Health Service Support in a Nuclear, Biological, and Chemical Environment

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United States. Department of the Army. Health Service Support in a Nuclear, Biological, and Chemical Environment

Health Service Support in a Nuclear, Biological, and Chemical Environment

Table of Contents

PREFACE

CHAPTER 1 NUCLEAR, BIOLOGICAL, AND CHEMICAL WARFARE ASPECT OF THE MEDICAL THREAT

1–1. General

1–2. Medical Threat

1–3. Nuclear, Biological, Chemical, and Radiological Dispersal Device Threats—The Health Service Perspective

CHAPTER 2 COMMAND AND CONTROL

2–1. General

2–2. Health Service Support Command and Control Planning Considerations

2–3. Health Service Support Command and Control Appraisal of the Support Minion

2–4. Health Service Support Units

2–5. Movement/Management of Contaminated Facilities

2–6. Leadership on the Contaminated Battlefield

2–7. Homeland Security

CHAPTER 3 LEVELS I AND II HEALTH SERVICE SUPPORT

3–1. General

3–2. Level I Health Service Support

3–3. Level II Health Service Support

3–4. Forward Surgical Team

3–5. Actions Before a Nuclear, Biological, or Chemical Attack

3–6. Actions During a Nuclear, Biological, or Chemical Attack

3–7. Actions After a Nuclear, Biological, or Chemical Attack

3–8. Logistical Considerations

3–9. Personnel Considerations

3–10. Disposition and Employment of Treatment Elements

3–11. Civilian Casualties

3–12. Nuclear Environment

3–13. Medical Triage

3–14. Biological Environment

3–15. Chemical Environment

3–16. Operations in Extreme Environments

3–17. Medical Evacuation in a Nuclear, Biological, and Chemical Environment

CHAPTER 4 LEVELS III AND IV HOSPITALIZATION

4–1. General

4–2. Protection

4–3. Decontamination

4–4. Emergency Services

4–5. General Medical Services

4–6. Surgical Services

4–7. Nursing Services

4–8. Conventional Operations

CHAPTER 5 OTHER HEALTH SERVICE SUPPORT

Section I. PREVENTIVE MEDICINE SERVICES

5–1. General

5–2. Disease Incidence Following the Use of Nuclear, Biological, and Chemical Weapons

5–3. Preventive Medicine Section

5–4. Preventive Medicine Detachment

Section II. VETERINARY SERVICES

5–5. General

5–6. Food Protection

5–7. Food Decontamination

5–8. Animal Care

Section III. LABORATORY SERVICES

5–9. General

5–10. Level II

5–11. Level III

5–12. Level IV

5–13. Level V (Continental United States)

5–14. Field Samples

Section IV. DENTAL SERVICES

5–15. General

5–16. Mission in a Nuclear, Biological, or Chemical Environment

5–17. Dental Treatment Operations

5–18. Patient Treatment Considerations

5–19. Patient Protection

Section V. COMBAT OPERATIONAL STRESS CONTROL

5–20. General

5–21. Leadership Actions

5–22. Individual Responsibilities

5–23. Mental Health Personnel Responsibilities

Section VI. HEALTH SERVICE LOGISTICS

5–24. General

5–25. Protecting Supplies in Storage

5–26. Protecting Supplies During Shipment

5–27. Organizational Maintenance

Section VII. HOMELAND SECURITY RESPONSE

5–28. Chemical, Biological, Radiological, Nuclear, and High-Yield Explosive Response

5–29. Capabilities of Response Elements

APPENDIX A MEDICAL EFFECTS OF NUCLEAR, BIOLOGICAL, AND CHEMICAL WEAPONS AND TOXIC INDUSTRIAL MATERIAL

A-1. General

A-2. Physical Effects of Nuclear Weapons

A-3. Physiological Effects of Nuclear Weapons

A-4. Biological Effects of Thermal Radiation

A-5. Physiological Effects of Ionizing Radiation

A-6. Handling and Managing Radiologically Contaminated Patients

A-7. Radiological Patients in Stability Operations and Support Operations

A-8. Effects of Biological Weapons

A-9. Behavior of Biological Weapons

A-10. Management of Biological Warfare Patients

A-11. Effects of Chemical Weapons

A-12. Behavior of Chemical Weapons

A-13. Characteristics of Chemical Agents

A-14. Management of Chemical Agent Patients

A-15. Management of Toxic Industrial Material Patients

APPENDIX B SAMPLE/SPECIMEN COLLECTION AND MANAGEMENT

Section I. INTRODUCTION

B-1. General

B-2. Sample/Specimen Background Information

B-3. Sample/Specimen Collection and Preservation

B-4. Chain of Custody

Section II. SAMPLING TECHNIQUES AND PROCEDURES

B-5. General

B-6. Expended Material

B-7. Environmental Samples

B-8. Collection of Air and Vapor Samples

B-9. Collection of Water Samples

B-10. Collection of Soil Samples

B-11. Collection of Contaminated Vegetation

B-12. Medical Specimens

B-13. Collection of Medical Specimens

B-14. Post mortem Specimens

B-15. Reporting, Packaging, and Shipment

B-16. Handling and Packaging Materials

B-17. Collection Reporting

B-18. Sample/Specimen Background Documents

APPENDIX C GUIDELINES FOR OPERATIONAL PLANNING FOR HEALTH SERVICE SUPPORT IN A NUCLEAR, BIOLOGICAL, AND CHEMICAL ENVIRONMENT

C-1. General

C-2. Predeployment

C-3. Mobilization

C-4. Establish a Medical Treatment Facility

C-5. Operate a Medical Treatment Facility Receiving Contaminated Patients

C-6. Preventive Medicine Services

C-7. Veterinary Services

C-8. Dental Services

C-9. Combat Operational Stress Control

C-10. Medical Laboratory Services

C-11. Health Service Logistics

C-12. Homeland Security

APPENDIX D MEDICAL PLANNING GUIDE FOR THE ESTIMATION OF NUCLEAR, BIOLOGICAL, AND CHEMICAL BATTLE CASUALTIES

Section I. INTRODUCTION

D-1. General

D-2. Medical Planners' Tool

Section II. MEDICAL PLANNING GUIDE FOR THE ESTIMATION OF NUCLEAR, BIOLOGICAL, AND CHEMICAL BATTLE CASUALTIES (NUCLEAR)—AMedP-8(A), VOLUME I

D-3. General

D-4. Medical Planning Considerations

D-5. Triage

D-6. Evacuation

D-7. In-Unit Care

D-8. Hospital Bed Requirements

D-9. Medical Logistics

D-10. Medical Force Planning

Section III. MEDICAL PLANNING GUIDE FOR THE ESTIMATION OF NUCLEAR, BIOLOGICAL, AND CHEMICAL BATTLE CASUALTIES (BIOLOGICAL)—AMedP-8(A), VOLUME II

D-11. General

D-12. Medical Planning Considerations

D-13. Triage

D-14. Evacuation

D-15. In-Unit Care

D-16. Patient Bed Requirements

D-17. Medical Logistics

D-18. Medical Force Planning

Section IV. MEDICAL PLANNING GUIDE FOR THE ESTIMATION OF NUCLEAR, BIOLOGICAL, AND CHEMICAL BATTLE CASUALTIES (CHEMICAL)—AMedP-8(A), VOLUME III

D-19. General

D-20. Medical Planning Considerations

D-21. Triage

D-22. Evacuation

D-23. In-Unit Care

D-24. Patient Bed Requirements

D-25. Medical Logistics

D-26. Medical Force Planning

APPENDIX E Example X-__, ANNEX__, TO HSS PLAN/OPERATION ORDER__, MEDICAL NBC STAFF OFFICER PLANNING FOR HSS IN AN NBC ENVIRONMENT

APPENDIX F EMPLOYMENT OF CHEMICAL AND BIOLOGICAL COLLECTIVE PROTECTION SHELTER SYSTEMS BY MEDICAL UNITS

Section I. INTRODUCTION

F-1. General

F-2. Types of Collective Protection Shelter Systems

Section II. EMPLOYMENT OF THE CHEMICALLY BIOLOGICALLY PROTECTED SHELTER SYSTEM

F-3. Establish a Battalion Aid Station in a Chemically Biologically Protected Shelter

F-4. Division Clearing Station in a Chemically Biologically Protected Shelter

F-5. Forward Surgical Team in a Chemically Biologically Protected Shelter

Section III. EMPLOYMENT OF THE CHEMICALLY PROTECTED DEPLOYABLE MEDICAL SYSTEMS AND SIMPLIFIED COLLECTIVE PROTECTION SYSTEMS

F-6. Collective Protection in a Deployable Medical System-Equipped Hospital

F-7. Chemically/Biologically Protecting the International Organization for Standardization Shelter

F-8. Chemically/Biologically Protecting the Vestibules

F-9. Chemically/Biologically Protecting Air Handler Equipment

F-10. Establish Collective Protection Shelter Using the M20 Simplified Collective Protection System

F-11. Casualty Decontamination

Section IV. OPERATIONS, ENTRY, AND EXIT GUIDELINES

F-12. Operations

F-13. Decontamination of Entrance Area

F-14. Procedures Prior to Entry

F-15. Entry/Exit for the Collective Protection Shelter System

F-16. Resupply of Protected Areas

APPENDIX G PATIENT DECONTAMINATION

Section I. INTRODUCTION

G-1. General

G-2. Immediate Decontamination

G-3. Patient Decontamination and Thorough Decontamination Collocation

G-4. Patient Decontamination at the Battalion Aid Station (Level I)

G-5. Patient Decontamination at the Medical Company Clearing Station (Level II)

G-6. Patient Decontamination at a Hospital (Level III or IV)

G-7. Prepare Hypochlorite Solutions for Patient Decontamination

G-8. Classification of Patients

G-9. Patient Treatment

Section II. PATIENT DECONTAMINATION PROCEDURES

G-10. Decontaminate a Litter Chemical Agent Patient

G-11. Decontaminate an Ambulatory Chemical Agent Patient

G-12. Biological Patient Decontamination Procedures

G-13. Decontaminate a Litter Biological Agent Patient

G-14. Decontaminate an Ambulatory Biological Agent Patient

G-15. Decontaminate Nuclear-Contaminated Patients

G-16. Decontaminate a Litter Nuclear-Contaminated Patient

G-17. Decontaminate an Ambulatory Nuclear-Contaminated Patient

APPENDIX H FIELD EXPEDIENT PROTECTIVE SYSTEMS AGAINST NUCLEAR, BIOLOGICAL, AND CHEMICAL ATTACK

H-1. General

H-2. Protection Against Radiation

H-3. Expedient Shelters for Protection Against Radiation

H-4. Expedient Shelters Against Biological and Chemical Agents

APPENDIX I DETECTION AND TREATMENT OF NUCLEAR, BIOLOGICAL, AND CHEMICAL CONTAMINATION IN WATER

I-1. General

I-2. Detection of Contamination in Water

I-3. Procedures on Discovery of Contamination in Water

I-4. Treatment of Contaminated Water

APPENDIX J FOOD CONTAMINATION AND DECONTAMINATION

J-1. General

J-2. Protection of Food from Contamination

J-3. Nuclear

J-4. Biological

J-5. Chemical

GLOSSARY

REFERENCES

INDEX

Отрывок из книги

United States. Department of the Army

Tactics, Techniques, and Procedures

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e. For additional information on planning operations in an NBC environment see FMs 8–10, 4–02.10, 4–02.4, 4–02.6, 4–02.283, 8–9, 8–10-6, 8–10-26, 8–284, and 8–285. Higher headquarters must distribute timely plans and directives to subordinate units to ensure that the subordinate unit's HSS plan supports their plan.

The HSS personnel make an appraisal of the supported mission to determine the expected patient load. Once the appraisal has been accomplished, HSS personnel prepare for the HSS mission by assigning personnel responsibilities. Using triage and EMT decision matrices for managing patients in a contaminated environment improves treatment proficiency. See Figure 2–1 for a sample decision matrix. Training HSS personnel in the use of simple decision matrices should enhance their effectiveness and contribute to a more efficient battlefield HSS process. Prior training for designated nonmedical personnel in patient decontamination procedures will enhance their effectiveness in the overall patient care mission. See Appendix D for planning factors on the estimation of NBC casualties.

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