Field Craft #3

Detainees are protected against?

- All acts of violence to include rape, forced prostitution, assualt, theft, and bodily injury. -They will not be subjected to medical or scientific experiments.

The Army Suicide Prevention Program Model is based on?

- Prevention, intervention, and the integration of the installation/community resourses.

Why Warriors May Not Seek Help

-"It would be too embarrassing" -"It would harm my carreer" -"Unit members might have less confidence in me" -"Unit members might treat me differently" -"My leaders would blame me for the problem" -"I would be seen as weak" -These stigma concerns double once a Warrior develops behavorial health symptoms.

Who do you report any known or suspected violations of the Laws of War to?

--If you must report a known or suspected violation by someone in your chain of command. -Local office of the Inspector General -Office of the Provost Marshal (military police) -Judge Advocate (military lawyer) -A chaplain who can help you report through official channels.

What are the Medical Standards of care for detaniees?

--They must be treated humanely, be cared for without adverse distinction founded on sex, race, nationality, religion, or similar criteria, and attempts on their lives shall be strictly prohibited. -They shall not be left without medical assistance and care. -Priority for care should be based on the severity of the wound/injury. -Care for detainees should be the same as those for U.S. armed forces, IAW the Geneva Conventions.

Vector

-A carrier -Use to describe when an arthropod transports a disease-causing organism, or pathogen, from one host to another.

Other Detainees (OD)

-A person in the custody of the U.S. armed forces that have not yet been classified as an EPW, CI, or RP.

Geneva Conventions

-A series of treaties signed by most nations of the the world.

West Nile Virus (WNV)

-A strain of encephalitis. -Most people have no symptoms. -20% experience mild symptoms, these include: -Fever, headache, amd body aches -1 out of 150 infected develope more servere symptoms. These include: -High fever, neck stiffness, coma, seizures, and paralyisis. -Death is usually in the elderly population. -Treatment: Prevention and PPM

Mortuary Affairs

-After battle is over the remains can be recovered and turned over to this personnel.

When should the human recovery operations begin?

-After the area has been secure

What is consideered medical transport that should be protected under the Geneva Conventions?

-Ambulances -Medical ships -Medical aircrafts

Detainee

-Any person captured or otherwise detained by an armed force. -All detainees will be treated in accordance with the principles applicable to enemy prisoners of war unless and until more precise legal status is determined.

Expectant

-Casualties so crutically injured that only complicated and prolonged treatment offers any hope of improving life expectancy. -Seperate them from other casualties and treat them after everyone else has been treated. -Examples: Unresponsive casualties with penetrating head wounds and signs of impending death, Burns, mostly third degree, covering more than 85% of TBSA, Cervical (high) spinal cord injuries, mutilating explosice wounds involving multiple anatomical sites and organs, Profound shock with multiple injuries, Agonal respirations, Convulsions and vomiting with 24 hours post-radiation exposure, Without vital signs or signs of life, transcranial gunshot wound, and Open pelvic injury with uncontrolled bleeding ( shock with decreased mental status).

Evacuation and Care of Detainees

-Categorize sick and wounded detainees as walking or non-walking (liter) wounded: these will be delivered to the nearest Medical Facility (MTF) and evacuated through medical channels. -Detainees will only be transferred to another MTF is stable and will never be transferred out of the country without the approval of the SECDEF.

Diseases associated with flies and cockroaches?

-Cholera -Food-borne gastroentertis (Ex. of passive transmission)

Differences between Concussion and Combat and Operational Stress Reactions (COSR)/Post-Traumatic Stress Disorder (PTSD)

-Concussions: Headache. Dizziness/Imbalance, Excessive Fatigue (Physical and Mental), Noise/Light Intolerance, Tinnitus, Vision Change (Blurred or Doubled) -COSR/ PTSD Stress Symptoms, Emotional Numbing, and Aviodance

What is the physical screening exam that is provided on detainees during in processing?

-Conducted to detect lice, communicable diseases (TB, STDs), and to assess overall health, nutritional, and hygiene status. -Detainees will also be immunized against other diseases. -A medical record will be created during this in processing exam and follow the detainee.

When is sick call held for detainees?

-Daily

"What NOT To Do"

-Don't leave them alone -Don't assume the person is not the suicidal "type" -Don't make moral judgments, act shocked or make light of the situation. -Don't keep deadly secrets

What's the process of Recoverying the remains of a casualty that died during first-aid?

-Don't remove IVs, monitors patches, cut IV tubes and leave catheter in place. -prepare DD Form 1380 or TC3 card and attatch to remains. -Place remains and clothing removed from remains in Human Remains Pouch. -Place IBA in a separate bag marked with the name and date. -Evacuate to the nearest Mortuary Affairs Collection Point (MACP)

Retained Person (RP)

-Enemy personnel who are medical, chaplains or are in voluntary aid societies (Red Cross, ect.) are eligible to be considered retained personnel.

Treatment of Malaria

-Evaluation from the MO. -Chemoprophylaxis -Avoidence of mosquitoes

Attending Behaviors

-Eye Contact: maintained but not seen as staring -Attentive Posture: attend to your body language, match the Warrior's posture. -Verbal Following: respond without diverting from original topic

The International Community of the Red Cross

-Has the offiical role in protecting victims of war, but does not have to power to enforce these rules.

When are medical inspections for general health, nutrition and cleanliness be held and who conducts them?

-Held atleast once a month by Camp Commander

Immediate

-Highest priority; casualties whose conditions demands immediate resuscitative treatment to save life presents with servere life-threatening wounds. -Examples: Airway obstruction, Open Pneumothorax w/ respiratory distress, Tension Pneumothorax. Unstable abdominal wound w/ shock, Massive external bleeding, Open fracture of long bones, Hypovolemic shock, and Any burns to the face, neck, hands, feet, or perineum and genitals.

What are the four ways a pathogen can be passed to humans via active transmission?

-Innoculation: a vector injects the pathogen into the host with its saliva while it feeds on the host. (Example: Mosquitoes transmit malaria by inoculation.) -Regurgitation: the vector vomits the pathogen into the host while it feeds on the host. (Example:Fleas transmit bubonic plague by regurgitation.) -Fecal Contamination: the vector defecates into the wound on the host. -Crushing the Vector: the vector is smashed onto the skin of the host.

Civilian Internee (CI)

-Interned during an international armed conflict for security reasons,for protections, or because they have committed an offense (insurgent, criminal) against the detaining power.

What is Blackwater Fever?

-Its a complication of malaria that is an acute and potentially fatal hemorrhagic state, which includes kidney failure. -Mortality is from 20-30%

Lyme disease

-Leading cause of vector-borne infectious disease in the U.S. -Characterized by skin lesion, systemic symptoms and nuerologic, orthopedic and cardiac involovement that occur in combinations of months to years. -Includes: development of red, slowly expanding "bulls eye" rash(erythema migrans) with tiredness,fever, headache, stiff neck, muscle and joint pain.

Risk Factors Associated with Suicide

-Make a previous suicide attempt -A family or family lost through suicide -A victim of childhood abuse or witnessed family violence -Previously abused drugs and/or alcohol -Alcohol abuse or dependency by significant family member

Post-Deployment Health Assesment (PDHA)

-Mandatory requirement for all re-deploying military personnel. -DD Form 2796 -Must be validated within 30 days prior to redeployment.

Does Medical Personnel guard detainees?

-NO!

Skills Needed as a Battlemind Warrior Resiliency Healthcare Provider

-Observation Skills: for the Soldier-Medic of CLS who has continual and direct contact with your Warriors during the duty day ot in the barracks. -Interviewing Skills: for the primary care providers in hospitals or clinical settings. -Referral Skills: guidelines for what actions you should take when you identify a Warrior who should seek help from a behavorial health professional. -Connecting Skills: understanding what our Warriors and their Families have been through.

Enemy Prisoner of War (EPW)

-One who, while engaged in combat under orders of his or her government, is captured by the armed forces of the enemy. -Always initially treat a captured person as an EPW

What are medical personnel entitled to defend themselves and thier patients with?

-Only permitted to use SMALL DEFENSIVE ARMS against an enemy who might attack them in violations of the Conventions. -Example: ALLOWED: 9mm, M16, and M4 (defensive) NOT ALLOWED: 240B and M249 (offensive)

Quartmaster

-Personnel in charge of transportation and disposition of remains.

Five "Ss"

-Search (for weapons, ammunition, and documents with intelligence value.) -Segregate (them into groupds of enlisted, noncommissioned officers, and officers.) -Silence (them.) -Safeguard (them.) -Speed (them to the rear.)

Two Basic Components of Battlemind

-Self-confidence: to know you can do your job as well as the Warrior next to you. -Mental toughness: to overcome obstacles or setbacks while maintaining positive thoughts during times of adversity and challenge.

Types of Question to Ask

-Simple Questions: "Where were you born?" -Open-ended Questions: solicits their views, opinions, thuoghts and feelings. -Close-ended Questions: yes or no questions -Leading Statements: leading the Warrior by starting with a general statement or reference to earlier information gleaned.

Sandflies

-Small, bloodsucking gnat that looks like a small mosquitoes. -Spreads two main diseases: -Sandfly Fever: an acute, self-limiting viral disease transmitted by the bite of an infected sandfly. -Leishmaniasis: disease found in 3rd world countries.Can be spread also by domestic animals. -Treatment for both is prevention and PPM.

Department of Defense Suicide Prevention Programs Study Showed?

-That suicide within the military was not primarl associated with stress in an individual's life.

Resiliency

-The ability to recover rapidly from illness, changes or misfortune.

Who is Required to enfore the rules of the Geneva Conventions?

-The nations that have signed these conventions are required to enforce the rules themselves and publicize the most serious viloations, known as breaches or war crimes.

Envenomation

-The poisonous effects of the bites or stings of arthropods or snakes.

Battlemind

-The warrior's inner strength to face adversity, fear and hardship during combat with confidence and courage.

Why are mosquitoes important to the military?

-They are found everywhere, in high numbers and are capable of transmitting a large number of diseases, some of which have been war stoppers.

Temporary Morgues

-This is not an acutal morgue, as it has neither the required equipment nor is it staffed; it is only a temporary holding area until the quartermaster can assume custody of the body.

What is the most effective arthropod and why?

-Ticks -This is because female ticks can pass the pathogen to the egg so that when the larva hatches it is already able to pass on the disease upon eating its first meal.

Three species of lice

-body, head and crabs

Triage Categories

Immediate, Delayed, Minimal (ambulatory or walking wounded), and Expectant.

What TAIL Stands for

T- Tell them you are concerned A- All are impacted by war I- Insist they see someone L- Look for ways to help

What Does WIRED Stand for

W- Work: not getting there, not getting it done, and not getting along. I- Ideation (Suicidal): ACE, Ask, Care, and Escort R- Relationships: hyperactivity (irritabillity) or hibernation (avoidence) E- Ethanol (Alcohol or other substances): drinking to get sleep or to calm down, or drinking to stop thinking. D- Driving/Dinged: driving fast or irritable while driving/ history of head injuries.

Arthropods

-Animals, including ticks, spiders, mites and other insects as well as crustaceans such as shrimp, lobster, and crabs.

Minimal (Walking wounded; ambulatory)

-Can be managed by self-aid or buddy-aid. Compromised of casualties with wounds that are so superficial, they require no more than cleansing, minial debridement under local anesthesia, administration of tetanus toxiod, and first-aid dressings. -Examples: Minor lacerations and abrasions, Contusions, Sprains and strains, Minor combat stress problems, Burns that are first or second degree burns that cover less than 20% TBSA, Upper extremity fractures without neurovascular compromise, Behavioral disorders or other obvious psychiatric disturbances, and Suspicions of blast injury, Symptomatic but unquantified radiation exposure.

Delayed

-Casualities who have less of a risk of losing life or limb by treatment being delayed. Can tolerate delay prior to interventions w/o unduly compromising the likelyhood of a successful outcome. -Examples: Open chest wound (w/o respiratory distress), abdominal wounds (w/o shock), Eye and central nervous system (CNS) injuries, Soft tissue wounds requiring debridement (removal of foreign material and dead or damaged tissue), Other fractures open or closed, Second and third degree burns covering 20% or more of TBSA, Maxillofacial wounds without airway compromise, Gentitourinary tract disruption.

Viral Diseases spread by the Andes mosquito

-Dengue Fever -Yellow Fever

People Who Oppertunities to Identify Warriors in Need of Care

-Desk Clerk: typically first in healthcare chain to see the parient -Specialist: who updates their DEERS and handles their records -Soldier-Medic: who takes their vital signs and weighs them -Nurse: who provides patient education for their problems/treatment. -Primary Care Manager: who may fail to ask about the stress that may be causing headaches, lower back pain, insomnia, or irritability.

Signs and Symptoms of Malaria

-Fever alternating with chills -Headache -Muscle Aches -Sweats -Abdonminal pain with diarrhea

Post-Deplyment Health Reassessment (PDHRA)

-Identifies health care concerns that have emerged over time following the most recent deplayment. -DD Form 2900 -Must be completed 90-180 days post-deployment.

When it comes to prevention 68W must be able to?

-Identify high-risk individuals -Be proactive and care for individuals -Encourage help-seeking behavior -Promote positive life coping skills to deal with life crises -Be aware of suicidal thoughts and behavior in individuals -Know the community-wide/operational resourses for referral of individuals demonstrating self-destructive behavior -Ensure that individual's problems are properly addressed ( be an advocate for the individual)

Enemy Combatant (EC)

-In reference to the Global War on Terror (GWOT), there is an additional classification of detainees who, through their own conduct, are not entitled to the priviledges and protection of the Geneva Conventions. -Still entitled to be treated humanely.

Can you cuff a detainee?

-No! Detainees will not be handcuffed or tied, EXCEPT to ensure safe custody or when prescribed by a responsible medical officer as needed to control a medical case requiring restaint.

What are the Initial Actions upon Capture?

-Non-injured detainees will be humanely evacuated ASAP. -Sick and wounded detainees will be evacuated seperately. -Body exams may be preformed for valid medical reasons only by authorized individuals. NOT in the scope of 68W practice.

What are Civilians specifically protected from under the Geneva Conventions?

-Pilage, reprisals, indiscriminate destruction of property and taking of hostages is prohibited. Civilians are not to be subject to collective punishment or deportation. -The safety, honor, family, rights, religious practices, manners and customes of civillians are to be respected. -Civilians are to be protected from murder, torture or brutality, and discrimination on the basis of race, nationality, religion or political opinions. -Children who are orphaned or seperated from their families must be cared for. -If security allows, civilians must be permitted to lead their normal lives.

What are fleas effcient vectors for?

-Plague -Typhus -Tularemia -Plague and typhus have been identified as potential biowarfare agents.

What is the most effective means of malaria control, and what are some ways to do it?

-Prevention is the most efffective way. -Ways to prevent it are: -Insect Bars (bed nets) -Long-sleeved, loose fitting clothing -Chemical repellents (DEET, Permethtrin) -Education on eliminating or destroying mosquito larval habitats.

What is primary in the Army's efforts to reduce suicide?

-Prevention.

What protection do medics receive under the Geneva Conventions and how do they lose this protection?

-Protection for attack: Medical personnel who perform nonmedical duties harmful to the enemy lose their protective status. -Protection upon capture: If captured medical personnel are considered "retained personnel," not POWs.

What do the convetions and their protocols specifically protect?

-Protects people who do not take part in fight and those who can no longer fight (noncombatants) -Noncombatants: -Civilians -Wounded and Sick in the Field and at Sea (those who can no longer fight) -Prisoners of War (surrender) -Chaplains -Medical Personnel (doctors, nurses, PAs, and medics)

What emblems does the Geneva Conventions authorize on a white background?

-Red Cross: From the reverse side of the swiss flag in honor of the origin of this initation. -Red Cresent -Red Crystal -The Red Star of David has not officailly been authorized, but it is recognized in practice.

What are major causes of completed suicides?

-Relationship problems (75%) -Alcohol (34%) -50% of suicides were committed while they were pending UCMJ action -42% were experiencing financial problems

"What To Do" when confronted with suicide:

-Remove potential means of self-harm -Ask directly -Convey concerns -Get Help

Responsibilities of Medic during triage

-Responsibilities are based on tactical and enviromental situations. -Survey and classify casualties -Assure treatment -Locate troops with minor wounds and return them to duty. (RTD)

Immediate Danger Signals Related to Suicide

-Talking about their death or hinting suicide -Giving away important possessions -Obsession with death, sad music, or sad poetry -Uncharacteristic behaviors -Significant change in performance -Has specific plans to commit suicide and access to lethal means -Buying a gun in connection with any of the above

Encephalitis

-The Andes and Culex mosquitoes carry several forms of this viral disease. -Acute inflammatory disease that involve the central nervous system.

Iternational Humanitarian Law (IHL)

-The body of rules which, in wartime, protects people who are not or are no longer participating in the hostilities. -Central purpose is to limit and prevent human suffering in times of armed conflicts.

Active Transmission (Biological Transmission)

-The disease-causing agent undergoes some change in the body of the arthropod.

Healthcare Providers Role in Battlemind Warrior Resiliency

-To ensure early identification of the "at-risk" Warriors. -To ensure the Warrior understandds that many of their thoughts and emotions are "predictable." -To educate everyone in the chain of command on how to diminish stigma and help eliminate the barrier to seeking behavioral health care. -To ensure the at-risk Warrior is reffered to a behavioral health professional who can care for them.

Main Objectives of Battlemind Warrior Resiliency

-To prepare our Warriors mentally for the rigors of combat and other military deployments. -To assist our Warriors in a successful transition back home once their tour of duty has been completed. -To prepare our Warriors with the skills to assist their battle-buddies with their transition home. -To prepare our Warriors to possibly deploy again in support of all types of military operations, including additional combat tours.

Venom

-Toxin produced by some animals, such as scorpions, spiders and snakes.

How are human remains to be treated?

-Treat human remains with respect, dignity, and reverence.

Malaria

-Tremendous problem in tropical,developing countries; causing 300-500 millions cases each year. -Ancient disease and one of the most important preventable diseases in man. -Humans get malaria from the bite of a malaria-infected FEMALE mosquito. -Chloroquine is a standard antimalaria medication. -Time between bite and appearence of symptoms is approximately 7-30 days.

Suppose you are given an unlawful order. What are your obligations?

-Try to get order resended. If they persist disreguard the order. NO ONE CAN FORCE YOU TO COMMIT A CRIME. -You must report any known or suspected violation of the Laws of War.

What are medical aircrafts used for?

-Used exclusively for the removal of the sick and wounded and for the transport of medical personnel and equipment -shall not be attacked, but respected by the enemy, while it is marked with a distinctive medical emblem and is flying at heights, times, and on routes specifically agreed upon between the parties concerned. -Must also obey every summons to land.

"Tail" Light Effect

-Warriors that hesitate to get help or are not aware they are having problems.

Passive Transmission (Mechanical Transmission)

-When the arthropod carries the pathogen from one host to another.

Triage

-medical sorting of casualties to the types and seriousness of injury, likelyhood of survival and establishment of priorities of treatment. -affords the greatest number of casualties the greatest chance of survival. -critical and always applied in Mass-Casuality situations. (MASCAL) -usually the responsibility of the senior medical person present.

MASCAL

-situation where the number of casualties exceeds the availble medical capability to rapidly treat and evacuate them. -A MASCAL can occur in multiple locations with varying resourses. -major medical center with full medical capabilities -On FOB with medical treatment facility - Combat outpost with minimal resourses

What BATTLEMIND Stands For

B- buddies (cohesion) vs. withdrawl A- accountability vs. controlling T- targeted agression vs. inappropriate agression T- tactical awareness vs.hypervigilance L- lethally armed vs. "locked and loaded" at home E- emotional control vs. anger/detachment M- mission operational security (OPSEC) vs. secretiveness I- individual responsibilites vs. guilt N- non-defense (combat) driving vs. aggressive driving D- disipline and ordering vs. conflict