INJURIES,
AND PAIN MANAGEMENT, EAR INJURY
8. TREAT A CASUALTY FOR AN OCULAR INJURY
FOCUSED ASSESSMENT (HX, INCIDENT, COMPLAINTS, ACUITY, PUPIL, ORBITAL RIM, CHEMICAL), IRRIGATE
EYES, SUPERFICIAL FOREIGN BODY REMOVAL, EXTRUSIONS OF THE EYE, BURNS AND CONTUSIONS, APPLICA-
TION OF BANDAGES, PREPARE FOR EVACUATION
9. TREAT A CASUALTY FOR HEAD INJURY
FOCUSED ASSESSMENT, OPEN AND CLOSED INJURIES, TX FOR SPECIFIC INJURY, PREPARE FOR EVACUATION
10. TREAT A CASUALTY FOR A CHEST INJURY
FOCUSED ASSESSMENT, OPEN/CLOSED CHEST INJURES, NEEDLE DECOMPRESSION, FLAIL CHEST, EMPHY-
SEMA, TENSION PNEUMOTHORAX, ADMINISTRATION OF O2, PAIN MANAGEMENT, PREPARE FOR EVACUATION,
BLAST INJURY
11. TREAT A CASUALTY FOR AN ABDOMINAL INJURY
FOCUSED ASSESSMENT (BOWEL SOUNDS), TX OPEN AND CLOSED INJURIES (BANDAGES AND POSITION), IV
FLUID MANAGEMENT, PREPARE FOR EVACUATION
12. TREAT A CASUALTY WITH A WOUND
FOCUSED ASSESSMENT (OPEN/CLOSED), TX FOR LACERATIONS AND FRACTURES (FX), APPLICATION OF
DRESS-INGS/BANDAGES, SLINGS, SPLINTS, SUPERFICIAL REMOVAL OF FOREIGN BODY(IES), WOUND CARE,
ESTABLISH A STERILE/CLEAN FIELD, PERFORM SIMPLE SKIN CLOSURE TECHNIQUES, PAIN MANAGEMENT,
PREPARE FOR EVACUATION
13. TREAT A CASUALTY WITH AN EXTREMITY INJURY
FOCUSED ASSESSMENT (INCLUDE NERVE INJURIES AND OPEN/CLOSED INJURY), TX DISLOCATIONS AND FX,
APPLICATION OF SPLINTS/SLINGS AND FX DEVICES, PAIN MANAGEMENT, PREPARE FOR EVACUATION
14. TREAT A CASUALTY WITH A MANGLED BODY PART
FOCUSED ASSESSMENT, TX CRUSHED, PARTIAL AND COMPLETE AMPUTATIONS AND AVULSIONS, IV FLUID
MANAGEMENT, PAIN MANAGEMENT, USE OF TOURNIQUET, APPLY DRESSINGS, PREPARE FOR EVACUATION
15. TREAT A CASUALTY WITH AN IMPALED OBJECT
FOCUSED ASSESSMENT, TX ABDOMINAL AND EXTREMITY IMPALEMENTS, PAIN MANAGEMENT, PREPARE FOR
EVACUATION
L-5
FM 4-02.6
Table L-4.
91W10/20 Critical Task List (Continued)
16. CONTROL BLEEDING
FOCUSED ASSESSMENT, APPLY DIRECT PRESSURE, PRESSURE POINTS, HEMOSTATIC DRESSINGS (WHEN
AVAILABLE) PRESSURE DRESSINGS, TOURNIQUET, IV THERAPY (INSERTION AND MANAGEMENT)
17. TREAT FOR SHOCK
FOCUSED ASSESSMENT (VS FOR EBL), DECISION IV FLUID MANAGEMENT/THERAPY, USE OF ALBUMIN, ASSESS
URINE OUTPUT, FOLEY INSERTION
18. PROVIDE TREATMENT FOR BITES AND STINGS
FOCUSED ASSESSMENT (TYPE OF INSECT/SNAKE AND SO FORTH), TX INJURY AND COMPLICATIONS, IN-
STRUCT PREVENTIVE MEASURES
19. TREAT FOR ANAPHYLAXIS
FOCUSED ASSESSMENT (TYPE OF INCIDENT-FOOD, DRUGS, AND BITES/STINGS); ADMINISTER EPINEPHRINE
AND OXYGEN, AIRWAY MANAGEMENT
20. PROVIDE TREATMENT FOR A TOXIC EXPOSURE
FOCUSED ASSESSMENT (INGESTED, CONTACT, INHALED) ADMINISTER IPECAC, CHARCOAL, AIRWAY MANAGE-
MENT (CPR), PREPARE FOR EVACUATION
21. MANAGE A SEIZING CASUALTY
FOCUSED ASSESSMENT (INCLUDE HX AND INCIDENT OF ONSET), AIRWAY MANAGEMENT, USE OF DRUGS/
NARCOTICS, PREPARE FOR EVACUATION, POSITION PATIENT
22. TREAT A CASUALTY FOR A COLD INJURY
FOCUSED ASSESSMENT (MINOR TO SEVERE), PROVIDE TX FOR EACH (TEMP CONTROL, REWARMING, AND SO
FORTH), INSTRUCT PREVENTIVE MEASURES, AND PREPARE FOR EVACUATION
23. TREAT A CASUALTY FOR A HEAT INJURY
FOCUSED ASSESSMENT (MINOR TO SEVERE), PROVIDE TX FOR EACH (TEMP CONTROL, COOLING, AND SO
FORTH), INSTRUCT PREVENTIVE MEASURES, ORAL AND IV FLUID MANAGEMENT, PREPARE FOR EVACUATION
24. MANAGE A BEHAVIORAL CASUALTY
FOCUSED ASSESSMENT (INCLUDE DEPRESSION, SUICIDE, STRESS, AND SO FORTH), INITIATE CARE OR
PREVENTIVE MEASURES, PREPARE FOR EVACUATION, STRESS MANAGEMENT PRINCIPLES
25. EXTRACT A CASUALTY
PROVIDE SUPPORT DEVICES, SPINE PRECAUTIONS/IMMOBILIZATIONS, REMOVE FROM GROUND, VEHICLE,
TANK, FIXED FACILITY, AIRCRAFT, PROVIDE GROUND SURVEILLANCE FOR LAND MINES/SCENE SAFETY.
26. PERFORM CASUALTY TRIAGE
MASCAL-CORRECTLY TRIAGE CASUALTIES INTO DELAYED, IMMEDIATE, MINIMAL, OR EXPECTANT
27. EVACUATE A CASUALTY BY GROUND
ASSESS AND TRIAGE CASUALTY/IES FOR TYPE OF ROUTE APPROPRIATE FOR INJURY, LOAD AND UNLOAD A
CASUALTY, LITTER CARRIES
28. EVACUATE A CASUALTY BY AIR
ASSESS AND TRIAGE CASUALTY/IES FOR TYPE OF ROUTE APPROPRIATE FOR INJURY, LOAD AND UNLOAD A
CASUALTY, LITTER CARRIES
29. MANAGE MEDICAL COMMUNICATIONS
REQUEST FOR CASUALTY EVACUATION, WRITTEN FORMS OF COMMUNICATION, 9 LINE, USE OF VARIOUS
EQUIPMENT, TELEMEDICINE, GUIDE COMBAT LIFE SAVERS
L-6
FM 4-02.6
Table L-4.
91W10/20 Critical Task List (Continued)
30. PROVIDE POSTMORTEM CARE
PREPARE AND WRAP BODY, GRAVES REGISTRATION
31. PROVIDE TREATMENT FOR A BIOLOGICAL EXPOSED CASUALTY
FOCUSED ASSESSMENT, TRIAGE, APPROPRIATE TX PER PROTOCOL
32. PROVIDE TREATMENT FOR A NUCLEAR EXPOSED CASUALTY
FOCUSED ASSESSMENT, TRIAGE, APPROPRIATE TX PER PROTOCOL
33. PROVIDE TREATMENT FOR A CHEMICAL AGENT CASUALTY
FOCUSED ASSESSMENT, TRIAGE, APPROPRIATE TX PER PROTOCOL
34. DECONTAMINATE A CASUALTY
FOCUSED ASSESSMENT, APPROPRIATE DECONTAMINATION PROCEDURES
35. PERFORM MEDICAL SCREENING
ADMINISTER IMMUNIZATIONS, PERFORM SICK CALL PROCEDURES UTILIZING THE ALGORITHM DIRECTED
TROOP MEDICAL CARE, PERFORM EMERGENCY INCIDENT REHABILITATION
36. PROVIDE BASIC CARE
BED BATH, BLOOD DRAWS (NEEDLE/VACUTAINER), MAINTAIN BLOOD/FLUID PRECAUTIONS
37. PREVENT THE SPREAD OF DISEASE
PERFORM BASIC FIELD SANITATION, INSTRUCT ON PERSONAL HYGIENE IN REMOTE ENVIRONMENTS,
PREVENT NOSOCOMIAL INFECTIONS, WASH HANDS, DISPOSE OF INFECTIOUS WASTE, BODY SUBSTANCE
ISOLATION
38. TREAT A CASUALTY FOR SPINE INJURY
FOCUSED ASSESSMENT, C-SPINE AND NERVE INJURIES, APPROPRIATE IMMOBILIZATION
39. TREAT CARDIOPULMONARY SYMPTOMS
FOCUSED ASSESSMENT, CHEST PAIN, HA, ABDOMINAL PAIN, SITE OF BURN; DIFFERENTIAL DIAGNOSIS OF
CHEST PAIN
40. TREAT GASTROINTESTINAL SYMPTOMS
FOCUSED ASSESSMENT, ACUTE ABDOMINAL PAIN, N/V/D
41. TREAT GENITOURINARY SYMPTOMS
FOCUSED ASSESSMENT, UTIs, STDs (UNDER TREAT INFECTIOUS DISEASE), VAGINAL DELIVERY (ISOLATED
ENVIRONMENT IN EMERGENCY CASES ONLY)
42. TREAT NEUROLOGICAL SYMPTOMS
FOCUSED ASSESSMENT, TX PER PROTOCOL
43. TREAT METABOLIC/ENDOCRINE SYMPTOMS
FOCUSED ASSESSMENT, ASSIST WITH TX OF HYPOGLYCEMIA PER PROTOCOL
44. TREAT INFECTIOUS DISEASE IMMUNOLOGICAL SYMPTOMS
FOCUSED ASSESSMENT, TRIAGE, APPROPRIATE TX PER PROTOCOL
45. TREAT SKIN DISORDERS
FOCUSED ASSESSMENT, TRIAGE, APPROPRIATE TX PER PROTOCOL
46. VAGINAL DELIVERY (EMERGENCY CASES ONLY)
FOCUSED ASSESSMENT, MANAGE AIRWAY, MANAGE AREA BLEEDING, PAIN MANAGEMENT, FETAL ASSESS-
MENT, UMBILICAL CORD MANAGEMENT
L-7
FM 4-02.6
Table L-5.
91W30 Critical Task List
EVACUATE A MEDICAL CASUALTY
• THE MEDICAL EVACUATION SYSTEM INCLUDES PROPERTY EXCHANGE, MEDICAL SUPPORT OF
OFFENSIVE/DEFENSIVE OPERATIONS
• ESTABLISH GROUND AND AIR AXP
• COMMUNICATE WITH FORWARD SUPPORT AIR AMBULANCE TEAM, ESTABLISH LZ
• EVACUATION OF PRISONERS OF WAR
• EVACUATION IN SPECIFIC ENVIRONMENTS INCLUDES MOUNTAIN, JUNGLE, DESERT, AND OTHER
OPERATIONS
• USE OF SMOKE IN GROUND/AIR EVACUATION MISSIONS (IAW GENEVA CONVENTIONS)
PERFORM MEDICAL FORCE PROTECTION
EMPLOY PREDEPLOYMENT MEDICAL SURVEILLANCE REQUIREMENT
• CONDUCT MEDICAL SOLDIER READINESS PROCESSING
• IDENTIFY AND COORDINATE WITH PVNTMED ASSETS
• CONDUCT INSPECTIONS OF UNIT FIELD SANITATION PRACTICES
• CONDUCT INJURY PREVENTION CLASSES
• CONDUCT A MEDICAL THREAT ASSESSMENT
EMPLOY MEDICAL SURVEILLANCE REQUIREMENTS DURING DEPLOYMENT
• CONDUCT MEDICAL SURVEILLANCE DATA COLLECTION ACTIVITIES
• CONDUCT MEDICAL SURVEILLANCE DATA ANALYSIS ACTIVITIES
• REPORT MEDICAL SURVEILLANCE DATA ANALYSIS FINDINGS
EMPLOY MEDICAL SURVEILLANCE REQUIREMENTS DURING REDEPLOYMENT
• COORDINATE WITH PVNTMED FOR DEBRIEFING
• CONTINUE MONITORING POTENTIAL DISEASE SYMPTOMS FROM DEPLOYMENT
CONDUCT MEDICAL FORCE PROTECTION RISK ASSESSMENT
• IDENTIFY THE 5 STEPS OF CONTINUOUS RISK MANAGEMENT IAW FM 100-14
• UTILIZE RISK ASSESSMENT FORM FOR MEDICAL OPERATIONS
• CONFINED SPACES
• PERSONAL PROTECTIVE MEASURES
SUPERVISE A MEDICAL TREATMENT AREA
• ESTABLISH BAS, TREATMENT TEAM; MINIMAL CARE WARD, AND SO FORTH
• ESTABLISH NBC DECONTAMINATION STATION, BAS, TREATMENT TEAM/PLATOON IAW FM 8-10-7
• SUPERVISE FIELD/FIXED TREATMENT FACILITIES (WARDS, CLINICS)
• COORDINATE MEDICAL COMPETENCY BASE TRAINING.
• NATIONAL REGISTRY OF EMERGENCY MEDICAL TECHNICIAN STANDARDS
• REFRESHER COURSE
• CPR/OTHER REQUIREMENTS
APPLY MEDICAL LOGISTICS
• CLASS VIII MEDICAL RESUPPLY SYSTEM
• MEDICAL EQUIPMENT MAINTENANCE
• BLOOD STORAGE AND DISTRIBUTION
• NEW TECHNOLOGY SUCH AS O2 GENERATION, RESUSCITATIVE FLUIDS DEVELOPMENT, BLOOD
SUBSTITUTES AND FROZEN BLOOD AND HEMOSTATIC DRESSINGS
ASSIST WITH ADVANCED TRAUMA MEDICAL PROCEDURES
• CRICOTHYROTOMY
• NEEDLE CRICOTHYROTOMY/PERCUTANEOUS TRANSTRACHEAL JET VENTILATION
• CHEST TUBE INSERTION
• DIAGNOSTIC PERITONEAL LAVAGE
• CENTRAL VENOUS CANNULATION
• VENOUS CUTDOWN
• PERICARDIOCENTESIS
• RESUSCITATIVE THORACOTOMY
• ESCHAROTOMY FOR BURNS
L-8
FM 4-02.6
Table L-6.
91W40 Critical Task List
ASSESS MEDICAL CAPABILITIES
• CONSIDER RECONFIGURING ASSETS (PERSONNEL, EQUIPMENT) FOR STABILITY OPERATIONS AND SUP-
PORT OPERATIONS
• DEVELOP VIABLE HEALTH CARE PROGRAM FOR DISASTER ASSISTANCE, COMMUNITY AND ENVIRON-
MENTAL ASSISTANCE, AND LAW ENFORCEMENT SUPPORT
• INDIGENOUS MEDICAL CAPABILITIES
• RESEARCH AND IDENTIFY MEDICAL INTELLIGENCE
• ECHELONS OF CARE FOR JOINT OPERATIONS
MEDICAL REGULATING
• RESPONSIBILITIES AND COORDINATION WITH OTHER SERVICES (INTRACORPS, INTRATHEATER, AND
INTERTHEATER MEDICAL REGULATING).
• REGULATING WITHIN THE CZ
• ORIGINATING MEDICAL FACILITY’S RESPONSIBILITIES
• ESTIMATING MEDICALLY SIGNIFICANT CASUALTIES
• ESTIMATING ECHELON III HOSPITAL BED REQUIREMENTS
MANAGE INFECTIOUS AND REGULATED MEDICAL WASTE
• IDENTIFY PROPER DISPOSAL TECHNIQUES FOR REGULATED MEDICAL WASTE
• IDENTIFY SOURCE REDUCTION TECHNIQUES FOR REGULATED MEDICAL WASTE
APPLICATION/UTILIZATION OF MEDICAL TECHNOLOGY
REQUIRES FURTHER REFERENCES FROM AMEDD CENTER & SCHOOL, ATTN: MCCS-FC, FT SAM HOUSTON,
TX OR THE DCDD WEBSITE: http://dcdd.amedd.army.mil/index1.htm
PREPARE THE MEDICAL ANNEX TO AN OPERATION ORDER
• PREPARE HEALTH SERVICES ANNEX INCLUDING SERVICE SUPPORT, PATIENT EVACUATION, TREAT-
MENT AND HOSPITALIZATION.
• MISCELLANEOUS—CP LOCATIONS, COMMUNICATIONS, JOINT INTERNATIONAL OR HOST AGREEMENTS.
ALSO INCLUDED ARE: OVERLAYS AND PVNTMED.
L-9. Semiannual Combat Medic Skills Validation Test
a. The Army Surgeon General has directed that all 91W health care specialists validate their skill
proficiency semiannually. The Semiannual Combat Medic Skills Validation Test (SACMS-VT) will be
administered at least twice a year with a minimum of 4 months separating record of events. Commander
may administer the SACMS-VT more than twice a year, but must indicate beforehand when results are for
record purposes.
b. The SACMS-VT documents the 91W’s level of proficiency in critical medical skills and
provides the impetus for sustainment training to maintain readiness. Commanders will find that this test
facilitates the EMT-B civilian biannual certification process and ties in additional critical battlefield treatment
modalities. Detailed information for the test is provided in soon-to-be published Training Circular (TC)
8-800, Semiannual Combat Medic Skills Validation Test. The TC can be obtained by accessing the 91W
website: http://www.cs.amedd.army.mil/91w/default.htm.
L-9
FM 4-02.6
Section III. DENTAL-LEAD TREATMENT AND CLINICAL
DIAGNOSTIC SUPPORT MODULES
L-10. Comprehensive Dental Officer (63B00 DC)
The dental officer leading the area support squad of an Echelon II MTF is accredited by the American
Dental Association to provide comprehensive oral health care. He examines, diagnoses, and treats diseases,
injuries and defects of teeth, jaws and oral cavity, and supporting structure. The dental officer also
provides technical supervision of assigned dental, medical laboratory, and radiology personnel and insures
the efficacy of their technical capability.
L-11. Dental Specialist (91E)
a. The 91E assigned to the dental element of the area support squad, serves as an integral
member of the dental team by combining the skills of soldier and dental caregiver.
b. This specialist assists the dental officer in prevention, examination, and treatment of disease of
teeth and oral region, and assist with the management of the dental facility. The 91E receives patients,
prepares the dental operatory, selects and arranges instruments, measures and records temperature blood
pressure and pulse, and assists dentist during patients exams. Assist with the administration of anesthesia
and in placement and removal of sutures. Prepares restorative and impression material. Performs
cardiopulmonary resuscitation. Performs dental radiography. Performs preventive maintenance on dental
equipment. Sets up, maintains, disassembles, and packs dental field equipment shelters.
L-12. Core Competencies/Critical Tasks and Training for the 91E
a. The 91Es of medical companies/troops must be trained in several areas of core competencies
as outlined below. These core competencies are clinically focused requiring specific skills that establishes
the scope and depth of clinical practices required by the AMEDD Dental Service.
b. Tables L-7 below contain the core competency and critical task list to be used by the
commander in the development of the unit’s dental proficiency training program. Proficiency training for
the dental specialist will be conducted annually. Such training will be conducted under the auspices of a
certified dentist. The medical company/troop commander, in collaboration with the senior dental officer,
will establish a continuing education program for the dental specialist. Such training will be conducted
annually.
L-10
FM 4-02.6
Table L-7.
91E Core Competency/Critical Task List
GENERAL DENTAL CORE COMPETENCY TASKS
1.
SET UP FIELD DENTAL OPERATING/TREATMENT UNIT
2.
PERFORM BASIC LIFE SUPPORT PROCEDURES
3.
MEASURE AND RECORD PATIENT’S VITAL SIGNS
4.
PREPARE PATIENT FOR DENTAL TREATMENT
5.
PREPARE MATRIX BANDS
6.
PREPARE DENTAL MATERIAL IN ACCORDANCE WITH MANUFACTURER’S INSTRUCTIONS
7.
STERILIZE DENTAL ITEMS
8.
PROCESS STERILIZED DENTAL ITEMS
9.
PREPARE PATIENT FOR DENTAL TREATMENT
10. PERFORM FOUR-HANDED DENTISTRY TECHNIQUES
11. PREPARE A RESTORATIVE PROCEDURE SETUP
12. SETUP COMPRESSOR/HYDRATOR
13. OPERATE COMPRESSOR/HYDRATOR
DENTAL CORE COMPETENCY CLINICAL TASKS
14. PREPARE A DENTAL LOCAL ANESTHETIC SETUP
15. PREPARE SURFACE DISINFECTION
16. PREPARE PATIENT FOR BASIC DENTAL EXAMINATION
17. SET UP FIELD SURGICAL SCRUB SINK
18. ASSIST IN MANAGEMENT OF CHAIR-SIDE EMERGENCIES
19. PREPARE OPERATIVE SITE
20. PREPARE AMALGAM RESTORATIVE MATERIAL
21. RETRACT SOFT TISSUE DURING DENTAL PROCEDURES
22. PROVIDE SUCTION DURING DENTAL PROCEDURES
23. PREPARE COMPOSITE RESIN MATERIAL
24. PREPARE IMMEDIATE RESTORATIVE MATERIAL
25. STORE ALL INSTRUMENTS TO MAINTAIN STERILE CONDITIONS
26. PROVIDE DENTAL PROPHYLAXIS WITH PROPHY CUP AND MINIMAL HAND SCALING TO REMOVE SUP-
RAGINGIVAL/DEPOSITS FOR PATIENTS
27. PREPARE EXTRACTION SETUP
28. PROVIDE—IRRIGATION DURING DENTAL PROCEDURES
29. DRY OPERATIVE SITE WITH AIR SYRINGE
30. PREPARE ALGINATE IMPRESSION MATERIAL
31. PREPARE DENTAL CEMENT
32. OPERATE THE FIELD SURGICAL SINK
33. ASSIST IN DENTAL TECHNIQUES FOR PREVENTION OF MEDICAL EMERGENCIES
DENTAL RADIOGRAPHY CORE COMPETENCY TASKS
34. ASSEMBLE FIELD DENTAL X-RAY UNIT
35. OPERATE FIELD DENTAL X-RAY UNIT
36. PROTECT THE PATIENT AND OPERATOR THROUGH THE USE OF BARRIER TECHNIQUE
37. EXPOSE A RADIOGRAPH MANUALLY
38. PROCESS AN EXPOSED RADIOGRAPH MANUALLY
39. EXPOSE A DENTAL RADIOGRAPH USING THE PARALLELING TECHNIQUE
40. EXPOSE A DENTAL RADIOGRAPH USING THE BISECTING ANGLE TECHNIQUE
41. MOUNT A FULL MOUTH SERIES OF RADIOGRAPHS
42. PREPARE AN ENDODONTIC SETUP
43. PREPARE A PROSTHODONTIC PROCEDURE SETUP
L-11
FM 4-02.6
Table L-7.
91E Core Competency/Critical Task List (Continued)
GENERAL DENTAL CRITICAL TASKS
44. PERFORM ROUTINE MAINTENANCE FOR HIGH- AND LOW-SPEED PIECES
45. DISASSEMBLE FIELD DENTAL X-RAY MACHINE
46. PACK DENTAL FIELD X-RAY MACHINE
47. DISASSEMBLE COMPRESSOR/HYDRATOR
48. DISASSEMBLE FIELD DENTAL OPERATING AND TREATMENT UNIT
49. PERFORM PREVENTIVE MAINTENANCE CHECKS AND SERVICES ON FIELD DENTAL EQUIPMENT
50. DISPOSE OF REGULATED DENTAL WASTE
51. PACK FIELD OPERATING AND TREATMENT UNIT
L-13. Radiology Specialist (91P)
a. The 91Ps assigned to the x-ray element of the area support squad, serves as an integral
members of the diagnostic support team by combining the skills of soldier and clinical radiology
expertise.
b. The radiology specialist—
• Operates fixed and portable radiology equipment.
• Reads and interprets radiographic request and physician orders.
• Prepares assembles and adjust instruments, materials, and equipment.
• Performs radiographic examinations of the upper and lower extremities, vertebral
column, trunk, and skull.
• Performs soft tissue radiographic examinations
• Assist in performing body section radiographic procedures using conventional and com-
puterized tomography.
• Assist in performing foreign body localization
• Assist in performing prenatal, pediatric, urogenital, and radiographic examinations of
respiratory, vascular and nervous system.
• Develops radiographic film using automatic processing.
• Applies radiation, electrical, and mechanical protective measures.
L-12
FM 4-02.6
• Maintains daily ledger and performs routine patient administration.
• Inspects and performs operator maintenance on radiology equipment.
• Packs and unpacks, loads and unloads radiology equipment.
• Assembles and dissembles radiology equipment and shelters.
L-14. Radiology Specialist/Sergeant Core Competencies, Critical Tasks, and Training
a. The 91P10/20s of medical company/troop must be trained/credentialed in several areas of
core competencies. These core competencies in radiography techniques and procedures are examples of
specific skills that establishes the scope and depth of clinical practices outlined in Table L-8 below.
b. The critical tasks listed in these tables are be used by the commander in the development of the
unit’s medical radiology training program for assigned radiology specialists (91P). Normally the training
will be conducted under the auspices of a certified diagnostic radiologist (61R00 MC) assigned to an
Echelon III MTF. The commander (medical company/troop) will make coordination, through channels,
with the supporting hospital and arrange for a continuing education program to support his clinical radiology
personnel. Such training/recertification should be conducted annually, METT-TC permitting.
Table L-8. Specialist/Sergeant (91P10/20) Core Competency/Critical Task List
TASK TITLE SKILL LEVELS 1&2
1.
TRANSPORT A CASUALTY WITH A SUSPECTED SPINAL INJURY
2.
ASSIST HEALTH CARE PROVIDER WITH TREATMENT FOR ANAPHYLACTIC SHOCK
3.
ADMINISTER CARDIOPULMONARY RESUSCITATION
4.
PREPARE PORTABLE RADIOGRAPHIC UNIT FOR OPERATION
5.
PERFORM RESCUE BREATHING
6.
MANAGE UNCONSCIOUS PATIENT
7.
OPERATE MOBILE RADIOGRAPHIC UNIT
8.
PREPARE FOR FIELD OPERATION IN AN NBC ENVIRONMENT
9.
OPERATE DEPMEDS PORTABLE RADIOGRAPHIC UNIT
10.
OPERATE FIELD CTC SCANNER
11.
INITIATE INTRAVENOUS INFUSION
12.
MANAGE CONVULSIVE AND/OR SEIZING PATIENT
13.
PERFORM CT EXAMINATION (EXAM) OF UNENHANCED SPINE
14.
MONITOR PATIENT’S CONDITION DURING ANGIOGRAPHY/INVASIVE PROCEDURE
15.
X-RAY THE CHEST
16.
X-RAY TRAUMA— LUMBAR SPINE
17.
PERFORM CT EXAM OF ENHANCED CHEST
18.
X-RAY THE CERVICAL SPINE
19.
X-RAY THE PELVIS
L-13
FM 4-02.6
Table L-8. Specialist/Sergeant (91P10/20) Core Competency/Critical Task List (Continued)
TASK TITLE SKILL LEVELS 1&2 (CONTINUED)
20.
PROCESS FILM USING AN AUTOMATIC FILM PROCESSOR
21.
OPERATE A FIELD CTC SCANNER
22.
CODE PATIENT’S ID TO FILM FILE PACKETS/ENVELOPES
23.
EVALUATE QUALITY OF DEVELOPED RADIOGRAPHS
24.
USE UNIVERSAL PRECAUTIONS
25.
PREPARE FIELD X-RAY PROCESSOR FOR OPERATION
26.
PERFORM PREOPERATIONAL CHECK ON DEPMEDS PORTABLE RADIOGRAPHIC UNIT
27.
PREPARE DEPMEDS RADIOGRAPHIC UNIT (CS 8952) FIELD DEPLOYABLE X-RAY SYSTEM
28.
TRANSMIT IMAGES VIA SATELLITE
29.
OPERATE RADIOGRAPHIC UNITS
30.
PERFORM A PATIENT CARE HANDWASH
31.
PREPARE AN INJECTION FOR ADMINISTRATION
32.
ADMINISTER AN INJECTION (INTRAMUSCULAR, SUBCUTANEOUS, INTRADERMAL)
33.
ESTABLISH A STERILE FIELD
34.
APPLY IMMOBILIZATION DEVICE TO PATIENT
35.
PREPARE AN AREA FOR OPERATIVE TREATMENT
36.
ASSESS PATIENT CONDITION BEFORE X-RAY
37.
ASSIST HEALTH CARE PROVIDER IN MANAGING CARDIAC ARREST
38.
HANDLE PATIENT USING PROPER BODY MECHANICS
39.
ADMINISTER OXYGEN BY MASK/CATHETER
40.
ADMINISTER INTRAVENOUS CONTRAST MEDIA
41.
OPERATE ANGIOGRAPHIC IMAGING EQUIPMENT
42.
DIGITIZE CONVENTIONAL RADIOGRAPHIC IMAGES
43.
DIGITIZE IMAGES FROM NON-RACS IMAGING MODALITIES
44.
TRANSMIT IMAGES USING TELERADIOLOGY SOFTWARE AND HARDWARE
45.
PERFORM CT EXAM OF UNENHANCED BRAIN
46.
PERFORM CT EXAM OF UNENHANCED SINUSES
47.
PERFORM CT EXAM OF UNENHANCED NECK—SOFT TISSUE
48.
PRINT IMAGES
49.
PERFORM CT OF TEMPORAL BONE
50.
PERFORM CT EXAM OF UNENHANCED EXTREMITY
51.
PREPARE OXYGEN TANK FOR PATIENT USE
52.
MAINTAIN RADIOLOGY EMERGENCY EQUIPMENT TRAY/CART
53.
OPERATE SPOT FILM DEVICE
54.
X-RAY THE LUMBAR SPINE
55.
X-RAY ABDOMEN
56.
X-RAY THE HAND
57.
X-RAY THE FOOT
58.
OPERATE DIGITAL FLUOROSCOPIC UNIT
59.
OPERATE PORTABLE C-ARM RADIOGRAPHIC/FLUOROSCOPIC UNIT
60.
REPRINT CT IMAGES
61.
X-RAY TRAUMA HIP
62.
X-RAY THE TOES
63.
MAINTAIN TECHNIQUE CHARTS FOR RADIOGRAPHIC UNIT
64.
X-RAY DECUBITUS ABDOMEN
65.
X-RAY DECUBITUS CHEST
66.
X-RAY THE WRIST
67.
X-RAY TRAUMA SHOULDER
68.
X-RAY THE HIP
L-14
FM 4-02.6
Table L-8. Specialist/Sergeant (91P10/20) Core Competency/Critical Task List (Continued)
TASK TITLE SKILL LEVELS 1&2 (CONTINUED)
69.
X-RAY THE FEMUR
70.
X-RAY THE ANKLE
71.
X-RAY THE PATELLA
72.
X-RAY THE SKULL
73.
X-RAY FACIAL BONES
74.
X-RAY THE MANDIBLE
75.
X-RAY THE TEMPOROMANDIBULAR JOINTS
76.
X-RAY THE ZYGOMATIC ARCHES
77.
X-RAY SOFT TISSUE LARYNX
78.
X-RAY THE THORACIC SPINE
79.
X-RAY THE SACRUM/COCCYX
80.
X-RAY THE SACROILIAC JOINT AND LUMBOSACRAL ARTICULATION
81.
X-RAY THE RIBS
82.
X-RAY THE SCAPULA
83.
X-RAY THE SHOULDER
84.
X-RAY THE HUMERUS
85.
X-RAY THE ELBOW
86.
X-RAY THE FOREARM
87.
X-RAY FINGER OR THUMB
88.
X-RAY THE CLAVICLE
89.
X-RAY THE ACROMIOCLAVICULAR JOINTS
90.
X-RAY THE KNEE
91.
X-RAY THE LEG
92.
X-RAY THE CALCANEUS
93.
X-RAY THE PARANASAL SINUSES
94.
X-RAY THE STERNUM
95.
X-RAY THE NOSE
96.
ASSIST WITH PATIENT URINARY CATHETERIZATION
TASK TITLE SKILL LEVEL 2
1.
ESTABLISH RADIATION SAFETY PROGRAM
2.
PREPARE PATIENT EMERGENCY EVACUATION PLAN
3.
PERFORM RETAKE ANALYSIS
4.
PERFORM PROTECTIVE DEVICES QUALITY CONTROL TESTS
5.
DEVELOP STANDING OPERATING PROCEDURE DOCUMENT FOR A RADIOLOGY SECTION
6.
MAINTAIN RADIOLOGY SUPPLIES AND EQUIPMENT
7.
EVALUATE RADIOLOGY EQUIPMENT PREVENTIVE MAINTENANCE PROCEDURES
8.
PERFORM COLLIMATOR QUALITY CONTROL TEST
L-15. Medical Laboratory Specialist (91K)
a. The 91Ks assigned to the medical laboratory element of the area support squad, serves as
integral members of the diagnostic support team by combining the skills of a soldier and clinical laboratory
expertise.
L-15
FM 4-02.6
b. The medical laboratory specialist performs blood banking procedures and elementary and
advanced examinations of biological and environmental specimens to aid in the diagnosis, treatment, and
prevention of disease and other medical disorders. The duties the 91Ks assigned to area support squads
include the following:
(1) MOSC 91K10. Performs elementary clinical laboratory and blood banking procedures.
(2) MOSC 91K20. Performs elementary blood banking and clinical laboratory procedures
in hematology, immunohematology, biochemistry, serology, bacteriology, parasitology, and urinalysis.
L-16. Core Competencies of the 91K
The 91Ks of medical company/troop must be trained/credentialed in several areas of core competencies.
These core competencies are examples of specific skills that establishes the scope and depth of clinical
laboratory practices that are outlined in Table L-9.
Table L-9. Core Competency for Clinical Laboratory Specialists
CORE COMPETENCY IN MEDICAL LABORATORY TECHNIQUES AND PROCEDURES FOR THE 91K IS INCLUSIVE
OF THE FOLLOWING FOR AN AREA SUPPORT SQUAD:
THE MEDICAL LABORATORY SPECIALIST PERFORMS CLINICAL LABORATORY PROCEDURES IN A FIELD LAB-
ORATORY COMMENSURATE WITH THE CAPABILITY OF THE FACILITY. THIS SPECIALIST AIDS THE PHYSICIAN,
PA, AND OTHER MEDICAL PROFESSIONALS IN THE DIAGNOSIS, TREATMENT, AND PREVENTION OF DISEASE
IN PERFORMING THE FOLLOWING:
• REPORTING ACCURATE AND RELIABLE RESULTS
• BASIC HEMATOLOGY PROCEDURES
• BASIC MICROBIOLOGY AND SEROLOGICAL PROCEDURES
• BASIC CHEMISTRY PROCEDURES
• BASIC BLOOD BANKING PROCEDURES
• SPECIMEN PROCESSING
• QUALITY CONTROL PROCEDURES
L-17. Clinical Laboratory Training
Table L-10 contains critical tasks to be used by the Commander in the development of a unit medical
laboratory training program for assigned medical laboratory specialists (91K). Normally the training will be
conducted under the auspices of a certified Clinical Laboratory Officer (71E67 MS) assigned to an Echelon
III MTF. The Commander (medical company/troop) will make coordination, through channels, with the
supporting hospital and arrange for a continuing education program to support his clinical laboratory
personnel. Such training/recertification will be conducted annually.
L-16
FM 4-02.6
Table L-10.
91K10/20 Critical Task List
THE MEDICAL LABORATORY TECHNICIAN (91K) MUST BE COMPETENT IN THE FOLLOWING TASKS ALONG
WITH HAVING KNOWLEDGE AND TRAINING IN SETTING UP, MAINTAINING AND DEPLOYING DEPMEDS EQUIP-
MENT AND DEPMEDS LABORATORY EQUIPMENT. THE 91K MUST REMAIN FOCUSED ON OPERATIONAL
READINESS AND ENSURE THE CORE COMPETENCY SKILLS ARE MAINTAINED. COMMUNICATION WITH THE
NEXT LEVEL OF CARE IS IMPERATIVE TO SUSTAIN EQUIPMENT READINESS AND TRAINING
1. PERFORM ROUTINE URINALYSIS
FOCUSED ASSESSMENT, COLOR AND APPEARANCE, PH AND SPECIFIC GRAVITY, IDENTIFICATION OF URINARY
SEDIMENTS AND THEIR SIGNIFICANCE, ANALYZE AND INTERPRET COLOR REACTIONS ON DIPSTICK, CON-
FIRMATION TESTING, MICROSCOPIC EXAMINATION, QUALITY CONTROL
2. PERFORM BASIC HEMATOLOGY
FOCUSED ASSESSMENT, OBTAINING BLOOD SPECIMENS (CAPILLARY AND VENOUS), MICROHEMATOCRITE
DETERMINATION, MANUAL WBC, PLATELET ESTIMATE AND RBC COUNT BY UNNA-PAPPENHEIM STAIN,
WRIGHT’S STAIN, GIEMSA STAIN FOR THE PRESENCE OF MALARIAL PARASITE, QUALITY CONTROL
3. PERFORM BASIC MICROBIOLOGY
FOCUSED ASSESSMENT, GRAM STAIN, CONCENTRATION TECHNIQUES FOR OVA, CYSTS AND PARASITES,
MACROSCOPIC EXAMINATION OF FECES AND TEST FOR OCCULT BLOOD, SKIN SCRAPING USING KOH OR
NAOH, QUALITATIVE PREGNANCY TEST, RAPID PLASMA REAGIN (RPR), THROAT CULTURE, INFECTIOUS
MONONUCLEOSIS, QUALITY CONTROL
4. PERFORM BASIC CHEMISTRY
FOCUSED ASSESSMENT, USE CHEMICAL ANALYZER TO DETERMINE CHEMICAL ANALYTES (ELECTROLYTES,
AMYLASE, BILIRUBIN, BUN, CREATININE, AST, ALT, GLUCOSE), BLOOD GAS, QUALITY CONTROL
5. PERFORM BASIC BLOOD BANKING
FOCUSED ASSESSMENT, RECEIVING, STORING AND ISSUING BLOOD PRODUCTS. PERFORM AN IMMEDIATE
SPIN CROSS MATCH. PERFORM VENOUS PUNCTURE FOR BLOOD COLLECTION
Section IV. MENTAL HEALTH CLINICAL SUPPORT MODULES
L-18. Psychiatrist (60W00 MC)
The psychiatrist assigned to the divisional MH section of an Echelon II MTF is a licensed medical doctor
and is credentialed in psychiatry. This medical corps officer examines, diagnoses, and treats or provides
courses of treatment for personnel suffering from emotional or mental illness, mental retardation, or
situational maladjustment. This chief of section serves as the division psychiatrist (staff advisor). He also
provides technical supervision of assigned MH personnel and insures the efficacy of their technical capability.
L-19. Social Worker (73A67 MS)
The social worker assigned to the MH section of an Echelon II MTF holds a master’s degree in social work
and is credentialed by the Council on Social Work Education. This officer performs social work functions
L-17
FM 4-02.6
which include: providing critical event debriefing, psychological autopsies, suicide prevention, clinical
counseling, disaster relief, civil affairs, crisis intervention, substance abuse intervention, teaching and
training, supervision, research, administration, consultation, and policy development in various military
settings. These functions are provided to enhance unit readiness and the emotional well-being of service
members, their eligible family members, and DA civilians as appropriate. He also teaches and provides
technical guidance for behavioral science personnel.
L-20. Clinical Psychologist (73B67 MS)
The Clinical psychologist assigned to the MH section of an Echelon II MTF holds a PhD in clinical
psychology, and counseling psychology. He is a licensed psychologist, credentialed by the American
Psychological Association. This health professional applies psychological principles, theories, methods,
and techniques through direct patient services, consultation, education, and research to human effectiveness,
adjustment, and emotional disturbance in medical and other settings; investigation, evaluation and
amelioration of mental and behavioral disorders; prevention of mental illness; and promotion of effective
MH. He also teaches and provides technical guidance for behavioral science personnel.
L-21. Mental Health Specialist (91X)
The mental health specialist under the supervision of a psychiatrist, social worker, psychiatric nurse, and/or
psychologist assists with the management and treatment in in/outpatient MH activities; during peacetime or
mobilization; collects and records psychosocial and physical data; counsels and treats clients/patients with
personal, behavioral, or MH problems. Duties for the 91X at each military occupational specialty code
(MOSC) are as follows:
a. MOSC 91X. Under close supervision, collects and records psychosocial and physical data,
assists with care and treatment of psychiatric, drug and alcohol patients, and counsels client/patient with
personal, behavioral, or psychological problems.
b. MOSC 91X20. Collects and records psychosocial and physical data and assists with care and
treatment of psychiatric, drug and alcohol patients, and counsels clients/patients with personal, behavioral,
or psychological problems.
c.
MOSC 91X30. Collects and records psychosocial and physical data and assists with care and
treatment of psychiatric, drug and alcohol patients, and counsels clients/patients with personal, behavioral,
or psychological problems and assists with management of mental health activity.
d. MOSC 91X40. Assists professional staff with management and supervision of patient treatment
in in/outpatient mental health activities. Assist professional staff in the supervision of patient treat-
ment programs, personnel matters, supply economy procedures, fiscal, technical, and administrative
matters.
L-18
FM 4-02.6
L-22. Core Competencies of the 91X
The behavioral science specialist of medical companies must be trained/credentialed in several areas of core
competencies. These core competencies are examples of specific skills that establish the scope and depth of
clinical practices that are outlined in Table L-11.
Table L-11. Core Competency for Behavioral Specialists
CORE COMPETENCY IN BEHAVIORAL SCIENCE TECHNIQUES AND PROCEDURES FOR THE 91X IS TO TRIAGE,
EVALUATE, COUNSEL AND/OR TREAT STRESSED PATIENTS. THE PRIMARY TECHNIQUES AND PROCEDURES
USED INCLUDE THE FOLLOWING:
• MAXIMIZE PREVENTION TO CONTROL (AND WHEN FEASIBLE, REDUCE) STRESSORS THAT ARE KNOWN
TO INCREASE BF AND MISCONDUCT STRESS BEHAVIOR.
• TREAT BF IN THE SITUATIONAL AREAS OF PROXIMITY, IMMEDIACY, EXPECTANCY, AND SIMPLICITY.
EXAMPLES:
A. PROXIMITY REFERS TO THE NEED IN TREATING SOLDIERS AS CLOSE TO THE UNIT AND BATTLE AS
POSSIBLE. IT IS A REMINDER THAT OVER EVACUATION SHOULD BE PREVENTED.
B. IMMEDIACY INDICATES THAT BF REQUIRES TREATMENT IMMEDIATELY.
C. EXPECTANCY RELATES TO THE POSITIVE EXPECTATION PROVIDED TO BF CASUALTIES FOR THEIR
FULL RECOVERY AND EARLY RETURN TO DUTY.
D. SIMPLICITY INDICATES THE NEED FOR USING SIMPLE, BRIEF, STRAIGHTFORWARD METHODS TO
RESTORE PHYSICAL WELL-BEING AND SELF CONFIDENCE BY USING NONMEDICAL TERMINOLOGY
AND TECHNIQUES.
L-23. Mental Health Specialty Training
Tables L-12 and L-13 contain the critical tasks to be used by the unit commander and the senior mental
health officer in the development of a unit medical training program for assigned 91X personnel.
Table L-12.
91X10/20 Critical Task List
1. PERFORM CASUALTY EVALUATION
TRIAGE CASUALTY TO DETERMINE STATUS
2. PERFORM RESTRAINTS
RESTRAIN PATIENTS WHO POSE A THREAT TO OTHERS
3. PERFORM CASUALTY ASSESSMENT/SEPARATION
A. ASSESS CASUALTIES AND DATA OBTAINED TO DETERMINE FUNCTIONAL CAPACITY, APPROPRIATE
TREATMENT, AND OR RTD
L-19
FM 4-02.6
Table L-12.
91X10/20 Critical Task List (Continued)
B. SEPARATE STRESS AND MISCONDUCT COMBAT STRESS BEHAVIOR (MCSB) CASES FROM PSYCHI-
ATRIC, WOUNDED, AND SICK PATIENTS
4. PERFORM ADMINISTRATIVE ACTIONS
A. PREPARE BF AND NP CASES FOR EVACUATION OR TRANSFER
B. COORDINATE RTD OF MCSB AND RECOVERED BFC TO ORIGINAL OR ALTERNATE UNIT
Table L-13.
91X30/40 Critical Task List
PERFORM SUPERVISION AND IMPLEMENTATION OF THE ORGANIZATION’S PREVENTIVE MENTAL HEALTH
PROGRAM
A. TRAIN PHYSICIANS AND PHYSICIAN ASSISTANTS TO PERFORM NP TRIAGE.
B. COORDINATE THROUGH MEDICAL COMPANY’S HEADQUARTERS FOR ADDITIONAL CSC SUPPORT FROM
THE SUPPORTING MEDICAL BRIGADE.
C. MAINTAIN COORDINATION WITH SUPPORTED UNITS AND HIGHER HQ TO PREDICT POSSIBLE BF AND
STRESS CASUALTIES.
D. PREPARE CSC ESTIMATE OF TACTICAL SITUATION.
E. COORDINATE TRAINING WITH SUPPORTED FORCES HQ FOR COMBAT STRESS MANAGEMENT AND
PREVENTION.
F. COORDINATE CRITICAL INCIDENT STRESS DEBRIEFING OF TEAMS, CREWS, SQUADS, AND PLATOONS
AT RECONSTITUTION SITES.
G. FORWARD STATUS REPORT TO COMPANY HQ IAW TSOP.
Section V. PREVENTIVE MEDICINE SUPPORT MODULES
L-24. Preventive Medicine Officer (60C00 MC)
The PVNTMED officer leading the section of an Echelon II MTF is a practicing medical doctor, credentialed
in public health science. He determines status of, and conditions influencing, health of military and
appropriate civilian personnel; formulates and recommends measures for health improvements; and plans,
coordinates, and directs a program designed to maintain health, improve physical fitness, and prevent
disease and injury. This practicing physician also provides technical supervision of assigned professional
and paraprofessional personnel, and insures the efficacy of their technical capability.
L-25. Environmental Science Officer (72D67 MS)
The environmental science officer advises or performs professional and scientific work in environ-
mental health and industrial hygiene. Functions include: identification, evaluation, and formulation of
L-20
FM 4-02.6
recommendations for the control of potential health hazards; health hazard assessment of weapons,
equipment, clothing, training devices and materiel systems; development of environmental health and
industrial hygiene criteria and standards; promotion of policies, programs, practices, operations directed
toward the prevention of disease, illness, and injury. The environmental science officer also ensures the
establishment of protocols for the training of 91S personnel.
L-26. Preventive Medicine Specialist (91S)
The PVNTMED specialist conducts or assists with PVNTMED inspections, surveys, control operations,
and PVNTMED laboratory procedures, supervises PVNTMED facilities, or serves on PVNTMED staff.
The duties for 91S at each skill are as follows:
a. MOSC 91S/20. Conducts PVNTMED inspection, surveys and controls operations and assists
with PVNTMED laboratory procedures. Additionally, the 91S20 supervises subordinate personnel in the
performance of their duties.
b. MOSC 91S30. Conducts PVNTMED inspection, surveys and controls operations and assists
with PVNTMED laboratory procedures. Organizes water, food sanitation, hospital environment,
entomological, epidemiology, and environmental stress surveillance programs. Analyzes and evaluates
collected data. Supervises technical and administrative functions of PVNTMED activities.
c.
MOSC 91S40. Supervises medium size PVNTMED services or medical team/detachments.
Assists with development of unit defense plans and operational orders. Reviews and make appropriate
recommendations on doctrine and training literature. Maintains intelligence information and records.
Establishes quality control procedures for inspection programs and laboratory analysis. Develops community
health education programs. Evaluates existing PVNTMED programs and modifies as necessary to meet the
needs of the population served.
Section VI. OPTOMETRY CLINICAL SUPPORT MODULES
L-27. Optometry Officer (67F00 MS)
The optometry officers (67F MS) in the optometry section of the DSMC, MSMC and the medical com-
pany of the HSB are a primary health care provider in Echelons II and above MTFs. These certified
practicing optometrists, independently conduct examination to detect, prevent, diagnose, and manage ocular
related disorders; that is, injuries, diseases, and visual dysfunctions. Uses diagnostic and therapeutic
pharmaceutical agents (TPA) medical/surgical instruments. Prescribes spectacle and medical related con-
tact lenses, TPA and other therapy. Their duties include consultation in such areas as occupational vision
and the diagnosis and treatment of battlefield laser-induced injuries. The senior optometry officer/chief of
section provides technical supervision of assigned clinical personnel and insures the efficacy of their
technical capability.
L-21
FM 4-02.6
L-28. Eye Specialist (91WP3)
a. The eye specialist (91WP3) and the eye sergeant (91W20) perform routine diagnostic tests and
assist in the care of ophthalmology or optometry patients. As optometry specialist these duties are conducted
under the auspices of an optometrist or ophthalmologist.
b. As 91Ws these specialists also perform emergency and evacuation care under the medical
direction of a physician or other credentialed providers. Serves as a clinical technician in inpatient and
outpatient areas of MTFs. Performs basic force health protection care for individual soldiers and small
units. Is trained for combat and other operational environments. Conducts casualty triage and provides
medical care for patients in all operational environments to include enroute care during ground and air
ambulance evacuations. The 91W is certified to the national standards of EMT-B. Refer to Section II
above.
L-29. Core Competencies of the 91WP3
The eye specialist (91WP3) of medical companies must be trained in several areas of core competencies.
These core competencies are examples of specific skills that establishes the scope and depth of tactics,
techniques, and procedures that are outlined in Tables L-14 below.
Table L-14. Core Competency for Eye Specialists
CORE COMPETENCY IN EYE SPECIALTY TECHNIQUES AND PROCEDURES FOR THE 91WP3 IS INCLUSIVE OF
THE FOLLOWING:
• PATIENT SCREENING
• HISTORY TAKING
• TONOMETRY
• LENSOMETRY
• PHOTOGRAPHY
L-30. Training for the 91WP3
Table L-15 below contains the critical tasks to be used by the optometry chief of section in the development
of training program for assigned 91WP3 personnel. Also the unit commander will ensure that these
personnel comply with the 91W continued education and training program as outlined in Paragraph L-8 and
Table L-4 above.
L-22
FM 4-02.6
Table L-15.
91WP310/20 Critical Task List
FIELD-SPECIFIC TASKS
•
ASSEMBLE A FIELD COMBAT OPTOMETRY SET
•
DISASSEMBLE A FIELD OPTOMETRY SET
ADMINISTRATIVE TASKS
•
MAINTAIN AN EYE CLINIC HAND RECEIPT ACCOUNT
•
MAINTAIN THE EYE CLINIC FORMS SUPPLY
•
MAINTAIN THE EYE CLINIC PUBLICATIONS LIBRARY
•
ORDER EYE CLINIC EQUIPMENT
•
ORDER EYE CLINIC SUPPLIES
•
SCHEDULE EYE CLINIC APPOINTMENTS
•
MONITOR EYE CLINIC SCHEDULES
•
PREPARE EYE CLINIC COMPOSITE HEALTH CARE SYSTEM REPORTS
•
PREPARE EYE CLINIC SPECTACLE REQUEST TRANSMISSION SYSTEM REPORTS
PRESCRIPTION EYEWEAR TASKS
•
ORDER PRESCRIPTION EYEWEAR
•
MAINTAIN PRESCRIPTION EYEWEAR ORDER FILES
•
DISPENSE PRESCRIPTION EYEWEAR
•
RECEIVE PRESCRIPTION EYEWEAR
•
INSPECT COMPLETED PRESCRIPTION EYEWEAR
•
PERFORM REPAIRS AND ADJUSTMENTS ON PRESCRIPTION EYEWEAR
CLINICAL TASKS
•
CONDUCT AN EYE CLINIC PRE-EXAMINATION PATIENT SCREENING
•
CONDUCT AN OPTOMETRIC PHYSICAL SCREENING
•
CONDUCT AN OPTOMETRIC SCREENING FOR A DOD MEDICAL EVALUATION REVIEW BOARD CANDIDATE
•
CONDUCT AN OPTOMETRIC PHYSICAL SCREENING FOR AVIATION CANDIDATE
•
ADMINISTER DOCTOR-ORDERED TREATMENT FOR OCULAR INJURIES
•
ADMINISTER DOCTOR-ORDERED TREATMENT FOR OCULAR BURNS
•
ADMINISTER DOCTOR-ORDERED TREATMENT FOR OCULAR DISEASES
•
INITIATE EMERGENCY TREATMENT FOR A CHEMICAL BURN OF THE EYE
•
REMOVE NONEMBEDDED FOREIGN BODIES FROM THE CONJUNCTIVA OR CORNEA
•
CONDUCT VISUAL FIELD TEST
•
PERFORM OCULAR A/B SCAN
•
PERFORM OCULAR PHOTOGRAPHY
•
CONDUCT A FLUORESCEIN ANGIOGRAPHY
•
ADMINISTER A TEAR FLOW TEST
•
TRIAGE EYE EMERGENCIES
•
PERFORM OPERATOR MAINTENANCE ON OPHTHALMIC EQUIPMENT
•
CALIBRATE THE EYE CHART
•
DISPENSE CONTACT LENS
SURGICAL TASKS
•
CONDUCT AN OCULAR SURGERY PREOPERATIVE SCREENING
•
PREPARE FOR A MAJOR OCULAR SURGICAL PROCEDURE
•
PREPARE FOR A MINOR OPHTHALMIC SURGICAL PROCEDURE
•
PREPARE FOR OCULAR LASER TREATMENT
•
ASSIST THE DOCTOR DURING OCULAR SURGERY
•
CONDUCT AN OCULAR SURGERY POSTOPERATIVE CLEANUP
•
CONDUCT AN OCULAR SURGERY POSTOPERATIVE SCREENING
•
RECEIVE OPHTHALMIC SURGICAL SETS FROM CENTRAL MATERIAL SERVICE
L-23
FM 4-02.6
L-31. Optical Laboratory Specialist (91H10)
The optical laboratory specialist assembles spectacles utilizing presurfaced single-vision lens; surfaces
multivision lens and assembles multivision spectacles; repairs and fabricates spectacles; and maintains tools
and equipment.
L-24
FM 4-02.6
GLOSSARY
ABBREVIATIONS, ACRONYMS, AND DEFINITIONS
A2C2
Army airspace command and control
AASLT air assault
ABC airway, breathing, circulation
ABCA American, British, Canadian, and Australian
ABCS Army Battle Command Systems
abn airborne
ACR armored cavalry regiment
ACS armored cavalry squadron
ACUS Area Common-User System
admin administrative
advanced trauma management (ATM) Resuscitative and stabilizing medical or surgical treatment
provided to patients to save life or limb and to prepare them for further evacuation without
jeopardizing their well-being or prolonging the state of their condition.
AELT air evacuation liaison team
AFMIC Armed Forces Medical Intelligence Center
AIR STD air standardization agreement
AM amplitude-modulated
amb ambulance
ambulance control point The ambulance control point consists of a soldier (from the ambulance company
or platoon) stationed at a crossroad or road junction where ambulances may take one of two or more
directions to reach loading points. The soldier, knowing from which location each loaded ambulance
has come, directs empty ambulances returning to the rear. The need for control points is dictated
by the situation. Generally, they are more necessary in forward areas.
ambulance exchange point (AXP) A location where a patient is transferred from one ambulance to
another en route to an MTF. This may be an established point in an ambulance shuttle or it may be
designated independently.
Glossary-1
FM 4-02.6
ambulance loading point This is a point in the shuttle system where one or more ambulances are
stationed ready to receive patients for evacuation.
ambulance relay point This is a point in the shuttle system where one or more ambulances are stationed
ready to advance to a loading point or to the next relay point to replace an ambulance that has
moved from it. As a control measure, relay points are generally numbered from front to rear.
ambulance shuttle system The shuttle system is an effective and flexible method of employing ambulances
during combat. It consists of one or more ambulance loading points, relay points, and when nec-
essary, ambulance control points, all echeloned forward from the principal group of ambulances,
the company location, or basic relay points as tactically required.
AMEDD Army Medical Department
AMEDDC&S Army Medical Department Center and School
AML area medical laboratory
AN Army Nurse Corps
ANCD automated net control device
AO area of operations
AOE Army of Excellence
AOR area of responsibility
AR Army regulation
ARPERCEN Army Reserve Personnel Center
ARPERSCOM Army Reserve Personnel Command
ARSOF Army Special Operations Forces
ARTEP Army Training and Evaluation Program
ASL authorized stockage list
ASMB area support medical battalion
ASMC area support medical company
ASMD area support medical detachment
Glossary-2
FM 4-02.6
asst assistant
ATLS® Advanced Trauma Life Support
ATM See advanced trauma management.
attn attention
augmentation A command relationship. Units that are designated to augment another unit are, therefore,
not available to the losing command for the period of augmentation.
AXP See ambulance exchange point.
BAS battalion aid station
BCIS battlefield combat identification system
BCIS-NS battlefield combat identification system-node switch
BCOC base cluster operations center
BCT brigade combat team
bde brigade
behav behavioral
BF battle fatigue
BFC battle fatigue casualty
BLS basic life support
BMSO brigade medical supply office
brigade support area (BSA) A designated area from which combat service support elements from
DISCOM and corps support command provide logistics support to the brigade. The BSA normally
is located 20 to 25 kilometers behind the forward edge of the battle area.
BSA See brigade support area.
BSB brigade support battalion
BSMC brigade support medical company
Glossary-3
FM 4-02.6
BSS brigade surgeon’s section
BW biological warfare
C2
command and control
C3
command, control, and communications
C4I command, control, communications, computers, and intelligence
casualty Any person who is lost to his organization by reason of having been declared dead, wounded,
injured, diseased, interned, captured, retained, missing, missing in action, beleaguered, besieged,
or detained.
casualty collection point A specific location where casualties are assembled to be transported to a
medical treatment facility. It is usually predesignated and may be either staffed or not. The
echelon designating the point provides the staffing.
casualty evacuation is a term used by nonmedical units to refer to movement of casualties aboard
nonmedical vehicles or aircraft. Casualties transported in this manner do not receive en route
medical care.
CBT combat
CDR commander
CE communications-electronics
CEMR civilian employee medical record
CHL combat health logistics
CHPPM Center for Health Promotion and Preventive Medicine
CHS See combat health support.
CIP combat identification panel
clr clearing
cmd command
CME continuing medical education
Glossary-4
FM 4-02.6
CMO civil-military operations
CNR combat net radio
co company
COA course(s) of action
combat health support (CHS) All support services performed, provided, or arranged by the Army
Medical Department to promote, improve, conserve, or restore the mental and/or physical well-
being of personnel in the Army and, as directed, in other services, agencies, and organizations.
These services include, but are not limited to, the management of health service resources such as
manpower, monies, and facilities; preventive and curative health measures; the health service
doctrine; evacuation of the sick (physically and mentally), injured and wounded, selection of the
medically unfit; medical supply, equipment, and maintenance thereof; and medical dental, veterinary
laboratory, optometry, and medical food services.
combat service support (CSS) The assistance provided to sustain combat forces, primarily in the fields of
administration and logistics. It includes administrative services, chaplain services, civil affairs,
food service, finance, legal services, maintenance, health service support, supply, transportation,
and other logistical services.
combat support (CS) Consists of fire support and operational assistance provided to combat elements. It
includes field artillery, air defense artillery, engineer, military police, signal, military intelligence,
and chemical.
combat trains Is the portion of the unit trains that provides combat service support required for immediate
response to the needs of forward tactical elements. At company level, health service support,
recovery, and maintenance elements normally constitute the combat trains. At battalion, the com-
bat trains normally consist of ammunition and petroleum, oils, and lubricates, vehicles, maintenance/
recovery vehicles and crews, and the battalion aid station.
(See also field trains; unit trains.)
combat zone (CZ)
(1) That area required by combat forces for the conduct of operations.
(2) The
territory forward of the Army rear boundary.
communications zone (COMMZ) Rear area of the theater of operations (behind but contiguous to the
combat zone) which contains the lines of communication, establishments for supply and evacuation,
and other agencies required for the immediate support and maintenance of the field forces.
COMMZ See communications zone.
company aid post A company aid post is a designated location on the battlefield where a combat medic
provides emergency medical treatment to casualties awaiting evacuation. This point is similar to the
collecting point (patient) except that it is manned by one of the company combat medics or medical
platoon’s aide/evacuation team.
Glossary-5
FM 4-02.6
COMSEC communications security
constructive patients In training situations, these are representation of patients in reports, messages, or
other written and oral communications; they do not require physical movement of care.
CONUS continental United States
COSC combat operational stress control
COTS commercial off-the-shelf
CP command post
CRP common relevant picture
CPR cardiopulmonary resuscitation
CRT control receiver-transmitter
CS See combat support.
CSAR combat search and rescue
CSH combat support hospital
CSOP clinical standing operating procedure
CSS See combat service support.
CSSCS Combat Service Support Control System
ctrl control
CW chemical warfare
CZ See combat zone.
DA Department of the Army
DABS division aviation brigade support
DAGR Defense Advance Global Positioning System Receiver
DC Dental Corps
Glossary-6
FM 4-02.6
DD Department of Defense
DDL Daily Disposition Log
DE directed energy
decon decontamination
DIG digitized
DISCOM division support command
div division
division support area (DSA) An area normally located in the division rear area positioned near air-
landing facilities and along the main supply route. The division support area contains the division
support command post, headquarters elements of the division support command battalions, and
those division support command elements charged with providing backup support to the combat
service support elements in the brigade support area and direct support units located is the division
rear. Selected corps support command elements in the division may be located in the division sup-
port area to provide direct support backup and general support as required.
DLA Defense Logistics Agency
DMLSS-AM Defense Medical Logistics Standard Support
DMOC division medical operations center
DMSO division medical supply office(r)
DNBI disease and nonbattle injury
DNVT digital nonsecure voice telephone
DOA dead on arrival
DOD Department of Defense
DODD Department of Defense Directive
DODI Department of Defense Instruction
DS direct support
DSA See division support area.
Glossary-7
FM 4-02.6
DSMC division support medical company
DSS division surgeon’s section
DTF dental treatment facility
DTG date time group
DVE driver’s vision enhancer
EAB echelons above brigade
EAC echelons above corps
EBL estimated blood loss
Echelon I (Level I) Unit level—The first medical care a soldier receives is provided at this level. This
care included immediate lifesaving measures, advanced trauma management, disease prevention,
combat stress prevention, casualty collection, and evacuation from supported unit to supporting
medical treatment facility. Echelon I elements are located throughout the combat and communi-
cations zones. These elements include the combat lifesaver, combat medic, and battalion aid
station. Some or all of these elements are found in combat, combat support, and combat service
support units. When Echelon I capability is not organic to a unit then this support is provided that
unit by the supporting Echelon II medical unit.
Echelon II (Level II) Duplicates Echelon I and expands services available by adding dental, laboratory,
x-ray, and patient holding capabilities. Emergency care, advanced trauma management, including
urgency initial surgery with forward surgical team augmentation. Echelon II units are located in
the combat zone—brigade/regimental support area, corps support area, and communication zone.
Echelon II medical support may be provided by clearing stations of divisional and nondivisional
medical companies/troops.
Echelon III (Level III) This echelon of support is provided in the corps . Echelon III expands the support
provided at Echelon II (division-level). Casualties who are unable to tolerate and survive movement
over great distances will receive definite care in hospitals close to the division rear boundary as the
tactical situation will allow. Echelon III hospitalization is provided by the combat support hospital.
Operational conditions may require hospitals to locate in offshore support facilities, third country
support bases, or in the communication zone.
Echelon IV (Level IV) This echelon of support is provided in the communication zone by the combat
support hospital. It provides further treatment to stabilize those patients requiring evacuation to the
continental United States. This echelon also provides resuscitative and definitive care of soldiers
located in the communication zone.
Glossary-8
FM 4-02.6
echelon of care A North Atlantic Treaty Organization term which can be used interchangeably with the
term level of care.
EIC electronic information carrier
emergency medical treatment (EMT) The immediate application of medical procedures to the wounded,
injured, or sick by specially trained medical personnel.
EMT See emergency medical treatment.
EMT-B emergency medical treatment (technician)—basic
EN electronic notebook
env environmental
EOH equipment on hand
EPLRS Enchanced Position Location Reporting System
EPW enemy prisoner(s) of war
equip equipment
evac evacuation
evacuation policy A command decision indicating the length in days of the maximum period of non-
effectiveness that patients may be held within the command for treatment. Patients, who, in the
opinion of the responsible medical officers, cannot be returned to duty status within the period
prescribed are evacuated by the first available means, provided the travel involved will not aggravate
their disabilities.
F Fahrenheit
FAX facsimile
FBCB2
Force XXI Battle Command Brigade and Below
FEBA forward edge of the battle area
field trains is the combat service support portion of a unit at company and battalion level that is not
required to respond immediately. At company level, supply and mess teams normally will be
located in the field trains A battalion’s field trans may include mess teams, a portion of the supply
Glossary-9
FM 4-02.6
section of the support platoon, a maintenance element, as well as additional ammunition and
petroleum, oils and lubricants. Positions of the field trains is dependent on such factors as the type
of friendly operation underway, available suitable terrain, and intensity of enemy activity in the
area.
(See also combat trains; unit trains.)
first aid Urgent and immediate lifesaving or other measures which can be performed for casualties (or
performed by the victim himself) by nonmedical personnel when medical personnel are not
immediately available.
1SG first sergeant
fld field
FLOT forward line of own troops
FM frequency-modulated; field manual
FMC US Field Medical Card (DD Form 1380)
FMTV Family of Medium Tactical Vehicles
forward arming and refueling point (FARP) A temporary facility that is organized, equipped, and
deployed by an aviation unit commander, and located closer to the area of operations than the
aviation units combat service support area. It provides fuel and ammunition necessary for the
employment of helicopter units in combat.
FSB forward support battalion
FSE forward support element
FSMC forward support medical company
FSMT forward support medical evacuation team
FST forward surgical team
FX fracture(s)
G1
Assistant Chief of Staff, G1 (Personnel)
GC Geneva Convention Relative to the Protection of Civilian Internees in Time of War
GCSS-A Global Combat Support System-Army
Glossary-10
FM 4-02.6
general support (GS) A general support unit provides support to the total force, not to any particular sub-
division. Therefore, subdivision may not directly request support from the general support unit.
Only the supported force headquarters may determine priorities and assign missions or tasks to the
general support unit. A general support unit has no command relationship with the supported unit
or force.
GOTS government off-the-shelf
GPS global positioning system(s)
GPW Geneva Convention Relative to the Treatment of Prisoners of War
GRC ground radio communications
GS See general support.
GTN global traffic network
GWS Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in the Armed
Forces
GWS (SEA) Geneva Convention for the Amelioration of the Condition of the Wounded, Sick, and Ship-
wrecked Members of the Armed Forces at Sea
HA heart attack
hldg holding
hlth health
HMMWV high-mobility multipurpose wheeled vehicle
HN host nation
HQ headquarters
HREC health record
HSB heavy separate brigade
HSMO health service materiel officer
HSSO health service support officer
HX history
Glossary-11
FM 4-02.6
IAW in accordance with
IBCT interim brigade combat team
IHFR improved high-frequency radio
IIF informal information flow
initial point of treatment Any point within the combat health support system at which a soldier is seen
and treated by trained medical personnel
IR infrared
IV intravenous
JTF joint task force
kbps kilobits per second
kg kilogram
kHz kilohertz
KIA killed in action
km kilometers
LAB laboratory
ldr leader
lines of patient drift Natural routes along which wounded soldiers may be expected to go back for
medical care from a combat position
LOC lines of communication
LOG logistical; logistics
LOGPAC logistical package
LZ landing zone
Glossary-12
|
|