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Military

Appendix F

Combat Health Support

This Appendix provides an overview of CHS system activities designed to provide care to soldiers during RSO&I activities.

PREDEPLOYMENT COMBAT HEALTH SUPPORT ACTIVITIES
  F-1. Predeployment CHS activities will focus on individual and unit measures designed to ensure the health of the command. Depending on the medical threat in the area of deployment, the following factors indicate command and medical measures that should be taken into consideration prior to deployment.
 
  • Acclimatization of troops. (Includes requirements for acclimatization of newly arrived troops or for forecasted operations, such as desert or mountain operations.)
  • Presence of disease. (Includes the endemic diseases that are not at a clinically significant level in the native population. Deploying forces may not be immune and the incidence of endemic disease cases may increase with a disruption of services, such as sanitation and garbage disposal.)
  • Status of immunizations. (US Forces should maintain current shots and receive all appropriate immunization prior to deployment.) Commanders at all levels are responsible for assuring the medical readiness of their soldiers, that they receive required immunizations/prophylaxes, and that appropriate immunization, health, and dental records are maintained.
  • Status of nutrition.
  • Clothing and Equipment. (Includes consideration for specialized clothing and equipment, such as jungle fatigues, bed netting, parkas, and mountain climbing equipment. When deploying to desert environments, both hot and cold weather clothing should be brought.)
  • Fatigue. (The fatigue factor must be monitored since fatigue can contribute to lowering an individual's resistance to disease and may lead to combat stress reactions.)
  • Morale. (It is important to the morale of a soldier that he knows that medical attention is readily available if he is wounded.)
  • Status of Training. (Includes soldier training, first aid training, and MOS-and mission-specific training.)
  • Other, as appropriate. This can include water discipline programs or other preventive medicine measures and programs.

MOBILIZATION REQUIREMENTS
  F-2. Mobilization requires extensive and comprehensive planning to ensure the medical readiness posture of the unit is maintained so that the unit can deploy in an efficient and timely manner. Commanders at all levels must ensure the highest degree of medical readiness of their units. Initial and refresher training can be conducted in the following areas:
 
  • Field sanitation teams and personal hygiene (FM 21-10 and FM 21-10-1).
  • First Aid (FM 21-11).
  • Endemic and epidemic disease prevalence.
  • Poisonous plants, wild animals, arthropods, and reptiles.
  • Climate and associated environmental concerns.
  • Pest management.
  • Field Waste.
 

F- 3. Combat stress control concerns include:

  • Review of stressors associated with deployment and the specific operational scenario.
  • Individual, buddy, and leader coping strategies and techniques.
  • Sleeping planning.
  • Home front issues and family support groups.
  • Recognition and management of Battle Fatigue Casualties and Misconduct Stress Behaviors.

PREDEPLOYMENT VETERINARY ASSISTANCE
  F-4. Units with military working dogs and/or government-owned animals will require veterinary assistance prior to deployment. Government-owned animals will be given a predeployment physical and immunizations/vaccines as required. The records of government-owned animals will be updated and checked for appropriate documents that may be required by host nation customs or health officials at the port of debarkation.
  F-5. Veterinary personnel at the production facility inspected basic loads of rations being shipped with the unit. If these rations were properly stored, rotated, and expiration dates maintained, additional inspections are not necessary.

COMBAT HEALTH SUPPORT IN THE DEPLOYMENT STAGING AREA
  F-6. When the unit is deployed, the commander is responsible for coordinating with the supporting medical units to ensure the unit is provided combat health support at the POE. Detailed coordination is required to provide treatment, hospitalization, and evacuation capability to the supported unit en route to and at the POE. The commander is responsible for coordinating for the provision of medical support at the mobilization site or staging area as organic medical supplies and equipment are loaded and not available for use.

COMBAT HEALTH SUPPORT IN THE RECEPTION AREA
  F-7. Combat Health Support must be coordinated to ensure availability of emergency medical care, emergency dental care, and sick call support to arriving forces. Sick or injured soldiers requiring evacuation out of the theater of operations must be tracked through available automated systems. Soldiers are oriented to the AO in the following combat health support areas:
 
  • Medical threat.
  • Combat health support issues, to include preventive medicine measures and combat stress control procedures.
  • Available host nation medical support.
  • Class VIII supply procedures.
  • Hospitalization and evacuation.

COMBAT HEALTH SUPPORT ONWARD MOVEMENT AND INTEGRATION
  F-8. Combat Health Support will be provided in accordance to the specifics of the OPLAN and mission requirements. The CHS system encompasses all of the functional areas (hospitalization, evacuation, dental, and so forth). The full spectrum of CHS services are provided by a combination of organic, assigned, attached, in direct support, and in general support CHS resources.

Preventive Medicine Site Survey Checklist
  F-9. A checklist for each category of preventive medicine is as follows:

Individual PVNTMED Measures

 

N/A

SAT

UNSAT

A

Showering devices

 

 

 

B

Handwashing devices

 

 

 

 

(1) Outside all latrines

 

 

 

 

(2) In food service area

 

 

 

Individual PVNTMED Measures (continued)

 

N/A

SAT

UNSAT

C

Soakage pits located under hand washing and showering devices

 

 

 

D

Laundry facilities

 

 

 

Water Supply

 

N/A

SAT

UNSAT

A

Quantity of water required for soldiers is available

 

 

 

 

(1) Cold Climate Drinking (potable) water: 1/2 Gallon/soldier/day

 

 

 

 

(2) Hot Climate Drinking water: 3-4 Gallons/soldier/day

 

 

 

 

(3) Food Preparation: Meal, Ready-to-eat, 2 Quarts/soldier/day

 

 

 

 

(4) Food Preparation: A-, B-, or T-ration

 

 

 
  (5) Nonpotable: General planning to meet water requirements in an arid zone is 3-6 gallons/soldier/day unless improvised shower devices are made available. In this case the requirement should be increased to 15 gallons or more/soldier/day.

 

 

 

B

Quartermaster water distribution points

 

 

 

C

Water sources

 

 

 

 

(1) Surface water

 

 

 

 

(2) Ground water

 

 

 

 

(3) Rain water

 

 

 

 

(4) Melted ice water

 

 

 

 

(5) Melted snow water

 

 

 

 

(6) Sea water

 

 

 

D

Water containers

 

 

 

 

(1) Five (5) gallon water cans

 

 

 

 

(2) Collapsible fabric drums

 

 

 

 

(3) Water trailer (400 gallon)

 

 

 

 

(4) Other water containers

 

 

 

Food Service Sanitation
 

N/A

SAT

UNSAT

A

Transportation of food

 

 

 

 

(1) Vehicle used is clean and completely covered

 

 

 

 

(2) Vehicle used to transport garbage, trash, petroleum products, or similar material is thoroughly cleaned/sanitized before it is used to transport food

 

 

 

B

Food storage

 

(1) Refrigerator available to store food at 45oF or below

 

 

 

 

(2) Ice chest available

 

 

 
  (3) Ice obtained from an approved source

 

 

 
  (4) Insulated food containers

 

 

 

 

(5) Dunnage available for dry storage

 

 

 

C

Mess kit laundry

 

 

 

 

(1) Correct number of containers available per line

 

 

 

 

(2) Containers correctly prepared and at right temperatures

 

 

 

Food Service Sanitation (continued)

 

N/A

SAT

UNSAT

D

Sanitation center

 

 

 

 

(1) Correctly setup

 

 

 

 

(2) Containers correctly prepared and at right temperatures

 

 

 

Food Preparation and Serving

 

N/A

SAT

UNSAT

A

Food protected from contamination during preparation and serving

 

 

 

B

Food maintained at correct temperature during serving (cold 45oF or above)

 

 

 

C

Correct disposal of leftovers

 

 

 

Waste Disposal

 

N/A

SAT

UNSAT

A

Human waste: Latrines

 

 

 

 

(1) Fixed latrine sites

 

 

 

 

(2) Authorized the digging of latrines

 

 

 

 

(3) Number of latrines (4% of male population/6% of female population

 

 

 

 

(4) Latrine construction supplies (lumber, toilet seats, #10 cans, and screening)

 

 

 

 

(5) Authorized the use of burn-out latrines

 

 

 

 

(6) Pail latrines

 

 

 

 

(7) Chemical latrines

 

 

 

 

(8) Latrine location: 100 yards downwind (prevailing wind) from the unit food service facility and at least 100 feet from any unit ground water source

 

 

 

 

Human waste: Urine disposal facilities

 

 

 

B

Solid waste disposal/temp storage

 

 

 

 

(1) Location: 100 feet from any natural water source used for cooking or drinking

 

 

 

 

(2) Solid waste will be buried

 

 

 

 

(3) Solid waste will be incinerated

 

 

 

 

(4) Solid waste will be hauled away

 

 

 

Arthropod Control

 

N/A

SAT

UNSAT

A

Ideal bivouac site:

 

 

 

 

(1) High, well-drained ground at least one (1) mile from breeding sites of flies and mosquitoes

 

 

 

 

(2) One (1) mile from native habitats

 

 

 

B

Screened billets

 

 

 

C

Availability of pesticides

 

 

 

D

Arthropod resistance to pesticides

 

 

 

Rodent Survey

 

N/A

SAT

UNSAT

A

Sightings of live or dead rodents

 

 

 

B

Droppings

 

 

 

C

Smudge marks

 

 

 

D

Tracks

 

 

 

E

Gnawing

 

 

 

F

Burrows/holes

 

 

 

G

Nests

 

 

 

H

Sounds

 

 

 

I

Odors

 

 

 

Heat/Cold Injuries
 

N/A

SAT

UNSAT

A

Seasonal temperatures

 

 

 

B

Seasonal winds

 

 

 
C

Humidity

 

 

 

D

Seasonal precipitation

 

 

 

E

Alcohol (ETOH) availability

 

 

 

F

Acclimatization program

 

 

 

G

Wet bulb globe temperature (WEGT) Index:

 

 

 

 

(1) Available from preventive medicine service

 

 

 

 

(2) Available from military meteorological service

 

 

 

Chemical Hazards (Non-NBC

 

N/A

SAT

UNSAT

A

Gas, liquid, or solid chemicals stored in area

 

 

 

B

Enclosed areas ventilated

 

 

 

C

Correct solvent being used

 

 

 

Noise Hazards

 

N/A

SAT

UNSAT

A

Noise hazard areas clearly marked

 

 

 

B

Hearing protection devices being used

 

 

 

 



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