Military

2. There is a lack of consistency in how FSB medical companies establish treatment facilities. Some units use tracked or wheeled vehicles; others use various shapes and sizes of tentage for treatment space.

3. FSB medical company facilities are poorly marked.

PROBLEM 4-2:

1. Combat health support planners develop combat health support plans without understanding the maneuver plan.

2. Brigades do not conduct parallel planning; i.e., combat health support planners are not present for mission analysis and course of action (COA) development.

3. Planners continue to write the combat health support plans without doing a casualty estimate and without knowledge of medical asset status and capabilities.

PROBLEM 4-3: Casualty feeder cards are too often incorrectly filled out. Medical company personnel do not have the information necessary to complete and/or correct the cards.

3-4QFY95

PROBLEM 4-4: (Repeat of Problem 4-1) Medical units are generally deficient in the planning, management, and execution of medical operations.

1. Combat Health Support (CHS) planning is not integrated into the brigade planning process.

2. Too often the forward support battalion (FSB) medical company commander is unable to participate in the orders process because of operational responsibilities.

3. The FSB support operations officer is often tasked to participate in the brigade orders process but lacks the necessary experience in medical operations.

4. FSB medical companies do not establish standardized treatment facilities. Various shapes and sizes of tentage are used for treatment space.

5. FSB medical companies do not exhibit standardized blood management procedures.

1-2QFY96

PROBLEM 4-5: The Professional Filler System (PROFIS) physicians are not incorporated into medical platoon training and are not prepared to conduct tactical operations.

1. The majority of PROFIS doctors deploying to the combat training center have never trained with the unit they are supporting and have only been with the unit an average of about one week.

2. PROFIS physicians are too often not trained on common soldier skills.

PROBLEM 4-6: (Repeat of Problem 4-3) Units are challenged with preparing and submitting DA Form 1156 to standard.

1. Units are expected to quickly prepare and submit DA Form 1156 when they receive casualties.

2. DA Forms 1156 are frequently not completed with all pertinent information.

3. DA Forms 1156 for soldiers who are lightly wounded, treated, and immediately returned to duty (RTD) are not submitted to the task force S1 or S1 representative at the forward aid station or main aid station (FAS/MAS).

3-4QFY96

PROBLEM 4-7: Medical companies frequently do not utilize an established layout to employ their assets when they occupy a new area of operations.

PROBLEM 4-8: Medical company commanders do not have systems in place to manage and track the brigade's medical assets.

PROBLEM 4-9:

1. There is rarely a medical officer involved in the planning of brigade combat health support operations.

2. The medical planning and the S1 are not considering the casualty estimate when developing the CHS plan.

3. The medical planner is not integrated into the brigade's military decision-making process (MDMP).

Does not support the maneuver commander's plan.
Fails to take into consideration time/distance factors in the evacuation and treatment of casualties.

1-2QFY97

PROBLEM 4-10: (Repeat of Problem 4-7) Medical companies frequently do not utilize an established layout to employ their assets when they occupy a new area of operations.

PROBLEM 4-11: (Repeat of Problem 4-8) Medical company commanders do not have systems in place to manage and track the brigade's medical assets.

PROBLEM 4-12: (Repeat of Problem 4-9)

1. There is rarely a medical officer involved in the planning of brigade combat health support operations.

2. The medical planning and the S1 are not considering the casualty estimate when developing the CHS plan.

3. The medical planner is not integrated into the brigade's military decision-making process (MDMP).

RESULTS:

Does not support the maneuver commander's plan.
Fails to take into consideration time/distance factors in the evacuation and treatment of casualties.

Techniques

1. Combat health planners must participate in the entire staff planning process.

2. Incorporate medical planning into all Home Station training field exercises.

1. The FSB medical company must practice the set-up of treatment facilities in a field environment to ensure a practical configuration based on projected treatment requirements.

2. Always incorporate the use and management of ground and air evacuation assets into field training exercises.

3. Pay particular attention to standardized blood management procedures.

3. The wounded soldier's chain of command is responsible for collecting DA Form 1156 feeder cards and ensuring they are filled out completely and correctly. Conduct training at Home Station on what a properly filled-out form should look like.

4. The task force should develop an SOP for submission of DA Form 1156 for return to duty (RTD) cases.

1. Have the company team consolidate its RTD 1156s with the first sergeant prior to his departure to the LRP meeting.

2. The first sergeant submits the RTD 1156s to the S1 or designated S1 representative who checks them for correctness and accountability.

3. Verified RTD 1156s are forwarded up the chain of command to the division G-1 section with all other 1156s collected that day at the FAS/MAS.

5. PROFIS physicians must be identified at least six months prior to deployment and train up with the unit at Home Station prior to deployment. This will allow him to become familiar with unit equipment and SOPs.

6. Health Services Command should develop a standard Table of Organizations and Equipment (TOE) for forward support battalion (FSB) medical company treatment sections.

7. Develop a standard template to assist in the layout of the company area. Establish and enforce one route through the company area; adjust based on terrain, but do not change the one-route concept. Place along the established traffic route:

• The command post
• Maintenance area
• Class VIII resupply point
• Fuel point

8. Work out a system between the medical platoons within the brigade combat team (BCT) and the medical company in the form of a brief standard report that gives their current status on maintenance and Class VIII.

1. Design a simple report form that can be passed either by FM or ambulance messenger.

2. The form must be easy and fast to promote its use by the platoon leaders.

9. The forward support medical commander (FSMC) is currently the only technical expert available to the brigade. He must be included into the brigade's MDMP to ensure a technically sound plan that is synchronized with and integrated into the maneuver commander's plan.

1. This individual must bring to mission analysis the maintenance status of the brigade's evacuation platforms and the status of Class VIII medical supplies and blood in the brigade.

2. The medical planner must have an understanding of the commander's intent and the course of action so that he/she is able to develop a medical support that supports the tactical plan.

3. The medical planner must be actively involved in the wargaming process to ensure that his/her plan is synchronized and integrated with the rest of the BOS in the brigade.

10. The medical planner and the brigade S1 must look carefully at the casualty estimate and the S2's situational template (SITEMP) to determine the densities of casualties during the different phases of the operation.

1. They must determine the required number of evacuation platforms to move these casualties.

2. They must determine if there is a requirement for additional nonstandard platforms to assist in the evacuation process.

3. The requirement for additional assets is then integrated into the CHS annex as a specified task to subordinate units.

TA.7 Combat Service Support, Part IV

TA.7, Part VI