EFMB Study Guide

19. What are the junctional wounds and how are they treated?

"Junctional zone trauma, by definition, is an injury occurring at the junction of anatomically distinct zones (Table 12-1). These injuries may be defined as damage to tissues that span the root of an extremity and adjacent body cavity. Such regions include the lower abdomen, groin, axillae, and proximal extremities" "Junctional areas are traversed by major blood vessels and, when injured, may not be suitable for tourniquet application. Consequently, junctional injuries are frequently associated with profound bleeding that may be difficult to control" "may therefore need early and aggressive resuscitation and surgical hemorrhage control; occasionally, limb salvage may have to give way to preservation of life"

37. How are insect stings/bites and snake bites identified and treated? a. Black widow spider.

(1) A pinprick sensation at the bite site, becoming a dull ache within about 30 minutes. (2) Severe painful muscle spasms, expecially in the shoulders, back, chest and abdomen. (a) Begin in 10 to 40 minutes. (b) Peak in 1 to 3 hours. (c) Persist for 12 to 48 hours. (3) Rigid, board-like abdomen. (4) Dizziness, nausea and vomiting and respiratory distress in severe cases.

14. Identify the types of seizures and their characteristics. a. Petit mal

(1) Brief loss of concentration or awareness without loss of motor tone. (2) Lip smaking or eye blinking. (3) Occurs mainly in children and is rarely an emergency

Disperse

(1) Extend the arm horizontally. (2) Wave the arm and hand to the front, left, right, and rear (3) Point toward the direction of each movement.

wedge

(1) Extend the arms downward to the side. (2) Turn the palms to the front. (3) Place your arms at a 45-degree angle below horizontal.

Staggered Column

(1) Extend the arms so that upper arms are parallel to the ground. (2) Make sure the forearms are perpendicular. (3) Raise the arms so they are fully extended above the head.

Line

(1) Extend the arms. (2) Turn palms downward parallel to the ground.

Enemy in sight

(1) Hold the rifle in the ready position at shoulder level. (2) Point the rifle in the direction of the enemy.

6. What are the different types of poisoning and how do you treat each? Injected poisons.

(1) Maintain the airway and be prepared to provide assisted ventilations. (2) Give supplemental oxygen. (3) Look for gross soft tissue damage ("tracks"). (4) Protect the casualty from harming self and others. NOTE: Be prepared to use restraints. (5) Transport to the nearest medical treatment facility. 3. Document procedures. (See tasks 081-831-0033 and 081-833-0145.)

6. What are the different types of poisoning and how do you treat each? Ingested poisons.

(1) Maintain the airway. (2) Gather all information about the type of ingested poisoning. (3) Administer activated charcoal. NOTE: Be prepared to provide oral suctioning if the casualty starts to vomit. All vomitus must be saved. (a) Adults and children: 1 gram of activated charcoal/kg of body weight. (b) Usual adult dose: 25-50 grams. (c) Usual pediatric dose-(1-10 years): 12.5-25 grams. (4) Give supplemental oxygen. (5) Record the name, dose, and time of administration of medication. (6) Transport to the nearest medical treatment facility

14. Identify the types of seizures and their characteristics. b. Grand mal (generalized).

(1) May be preceded by an aura. (2) Has two phases. (a) Tonic/Clonic Phase--characterized by rigidity and stiffening of the body, drooling and occasional cyanosis around the face and lips. (b) Postictal Phase-begins when convulsions stop. The patient may regain consciousness and enter a state of drowsiness and confusion or remain unconscious for several hours. (3) May involve incontinence, biting of the tongue (rare), cyanosis or mental confusion.

Join me, Follow me, or Come forward

(1) Point toward person(s) or unit. (2) Beckon by holding the arm horizontally to the front with palm up. (3) Motion toward the body.

Coil

(1) Raise one arm above the head. (2) Rotate it in a small circle.

Vee

(1) Raise the arms. (2) Extend the arms 45-degrees above the horizontal

Increase speed, Double time, or Rush

(1) Raise the fist to the shoulder. (2) Thrust the fist upward to the full extent of the arm and back to shoulder level. (3) Continue rapidly several times.

6. What are the different types of poisoning and how do you treat each? Absorbed poisons.

(1) Remove the casualty from the source. (2) Remove contaminated clothing. (3) Brush off any powders from the casualty's skin. (4) Flush the skin with large amounts of water for at least 20 minutes.

6. What are the different types of poisoning and how do you treat each? Inhaled poisons.

(1) Remove the casualty from the unsafe environment. (a) Maintain the airway. (b) Administer high concentrations of oxygen. NOTE: This is the most important treatment for inhalation poisoning. (2) Transport to the nearest medical treatment facility. (3) Document interventions.

33. Understand the different ways to transport a casualty (individual or assisted) and when you would use different carries. a. Laterally.

(1) With the assistance of another Soldier grasp the casualty's arms and legs. (2) While stabilizing the casualty's head and neck as much as possible, lift the casualty free of the vehicle and move him/her to a safe place on the ground. Note: If medical personnel are available, they may stabilize the casualty's head, neck, and upper body with a special board or splint.

SF 600 (Chronological Record of Medical Care)

(Picture)

38. What observation techniques can you perform during day vs. limited visibility observation? (2) Use night vision scan technique

(a) Look from right to left or left to right using a slow, regular scanning movement. (b) At night avoid looking directly at a faintly visible object when trying to confirm its presence.

38. What observation techniques can you perform during day vs. limited visibility observation? (1) Use dark adaptation technique

(a) Stay in a dark area for about 30 minutes. (b) Move into a red-light area for about 20 minutes followed by about 10 minutes in a dark area. Note: The red-light method may save time by allowing you to get orders, check equipment, or do some other job before moving into darkness.

24. Understand medications and doses soldiers may receive after sustaining an injury in combat.

(d) Once the bleeding has stopped, give 500 ml of Hextend® as rapidly as possible Recheck in 30 minutes. If the radial pulse has returned, do not give any additional fluids but monitor as frequently as possible. (e) If the radial pulse does not return, give an additional 500 ml of Hextend®. (2) If the casualty is unable to fight-- (a) Morphine 5 mg given IV (through the saline lock) and repeated every 10 minutes as necessary is very effective in controlling severe pain. If a saline lock is used, it should be flushed with 5 ml of saline after the morphine administration. (b) Phenergan 25 mg IV or IM may be necessary to combat the nausea and vomiting associated with morphine. NOTE: Medics who carry morphine must be familiar with its side effects and trained in the use of Naloxone to counter these side effects. (c) Pain relief can also be attained with the use of fentanyl transmucosal lozenges. These lozenges are placed between the cheek and gum and will be absorbed through the oral mucosa. This method allows for narcotic pain control without IV access.

17. What is the Detainee Operations Medical Director (DOMD) responsible for?

- Advising the detainee operations commander on the health of the detainee population to include contagious disease, nutritional issues, and public health concerns. - Providing guidance, in conjunction with the staff judge advocate, on the ethical and legal aspects of providing health care to detainees. - Recommending task organization of medical resources to satisfy mission requirements. - Recommending policies concerning medical support to detainee operations. - Developing, coordinating, and synchronizing health consultation services for detainees. - Evaluating and interpreting medical statistical data. - Recommending policies and determining requirements and priorities for medical logistics operations in support of detainee health care. This includes blood and blood products, medical supply/resupply, formulary development, medical equipment, medical equipment maintenance and repair services, optometric support, fabrication of single- and multivision optical lenses, and spectacle fabrication and repair. - Recommending medical evacuation policies and procedures and monitoring medical evacuation of detainees. - Recommending policies, protocols, and procedures pertaining to medical and dental treatment of detainees. These policies, protocols, and procedures will provide the same standard of care provided to U.S. Forces in the same geographical area. - Ensuring medical records are maintained on each detainee as prescribed by AR 40-66 and AR 40-400. - Ensuring the nutritional adequacy (quality, quantity, and variety) of the menu served to the detainees to prevent the development of deficiencies through menu approval and evaluation by a dietitian. He further monitors the adequacy of the menu served to the detainees by ensuring detainees are monitored for weight loss by ensuring monthly weigh-ins are conducted and reported in accordance with regulations and international law. Planning for and implementing preventive medicine operations and facilitating health risk communications (to include preventive medicine programs and initiating preventive medicine measures to counter the health threat). - Planning for medical support to the detainee population.

35. What are common heat injuries and their signs and symptoms?

- Heat cramps-muscle cramps of the arms, legs, and/or abdomen. - Heat exhaustion - Profuse sweating and pale (or gray), moist, cool skin, headache, weakness, dizziness, loss of appetite or nausea, normal or slightly elevated body temperature - Heat stroke - Rapid onset with the core body temperature rising to above 106° F within 10 to 15 minutes, hot, dry skin headache, dizziness, headache, nausea, confusion, weakness, loss of consciousness, possible seizures.

22. What are the three principal types of civilian organizations?

- International organizations. These are established by intergovernmental agreements and operate at the international level (such as various United Nations organizations). - Nongovernmental organizations. These are voluntary organizations that are not funded by governments. - International humanitarian organizations. These are impartial, neutral, and independent organizations whose mandate is to assist and protect victims of conflict

36. During an initial evaluation of a hunger-striking detainee, the medical staff will?

- Measure and record the detainee's height and weight. - Measure and record vital signs. - Perform a urinalysis. - Conduct an psychological/psychiatric evaluation. - Examine the detainee's general physical condition and if clinically indicated, proceed with radiographs and or laboratory studies. - Take and record weight and vital signs at least once every 24-hours during the hunger strike. - Take other medical measures as required.

9. What are the movement techniques performed in urban operations?

- Move across streets or open areas - Move parallel to buildings - Move past building opening (windows and doors) - Move around corners - Cross a wall

30. What are the signs and symptoms of shock?

- Sweaty but cool skin. - Pale skin. - Restlessness or nervousness. - Thirst. - Severe bleeding. - Confusion. - Rapid breathing. - Blotchy blue skin. - Nausea and/or vomiting.

25. What are the rules for use of restraints?

- The degree of security and restraint exercised over detainees will reflect the conditions of and reasons for their internment and will recognize the potential for escape and difficulties of apprehension posed by detainees. - Ordinarily, detainee inpatients will be restrained consistent with command policy. This may include using two-point restraints at all times. The two-point restraints will be placed on opposing limbs (one arm and one leg) unless contraindicated due to the detainee's medical condition. - Restraints in addition to the two-point standard will be applied when detainees become combative or dangerous to themselves or others. Once the detainee becomes oriented or cooperative, the restraints in addition to the two-point standard will be removed. Restraint removal will be the result of a joint vetting process in close coordination with the commander of the security forces. - Restraints will be removed when detainees are transported between areas of the MTF. During such transfers, detainees will be accompanied by a medical staff member and the MPs. - For exercise or physical therapy, the detainee will not be restrained but will be escorted by medical staff and remain in clear sight of, and in proximity to, the MP security personnel at all times. - Use of leather restraints in the MTF emergency room will be at the discretion of the emergency room physician or clinic physician and charge nurse, in consultation with the MTF commander

13. What are the three ways to orient a map?

- Using a compass. The magnetic arrow of the compass points to magnetic north. As such, pay special attention to the declination diagram. - Using terrain association. This method is typically used when a compass is not available or when the user has to make many quick references as he moves across country. - Using Field-Expedient Methods. These methods are used when a compass is available and there are no recognizable terrain features.

18. Why is C-spine stabilization important and what issues may happen if not properly maintained?

-Paralysis

20. What are the steps to treating a casualty with an impaled object?

. Tell the casualty to remain still and not to move the impaled object. b. Expose the injury by cutting away or removing clothing or equipment around the wound site. c. If the impalement injury is on an extremity, check the pulse distal to the injury site. d. If the impalement is found in the cheek and both ends of the object can be seen. (1) Remove the object in the direction it entered the cheek. (2) Position the casualty to allow for drainage and be prepared to suction the casualty. e. If both ends of the object in the cheek cannot be seen, go to step 2. 2. Immobilize the impaled object. 2. Immobilize the impaled object. NOTE: If an assistant is available, one person should imimmobilize the object while the other applies the dressings and bandages. WARNING: Do not exert force on the impaled object. a. If necessary, apply direct pressure using gloved hands on either side of the object. b. Place several layers of bulky dressing around the injury site so that the dressings surround the object. c. Use additional bulky materials or dressings to build up the area around the object. 3. Apply the support bandages. a. Apply the bandage over the bulky support material to hold it in place. WARNING: Do not anchor the bandage on or exert pressure on the impaled object. b. Apply the bandage tightly but not so tight as to impair circulation or breathing. c. Check circulation after applying the support bandages. NOTE: If a pulse was palpated in step 1c and it cannot be palpated after the bandage has been applied, the bandage must be loosened until a pulse can be palpated. WARNING: Do not anchor a splint or sling to the impaled object. Avoid undue motion of the impaled object when applying a splint. 4. Immobilize the affected area with a splint or sling, if applicable. 5. Check for a pulse distal to the injury site. 6. Provide oxygen. 7. Treat for shock, if necessary. 8. Consider pain management as necessary. (See task 081-833-0174.) 9. Record the treatment on the FMC. 10. Evacuate the casualty.

14. Identify the types of seizures and their characteristics. c. Status Epilepticus.

1) Two or more seizures without an intervening period of consciousness or a seizure lasting more than 30 minutes. (2) A medical emergency. If untreated it may lead to: NOTE: Mentally note the aspects of seizure activity for recording after the seizure. (a) Aspiration of secretions. (b) Cerebral or tissue hypoxia. (c) Brain damage or death. (d) Fractures of long bones. (e) Head trauma. (f) Injured tongue from biting. CAUTION: Never place anything in the mouth of a seizing patient.

42. What are the principles of applying camouflage during operations?

1. Apply camouflage principles throughout camouflaged operations. a. Employ realistic camouflage. (1) Employ camouflage material that resembles the background. (2) Employ camouflage subtly without overdoing. b. Apply camouflaged movement technique. Note: Movement draws attention, and darkness does not prevent observation. The naked eye and infrared/radar sensors can detect movement. (1) Minimize movement. (2) Move slowly and smoothly when movement is necessary. c. Breakup regular shapes. (1) Use natural or artificial materials to breakup shapes, outlines, and equipment. (2) Stay in shadows when moving, if possible. (3) Disguise or distort the shape of your helmet and your body with natural or artificial materials when conducting operations close to the enemy. d. Reduce possible shine by covering or removing items that may reflect light. Note: Examples of items that should be covered and/or removed include: mirrors, eye glasses, watch crystals, plastic map cases, starched uniforms, clear-plastic garbage bags, red-filtered flashlights, goggles worn on top of helmets cigarettes and pipes. e. Blend colors with the surroundings or, at a minimum, ensure that objects do not contrast with the background (figure 052-COM-1361-1). Note: Change camouflage, as required, when moving from one area to another. What works well in one location may draw fire in another f. Employ noise discipline.

5. What are the steps for assisting with vaginal delivery? 1. Assist with the First Stage of Labor

1. Assist with the first stage of labor. a. Interview the pregnant woman. Request health history. (1) Present pregnancy history. Is this your first pregnancy? Have there been complications during your pregnancy? (2) Medical history. Is there a history of diabetes, hypertension, or chronic diseases? (3) Obstetric history. How many times have you been pregnant? b. Assess general appearance and behavior. c. Check vital signs between contractions. If hypotension occurs, place the patient on her left side, administer oxygen (if available), and notify the health care provider immediately. d. Assess the labor pattern status. (1) Contractions-initial onset, frequency, and duration. (2) Discomfort or pain. e. Assess amniotic membranes status. Inquire if the patient has experienced constant leakage or rupture of vaginal fluid.

29. What are the different phases of Tactical Combat Casualty Care? What treatment is in each of the phases? Stage 1

1. Perform care under fire. a. Return fire as directed or required before providing medical treatment. b. Determine if the casualty is alive or dead. Note: In combat, the most likely threat to the casualty's life is from bleeding. Attempts to check for airway and breathing will expose the rescuer to enemy fire. Do not attempt to provide first aid if your own life is in imminent danger. In a combat situation, if you find a casualty with no signs of life--no pulse, no breathing--do NOT attempt to restore the airway. Do NOT continue first aid measures. c. Provide care to the live casualty. Direct the casualty to return fire, move to cover, and administer self-aid (stop bleeding), if possible. Note: Reducing or eliminating enemy fire may be more important to the casualty's survival than the treatment you can provide. If the casualty is unable to move and you are unable to move the casualty to cover and the casualty is still under direct enemy fire, have the casualty "play dead." Cue: Enemy fire has been suppressed d. In a battle-buddy team, approach the casualty (use smoke or other concealment if available using the most direct route possible. e. Administer life-saving hemorrhage control. (1) Determine the relative threat of enemy fire versus the risk of the casualty bleeding to death. (2) If the casualty has severe, life-threatening bleeding from an extremity or has an amputation of an extremity, administer life-saving hemorrhage control by applying a tourniquet from the casualty's IFAK before moving the casualty. (See task 081-COM-1032.) Note: The only treatment that should be given at the point of injury is a tourniquet to control life-threatening extremity bleeding. f. Move the casualty, his weapon, and mission-essential equipment when the tactical situation permits. g. Recheck bleeding control measures (tourniquet) as soon as behind cover and not under enemy fire.

17. What is the mission, allocation, capabilities & dependencies of a BSMC (Bridage Support Medical Company)? CAPABILITIES

2-51. This unit provides: - Mission command of attached units which include medical planning and coordination of patient movement within and outside of the brigade. - Treatment of patients with DNBI, COSR, triage of MASCAL, ATM, initial resuscitation and stabilization, and preparation for further evacuation of patients incapable of returning to duty. - Ground evacuation for patients from the BAS and designated CCPs to the BSMC. - Operational dental care that consists of emergency and essential dental care designed to circumvent potential dental emergencies. - Class VIII supply support to units in the brigade AO. - Unit-level medical equipment maintenance. - Medical laboratory and radiology services commensurate with Role 2 MTFs. - Outpatient consultation services for patients referred from Role 1 MTFs. - Patient holding for up to 20 patients able to return to duty within 72 hours. - Limited reinforcement and augmentation to supported maneuver battalion medical platoons. - Regeneration of severely attrited BASs. - Treatment squads that are capable of breaking down into two treatment teams, which can also operate independently for limited periods of time. - Preventive medicine support.

29. What are the different phases of Tactical Combat Casualty Care? What treatment is in each of the phases? Stage 2

2. Perform tactical field care. Note: When evaluating and/or treating a casualty, seek medical aid as soon as possible. Do NOT stop treatment. If the situation allows, send another person to find medical aid. a. Form a general impression of the casualty as you approach (extent of injuries, chance of survival). Note: If a casualty is being burned, take steps to remove the casualty from the source of the burns before continuing evaluation and treatment. (See task 081-COM-1007.) b. Check for responsiveness. (1) Ask in a loud, but calm, voice: "Are you okay?" Gently shake or tap the casualty on the shoulder. (2) Determine the level of consciousness by using AVPU: A = Alert; V = responds to Voice; P = responds to Pain; U = Unresponsive. Note: To check a casualty's response to pain, rub the breastbone briskly with a knuckle or squeeze the first or second toe over the toenail. If casualty is wearing IBA, pinch his nose or his earlobe for responsiveness. (3) If the casualty is conscious, ask where his body feels different than usual, or where it hurts. Note: If the casualty is conscious but is choking and cannot talk, stop the evaluation and begin treatment. (See task 081- COM-1003.) c. Identify and control bleeding. (1) Check for bleeding. (a) Reassess any tourniquets placed during the care under fire phase to ensure they are still effective. (b) Perform a blood sweep of the extremities, neck, axillary, inguinal and extremity areas. Exposure is only necessary if bleeding is detected. (1) Place your hands behind the casualty's neck and pass them upward toward the top of the head. Note: whether there is blood or brain tissue on your hands from the casualty's wounds. (2) Place your hands behind the casualty's shoulders and pass them downward behind the back, the thighs, and the legs. Note: whether there is blood on your hands from the casualty's wounds. Note: If life-threatening bleeding is present, stop the evaluation and control the bleeding. (See task 081- COM-1032). (2) Once bleeding has been controlled, continue to step 2d. d. Position the casualty and open the airway. (See task 081-COM-1023.) e. Assess for breathing and chest injuries. (1) Expose the chest and check for equal rise and fall and for any wounds. (2) Look, listen, and feel for respiration. (See task 081-COM-1023.) Note: If the casualty is breathing, insert a nasopharyngeal airway (see task 081- COM-1023.) and place the casualty in the recovery position. Only in the case of non-traumatic injuries such as hypothermia, near drowning, or electrocution should CPR be considered when in a tactical environment prior to the CASEVAC phase. (3) If in a non-tactical environment, begin rescue breathing as necessary to restore breathing and/or pulse (See tasks 081- COM-1023 and 081-COM-0046.). (a) If the casualty has a penetrating chest wound and is breathing or attempting to breathe, stop the evaluation to apply an occlusive dressing (See task 081-COM-1026.). (b) Position or transport with the affected side down, if possible. (c) Check for an exit wound. If found, apply an occlusive dressing. f. Dress all non-life threatening injuries and any bleeding that has not been addressed earlier with appropriate dressings. (See task 081-COM-1032.) 3. Determine the need to evacuate the casualty and supply information for lines 3-5 of the 9-Line MEDEVAC request to your tactical leader. (See task 081-COM-0101.)

9. What treatments may be provided for an anaphylactic reaction?

3. Administer high concentration oxygen. 4. Administer epinephrine autoinjector. a. Pediatric autoinjector single dose, 0.15mg, adult autoinjector single dose for greater than 66lbs, 0.3mg. b. Additional epinephrine may be required if anaphylaxis progresses. Additional doses may be administered every 5 to 10 minutes if casualty has been prescribed additional autoinjectors. 5. Provide supportive measures for the treatment of shock, respiratory failure, circulatory collapse, or cardiac arrest. a. Position the casualty in the supine position with legs elevated if injuries permit. b. Perform rescue breathing, if necessary. c. Administer external chest compressions, if necessary.

16. How is a chemical burn to the eye identified and treated? S/S and treatment

3. Check for signs and symptoms. a. Irritation. b. Pain and redness. c. Watering or tearing. d. Possible erosion of the corneal surface. e. Inability to keep the eye open. f. Swelling of eyelid. g. Blurred vision. 4. Initiate treamtent for the chemical burn. a. IMMEDIATELY flood the eyes with water. b. Keep irrigating the eye with running water from a faucet, low pressure hose, bottle, cup, IV setup. Hold the irrigating tip 1 to 1 ½ inch away from the casualty's eye(s), direct the irrigating solution gently from the inner canthus to the outer canthus. c. Start the transport and continue washing out the eye(s) for at least 20 minutes or until the casualty's arrival at the treatment facility. d. Dry the area around the eye(s) by gently patting with gauze sponges. Do not touch the casualty's eye. e. Cover the injured eye(s) with a clean, sterile dressing. NOTE: In a combat environment, the eyes may have to remain uncovered so the casualty can see to get away from danger. Burned eyelids swell to protect the underlying eyes. If the

A zero is confirmed when ________ rounds land within the center 4 centimeter center circle or the zero offset circle.

5 of 6

17. How is an amputated part cared for?

5. Care for the amputated part. a. Wrap the part loosely in saline-moistened sterile gauze. b. Seal the amputated part inside a plastic bag or wrap it in a cravat. The amputated part should then be placed in another container containing ice. Keep it cool, but do not allow it to freeze. c. Avoid further injury to the amputated part. (1) Never warm an amputated part. (2) Never place an amputated part directly in water. (3) Never place an amputated part directly on ice. (4) Never use dry ice to cool an amputated part. d. Transport the part with the casualty to the hospital for possible reimplantation or skin graft. NOTE: Do not delay transport of a patient in order to locate and care for an amputated part. 6. Record all treatment on the casualty's FMC. 7. Evacuate the casualty to a definitive care facility as soon as possible.

Civilian Internee

A civilian internee is a person who is interned during armed conflict, occupation, or other military operation for security reasons or for protection or because he has committed an offense against the detaining power.

21. What are defensive tasks? Understand Table 3-3.

A defensive task is a task conducted to defeat an enemy attack, gain time, economize forces, and develop conditions favorable for offensive or stability tasks.

Prohibited Person

A detainee, former detainee, relative, or friend of a detainee or former detainee or any other person acting on behalf of a detainee or former detainee.

39. When will a detainee be screened by behavioral health?

All detainees will receive a BH screen at the time of inprocessing prior to distribution into the general population

38. When will a detainee undergo vision screening?

All detainees will undergo a vision screening, to include measurement of best-corrected visual acuity, during inprocessing. The screening can be accomplished with a written form or done by interview. If any problems are detected during the screening or if the best-corrected visual acuity is worse than 20/40 with both eyes together, then an SF 513 should be generated. At a minimum, the following information should be obtained: - Is the detainee presently experiencing any problems with his eyes/vision? - Does the detainee wear/need glasses and if so, for what purpose? Are the glasses present? - Does the detainee have any history of ocular disease, trauma, or surgery? - Does the detainee require medications for eye-related problems? What are the names of the medications and are they present

25. How is oxygen administered?

All medical grade oxygen cylinders are color coded green, silver or chrome to make easy identification of the cylinder. The safe residual level of the oxygen at which the cylinder should be replaced has been established to be 200 pounds per square inch (psi). A bag-valve-mask (BVM) system is the delivery device of choice for patient's with signs of severe inadequate breathing. (See task 081-833-0017.) Disposable humidifiers are available for one-time use. b. A non-rebreather mask (NRB) is usually the delivery device of choice in the prehospital setting for patients with signs of inadequate breathing, who are cyanotic, have chest pain, severe trauma, signs of shock or an altered mental status. c. A nasal cannula is appropriate for those who are unable to tolerate a NRB NRB 15Lpm 90% 02 Nasal canula 1-6lpm 22-44% O2

34. What are the considerations for administering detainee medications? B)

All medications to be administered to detainees must be dispensed by health care personnel. Depending upon the detainee's medical condition, health care providers, when possible, should prescribe medications which can be dispensed on a once or twice a day basis. To ensure the safety of detainees, medications are dispensed in unit doses by health care personnel.

24. What are the general/cultural considerations that health care personnel must understand when interacting with detainees?

All personnel participating in multinational operations normally receive, as part of their predeployment activities, an orientation to the culture, languages, and religious beliefs prevalent in the area of operations. Health care personnel must also ensure they understand the medical considerations presented by these beliefs. Cultural or religious norms may affect a detainee's compliance with a prescribed medical regimen, may prohibit the use of blood and blood products, or may restrict the use of certain food products, thereby affecting the detainee's nutritional status.

20. What are offensive tasks? Understand Table 3-2.

An offensive task is a task conducted to defeat and destroy enemy forces and seize terrain, resources, and population centers.

Anesthetics

Anesthetics are agents whose main toxic action is their depressant effect upon the central nervous system, particularly the brain. The degree of anesthetic effect depends upon the effective concentration in the brain as well as upon the specific makeup of the contaminant.

35. What is a hunger strike?

Any detainee refusing food for 72-hours is considered to be on a hunger strike and will be referred for medical evaluation and possible treatment

Former Detainee

Any person previously held as a detainee

Security Internee

Any person who is detained for imperative reasons of security as specified in the mandate set forth in the United Nations Security Council Resolution 1546

Detainee

Any person who is in U.S. custody

Black Water

Any water containing human waste

Proximity

Army Health System assets must be in proximity of the forces they are supporting. Due to the importance of providing lifesaving interventions as close to the time of wounding or injury as possible, medical assets must be employed close to the forces they are supporting but not so close that they impede ongoing operations.

Flexible

Army Health System plans must be flexible to enable the medical commander and/or command surgeon to shift scarce medical resources to meet emerging areas of patient density within the operational area.

30. When is medical photography authorized?

Army Regulation 190-8 prohibits the photographing, filming, or videotaping of individual detainees except for TIF administration and intelligence/civilian internee purposes. Health care personnel are permitted to photograph detainees to document preexisting conditions, injuries, and wounds. The individual's identity should be clearly visible. These photographs are invaluable, if a claim of unnecessary surgery or amputation is made. Any detainee who requires amputation or major debridement of tissue should be photographed. Once taken, these photographs are maintained as part of the individual's medical record. Consider the use of photography for documentation and treatment purposes. Detainees may arrive at the TIF with photographs of wounds or injuries taken by health care personnel at the detainee collection point or detainee holding area. These are helpful to monitor the resolution or progression of injuries and are filed in the detainee's individual medical record.

Asphyxiants

Asphyxiants are materials that deprive the respiratory tissues of oxygen; they do not damage the lungs. Simple asphyxiants are gases, which when present in sufficient quantities, exclude an adequate oxygen supply. Examples are nitrogen, nitrous oxide, carbon dioxide, hydrogen, helium, methane, and ethane. Chemical asphyxiants are materials which have the ability to render the body incapable of using an adequate oxygen supply. Two classic examples are carbon monoxide and cyanide.

12. How is a patient's mental status assessed?

Assess the patient's mental status using the Alert, Verbal, Pain, Unresponsive (AVPU). (1) A-Alert and oriented. (2) V-Responsive to verbal stimuli. (3) P-Responsive to painful stimuli. (4) U-Unresponsive.

7. When changing a sterile dressing what are wounds assessed for and how are they cleaned?

Assess the wound for: Redness, swelling, foul odor, and/or bleeding. Clean the wound with sterile gauze soaked with a sterile cleaning solution in accordance with medical officers orders and/or local standard operating procedure (SOP). a. Linear wound. (1) First stroke. Clean the area directly over the wound with one wipe and discard the gauze. (2) Second stroke. Clean the skin area on one side next to the wound with one wipe and discard the gauze. (3) Third stroke. Clean the skin area on the other side next to the wound with one wipe and discard the gauze. (4) Continue the procedure alternating sides of the wound, working away from the wound until the area is cleaned. b. Circular wound. (1) First stroke. Start at the center of the wound, wipe the wounded area with an outward spiral motion, and then discard the gauze. (2) Second stroke. Clean the skin area next to the wound using an outward spiral motion, approximately one and one half revolutions, and then discard the gauze. (3) Using successive outward, spiral strokes of approximately one and one half revolutions, clean the entire area around the wound.

24. What are the different MOPP levels one through four?

Assume MOPP Level 1 by donning the JSLIST over garments. Assume MOPP Level 2 by donning the over boots. Assume MOPP Level 3 by donning chemical-protective mask IAW task 031-COM-1004. Assume MOPP Level 4. Don the gloves.

5. What is the difference between Role 1 and 2 care? B. Role 2

At this role, care is rendered at the Role 2 MTFs (medical company [brigade support battalion] [BSMC] and MCAS, which areoperated by the treatment platoon of medical companies. Here, the patient is examined and his wounds and general medical condition are evaluated to determine his treatment and evacuation precedence, as a single patient among other patients. Advanced trauma management and TC3 and/or emergency medical treatment including beginning resuscitation is continued, and if necessary, additional emergency measures are instituted, but they do not go beyond the measures dictated by immediate necessities. The Role 2 MTF has the capability to provide packed red blood cells (liquid), limited x-ray, clinical laboratory, dental support, COSC, and preventive medicine (PVNTMED). The Role 2 MTF provides a greater capability and capacity to resuscitate trauma patients than is available at Role 1 Those patients who can return to duty within 72 hours (1 to 3 days) are held for treatment. Patients who are nontransportable due to their medical condition may require resuscitative surgical care from a forward surgical team (FST) collocated with a medical company/troop. This role of care provides medical evacuation from Role 1 MTFs and also provides Role 1 medical treatment on an area support basis for units without organic Role 1 resources.

Pay attention to the _____________ material

BOLDED

12. Who is in tactical control of the battalion aid station?

Battalion S-4

24. What are the general/cultural considerations that health care personnel must understand when interacting with detainees?

Be sensitive to male-female interactions. Use a female provider and nurse for a female detainee whenever possible. This allows the health care personnel to respect the detainee's cultural and religious beliefs, as well as protect against potential allegations of physical or sexual misconduct. Male detainees will usually allow female providers to examine them, although some staunch believers may refuse even minimal physical contact. However, the detainee may simply be hesitant if the complaint requires observation and examination of the genitals and breasts. Usually an explanation of the examination and an acknowledgment of the detainee's modesty will suffice. The detainee will then allow the examination to proceed. If the detainee continues to refuse, explanation of the ramifications of no examination and documentation of the refusal and its consequences is essential. Each health care provider must determine whether he will subsequently prescribe treatment even if a detainee refuses an examination.

45. What actions should you take in a hostage situation?

Becoming a hostage while providing medical care to detainees, especially in an internment or holding facility setting, is always a possibility. Personnel should remember if they find themselves in a hostage situation that hostages: - Do not have any rank once they have been taken and they should not act as if they do. They should avoid making demands or giving orders and should not give suggestions to their captors. - Should listen carefully for clues regarding the emotional state of the detainees who have taken them hostage. - Should remain calm and alert; and they should not become aggressive. - Should avoid political or religious discussions. - Should not make any promises that they cannot fulfill.

10. What are the six basic colors on a military map? What do they represent?

Black - Cultural (man-made) features other than roads Blue - Water Brown - All relief features; contour lines on old maps; cultivated land on red-light readable maps Green - Vegetation Red - Major roads, built-up areas, special features on old maps Red-brown - All relief features and main roads on red-light readable maps

14. What warrants a body cavity search?

Body cavity searches may only be performed when there is a reasonable belief that the detainee is concealing an item that could present a security risk and must be authorized by the first general officer in the chain of command. To the extent possible, body cavity examinations or searches will be conducted by trained personnel of the same gender and with the utmost respect for the detainee's dignity and privacy.

3. What are the brevity and frequency codes used in a training plan?

Brevity Codes BCT Basic Combat Training OSUT One Station Unit Training AIT Advanced Individual Training UNIT Trained in/by the Unit SD Self-Development Training Frequency Codes AN Annually SA Semiannually QT Quarterly

CTHELPVDCL

CT-HELP-Very deliberate cats live mission command, medical treatment (organic and area support), hospitalization, medical evacuation, medical logistics (MEDLOG), PVNTMED services, veterinary services, dental services, COSC(Combat and Operational Stress Control), and medical laboratory services.

27. What are the four triage categories? Know examples of injuries in each category. Triage Category: DELAYED

Casualties in the DELAYED category can tolerate delay prior to time-consuming operative intervention without unduly compromising the likelihood of a successful outcome. When surgical/medical resources are overwhelmed, Soldiers in this category are held until the IMMEDIATE cases are treated. (Approximately 20 percent of the casualties are normally in this category.) Sustaining treatment will be required such as stabilizing intravenous fluids, splinting, administration of antibiotics, and relief of pain amongst other medical interventions. An example of this category is a stable abdominal wound with probable visceral injury but no significant hemorrhage. These cases may go unoperated for 8 to 10 hours, after which there is a direct relationship between time lapsed and the advent of complications. Other examples include: - Soft tissue damage requiring debridement. - Maxillofacial wounds without airway compromise. - Vascular injuries with adequate collateral circulation. - Genitourinary tract disruption. - Fractures requiring operative manipulation, debridement, and external fixation. - Eye and central nervous system injuries. - Large muscle wounds. - Fractures of major bones. - Intra-abdominal and/or thoracic wounds. - Burns less than 50 percent of total body surface area.

13. What are the considerations that should be considered for the location of the BAS (Battalion aid station)?

Considerations for the location of the BAS should include: - Tactical situation/commander's plan. - Expected areas of high casualty density. - Security. - Protection afforded by defilade. - Convergence of lines of drift. - Evacuation time and distance. - Accessible evacuation routes. - Avoidance of likely target areas such as bridges, fording locations, road junctions, and firing positions. - Solid ground with good drainage. - Near an open area suitable for helicopter landing. - Available communication means. - Additional space near this site for establishing a patient decontamination site if required.

Control

Control of medical resources ensures that the use of scarce medical assets is maximized to provide the greatest good to the greatness number of patients in the OE. Control comes from the continuous synchronization of AHS operations with the tactical commander and within the AMEDD system of systems.

32. How often should detainees have access to medical care?

Daily

Decisive Action

Decisive action is the continuous, simultaneous combinations of offensive, defensive, and stability or defense support of civil authorities tasks.

21. Who is responsible for detainee security, custody, and control?

Designated security personnel are solely responsible for detainee security, custody, and control. At no time, when outside of the TIF, will a detainee be without a designated security person as overwatch. Note. Designated security personnel are normally MP personnel but may be other military occupational specialty or area of concentration Soldiers. Medical military occupational specialty or area of concentration personnel will not serve as security personnel.

27. What is the internment serial number?

Detainees are provided an ISN when being inprocessed to the TIF. The TIF is the only location where this number will be assigned. To identify detainees prior to the issuance of the ISN the capture tag number (DD Form 2745) is used on all documentation concerning the detainee. Once the ISN is issued, existing records are updated.Detainees require an ISN in order to begin medical processing, so that tests and medications can be ordered as required. This particular aspect is governed by the MP unit in charge of inprocessing. Any computer malfunctions or systems problems can affect how quickly a detainee is ready for medical screening. Of course, at any time if a detainee requires urgent or emergent care, capture tag numbers will suffice until the proper processing can be accomplished.

33. How often do detainees in segregation receive medical care/contact?

Detainees maintained in segregation will be monitored daily to assure health and well-being and to address current medical complaints. By protocol, a licensed independent provider (physician, physician assistant, or nurse practitioner) must screen and sign off on each detainee; however, local guidance may allow for a nurse to perform this screening as well. Given the segregation status of these detainees, it is usually more expedient for the provider to use this requirement as a sick-call opportunity as well. A translator is helpful, but not essential in this situation and either an English-speaking detainee or a hired linguist, if available, is appropriate.

15. What happens when a detainee refuses care?

Detainees may refuse routine examinations or parts of physical examinations. Competent detainees that do not consent, will be informed that this refusal may alter the type of detention environment in which they live, particularly if there is a suspicion that they harbor potential communicable diseases. The MTF commander responsible for providing health care to the detainee may authorize examination or treatment in the absence of consent if it is deemed necessary to preserve the life, limb, or eyesight of the detainee or to preserve the health or safety of other detainees or any other persons. Involuntary treatment or intervention in a TIF must be preceded by a thorough medical and BH evaluation of the detainee and counseling concerning the risks of refusing consent. Such treatment or intervention shall be carried out in a medically appropriate manner, under standards similar to those applied to personnel of the U.S. Armed Forces. Theater internment facility procedures for dealing with cases in which involuntary treatment may be necessary to prevent death or serious harm shall be developed

40. How do you challenge a person entering your area?

Detect all personnel entering your area. 2. Challenge an individual that enters your area. a. Cover the individual with your weapon without disclosing your position. b. Command the individual to "HALT" before they are close enough to pose a threat. Note: Commands and questions must be loud enough to be heard by the individual but not loud enough that others outside of the immediate area can hear. Commands should be repeated as necessary. c. Ask "WHO IS THERE?" just loud enough for the individual to hear. Note: The individual should reply with an answer that best describes them, example "Sergeant Jones". d. Order the individual to "ADVANCE TO BE RECOGNIZED". e. Continue to keep individual covered without exposing yourself. f. Order the individual to "HALT" when they are is within 2 to 3 meters from your position. Note: The individual should be halted at a location that provides protection to you and prevents them from escaping if they are deemed unfriendly. g. Issue the challenge in a low voice. Note: The challenge should only be heard by the individual challenged to prevent all others from overhearing. You may also ask the individual questions that only a friendly person should be able answer correctly. h. Determine if the individual is friendly based upon their return of the correct password and your own situational awareness. (1) Allow the individual to pass if the individual returns the correct password and you are convinced the individual is friendly. (2) Detain an individual if they return an incorrect password or cannot be positively identified as friendly. (a) Direct the individual to disarm. (b) Notify your chain of command. (c) Await instruction from your command

21. Identify the signs and symptoms related to burn injuries

Determine the degree of the burn. a. First degree. (1) Superficial skin only. (2) Red and painful, like a sunburn. b. Second degree. (1) Partial thickness of the skin. (2) Penetrates the skin deeper than first degree. (3) Blisters and pain. (4) Some subcutaneous edema. c. Third degree. (1) Damage to or the destruction of a full thickness of skin. (2) Involves underlying muscles, bones, or other structures. (3) The skin may look leathery, dry, and discolored (charred, brown, or white). (4) Nerve ending destruction causes a lack of pain. (5) Massive fluid loss. (6) Clotted blood vessels may be visible under the burned skin. CAUTION: Check for entry and exit burns when treating electrical burns and lightning strikes. The amount of injured tissue in an electrical burn is usually far more extensive than the appearance of the wound would indicate. Although the burn wounds may be small, severe damage may occur to deeper tissues. (High voltage can destroy skin and muscles to such an extent that amputation may eventually be necessary.)

33. Understand the different ways to transport a casualty (individual or assisted) and when you would use different carries. b. Neck drag.

Do NOT use the neck drag if the casualty has a broken arm or a suspected neck injury. Use in combat, generally for short distances.

28. How is patient accountability handled during a MASCAL?

During MASCAL situations, medical personnel do not have the time to fully complete the DD Form 1380 or DA Form 7656. A numbering system can be used to expedite this process. The patient can be identified by a number and this same number is then entered on the DD Form 1380 or DA Form 7656. The card is then attached to the individual's clothing. The card is used to record the treatment and medications that the patient receives. When the MASCAL situation begins to resolve, and as time permits, medical personnel obtain the necessary information to complete the card. If the electronic medical record is available at the MTF conducting the MASCAL operation, the handwritten record of the patient encounter should be entered into the electronic medical record at the earliest possible time.

5. What are the eight health threats to Soldiers in the field?

Endemic diseases, food and waterborne diseases, hazardous plants and animals, entomological hazards, toxic industrial materials, deployment-related stress, hazardous noise, climatic or environmental extremes

Retained Personnel

Enemy personnel who are within any of the categories listed below are classified as retained persons and may be retained only in so far as the state of health, the spiritual needs, and the number of prisoners of war require: - Health care personnel exclusively engaged in the - Search for, collection, transport, or treatment of the wounded or sick. - Prevention of disease. - Staff administration of medical units and establishments. - Chaplains attached to enemy armed forces. - Staff of national Red Cross societies and other voluntary aid societies duly recognized and authorized by their governments. The staff of such societies must be subject to military laws and regulations.

Mobility

Especially at Roles 1 and 2, medical units must have the same mobility, survivability, and sustainability as the forces they are supporting, as the only way to increase the mobility of medical units is to evacuate patients being held at the MTF

37. How can you exercise noise and light discipline?

Exercise noise discipline. a. Avoid all unnecessary vehicular and foot movement. b. Secure (with tape or other materials) metal parts (for example, weapon slings, canteen cups, identification [ID] tags) to prevent them from making noise during movement. Note: Do not obstruct the moving parts of weapons or vehicles. c. Avoid all unnecessary talk. d. Use radio only when necessary. e. Set radio volume low so that only you can hear. f. Use visual techniques to communicate. 2. Exercise light discipline. a. Do not smoke. Note: The smoking of cigarettes, cigars, etc., can be seen and smelled by the enemy. b. Conceal flashlights and other light sources so that the light is filtered (for example, under a poncho). c. Cover or blacken anything that reflects light (for example, metal surfaces, vehicles, glass). d. Conceal vehicles and equipment with available natural camouflage.

Immersion syndrome

Feet exposed to wet conditions 32-50*F, trench foot.

11. What are the 10 natural or man-made terrain features?

Five major terrain features: - Hill, Valley, Ridge, Saddle, Depression Three minor terrain features: - Draw, Spur, Cliff Two supplementary terrain features: - Cut, FIll

2. What is Health Service Support (HSS) and Force Health Protection (FHP) A. Force Health Protection (FHP)

Force health protection is defined as the measures to promote, improve, or conserve the mental and physical well-being of Service members. These measures enable a healthy and fit force, prevent injury and illness, and protect the force from health hazards

11. What are the functions of a combat medic?

Functions of combat medic are to: - Perform triage and TC3 for the sick and wounded. - Arrange medical evacuation for litter patients and direct ambulatory patients to the CCP or to the BAS. - Initiate a DA Form 7656 (Tactical Combat Casualty Care [TCCC] Card) preferably by electronic means or Department of Defense (DD) Form 1380 (U.S. Field Medical Card) for the sick and wounded and, as time permits, prepares a DD Form 1380 on deceased personnel. - Screen, evaluate, and treat within his capabilities those patients suffering minor illnesses and injuries. - Keep the company commander and the battalion surgeon/medical platoon leader informed on matters pertaining to the health and welfare of the troops. - Manage Class VIII resupply for the unit's combat lifesavers, vehicle first aid kits, and warrior aid and litter kits. - Maintain sufficient quantities of medical supplies to support the tactical situation. - Serve as a member of the unit field sanitation team. In this capacity, he advises the commander and supervises unit personnel on matters of personal hygiene and field sanitation. - Develop and maintain Soldier and combat medic skills in the context of the tactical and OE. - Maintain TC3 skills for a broad range of emergencies.

32. What are the two ways to open an airways and when would you use them?

Head-tilt/chin-lift method. (1) Kneel beside the casualty's head and shoulders. (2) Place the palm of one hand on the casualty's forehead and the index and middle fingers of the other hand on the bony part of the jaw below the chin. (3) Tilt the casualty's head backward gently. Note: Do NOT use the thumb to lift. Note: Do NOT completely close the casualty's mouth. (4) Release pressure on the chin to allow the mouth to open slightly once the head is tilted backward. Cue: Use Jaw-Thrust Method Note: If you are unable to maintain an airway after the second attempt, use the head-tilt/chin-lift method. (1) Kneel above the casualty's head (looking toward the casualty's feet). (2) Rest your elbows on the ground or floor. (3) Place on hand on each side of the casualty's lower jaw at the angle of the jaw, below the ears. this method if a spinal or neck injury is suspected. CAUTION Do not tilt or rotate the casualty's head. (4) Use the index and middle fingers to push the angles of the casualty's lower jaw forward. Note: If the casualty's lips are still closed after the jaw has been moved forward, use your thumbs to retract the lower lip and allow air to enter the casualty's mouth.

34. What are the considerations for administering detainee medications? C)

Health care personnel must verify the identity of the detainee (usually a wristband), obtain their signature on the medication issue register (Figure 3-4), and watch/verify that the detainee takes the prescribed dose. When dispensing oral medications, the detainee's hands and mouth should be inspected to ensure the detainee swallowed the medication and is not attempting to hoard the medications for later use. The medication issue registry is primarily used to accurately track the medications each detainee takes, as well as to prevent medication duplications, and potentially dangerous interactions. A local form can be developed to document the dosing schedule and the receipt and administration of the medication to detainee. This register requires the detainee to sign for his medications and when he has completed his course of treatment it can be filed in his medical record.

43. What are the restrictions/limitations for health care personnel and the interaction with detainees?

Health care personnel will not: - Fraternize with or act with undue familiarity towards a detainee, a former detainee, or a family member of a detainee or former detainee. Any contact or communication (oral or written, direct or mediated) between a health care worker and a detainee will be for an official purposes only. - Place hands on or touch a detainee except in self-defense or to: - Prevent escape. - Prevent injury to persons or damage to property. - Render medical assistance. - Conduct a search or inspection for other than medical reasons. - Apply the priorities of force, as specified. - Demonstrate how-to procedures in training. - Visit or enter the personal space of a detainee, former detainee, or family member of a detainee or former detainee except in the performance of official duties. - Engage in any act or attempt to engage in any act of sexual misconduct with a detainee, former detainee, or family member of a detainee or former detainee. - Engage in any act or attempt to engage in any act of sexual abuse, assault, or harassment of a detainee. -Knowingly allow a detainee to engage in sexual misconduct with another detainee.

16. What is the two-person verification rule?

Health care personnel will use a two-person verification rule when dealing with impaired detainees. In order to deem a detainee impaired and unable to give informed consent, two members of the medical staff must agree that the detainee is, in fact, impaired and this is to be documented clearly on the examination report. Preferably, one of the two individuals assessing competency will possess BH expertise.

2. What is Health Service Support (HSS) and Force Health Protection (FHP) A.Health Service Support (HSS)

Health service support is defined as all services performed, provided, or arranged to promote, improve, conserve, or restore the mental or physical well-being of personnel. 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; evacuation of the wounded, injured, or sick; selection of the medically fit and disposition of the medically unfit; blood management; medical supply, equipment,and maintenance thereof; combat and operational stress control and medical, dental, veterinary, laboratory, optometry, nutrition therapy, and medical intelligence services.

54. What are the cold and wet (nonfreezing/freezing) cold injuries?

Hypothermia Chilblains Immersion Syndrome

16. How is a chemical burn to the eye identified and treated? Identified

Identify the substance the casualty was exposed to. NOTE: Do not delay treatment to perform this step. a. Alkali-the most dangerous of all substances due to penetrating factor (common substances contain the hydroxides of ammonia, lye, potassium, magnesium, and lime). (1) Fertilizers. (2) Cleaning products, drain cleaners, and oven cleaners. (3) Plaster and cement. b. Acid-usually less severe than alkali burns (common acids contain sulfuric acid, hydrochloric acid, nitric acid, acetic acid, chromic acid and hydrofluoric acid). (1) Glass polish, vinegar, and nail polish remover. (2) Automobile battery acid. c. Irritants-substances that have a neutral pH, tend to cause more discomfort to the eye than actual damage. (1) Most household detergents. (2) Pepper spray.

31. When a casualty is in shock, when would you not elevate the legs?

If the casualty has an un-splinted fractured leg, an abdominal wound, or a head or spinal injury, do not elevate the casualty's legs.

IMPULSE NOISE

Impulse noise (also referred to as impact noise or blast overpressure), is noise that is characterized by a sharp rise in intensity followed by a rapid decline in intensity, such as that produced by weapons fire. It cannot be measured accurately with an ordinary sound level meter.

23. What are defense support of civil authorities' tasks? Understand Table 3-5.

In defense support of civil authorities tasks, Army forces provide essential support, services, or specialized resources to help civil authorities deal with situations beyond their capabilities. The purpose of defense support of civil authorities tasks is to meet the immediate needs of designated groups for a limited time until civil authorities can do so without Army assistance. Unlike support to stability tasks, defense support of civil authorities may be conducted as an independent operation.

Irritants

Irritants are materials that cause inflammation of mucous membranes with which they come in contact. Many irritants are strong acids or alkalis that are corrosive to nonliving things; however, they cause inflammation to living tissue. Examples are sulfur dioxide, acetic acid, formaldehyde, formic acid, sulfuric acid, iodine, ozone, and oxides of nitrogen

27. What will M8 detector paper react positively to?

M8 detector paper reacts positively with petroleum products and ammonia. When conducting agent test at night, remove any colored lens because it may provide a false negative response.

17. What is the mission, allocation, capabilities & dependencies of a BSMC (Bridage Support Medical Company)? MISSION

MISSION The mission of the BSMC is to provide Role 2 AHS support to supported maneuver battalions with organic medical platoons. This company provides both Roles 1 and 2 medical treatment on an area basis to those units without organic medical assets operating in the BCT AO.

26. What is a mass casualty situation?

Mass casualty situations occur when the number of casualties exceeds the available medical capability to rapidly treat and evacuate them. Therefore, the actual number of casualties required before a MASCAL situation is declared varies from situation to situation depending upon the availability of AHS resources.

17. What is the mission, allocation, capabilities & dependencies of a BSMC (Bridage Support Medical Company)? ASSIGNMENT AND DEPENDENCIES

Medical companies are organic to BCTs. They are dependent upon organizations organic to the BCTs and elements outside of the BCT, such as supporting theater organizations, the MEDBDE (SPT), the MEDCOM (DS), the MMB, and other appropriate elements according to the mission, operations, and the OE.

2. What are the five categories of the detainee health care system? Medically Acceptable—Not Always Necessary

Medical conditions which are considered elective procedures, when treatment may improve the detainee's quality of life. Conditions in this category are usually excluded from the scope of services provided to detainees.

19. What are the medical services provided in the TIF?

Medical services provided in the TIF to include: - Initial medical examinations. - Medical treatment (routine care, sick call, emergency services, hospitalization, and medical consultation and specialty care requirements). - Medical evacuation. - Preventive medicine (to include medical surveillance, occupational and environmental health surveillance, hygiene and sanitation standards and practices, pest management activities, water potability inspections, and dining facility/services hygiene and food preparation practices). - Dental services. - Veterinary service support (to include food safety, veterinary preventive medicine, animal health care, and oversight of animal welfare, as required). - Neuropsychiatric treatment and stress prevention (as required) and BH support. - Medical logistics (to include medical supplies, pharmaceuticals, medical equipment and medical equipment maintenance and repair, blood management, and optical lens fabrication). - Medical laboratory services for the clinical diagnosis of infectious diseases.

2. What is a unit METL?

Mission Essential Task List. Commanders use the METL to develop their unit-training plan.

34. What are the considerations for administering detainee medications? A)

Monitor medication compliance in each compound by detainee to optimize treatment. A good way to accomplish this goal is by creating a spreadsheet (Figure 3-3) that lists each ISN, drug allergies, the medication, route of administration and dosage, start date, number of refills, and whether the medication was "A" (administered), "R" (refused), or "NS" (no-show). No-shows can be further broken down to provide a reason (such as "FV" [family visit]), if desired. By tracking in this manner, medication compliance can be easily monitored and reported.

26. What colors/patterns would you detect on your M9 paper if you have been exposed to a liquid chemical agent?

Monitor the M9 detector paper constantly for any color change. If pink, red, red-brown, red-purple, or any shade of red streaks or spots are detected assume that you have been exposed to a liquid chemical agent. Blue, yellow, green, gray, or black spots are not from a liquid chemical agent.

37. How are insect stings/bites and snake bites identified and treated? b. Brown recluse spider.

NOTE: The brown recluse spider is medium sized, generally brown but can range in color from yellow to dark chocolate brown. It has a distinct groove between its chest and abdominal body parts. The characteristic marking is a brown, violin-shaped marking on the upper back. (1) Casualty seldom recalls being bitten, since bite is painless at first. (2) Several hours after the bite, it becomes bluish surrounded by a white periphery. (3) A red halo or "bull's-eye" pattern appears sometime later. (4) Within 7-10 days, the bite becomes a large ulcer.

37. How are insect stings/bites and snake bites identified and treated? f. Tick

NOTE: Tick bites are serious because ticks can carry tick fever, Rocky Mountain spotted fever, Lyme disease, other bacterial diseases, and may even cause anemia if the infestation is severe enough. (1) Itching and redness at the site. (2) Headache. (3) Moderate to high fever, which may last 2 to 3 weeks. (4) Pain in the joints or legs. (5) Swollen lymph nodes in the bitten area. CAUTION: Generally, a tick must remain attached to the body for 4 to 6 hours in order to transmit infections. Early detection and proper removal may prevent transmission. (6) Paralysis and other central nervous system disorders are possible after several days. g. Unknown, nonspecific insects. (1) Pain and swelling at the site. (2) Breathing difficulty. (3) Shock. WARNING: If the casualty shows and signs and symptoms of an allergic reaction, begin transport immediately.

22. What is a mechanism of injury and how does it apply to a trauma assessment?

Not in the 68w manual exactly. In "Perform an EMT-B Trauma Assessment" of 68W manual the steps are: 1. Take BSI precautions. 2. Perform a Scene Size-Up. a. Determine the safest route to access the casualty. b. Determine the mechanism of injury (MOI). c. Determine the number of casualties. d. Request additional help, if necessary. e. Consider the need for spinal stabilization.

14. What are the effects of metal and electricity on a lensatic compass? What should you stay away from?

Note: Effects of Metal and Electricity. Metal objects and electrical sources can affect the performance of a compass. However, nonmagnetic metals and alloys do not affect compass readings. The following separation distances are suggested to ensure proper functioning of a compass: High-tension power lines ........................................ 55 meters. Field gun, truck, or tank.......................................... 18 meters. Telegraph or telephone wires and barbed wire....... 10 meters. Machine gun ............................................................. 2 meters. Steel helmet or rifle................................................. 1/2 meter.

41. How would you camouflage your face?

Note: Exposed skin reflects light. a. Cover your skin oils, using paint sticks, even if you have very dark skin. Note: Paint sticks cover these oils and provide blending with the background. b. Use the color chart in table 052-COM-1361-1 when applying paint on the face. c. Paint high, shiny areas (forehead, cheekbones, nose, ears, and chin) with a dark color d. Paint low, shadow areas (around the eyes, under the nose and under the chin) with a light color. CAUTION Mud contains bacteria, some of which is harmful and may cause disease or infection. Mud should be considered as a last resort for field expedient paint. Expedient paint containing motor oil should be used with extreme caution. Prolonged exposure to motor oil may result in personal injury. e. Paint exposed skin on the back of the neck, arms, and hands with an irregular pattern.

25. How would you attach M9 detector paper to your MOPP gear?

Note: M9 detector paper will not detect chemical agent vapors. Paper band must not be too tight because it will tear with movement. However, it must not be too loose because it may slip down. If assistance is available, let your buddy tear off and attach your detector paper to your MOPP gear. a. If you are left handed, place a strip of M9 detector paper around your left upper arm, right wrist, and left ankle with approximately 1 inch overlaps. b. If you are right-handed, place a strip of M9 detector paper around your right upper arm, left wrist, and right ankle with approximately 1 inch overlaps. Note: These are the places where a moving Soldier will most likely brush against a surface (such as undergrowth) that is contaminated with a liquid chemical agent.

38. What observation techniques can you perform during day vs. limited visibility observation? (2) Use slow scan technique.

Note: Slow scan search technique uses the same process as the rapid scan but much more deliberately; this means a slower, sideto- side movement and more frequent pauses.

Assemble or Rally

Note: The assemble and rally signal is normally followed by pointing to the assembly or rally site. (1) Raise arm vertically overhead. (2) Turn palm to the front. (3) Wave in large horizontal circles.

38. What observation techniques can you perform during day vs. limited visibility observation? (3) Use detailed search technique paying attention to the following:

Note: The detailed search, even more than the rapid or slow scan, depends on breaking a larger sector into smaller sectors to ensure everything is covered in detail and no possible enemy positions are overlooked. (a) Likely enemy positions and suspected vehicle/dismounted avenues of approach. (b) Target signatures, such as road junctions, hills, and lone buildings, located near prominent terrain features. (c) Areas with cover and concealment, such as tree lines and draws.

33. Understand the different ways to transport a casualty (individual or assisted) and when you would use different carries. a. Fireman's carry.

Note: The fireman's carry is the typical one-man carry practiced in training. However, in reality, with a fully equipped casualty, it is nearly impossible to lift a Soldier over your shoulder and move to cover quickly. It should be discouraged from being practiced and used. Use for an unconscious or severely injured casualty.

17. What techniques can you use to move under direct fire? What is the proper positioning and advantages/disadvantages for each?

Note: The high crawl lets you move faster than the low crawl and still gives you a low silhouette. Use this crawl when there is good cover and concealment but enemy fire prevents you from getting up. Note: The low crawl gives you the lowest silhouette. It is used to cross places where the cover and/or concealment are very low and enemy fire or observation prevents you from getting up. Note: The rush is the fastest way to move from one position to another. Use when you must cross an open area and time is critical.

38. What observation techniques can you perform during day vs. limited visibility observation? (1) Use rapid scan technique.

Note: The rapid scan technique is used to detect obvious signs of enemy activity. It is usually the first method you will use. (a) Search a strip of terrain about 100 meters deep, from left-to-right, pausing at short intervals. (b) Search another 100-meter strip farther out, from right-to-left, overlapping the first strip scanned, pausing at short intervals. (c) Continue this method until the entire sector of fire has been searched.

38. What observation techniques can you perform during day vs. limited visibility observation? (3) Use off center vision technique

Note: The technique of viewing an object using central vision is ineffective at night due to the night blind spot that exist during low illumination. You must learn to use off-center vision. (a) View an object by looking 10 degrees above, below, or to either side of it rather than directly at it. (b) Shift your eyes from one off-center point to another. (c) Continue to pick-up the object in your peripheral field of vision.

Quick time

Note: This is the same signal as SLOW DOWN when directing vehicles. The difference in meaning must be understood from the context in which they are used. (1) Extend the arm horizontally sideward. (2) Turn palm to the front. (3) Wave the arm slightly downward several times, keeping the arm straight. (4) Keep arm at shoulder level.

Determine Grid Azimuth Using a Protractor

Note: To ensure an accurate measurement the line should extend past the starting point and ending point

16. What is the difference between navigating by terrain association and dead reckoning?

Note: Twenty percent is a general rule of thumb for cross country terrain - road movement and flat terrain do not require this 20 percent increase. Note: Handrails are linear features like roads or highways, railroads, power transmission lines, ridgelines, or streams that run roughly parallel to your direction of travel.

33. Understand the different ways to transport a casualty (individual or assisted) and when you would use different carries. b. Upward

Note: You may have to remove a casualty upward from a vehicle; for example, from the passenger compartment of a wheeled vehicle lying on its side or from the hatch of an armored vehicle sitting upright. (1) You may place a pistol belt or similar material around the casualty's chest to help pull him/her from the vehicle. (2) With the assistance of another Soldier inside the vehicle, draw the casualty upward using the pistol belt or similar material or by grasping his/her arms. 3) While stabilizing the casualty's head and neck as much as possible, lift the casualty free of the vehicle and place him/her on the topmost side of the vehicle. Note: If medical personnel are available, they may stabilize the casualty's head, neck, and upper body with a special board or splint. (4) Depending on the situation, move the casualty from the topmost side of the vehicle to a safe place on the ground. WARNING Do NOT use manual carries to move a casualty with a neck or spine injury, unless a life-threatening hazard is in the immediate area. Seek medical personnel for guidance on how to move and transport the casualty.

28. What do the different colors on M8 paper indicate to a particular agent?

Observe the M8 detector paper for a color change. Identify the contamination by comparing any color change on the M8 detector paper to the color chart on the inside front cover of the booklet. (1) A yellow-gold color indicates the presence of a nerve (G) agent. (2) A red-pink color indicates the presence of a blister (H) agent. (3) A dark green color indicates the presence of a nerve (V) agent. (4) Any other color or no color change indicates that the liquid cannot be identified using M8 detector paper.

MOPP level 4

Overgarment= Worn Booties= Worn Mask= Worn Gloves= Worn

MOPP level 2

Overgarment= Worn open or closed Booties= Worn Mask= Carried Gloves= Carried

MOPP level 3

Overgarment= Worn open or closed Booties= Worn Mask= Worn with hood open or closed Gloves= Carried

MOPP level 1

Overgarment= Worn open or closed Booties= Carried Mask= Carried Gloves= Carried

15. What is the role of medical personnel in regards to patient decontamination for CBRN patients?

Patient decontamination is performed by nonmedical personnel. The team is composed of eight nonmedical personnel from supported units working under the supervision of medical personnel. Patient decontamination teams perform best when they train and exercise their skills with the supporting BAS.

13. Understand treatment for a near drowning casualty

Perform prehospital management for near drowning and aspiration. a. Raise the casualty to the surface and remove him from the water as soon as possible. NOTE: Cervical or spinal injuries are always a primary concern. You must assume that the casualty has a spinal injury and treat accordingly. This means that initial resuscitation and spine immobilization must occur while the casualty is still in the water. b. Perform an initial assessment. Evaluate the need for suction, ventilation, O2 administration and basic life support (BLS), if needed. c. Float a buoyant backboard under the casualty as ventilation is continued. d. Secure the trunk and neck to the backboard to eliminate spine motion. Do not remove the casualty from the water until this is done. e. Remove casualty from water. f. Place the casualty in the lateral recumbent position, with the backboard in place. g. Cover the casualty with a blanket. h. Administer oxygen by mask.

26. What are the procedures for use of mechanical leather restraints on detainees?

Personnel will comply with the following guidelines in connection with the use of mechanical leather restraints on detainees: - Ensure that the detainee or any other patient is not able to manipulate the restraint buckle. - Check the integrity of the restraints and ensure a health care provider examines the patient's skin for redness or breakdown, and check pulses distal to the restraint site at least every two hours. - Check capillary refill within five minutes of the application of the restraints. - Rotate sites daily if not contraindicated by the patient's medical condition. - Ensure the patient can reach the urinal or offer toileting at least every two hours. - Pad the extremity with an antiseptic wound care dressing before applying the restraint if skin redness or breakdown occurs at the location of the restraint. - All health care providers will be issued one restraint key. The MP guard for the ward will have one restraint key. - All assessments and treatment rendered due to restraint use will be documented in the detainee's medical record.

34. Understand the purpose of triage and identify the different triage categories

Primary goal is to locate, and return to duty, troops with minor wounds; however, at no time should abandonment of a single casualty be considered. Triage establishes the order of treatment, not whether responsibility of the senior medical person present. a. Immediate-casualties whose conditions demand immediate treatment to save life, limb or eyesight. This category has the highest priority. (1) Airway obstruction. (2) Respiratory and cardiorespiratory distress from otherwise treatable injuries (for example, electrical shock, drowning or chemical exposure). NOTE: A casualty with cardiorespiratory distress may not be classified "Immediate" on the battlefield. This casualty may be classified "Expectant", contingent upon such things as the situation, number of casualties, and available support. (3) Massive external bleeding. (4) Shock. (5) Burns on the face, neck, hands, feet, perineum or genitalia. NOTE: After all life- or limb-threatening conditions have been successfully treated; give no further treatment to the casualty until all other "Immediate" casualties have been treated. Salvage of life always takes priority over salvage of limb. b. Delayed-casualties who have less risk of loss of life or limb if treatment is delayed. (1) Open wounds of the chest without respiratory distress. (2) Open or penetrating abdominal injuries without shock. (3) Severe eye injuries without hope of saving eyesight. (4) Other open wounds. (5) Fractures. (6) Second and third degree burns (not involving the face, hands, feet, genitalia, and perineum) covering 20% or more of the total body surface area (TBSA). c. Minimal-"walking wounded", can be treated by self-aid or buddy-aid. (1) Minor lacerations and contusions. (2) Sprains and strains. (3) Minor combat stress problems. (4) First or second degree burns (not involving the face, hands, feet, genitalia, and perineum) covering under 20% of the TBSA. NOTE: Minimal casualties may assist the Soldier Medic by providing buddy-aid or by monitoring other casualties. d. Expectant-casualties who are so critically injured that only complicated and prolonged treatment can improve life expectancy. This category is to be used only if resources are limited. If in doubt as to the severity of the injury, place the casualty in one of the other categories. (1) Massive head injuries with signs of impending death. (2) Burns, mostly third degree, covering more than 85% of the TBSA.

28. What standardized form is used for detainee physical screening?

Refer to Appendix B for sample preprinted formats for the SF 600 for detainee physical screening and quality assurance screen of a detainee's medical record.

Advanced Trauma Management

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.

High Value Detainee

Security internees of significant intelligence or political value.

1. What is a disease and nonbattle injury (DNBI)?

Soldier who is lost to an organization by reason of disease or injury and who is *not a battle casualty*

40. What are the indications/behaviors of severe depression?

Some of the more common signs and symptoms of severe depression include: - Extreme feeling of sadness. - Apparent feelings of hopelessness and helplessness. - Guilt and self-blaming. - Lack of energy and lack of interest in activities. - Withdrawal from other people, including other detainees. - Eating problems (eating very little or too much). - Sleep problems (inability to sleep well or sleeping too much). Note. Any of the above indications of depression combined with a detainee's talk of suicide, wishing for death, or similar statements is a serious suicide indicator.

22. What are stability tasks? Understand Table 3-4.

Stability is an overarching term encompassing various military missions, tasks, and activities conducted outside the U.S. in coordination with other instruments of national power to maintain or reestablish a safe and secure environment, provide essential government services, emergency infrastructure reconstruction, and humanitarian relief.

STEADY NOISE

Steady noise is noise that does not significantly change in intensity or frequency with time such as that produced by equipment and vehicles.

3. What warfighting functions are HSS and FHP aligned under?

Sustainment warfighting function and the protection warfighting function.

Theater Internment Facility

TIF

23. What are the phases of Tactical Combat Casualty Care?

Tactical combat casualty care (TC-3) can be divided into three phases. * Care under fire-you are under effective hostile fire and are very limited as to the care you can provide. * Tactical field care-you and the casualty are relatively safe and no longer under effective hostile fire, and you are free to provide casualty care to the best of your ability. * Tactical evacuation care-care is rendered during casualty evacuation (CASEVAC).

Technical Supervision

Technical supervision is the authority, less than command, over certain clearly delineated technical functions performed by units not in the chain of command. Technical supervision is governed by policies and procedures that are established by regulation and restricted to prescribing detailed and specific technical guidance to control the performance of those functions.

4. What are the six principles of AHS Support?

The AHS Principles of conformity, mobility, proximity, flexibility, continuity, and control form the underpinnings upon which every AHS support plan is developed. (Cheese Makes Pretty Fine Cheesy Cheese)

7. What are the ten medical functions of the AHS?

The AHS is comprised of ten medical functions—mission command, medical treatment (organic and area support), hospitalization, medical evacuation, medical logistics (MEDLOG), PVNTMED services, veterinary services, dental services, COSC (Combat and Operational Stress Control), and medical laboratory services. Although the ten functions are aligned with specific medical disciplines or support tasks, the execution of the individual functions are interrelated, interconnected, and interdependent and require close coordination and integration to facilitate the effective and efficient provision of AHS support. Acronym for 10 medical functions: CTHELPVDCL. CT-HELP-Very deliberate cats live VDCL

14. What should be considered for location of an AXP (ambulance Exchange Point)?

The AXP may be placed forward of the BAS when both tracked and wheeled vehicles are being used or when the distance to the BAS is extended. In this way, the ambulance drivers who are most familiar with the array of forces in the fight remain in the forward areas, and if tracked vehicles are being used, it shortens the distance they must travel.

1. What is the Army Health System (AHS)?

The Army Health System is defined as a component of the Military Health System that is responsible for operational management of the health service support and force health protection missions for training, predeployment, deployment, and postdeployment operations. Army Health System includes all mission support services performed, provided, or arranged by the Army Medical Department to support health service support and force health protection mission requirements for the Army and as directed, for joint, intergovernmental agencies, coalition and multinational forces (FM 4-02).

1. What are warrior tasks and battle drills?

The Army identified warrior tasks and battle drills (WTBD) that enhance a Soldier's readiness to fight on the battlefield. Warrior tasks are a collection of individual Soldier skills known to be critical to Soldier survival. Examples include weapons training, tactical communications, urban operations, and first aid. Battle drills are group skills designed to teach a unit to react and survive in common combat situations. Examples included react to ambush, react to chemical attack, and evacuate injured personnel.

18. What is the role of the BMSO (Bridage Medical Supply Office)?

The BSMC's medical supply element is the BMSO. This office provides brigade level, Role 2, Class VIII coordination, synchronization, and execution of MEDLOG support for the BSMC and supported BCT.

29. Understand how the Health Insurance Portability and Accountability Act pertains to detainees.

The Health Insurance Portability and Accountability Act does not apply to the medical records of detainees and EPWs. Given that the Geneva Conventions require the military to provide the same standard of care to detainees and EPWs as U.S.Forces, detainee/EPW medical records should be initiated and maintained at the same standard.

27. What are the four triage categories? Know examples of injuries in each category. Triage Category: IMMEDIATE

The IMMEDIATE triage category is for the patient whose condition demands immediate, resuscitative treatment. An example of this treatment is the control of hemorrhage from an extremity. Generally, the procedures used are short in duration and economical in terms of medical resources and should concern only those patients with high chances for survival. (Approximately 20 percent of the casualties are normally in this category.)

25. What is the mission, allocation, capabilities & dependencies of an MCAS (medical company area support)? BASIS OF ALLOCATION

The MCAS is allocated on the basis of 1 per 10,000 non-BCT troops supported in the committed brigade headquarters area and/or division and corps headquarters AO.

25. What is the mission, allocation, capabilities & dependencies of an MCAS (medical company area support)? ASSIGNMENT

The MCAS is assigned to the headquarters and headquarters detachment of the MMB.

25. What is the mission, allocation, capabilities & dependencies of an MCAS (medical company area support)? DEPENDENCIES

The MCAS is dependent upon - Appropriate elements of the theater for religious, legal, finance, personnel, and administrative services. - Forward surgical teams for surgical augmentation of nontransportable patients requiring surgical intervention in preparation for medical evacuation by air ambulance. - Medical logistics company for Class VIII support and medical equipment maintenance and repair capability. - Medical company (air ambulance) for rotary-wing air ambulance support. - Medical (ground ambulance) company for ground medical evacuation.

25. What is the mission, allocation, capabilities & dependencies of an MCAS (medical company area support)? MISSION

The MCAS provides Role 1 and Role 2 AHS support to units located in its AO. Role 1 AHS support is provided to organizations without organic Role 1 AHS support and the MCAS provides Role 2 AHS support on an area support basis for all assigned and attached organizations.;

42. Who is responsible for the operation of the pharmacy?

The MTF commander is responsible for operation of the pharmacy and exercises careful supervision over all phases of its operations

39. What is a SALUTE report?

The SALUTE format is an aid for the observer to report the essential reporting elements.

20. What is a SITREP used to report?

The SITREP is used to report any change since the last report, to request resupply, and to report the current location of the element; only lines or parts of lines that contain new information will be sent. It may require additional follow-up reports.

21. What is a SPOTREP used to report?

The SPOTREP is used to report timely intelligence or status regarding events that could have an immediate and significant effect on current and future operations. This is the initial means for reporting troops in contact and event information. Several lines of the SPOTREP provide sub-categories that structure reported data. Some lines may be omitted in an emergency. For example, the SPOTREP could provide only the reporting unit, event DTG, location, and activity. The format of a SPOTREP may also change based on unit's standing operating procedures (SOP).

3. What is the Law of Land Warfare and what is the purpose?

The conduct of armed hostilities on land is regulated by the Law of Land Warfare. This body of law is inspired by the desire to diminish the evils of war by: - Protecting both combatants and noncombatants from unnecessary suffering. - Safeguarding certain fundamental human rights of persons who fall into the hands of the enemy, particularly prisoner of war (POW), the wounded and sick, and civilians. - Facilitating the restoration of peace.4

5. What is the difference between Role 1 and 2 care? A. Role 1

The first medical care a Soldier receives is provided at Role 1 (also referred to as unit-level medical care). This role of care includes: - Immediate lifesaving measures. - Disease and nonbattle injury prevention. - Combat and operational stress control (COSC) preventive measures - Patient location and acquisition (collection). - Medical evacuation from supported units (point of injury or wounding, company aid posts, or casualty/patient collecting points) to supporting MTFs. - Treatment provided by designated combat medics or treatment squads. (Major emphasis is placed on those measures necessary for the patient to return to duty or to stabilize him and allow for his evacuation to the next role of care. These measures include maintaining the airway, stopping bleeding, preventing shock, protecting wounds, immobilizing fractures, and other emergency measures, as indicated.) Nonmedical personnel performing first aid procedures assist the combat medic in his duties. First aid is administered by an individual (self-aid/buddy aid) and enhanced first aid is provided by the combat lifesavers.

17. What is the mission, allocation, capabilities & dependencies of a BSMC (Bridage Support Medical Company)? BASIS OF ALLOCATION

The medical company is allocated on a basis of one per BCT.

17. What is the mission, allocation, capabilities & dependencies of a BSMC (Bridage Support Medical Company)? DEPENDENCIES

The medical company is dependent upon: - Appropriate elements within the theater Army for religious, legal, finance, and personnel and administrative services. - Headquarters and headquarters company, BSB for food service support, religious support, unit administration, and petroleum, oils and lubricants. - Field maintenance company, BSB for unit maintenance of all organic equipment (less medical). - Forward surgical team for surgical augmentation. - Medical company (air ambulance) for rotary-wing air ambulance support.

17. What is the mission, allocation, capabilities & dependencies of a BSMC (Bridage Support Medical Company)? ASSIGNMENT

The medical company is organic to the brigade support battalion (BSB), IBCT and/or BSB with forward support company, IBCT.

2. How do unit field sanitation teams (FST) assist commanders in maintaining health and well-being of Soldiers?

The mission of the unit field sanitation team is to assist commanders in maintaining the health and the well-being of the Soldiers assigned to the unit.

20. What does the Detainee Operations Commander do?

The operational commander shall designate the commander of the senior MP headquarters as the detainee operations commander with operational control of forces conducting detainee operations. While the detainee operations commander exercises operational control of all forces conducting detainee operations, technical supervision of medical assets remains in the medical channels to ensure medical guidelines and standards are met.

Conformity

The principle of conformity dictates that AHS plans must conform to the maneuver commander's tactical plan and commander's guidance and intent. Medical plans and operations that are not synchronized and rehearsed with the operational plan and ustainment concept of support will not provide efficient and effective health care support.

Continuity

The principle of continuity refers to the AHS continuity of care by moving patients through progressive, phased roles of care extending from the point of injury or wounding to the continental U.S.-support base.

51. What is the purpose of measuring the wet bulb-globe temperature index and when should you do this?

The purpose and general use of the wet bulb-globe temperature index is to determine the amount of heat stress on the body. Monitoring the index enables the proper preventive measures needed during hot conditions. Measure the wet bulb-globe temperature index when the ambient temperature is over 75 degrees Fahrenheit.

44. What are the three most encountered rodents?

The rodents most commonly encountered by Soldiers and pose the greatest health threat to Soldiers in the field are the: - Norway (Rattus norvegicus). - Roof rat (Rattus, rattus). - House mouse (Mus musculus).

Enemy Combatants

The term enemy combatant is used for personnel engaged in hostilities against the U.S. or its multinational partners during an armed conflict. This term includes both lawful combatants who are engaging in hostilities on behalf of a party to the conflict and unlawful combatants, such as spies, saboteurs, or civilians who are engaging in or supporting hostilities against the U.S. or multinational partners on behalf of a party to the conflict or on behalf of another party such as a terrorist organization. For purposes of the war on terrorism, the term enemy combatant means an individual regardless of age who was part of orsupporting terrorist forces that are engaging in hostilities against the U.S. or multinational partners.

TIF

Theater internment facility

57. What are the four properties and characteristics of noise?

There are four properties or characteristics of noise which determine whether a given noise is likely to be hazardous to workers' hearing. These characteristics are: - Frequency - Intensity - Nature of the noise - Exposure duration

53. What are the factors for cold injury?

There are many host factors which influence an individual's exposure, susceptibility, or response to cold environments and possible cold injury. These include: - Age - Rank - Previous cold injury - Fatigue - Discipline, training, and experience - Psychosocial factors - Gender - Race - Geographic origin -Nutrition - Activity - Drugs and medications

11. What assistance can health care personnel provide interrogation teams?

There must be a complete separation of custody and health care operations. No staff member will participate in any form of custody operations at any time. Health care personnel do not provide guards for detainees. Interrogations will not be conducted on the ward. Health care personnel providing detainee medical care will not assist or provide medical information to interrogators. Approval for interrogations to be conducted with a detainee must come from the detainee operations commander and be routed through the DOMD and MTF commander. Personnel from the Criminal Investigation Division may conduct investigations with the detainee, but only after notification of MTF command/operations staff.

34. What are the four different kinds of burns?

Thermal, Electric, Chemical, Laser

27. What are the four triage categories? Know examples of injuries in each category. Triage Category: MINIMAL

These casualties have relatively minor injuries that are so superficial that they require no more than cleansing, minimal debridement, administration of antibiotics or prophylactic vaccines, and first aid type dressings. They must be rapidly directed away from the triage area to uncongested areas where first aid is available. Most of the injured in this category are ambulatory. Medical providers should query casualties concerning their exposure to a potentially concussive incident and document the event in the Soldier's individual medical record. Examples include: - Burns of less than 15 percent of total body surface area with the exception of those involving the face, hands, and genitalia. - Upper extremity fractures. - Sprains. - Abrasions. - Behavioral health issues, such as COSR.

6. What is included in Role 1 medical care?

This role of care includes: - Immediate lifesaving measures. - Disease and nonbattle injury prevention. - Combat and operational stress control (COSC) preventive measures. - Patient location and acquisition (collection). - Medical evacuation from supported units (point of injury or wounding, company aid posts, or casualty/patient collecting points) to supporting MTFs. - Treatment provided by designated combat medics or treatment squads. (Major emphasis is placed on those measures necessary for the patient to return to duty or to stabilize him and allow for his evacuation to the next role of care. These measures include maintaining the airway, stopping bleeding, preventing shock, protecting wounds, immobilizing fractures, and other emergency measures, as indicated.)

25. What is the mission, allocation, capabilities & dependencies of an MCAS (medical company area support)? CAPABILITIES

This unit provides: - Mission command of attached units which include medical planning and coordination of patient movement within and outside of the MCAS's AO. - Treatment of patients with DNBI, COSR, triage of mass casualties, emergency medical treatment, ATM, initial resuscitation and stabilization, and preparation for further evacuation of patients incapable of returning to duty within 72 hours. - Treatment squads capable of breaking down into two treatment teams than can operate independently of the MCAS for a limited time. - Medical evacuation (ground) for patients from units within the MCAS's AO to the treatment squads of the MCAS. - Operational dental care consisting of emergency and essential dental care designed to circumvent dental emergencies. - Emergency Class VIII supply/resupply to supported units operating within the AO of the MCAS. - Unit-level field maintenance on the unit's organic vehicles and power equipment. - Behavioral health consultation and support, including coordinating operations of COSC elements operating within the AO of the MCAS. - Medical laboratory and radiology services commensurate with Role 2 MTFs. - Outpatient consultation services for patients referred from Role 1 MTFs. - Food service support for staff and patients and other medical elements dependent upon the MCAS for support. See note below for additional information. - Patient holding for up to 40 patients able to return to duty within 72 hours.

17. What isMOBILITY the mission, allocation, capabilities & dependencies of a BSMC (Bridage Support Medical Company)? MOBILITY

This unit requires 100 percent mobility of its TOE equipment to be transported in a single lift using organic vehicles.

25. What is the mission, allocation, capabilities & dependencies of an MCAS (medical company area support)? MOBILITY

This unit requires 100 percent mobility of its TOE equipment to be transported in a single lift using organic vehicles.

31. How often should detainees be screened for weight?

To ensure the continued health of detainees, international law requires that each detainee be screened monthly by health care personnel. During this screening, the detainee's weight is recorded on DA Form 2664-R which provides a concise, chronological weight history for the detainee. Significant fluctuations in weight can signal an underlying medical condition or can indicate that the detainee diet is not meeting his nutritional requirements.

38. What is the role of FSTs in regards to waste management?

Unit field sanitation teams provide: - Awareness training on the dangers associated with the handling of hazardous waste materials. - Monitoring of company- or unit-level waste management programs and facilities. - Training Soldiers on the appropriate use of personal protective equipment that must be used during waste management operations. Unit field sanitation teams also assist the unit commander in conducting inspections of waste management practices and provide supervision of: - The construction and maintenance of human waste disposal facilities. - The construction and maintenance of garbage and soakage pits.

44. Understand unauthorized disclosure of information. Who can authorize disclosure of information in advance?

Unless specifically authorized in advance by the DOMD or the detainee operations commander, health care personnel and detainees will not: - Review detainee medical or dental treatment files without having a clearly established and official need to know. Information extracted from these files will be used only for official purposes - Discuss the following matters with a detainee, a former detainee, a family member of a detainee or former detainee, the general public, or anyone else not having a need to know, except in the course of official business: - Allegations of misconduct against any medical personnel. - Allegations of misconduct against any internment or holding facility personnel. - Recommendations of any individual board, panel, or hearing body and/or the vote of any member of such entity. - Detainee mail, notes, or other written material of detainees. - Requests from former detainees for assistance in obtaining employment, including requests for recommendations. - Any information from the medical or dental treatment records of a detainee or former detainee. Only MTF personnel whose assigned duties include the disclosure of such information may reveal such information. -Information concerning particular incidents, occurrences, disturbances, acts of misconduct, or the handling of incidents involving detainees occurring at MTFs or at other facilities located at detainee internment or holding facilities. Only the public affairs office should release information regarding such incidents, upon approval by the DOMD, internment or holding TIF commander, or the detainee operations commander. Inquiries from the general public should be referred to these officials. -Information concerning plans, operations, and procedures that are designed to maintain the security, custody, or control of detainees, detainee internment or holding facilities, and the security of MTFs that provide medical care to detainees.

18. What is a Theater Internment Facility (TIF)?

Use of force, security, and control of detainees are entirely functions of the assigned TIF security personnel; however, planning, training, and preparing for the use of force is a necessary element in maintaining order in a facility. The TIF commander and the DOMD ensure that health care personnel are trained and prepared for the effective use of force when necessary to protect themselves and the detainees. Health care personnel will also ensure that the use of force continuum is applied when force is required for self-defense. Health care personnel assigned the mission of providing health care to detainees at the TIF should be issued and trained on rules of engagement (rules for the use of force specific to that mission)

33. Understand the different ways to transport a casualty (individual or assisted) and when you would use different carries. c. Cradle-drop drag

Use to move a casualty who cannot walk when being moved up or down stairs

41. What are the water consumption planning factors for the different climates?

Water consumption planning factors should be the same as for U.S. Forces. These factors are: - 1.5 gallons per person per day for drinking in temperate climates. - 3.0 gallons per person per day for drinking in tropical and arid climates. - 2.0 gallons per person per day for drinking in arctic climates. - 1.7 gallons per person per day for personal hygiene. - 1.7 gallons per person per day for centralized hygiene (showers) (1 shower per week per person). - 2.8 gallons per person per day for food preparation. - 3.1 gallons per person per day for laundry. - 1.24 gallons per person per day for medical treatment. - Detainees of certain religious faiths (such as Islam) should be provided an additional 0.5 to 1.5 gallons (2 to 5 liters) of potable water per person per day for washing and drinking associated with religious practices. - Detainees who practice anal washing following defecation require an additional 0.25 to 0.5 gallons (1 to 2 liters) per day.

20. What is water treatment and purification?

Water treatment and purification is the combination of one or more processes employed to improve the quality of water.

37. What is the detainee death notification process?

When an EPW, retained person, or detainee in U.S. custody dies, the attending medical officer will immediately notify the DOMD or the TIF commander (or if the death did not occur in a facility, the unit commander who exercised custody over the individual). The TIF commander will immediately report the death to the Criminal Investigation Division, the responsible investigative agency. The Criminal Investigation Division will contact the Office of the Armed Forces Medical Examiner to determine whether an autopsy will need to be performed. The attending medical officer will immediately furnish the TIF commander, DOMD, or other officer charged with the detainee custody before death the following information: - Full name of deceased. - Internment serial number of deceased (if the ISN has not been issued, use the capture tag number). - Date, place, and cause of death. - Statement that death was or was not the result of the deceased's own misconduct. - When the cause of death is undetermined, the attending medical officer will make a statement to that effect. When the cause of death is finally determined, a supplemental report will be made.

36. What are considerations that need to be taken to transport meals?

When prepared meals must be transported to remote feeding areas, the unit field sanitation teams are responsible for inspecting the vehicles to ensure that the rations will not be contaminated during transport. The vehicles used to transport food to field feeding sites shall be clean, covered, and used exclusively for transporting food. Should the need arise to use multipurpose vehicles (normally used to transport personnel, equipment, supplies, and other items) to transport food, the vehicle must: - Be completely washed with soapy water and rinsed to remove dirt, debris, and fuel, oil, or chemical residues. - The vehicle shall be allowed to air dry prior to transporting food. - Food containers, packages of single-use items, and utensils shall be placed on clean, dry pallets or other dunnage to prevent direct contact with the vehicle floor. - Food may not be transported with bulk fuel or chemicals.

8. What are considerations to take when packing personal hygiene supplies?

When preparing for the field or extended deployments, Soldiers should consider packing a two month's supply of standard toiletry articles that can last until sustainment of these items is assured.

heat stroke

a condition marked by fever and often by unconsciousness, caused by failure of the body's temperature-regulating mechanism when exposed to excessively high temperatures.

sunburn

a form of erythema in which skin cells are damaged by exposure to the ultraviolet rays in sunlight

10. What are the types and treatments for high altitude illness?

a. AMS. (1) Descent, if mission allows, will provide the quickest resolution of symptoms. (2) Increase fluid intake. (3) Give aspirin or a nonsteroidal anti-inflammatory drug (NSAID) for altitude headache. (4) Antiemetic. (5) Light diet. (6) Avoid any additional ascent or exertion until symptoms resolve. (7) Monitor patient for symptom progression to HAPE/HACE. b. HACE. (1) HACE requires immediate descent. (2) Give acetazolimide 125 -250 mg twice a day. (3) Give dexamethasone 4 mg orally, intramuscularly, or intravenously every 6 hours. c. HAPE. (1) Bed rest and oxygen at high altitude may be tried with mild HAPE, depending on mission requirements. (2) If the condition worsens, immediate descent is essential. (3) Once descent is accomplished, the patient should be continued on oxygen and managed as with other forms of pulmonary edema. (4) When promptly treated, patients usually recover from HAPE within 24 to 48 hours after descent.

15. Understand chest pain signs and symptoms and criteria for assisting with medication intake.

a. Altered mental status. (1) Unresponsiveness. (2) Sleepiness. (3) Head-bobbing. (4) Agitation. (5) Anxiety. b. Chief complaint of chest, neck, back, or jaw pain/discomfort. NOTE: A patient with a clenched fist over their chest is a sign of chest pain or discomfort. c. Severe difficulty breathing, including inability to speak only a few words per sentence. d. Poor skin color, including pale grey or cyanotic (blue); cool, moist skin. e. Abnormally slow or fast respiratory rates. f. Abnormal pulse (arrhythmia). (1) Bradycardia (less than 60 beats per minute). (2) Tachycardia (greater than 100 beats per minute). g. Abnormal blood pressure. (1) Hypotensive (systolic pressure less than 90 mmHg). (2) Hypertensive (systolic pressure greater than 150 mmHg). h. Shallow respirations with any respiratory rate. NOTE: You must call medical control for approval to assist with the patient's prescribed nitroglycerin. All signs and symptoms of chest pain/cardiac compromise must be in place before assisting the patient with their medication

5. What are the steps for assisting with vaginal delivery? 2. Assist with the Second Stage of Labor

a. Assist with delivery of the infant as directed by health care provider. b. Determine if the umbilical cord is around the infant's neck as the infant is being born. Place two fingers under the cord at the back of the baby's neck. Bring the cord forward, over the baby's upper shoulder and head. If you cannot loosen or slip the cord over the baby's head, clamp the cord in two places and, with extreme care, cut the cord between the two clamps and unwrap the ends of the cord from around the baby's neck and proceed with the delivery. c. Support the head after the infant's head is born. d. Suction the mouth two or three times and the nostrils. Avoid contact with the back of the mouth. e. Support the infant with both hands as the torso and full body are born. f. Wipe blood and mucus from the mouth and nose with sterile gauze. Suction the mouth and nose again. g. Clamp, tie, and cut the umbilical cord (between the clamps) as pulsations cease approximately four finger widths from the infant. h. Wrap the infant in a warm blanket and place on its side, head slightly lower than the trunk.

Treat the bite or sting.

a. Black widow spider, brown recluse spider, fire ant, and scorpion bites or stings. (1) Keep the casualty calm and reassured. (a) Explain to casualty what will be done. (b) Limit their physical activity. NOTE: Keep the limb immobilized and the casualty still to prevent distribution of the poison to other parts of the body. (2) Remove jewelry. (3) Cleanse the bite site gently using normal saline and mild or strong soap solution. NOTE: If necessary, irrigate the area with a large amount of sterile saline. Make sure contaminated saline flows away from the body. Never scrub the area. (4) Place the site below the level of the casualty's heart. (5) Treat the casualty for anaphylactic shock, if necessary. (See task 081-833-0003.) (6) Monitor vital signs. b. Bee, wasp, hornet, and yellow jacket. (1) Keep the casualty calm and reassured. (a) Explain to the casualty what will be done. (b) Limit their physical activity and keep warm. (2) Remove any jewelry or other constricting objects as soon as possible, ideally before any swelling begins. (3) Remove the stinger or venom sac. (4) Cleanse the site using normal saline and a mild or strong soap solution. NOTE: If necessary, irrigate the area with a large amount of sterile saline. Make sure that the contaminated saline flows away from the body. Never scrub the area. CAUTION: Application of a cold pack to an insect bite or sting to relieve pain and swelling should be followed in accordance with (IAW) local standard operating procedure (SOP) and medical officer's order.

44. What are the basic principles of the Law of War?

a. Define Military Necessity. (1) Describe a Legitimate Military Target. (2) Define combatant force. (3) Describe collateral damage. b. Defines Unnecessary Suffering c. Define Discrimination and Distinction d. Define Proportionality. e. Define Chivalry

43. What are the key elements of the Law of War?

a. Describe how the Hague Convention and Geneva Conventions pertain to combat operations. b. Describe International Customary Law of War. c. Describe other international Treaty law.

11. Name the signs and symptoms of diabetic emergencies. Identify the signs and symptoms of a diabetic emergency.

a. Hypoglycemia (low blood sugar). NOTE: Hypoglycemia is the most common of all diabetic emergencies. (1) Rapid onset of altered mental status. NOTE: This occurs after missing a meal, prolonged vomiting or an unusual amount of physical exertion. (2) Intoxicated appearance, staggering, slurred speech, or unconsciousness. (3) Elevated heart rate. (4) Cold, clammy skin. (5) Hunger. (6) Seizures. (7) Uncharacteristic behavior. (8) Anxiety. (9) Combativeness. b. Hyperglycemia (high blood sugar). (1) Slow onset. (2) Warm, red, dry skin. (3) Sweet, fruity breath odor (acetone). (4) Deep, rapid breathing. (5) Dry mouth. (6) Intense thirst. (7) Abdominal pain. (8) Nausea and vomiting

19. What are the eight lines of a SITREP?

a. Line 1: Date and Time Group (DTG)-Report date and time the report is being submitted. Note: Date is the date that the report is being submitted. Time is the local time or zulu time that the report is being initiated. b. Line 2: Unit-Identify the unit making the report. c. Line 3: From-Report the time that the operational situation started or will start. d. Line 4: Until-Report the time that the operational situation ends or will end. e. Line 5: Map-Give a minimum six digit grid of the squad or team current location. f. Line 6: Enemy-Report enemy activity. (1) Nationality. (2) Location. (3) Mission. (4) Time of Sighting. g. Line 7: Nonhostile-Report nonhostile activity. h. Line 8: Own-Report activities of own forces. (1) Changes in location of units and/or formations. (2) Activities of forces not attached to originating unit.

5. What are the steps for assisting with vaginal delivery? 3. Assist with the Thrid Stage of Labor

a. Observe for delivery of the placenta while preparing the mother and infant for evacuation. b. Place a sterile pad over the vaginal opening and lower the patient's legs. c. Record the time of delivery and evacuate the mother, infant, and placenta to the hospital. 4. Provide initial care for the newborn. a. Position, dry, wipe, and wrap the newborn in a blanket and cover the head. b. Perform appearance, pulse, grimace, activity, and respirations (APGAR) testing at 1 and 5 minutes after birth. (1) Appearance (color)-no central (trunk) cyanosis. (2) Pulse-greater than 100/min. (3) Grimace-vigorous and crying. (4) Activity-good motion in extremities. (5) Respirations, breathing effort-normal, crying.

NG tubes

a. Patient with mid-facial trauma. b. Gastric distention which impedes airway, breathing and circulation (ABC). (1) Full arrest. (2) Near drowning. c. Intestinal obstruction. d. Preoperative and postoperative care. e. Patient requires a gastrointestinal lavage. (1) Overdose. (2) Gastrointestinal bleeding. f. Patient requires a gavage. (1) Comatose patients. (2) Debilitated patients. g. Need to analyze stomach contents. (1) Patient may be bleeding internally. WARNING: Orogastric tube insertion is contraindicated in patients with esophageal strictures, ingested caustics, significant facial or head trauma or patients with bleeding disorders. CAUTION: Insertion of an orograstric (OG) tube into trachea/lung, patient may experience respiratory distress. If this occurs at any time during the procedure, remove the tube immediately. (2) Overdose. NOTE: NG tubes may be contraindicated in patients with nasopharyngeal or esophageal obstruction, severe, uncontrolled coagulopathy or severe maxillofacial trauma.

8. Name the signs and symptoms of Anaphylactic Shock

a. Skin. (1) Flushed or ashen. (2) Burning or itching. (3) Edema (swelling), especially in the face, tongue, or airway. (4) Urticaria (hives) spreading over the body. (5) Marked swelling of the lips and cyanosis about the lips. b. Respiratory. (1) Tightness or pain in the chest. (2) Sneezing and coughing. (3) Wheezing, stridor, or difficulty in breathing (dyspnea). (4) Sputum (may be blood tinged). (5) Respiratory failure. c. Circulatory. (1) Weak, rapid pulse. (2) Falling blood pressure. (3) Hypotension. (4) Dizziness or fainting. (5) Coma.

45. What are the 10 Soldier Rules?

a. Soldiers only fight enemy combatants. b. Soldiers treat humanely all who surrender or are captured. c. Soldiers do not kill or torture detained personnel. d. Soldiers collect and care for the wounded. e. Soldiers do not attack medical personnel, facilities or equipment (Soldiers do not attack protected places or persons). f. Soldiers destroy no more than the mission requires. g. Soldiers treat civilians and noncombatants humanely. h. Soldiers do not steal. Soldiers respect private property and possessions. i. Soldiers should do their best to prevent violations of the Law of War. j. Soldiers report all violations of the Law of War to their superior.

33. What is a casualty collection point and how is it established?

a. The location of the CCP will depend on the unit location, the tactical situation, and the number of casualties to be evacuated. b. This location should be decided by the unit first sergeant with guidance from the company/platoon medics.

46. What are the five levels of hostile civilian threat?

a. Verbal. b. Physical without weapons (touching, pushing). c. Physical with weapons (rocks, clubs, spitting). d. Physical with firearms shown. e. Physical with firearms used.

Heat Exhaustion

condition resulting from exposure to heat and excessive loss of fluid through sweating

Hyponatremia

deficient sodium in the blood

Rhabdomyolysis

dissolution of striated muscle (caused by trauma, extreme exertion, or drug toxicity; in severe cases renal failure can result)

33. Understand the different ways to transport a casualty (individual or assisted) and when you would use different carries. d. Use litters

if materials are available, if the casualty must be moved a long distance, or if manual carries will cause further injury

Chilblains

inflammation of the hands and feet caused by exposure to cold and moisture

Heat Cramp

muscle pain or spasm due largely to the loss of salt from the body from sweating, or inadequate intake of salt

24. What are protozoan infections? Know the different types listed.

protozoan infection is a condition which is characterized by an infection caused by protozoans. -Protozoan Infections, Amebiasis, Cryptosporidiosis, Giardiasis, Schistosomiasis, Schistosome Dermatitis

3. What does an FST consist of and where are they assigned?

*The unit field sanitation teams consist of one noncommissioned officer and one enlisted Soldier.* In units with organic medical personnel, the noncommissioned officer should be a medical noncommissioned officer. Soldiers appointed to field sanitation teams should have at least six months of service remaining with the unit after completion of certification training. *Unit field sanitation teams are established within company-, battery-, and similar-sized units.*

9. When is handwashing and sanitizing most effective?

- Before eating or snacking. - After eating or snacking. - Before handling and or preparing food. - After using the latrine. - After handling anything that could potentially transfer germs. - Frequently during the work day to keep your hands free of germs. - After coming into contact with any local flora or fauna. - After physical contact with local nationals.

26. What chemicals are used to disinfect drinking water?

- Calcium hypochlorite. - Water purification tablets, chlorine. - Water purification tablets, iodine.

33. What are the eight known pathogens that account for the majority of illnesses, hospitalizations and deaths?

- Campylobacter. - Clostridium perfringens. - Escherichia coli. - Listeria monocytogenes. - Toxoplasma gondii. - Norovirus. - Salmonella. - Staphylococcus aureus.

27. What are the four variables in determining the effectiveness of chlorine disinfection of drinking water?

- Dose. - Demand. - Residual concentration. - Contact time.

18. What are the rules of water discipline?

- Drink water from approved sources only. - Prevent water waste. - Protect water sources with good sanitary practices.

30. How do you disinfect canteens with calcium hypochlorite?

- Fill the canteen with the cleanest, clearest water available, leaving an air space of an inch or more below the neck of the canteen. - Fill a canteen cup half full of water and add the calcium hypochlorite from one ampule, stirring with a clean utensil until this powder is dissolved. - Fill the cap of a plastic canteen half full of the solution in the cup and add it to the water in the canteen. Then place the cap on the canteen and shake it thoroughly. - Loosen the cap slightly and invert the canteen, letting the treated water leak onto the threads around the neck of the canteen. - Tighten the cap on the canteen and wait at least 30 minutes before using the water for any purpose.

9. What is the responsibility of health care personnel in detainee operations?

- Have a duty in all matters affecting the physical and behavioral health (BH) of detainees to perform, encourage, and support, directly and indirectly, actions to uphold the humane treatment of detainees. See Appendix B for additional information on detainee BH care. - Charged with the medical care of detainees have a duty to protect detainees' physical and BH and provide appropriate treatment for disease. To the extent practicable, treatment of detainees should be guided by professional judgments and standards similar to those applied to personnel of the U.S. Armed Forces. - Will not be involved in any professional provider-patient treatment relationship with detainees the purpose of which is not solely to evaluate, protect, or improve their physical and BH. - Whether or not in a professional provider-patient treatment relationship, will not apply their knowledge and skills in a manner that is not in consonance with applicable law or the standards set forth in DODD 2310.01E. - Will not certify or participate in the certification of, the fitness of detainees for any form of treatment or punishment that is not in consonance with applicable law or participate in any way in the administration of any such treatment or punishment. - Will not participate in any procedure for applying physical restraints to the person of a detainee unless such a procedure is determined to be necessary for the protection of the physical or BH or the safety of the detainee or necessary for the protection of other detainees or those treating, guarding, or otherwise interacting

49. What are types of heat injury?

- Heat Cramp - Heat Exhaustion - Heat Stroke - Heat Rash - Sunburn - Skin Cancer - Rhabdomyolysis - Hyponatremia

7. What are protective measures that fall under an individual Soldier's responsibility?

- Heat injury in hot and sunny climates by following work/rest and water consumption guidelines, by properly adhering to uniform wear policies, and by using sunscreen on exposed body parts. - Cold injury in cold climates by wearing proper cold-weather clothing and frequently changing socks to keep feet dry, by careful handling of gasoline-type liquids, and by avoiding contact between skin and cold metal. - Mosquito, fly, tick, and other arthropod borne diseases by using insect repellents, netting, and insecticide aerosols; by taking approved chemoprophylaxis; and by wearing the uniform properly. - Enteric diseases by using water purification tablets whenever water quality is uncertain and by avoiding foods prepared by unapproved food vendors, and by properly disposing of bodily wastes. - Skin diseases by washing the body as often as practicable.

34. What are the five risk factors related to food handler behaviors that contribute to foodborne illness?

- Improper holding temperatures. - Inadequate cooking. - Contaminated equipment. - Foods from unsafe sources. - Poor personal hygiene.

39. What are the disposal methods for nonhazardous solid waste?

- Incineration - Burn Pits - Burial - Landfilling - Tactical Burial

13. What actions do you take if you suspect any abuse? When dealing with detainees, Soldiers need to use their common sense and exercise good judgment. Remember that if:

- It looks wrong, then it probably is. - It is something that would enrage you if you saw a Family member or another Soldier being subjected to, then it is probably wrong. - You are confused and you do not know if it is right or wrong seek help and guidance.

4. What was the Law of Land Warfare derived from?

- Lawmaking treaties or conventions (such as The Hague and Geneva Conventions). - Customary International Law (unwritten customary law binding on all States developed from a general and consistent practice of States followed by them out of a sense of legal obligation). Under the U.S. Constitution, treaties constitute part of the Supreme Law of the Land and, thus, must be observed by both military and civilian personnel. The Customary International Law is also part of U.S. law. It is binding upon the U.S., citizens of the U.S., and other persons serving this country.

11. Understand how to use the DoD Insect Repellent System. What are the three components?

- Permethrin on uniforms and bed nets. - A 33 percent N, N-diethyl-meta-toluamide (DEET) insect repellent applied to exposed skin. - Proper wearing of the uniform.

17. What are the three considerations for the amount of water necessary to sustain Soldiers?

- Season of the year. - Geographical location. - Tactical situation.

12. How can you avoid potential heat injury?

- Soldiers must become acclimatized. Significant heat acclimatization requires at least three to five days and full acclimatization can take up to two weeks. - Use sunscreen on all exposed body parts. - Drink plenty of water, depending on the heat and activity level, Soldiers may need to drink from ½ to 1½ quarts of water per hour. Three gallons or 12-quarts per day in hot, dry climates. Drinking water is a must in order to prevent heat Illness. - Use work/rest cycles, as leaders direct. A rest period helps prevent dangerous increases in body temperatures by minimizing heat production. - Eat all meals to replace salts; eating all meals in the field will usually provide the body's requirements for salts. Field rations are designed to meet the daily requirements for minerals and electrolytes (sodium). - Modify the uniform, when directed/authorized by the commander to reduce heat stress and to protect against ultraviolet radiation.

1. What are the principles of detainee health care?

- Treat enemy casualties and detainees with the same ethics and medical standards of care as for multinational forces. Triage by medical condition only. - Treat all detainees with dignity and respect for the culture, age, and gender. Cavity searches may be performed for legitimate medical reasons, but if done for purposes of a search, must be approved by the first general officer in the chain of command. - Detainees have the right to informed consent and the right to refuse medical treatment and medication unless such refusal could jeopardize their life or the safety of others. - All detainee health care/examinations must be documented in their medical record. - All allegations or possible signs/symptoms of abuse, torture, or maltreatment must be immediately reported to the Criminal Investigation Division, as well as detainee operations and medical chains of command, regardless of who may be involved, where it occurred, or when it occurred. - Health care personnel will never participate in interrogations, provide detainee medical information to interrogation personnel, or serve as a detainee guard. - Maintain the moral high ground. How would you want to be treated?

32. How do FSTs assist commanders in preventive foodborne illnesses?

- Unit field sanitation teams assist commanders and fellow Soldiers in preventing foodborne illnesses by inspecting— - Unit-level food handling personnel and facilities to ensure a high level of personal hygiene, cleanliness, and sanitation. - Procedures for food being transported to remote feeding sites. - Unit feeding sites for safe recommended distances in relation to waste disposal sites and latrine facilities. - Placement and maintenance of handwashing/sanitizing facilities.

42. What are the different types of urine disposal?

- Urine Disposal Facilities - Disposable Urine Collection devices - Manufactured Urine Disposal Devices - Improvised Urinals - Urine Soakage Pit - Pipe Urinals - Trough Urinal - Urinoil

13. How can you avoid potential cold injury?

- Wear clothing as directed by commanders and leaders. - Wear clothing in loose layers (top and bottom). Avoid tight clothing, including tight underwear. - Keep clothing clean and dry. - Remove or loosen excess clothing when working or in heated areas to prevent sweating. - Wear headgear to prevent body heat loss. The body loses large amounts of heat through the head. - Change wet/damp clothes as soon as possible. - Keep the body warm by continuing to move, if possible. - Exercise large muscle groups (arms, shoulders, trunk, and legs) frequently to keep warm. - If Soldiers must remain in a small area, exercise the toes, feet, fingers, and hands. - Avoid the use of alcohol as it makes the body lose heat faster. - Avoid standing directly on cold, wet ground, when possible. - Avoid tobacco products. Using tobacco products decreases blood flow to the skin. - Eat all meals to maintain energy. - Drink plenty of water and/or warm nonalcoholic fluids. Dark yellow urine indicates that Soldiers are not drinking enough fluids!

8. What is the process for a compassionate release?

-Submit and track compassionate release candidates (elderly detainees 65 years or older, complex or chronic medical problems, terminal or end-stage conditions, problems that cannot be treated within the theater medical system, and problems that require constant supervision or that restrict movement and/or personal care) to avoid inappropriate transfers or on-going difficulty within the theater internment facility. -Compassionate release requests must be submitted to the higher command governing detainee operations via secret internet protocol router network. All requests must be cleared through military intelligence and the staff judge advocate before the request is submitted to the commander, detainee operations.

5. What are the four separate international treaties of the Geneva Conventions? (understand the highlighted articles in each of the four treaties)

-The first Geneva Convention protects wounded and sick soldiers on land during war. -The second Geneva Convention protects wounded, sick and shipwrecked military personnel at sea during war. -The third Geneva Convention applies to prisoners of war. -The fourth Geneva Convention affords protection to civilians, including in occupied territory.

25. What are viral infections? Know the different types listed.

A viral infection is caused by a virus and is often the cause of minor illness, such as a cold or the stomach flu. A viral infection usually causes many different symptoms that often come on quickly (over hours to a day or two) without prior illness. Viral infections that cause minor illnesses are usually not serious and go away without medical treatment. -Hepatitis, Norovirus,

23. What are bacterial infections? Know the different types listed.

Bacteria are microscopic life forms. They are single-celled, often parasitic microorganisms without distinct nuclei or organized cell structures. Various species are responsible for decay, fermentation, nitrogen fixation, and many plant and animal diseases. -Campylobacteriosis, Travelers Diarrhea, Cholera, Escherichia Coli (E. coli), Legionnaires Disease, Leptospirosis,Metabolite of Cyanobacteria, Salmonellosis, Typhoid, Shigellosis

29. Understand how to use iodine tablets to disinfect water.

CANTEENS To disinfect the water in a canteen you: - Fill the canteen with the cleanest, clearest water available. - Add two iodine tablets to each one-quart canteen full of water, or four tablets to two-quart canteens. A two percent solution of tincture of iodine may be used in place of iodine tablets. Note. Five drops of two percent iodine liquid are equivalent to one iodine tablet. - Put the cap on the canteen. Shake the canteen to dissolve tablets. - Wait five minutes. Loosen the cap and tip the canteen over to allow leakage around the canteen threads. - Tighten the cap and wait an additional 25 minutes before drinking.

15. What are the injuries that could come from carbon monoxide, smoke, bore/gun gases, and fuel/solvents/grease/oils? How can you protect yourself against them?

Carbon monoxide— Is a colorless, odorless, and tasteless gas that causes headache, sleepiness, coma, and death. Smoke used for obscuration and signaling— Is a very irritating gas that can cause severe coughing, wheezing, and lung damage, if inhaled. Bore/gun gases— Is an extremely irritating gas that reacts with body fluids to produce hydrochloric acid in the throat, lungs, and eyes. It causes coughing, acid burns to tissues, and flu-like lung disease. Fuel, solvents, grease, and oils— Cause skin rashes, burns, drying, and infections. They also cause damage to the liver, blood, and brain.

Carcinogens

Carcinogens are materials that have demonstrated that they cause cancer or are suspected of causing cancer.

16. How should commanders and FSTs plan for field sanitation devices?

Commanders can plan for the construction and maintenance of field sanitation devices by determining the type of devices required. The most common type of human waste disposal devices in field sites are chemical toilets. When moving, individual waste collection bags are the primary type of collection device used. When prefabricated latrine facilities are not available, the type of improvised waste disposal facilities used depends on the mission, length of stay in the area, terrain, and weather conditions. If chemical toilets are not available, the burn-out latrine is the preferred improvised waste disposal device. Select location for field latrines as follows: - As far from food operations as possible (100 meters or more). Downwind and downslope, if possible. - Downslope from wells, springs, streams, and other water sources (30 meters or more).

55. What are other conditions associated with cold weather and the treatment?

Dehydration - Replace lost water. Water should be sipped, not gulped and warm fluids are helpful for rewarming the body. Get medical treatment if necessary. Carbon Monoxide Poisoning - Move to fresh air and administer oxygen if available, provide cardiopulmonary resuscitation if needed and evacuate. Snow Blindness - Rest in total darkness; bandage eyes with gauze. Evacuate if no improvement within 24 hours

Disinfection

Disinfection is a water treatment process in which pathogenic (disease-producing) organisms are destroyed or otherwiseinactivated. Common methods of disinfecting drinking water include boiling, ultraviolet radiation, and various procedures using chlorine, chlorine dioxide, iodine, or ozone. The preferred field method of water disinfection in the United States Army is chlorination which can be accomplished using chlorine compounds such as calcium hypochlorite (granular) and sodium hypochlorite (liquid bleach). Disinfection is usually the last process and final treatment barrier to microbiological contaminants in water treatment systems. Disinfection involves exposing the water to an oxidant for a specific period of time to kill or inactivate pathogenic microorganisms that were not removed by the preceding treatment processes. The disinfectant may also oxidize certain chemical contaminants that passed through the previous treatment steps. A secondary purpose for disinfecting military drinking water is to provide a measurable disinfectant residual in storage and distribution systems as a sentinel to post-treatment contamination and to prevent or minimize biofilm growth.

Gray Water

Gray water refers to wastewater from nonlatrine sources such as showers, laundry, kitchen operations, vehicle wash racks, and hand wash devices

46a. How do yopu prevent rabies?

How to prevent rabies: - Do not adopt mascots or pets when deployed. This practice, though common, is highly discouraged and dangerous. - Do not approach, feed or handle wild or stray animals. - If you are bitten or get animal saliva on broken skin or in your eyes or mouth, immediately wash the area with soap and water and seek immediate medical attention. Rabies is preventable if exposed individuals receive prompt medical care after being exposed. - Report animal exposures immediately. - Capturing animals for observation or euthanizing animals for rabies testing is best performed by qualified veterinary or force health protection personnel who are already vaccinated against the disease. If the animal is killed, its intact head should be placed in a waterproof bag; packed in ice, and carried to a veterinary or medical laboratory for examination to determine if rabies infection is present. - Local regulations requiring vaccination and restraint of pets are vital. They afford our domestic animal population with protection from wildlife reservoirs of rabies.

46. What are the key facts about rabies?

Key facts about rabies are as follows: - Rabies is a viral disease that can be transmitted to humans through the saliva of infected mammals. - Animals present in deployment settings are not vaccinated against rabies as pets are in the United States. - Humans can be infected with rabies by being bitten by infected animals or getting saliva from infected animals in open wounds, mouth, or eyes. - You cannot always tell if an animal has rabies. Once the signs and symptoms of rabies develop, the disease is almost always fatal in man. - Rabies is preventable. Treatments for rabies are available at medical treatment facilities. Survival requires extensive supportive care to maintain ventilation and nutrition; only three humans have survived rabies and only one without permanent after effects of the disease.

37. How should food containers be labeled?

Label each food container after it is filled. A good label can be made by placing a strip of masking tape across the top of the container lid. Write the menu item, the number of servings, the date, the time the item was placed in the container, and consume by or discard (fill in the time, the entry should state the time 4 hours after the container was filled) on the tape. If the food is transported to other sites, use a code letter or color to identify each site. Make sure that each site has a complete menu. Write the menu items, the number of servings, the date and time prepared, consumed by or discard date and time, and the site code on each container label. For feeding small units, put a separate insert of meat, starch, and vegetable in each insulated food container.

2. What are the five categories of the detainee health care system? - Limited Medical Value.

Medical conditions in which treatment provides little or no medical value, are not likely to provide substantial long-term gain, or are expressly for the detainee's convenience. Conditions in this category are usually excluded from the scope of services provided to detainees.

2. What are the five categories of the detainee health care system? Medically Necessary—Non-emergent

Medical conditions that are not immediately life-threatening but without care the detainee could not be maintained without significant risk of serious deterioration leading to premature death; significant reduction in the possibility of repair later without present treatment; or significant pain or discomfort which impairs the detainee's participation in activities of daily living. Conditions in this category are included in the scope of services provided to detainees.

2. What are the five categories of the detainee health care system? - Medically Necessary—Acute or Emergent.

Medical conditions that are of an immediate, acute, or emergent nature that without care would result in the rapid deterioration of the detainee's health, significant irreversible loss of function, or may be lifethreatening. Conditions in this category are included in the scope of services provided to detainees.

2. What are the five categories of the detainee health care system? - Extraordinary.

Medical interventions are deemed extraordinary if they affect the life of another individual, such as organ transplantation, or are considered investigational in nature. This category will not be provided unless directed by the appropriate authority.

48. How long does it take Soldiers to acclimatize to heat?

Most Soldiers' physiological responses to heat stress improve in 10 to 14 days of exposure to heat and regular strenuous exercise. Factors to consider in acclimatizing Soldiers are the wet bulb-globe temperature index; work rates and duration; uniform and equipment; and Soldiers' physical and mental conditions.

Nonpotable Water

Nonpotable water is water from an untreated source or treated source (including bottled water) that is not safe to drink. In the operational environment, water from any source that has not been tested and determined to be safe by preventive medicine personnel or another local medical authority for use as drinking water is considered nonpotable.

14. What are toxic industrial materials and what areas are they generally found? What are the commonly encountered gases and liquids?

Occupational hazards: - Exhaust from engines and fuel space heaters. - Gases from weapons firing, such as rockets and M8 smoke. - Solvents used to clean weapons. - Greases and oil from vehicle maintenance repair. - Detergents used to clean equipment. Industrial hazards: - Compressed gases. - Industrial solvents. - Hazardous chemical waste. - Materials used at water treatment plants. - Materials and water used at waste sewage and water treatment plants. Biological/radiological hazards include: - Medical waste. - Materials used at medical research facilities. - Radioactive isotopes. - Substances at nuclear power plants. - Depleted uranium. If necessary request preventive medicine assistance in identifying sources.

10. How can you avoid contracting water and foodborne disease?

Only eat and drink food and water from United States-approved sources. Do not buy foods, drinks, or ice from civilian vendors unless approved by veterinary personnel. Wash hands using soap and potable water as follows: - After using the latrine. - Before touching eating utensils or food. - After eating. - After handling any item that can potentially transfer germs. - Frequently during the work day to keep hands free of germs.

29. Understand how to use iodine tablets to disinfect water.

PERSONAL HYDRATION SYSTEMS To disinfect a personal hydration system bladder you: - Use two iodine tablets for 40-ounce water reservoirs, four iodine tablets for 70- or 72-ounce water reservoirs, and 6 for 100- or 102-ounce reservoirs. - Allow 30 minutes of contact time before consuming the water. - If the water to be treated is cloudy or discolored, either double the dosage or use the chlorination kit (water purification) in a separate container.

Packaged Field Water

Packaged field water is potable water that is produced and packaged in sealed containers by military water treatment personnel in the field. It may be issued to deployed units and personnel in plastic bags or bottles. The requirements for treatment, disinfection, and preventive medicine monitoring associated with field water supplies also apply to packaged water operations. Veterinary services personnel have the responsibility to evaluate, test, and approve military services water bottling equipment, systems, and processes, and preventive medicine has the responsibility for medical surveillance of the quality of water as it is produced and after it is in bottles and packages in bulk storage.

Palatable Water

Palatable water is cool, aerated, significantly free from color, turbidity, taste, and odor, and is generally pleasing to the senses. Palatable water is not necessarily potable and may contain disease or illness-causing substances

Pests

Pests are defined by the Department of Defense as arthropods, birds, rodents, nematodes, fungi, bacteria, viruses, algae, snails, marine borers, snakes, weeds, and other organisms (except for human or animal disease-causing organisms) that adversely affect readiness, military operations, or the well-being of personnel and animals; attack or damage real property, supplies, equipment, or vegetation; or are otherwise undesirable.

Potable Water

Potable water is water from a source that has been treated and approved by preventive medicine personnel to meet the short-term potability or long-term potability standards, and is therefore considered safest to drink for the period that the standards apply. Potable water may or may not be palatable.

6. What are preventive medicine measures and their principles?

Preventive medicine measures are simple, common sense actions that every Soldier can perform. Adhering to basic field hygiene and sanitation practices combined with the application of preventive medicine measures significantly reduces the spread of disease and greatly reduces or eliminates the incidence of disease and nonbattle injury. The principles of preventive medicine measures are: - Soldiers perform individual techniques of preventive medicine measures. - Field sanitation teams train Soldiers in preventive medicine measures and advise the commander and unit leaders on - implementation of unit-level preventive medicine measures. - Chain of command plans for and enforces preventive medicine measures.

10. What is considered a prohibited act?

Prohibited acts include killing, torture, medical/scientific experimentation, physical mutilation, removal of tissues/organs for transplantation, and causing serious injury, pain, and suffering.

35. What temperature ranges should potentially hazardous foods be stored?

Properly maintain potentially hazardous foods; hot foods at a product temperature of 135 degrees Fahrenheit (57 degrees Celsius) or above and cold foods at a product temperature of 41 degrees Fahrenheit (5 degrees Celsius) or below.

21. What are the two water sources and examples of each?

Raw water sources include surface water (rivers, streams, ponds, lakes, rain, ice, snow, seas, and oceans), ground water (wells or springs), and in some cases municipal water treatment systems located in the deployment area. Additional sources of potable water include commercially bottled water and packaged field water that are approved for use by veterinary service personnel.

52. What are the factors for heat injury?

Risk factors for heat injury include the following: - High heat category, especially on several sequential days (measure the wet bulb-globe temperature index when ambient temperature is over 75 degrees Fahrenheit). - Exertional level of training, especially on several sequential days. - Acclimatization. - Time (length of heat exposure and recovery time). - Not acclimatized to heat. - Exposure to any of the following in the previous two to three days: - Increased heat exposure. - Increased exertional levels. - Lack of quality sleep. - Poor fitness (unable to run two miles in less than 16 minutes). - Overweight. - Minor illness (cold symptoms, sore throat, low-grade fever, nausea, vomiting) will increase the amount of heat to be dissipated by the body. - Taking medications (either prescribed or over the counter)/supplements/dietary aids (for example, allergy or cold remedies, ephedra supplement) that inhibit sweating, such as atropine, antihistamines, some tranquilizers, cold medicines, and some antidiarrheal medications. - Use of alcohol in the last 24 hours especially the amount needed to cause hangovers. - Prior history of heat injury (any heat stroke, or more than two episodes of heat exhaustion). - Skin disorders such as heat rash and sunburn that prevent effective sweating. - Age more than 40 years old. - Heavy metals and hot foods and drinks (coffee and tea) add heat to the body and put unnecessary stress on the body. - Tight clothing is detrimental to heat loss from the body. Clothing should be loose so as not to restrict circulation or impede movement of air over the skin.

45. What are the six control techniques for rodents?

Rodent control starts with six basic steps that involve: - Survey - Environmental sanitation - Rodent proofing - Rodent ectoparasite (flea) control - Rodent killing - Maintenance.

40. What is wastewater? What are the disposal methods?

Roughly 80 percent of all water used for purposes other than human consumption ends up as wastewater which requires treatment and disposal. Black water refers to latrine wastewater containing human waste. Gray water refers to wastewater from nonlatrine sources such as showers, laundry, kitchen operations, vehicle wash racks, and hand wash devices. - Soakage Pits - Soakage Trenches - Evaporation Bed - Grease Trap - Baffle Grease Trap - Barrel Filter Grease Trap - Evaporation Bed - Soakage Area

58. What are the two types of noise?

STEADY NOISE Steady noise is noise that does not significantly change in intensity or frequency with time such as that produced by equipment and vehicles. IMPULSE NOISE Impulse noise (also referred to as impact noise or blast overpressure), is noise that is characterized by a sharp rise in intensity followed by a rapid decline in intensity, such as that produced by weapons fire. It cannot be measured accurately with an ordinary sound level meter.

28. Understand the process for determining chlorine residual.

Steps for using the chlorine residual test strips are: - Thoroughly wash hands before testing. - Flush water through the taps of the trailer for several seconds before wetting the test strip. - After wetting the test strip, carefully monitor the color changes of the strip. - Compare the color of the free chlorine pads on the test strip to the color chart on the bottle. Estimate the results when the color of the free chlorine pads on the test strip falls between two of the color blocks on the chart then record and report the chlorine residual as required. Procedures for using the N, N-Diethyl-1, 4 Phenylenediamine Sulfate test kit are: - Thoroughly wash hands before testing. - Flush water through the taps of the trailer for several seconds before filling the color comparator tube to a point just below the top of the tube. - Place one chlorine test tablet in the comparator and allow it to dissolve. - Hold the color comparator at eye level and toward a good light source. - Compare the color of the water with the color disc on the opposite side of the color comparator.

Systemic Poisons

Systemic poisons cause damage to internal organs such as the liver, kidney, central nervous system, or the cardiovascular system. For example, carbon tetrachloride produces necrosis of the liver.

7. The Geneva Conventions provide for the repatriation of?

The Geneva Conventions provide for the repatriation of: - Retained medical personnel once they are no longer needed to provide medical care to members of their own forces (Articles 28, 30, and 31, Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field). - Seriously wounded and sick POW.

12. What are the four "Ps" of abuse prevention?

The four "Ps" of abuse prevention are: - Priorities—Has a command philosophy that places honor and dignity at the top of priorities been established? - Policies—It is not good enough to tell everyone to do the right thing . . . put it in writing. - Procedures—Have systems in place that by nature reduce the potential for abuse. - Practices—Continuous exercise of a professional demeanor and conduct is required.

6. What is the importance of the words "respect" and "protect" in Article 12, Geneva Convention for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field?

The word respect means "to spare, not to attack," and protect means "to come to someone's defense, to lend help and support." These words make it unlawful to attack, kill, ill-treat, or in any way harm a fallen and unarmed enemy soldier. At the same time, these words impose an obligation to come to his aid and give him such care as his condition requires.

41. What are the four types of latrines that can be employed to meet the requirements of Soldiers in the field?

There are essentially four types of latrine systems that can be employed to meet the requirements of Soldiers in the field. These types of latrines are: - Portable/disposable latrine systems are especially useful for Soldiers who are mobile, or will only be in place for very short periods of time. - Chemical latrine systems are prefabricated latrines that are placed and serviced under contract from a trusted vendor. - Containerized latrine systems are a prefabricated component part of the Force Provider system. - Improvised latrine systems are latrines that are dug and/or constructed from readily available materials by the Soldiers who will use them. These systems are generally used when Soldiers are mobile or when they are just establishing a new base of operations.

29. Understand how to use iodine tablets to disinfect water.

To disinfect a five-gallon water can you: - Fill a five-gallon container with the cleanest, clearest water available. - Dissolve 40 iodine tablets in a canteen cup full of water to disinfect any type of water. - Add this solution to the five-gallon container of water and agitate the solution. - Place the cap on the container loosely. Wait five minutes and then agitate the container vigorously to allow leakage to rinse the threads around the neck of the can. - Tighten the cap and wait an additional 25 minutes before using the water for any purpose.

31. How do you disinfect a five-gallon water can with iodine tablets? Personal Hydration Systems? Canteens?

To disinfect a five-gallon water can you: - Fill a five-gallon container with the cleanest, clearest water available. - Dissolve 40 iodine tablets in a canteen cup full of water to disinfect any type of water. - Add this solution to the five-gallon container of water and agitate the solution. - Place the cap on the container loosely. Wait five minutes and then agitate the container vigorously to allow leakage to rinse the threads around the neck of the can. - Tighten the cap and wait an additional 25 minutes before using the water for any purpose. To disinfect a personal hydration system bladder you: - Use two iodine tablets for 40-ounce water reservoirs, four iodine tablets for 70- or 72-ounce water reservoirs, and 6 for 100- or 102-ounce reservoirs. - Allow 30 minutes of contact time before consuming the water. - If the water to be treated is cloudy or discolored, either double the dosage or use the chlorination kit (water purification) in a separate container. To disinfect the water in a canteen you: - Fill the canteen with the cleanest, clearest water available. - Add two iodine tablets to each one-quart canteen full of water, or four tablets to two-quart canteens. A two percent solution of tincture of iodine may be used in place of iodine tablets. Note. Five drops of two percent iodine liquid are equivalent to one iodine tablet. - Put the cap on the canteen. Shake the canteen to dissolve tablets. - Wait five minutes. Loosen the cap and tip the canteen over to allow leakage around the canteen threads. - Tighten the cap and wait an additional 25 minutes before drinking.

56. What are the routes of entry that toxic industrial materials can enter the body?

Toxic industrial materials can enter the body by various routes. The body's response to toxic industrial chemicals may vary markedly depending on the specific route of entry. Common routes of entry include: - Inhalation - Absorption - Ingestion - Injection

4. What is a FST dependent on support from brigade level and higher preventive medicine personnel?

Unit field sanitation teams are dependent on support from preventive medicine personnel at brigade and echelons above brigade for: - Field sanitation team certification training. - Field screening and presumptive analysis of water supplies. - Basic pest management and surveillance. - Limited application of pesticides. - Limited medical surveillance.

19. What is the responsibility of the FST in regards to water supplies?

Unit field sanitation teams are responsible for ensuring that unit bulk water supplies are thoroughly disinfected to eliminate the pathogens which are responsible for the spread of waterborne disease and maintaining appropriate chlorine residuals to ensure that the water remains pathogen-free