FC3

MASCAL

# of casualties exceeds medical resources, treatment and evacuation.

Snakes

2 poisonous, pit viper (rattlesnakes, copperheads, water moccasins) and coral snakes.

Vector

A carrier, transports a disease-causing organism/pathogen, from one host to another.

Other Detainees (OD)

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

Geneva Conventions

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

West Nile Virus (WNV)

A strain of encephalitis. Most people No symptoms, 20% mild symptoms, Fever, headache, body aches 1 out of 150 develop more severe symptoms.High fever, neck stiffness, coma, seizures, and paralysis. Death is usually in the elderly population. Treatment: Prevention and PPM

Detainees are protected against?

Acts of violence rape, forced prostitution, assault, theft, and bodily injury. They will not be subjected to medical or scientific experiments.

Mortuary Affairs

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

When should the human recovery operations begin?

After the area has been secure

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

Ambulances, Medical ships, Medical aircraft.

Encephalitis

Andes and Culex mosquitoes carry several viral diseases. Acute inflammatory disease that involve the central nervous system.

Arthropods

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

Detainee

Any person captured or detained by an armed force.

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

At least once a month by Camp Commander

What BATTLEMIND Stands For

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

Spiders

Brown recluse; dark, violin-shaped on its back. pain begins 1-4hrs. treat with tetanus, antibiotic & surgical excision. Black widow; red hourglass, symptoms 10-60 min, pain, muscle spasm, headache, nausea n vomiting lasting 24-36hrs. treat for antivenom, observe for 12-24hrs.

Minimal (Walking wounded; ambulatory)

Can be managed by self-aid or buddy-aid. -Examples: Minor lacerations and abrasions, Contusions, Sprains and strains, Minor combat stress problems, Burns that are 1st or 2nd degree burns that cover less than 20% TBSA, Upper extremity fractures w/o neurovascular compromise, Behavioral disorders or other obvious psychiatric disturbances, and Suspicions of blast injury, Symptomatic but unquantified radiation exposure.

Expectant

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

Delayed

Casualties with less risk of losing life or limb if treatment is delayed. -Examples: Open chest wound (w/o respiratory distress), abdominal wounds (w/o shock), Eye and central nervous system (CNS) injuries, Soft tissue wounds requiring debridement (removal of foreign material and dead or damaged tissue), Other fractures open or closed, 2nd & 3rd degree burns covering 20% or more of TBSA, Maxillofacial wounds w/o airway compromise, Genitourinary tract disruption.

Evacuation and Care of Detainees

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

Diseases associated with flies and cockroaches?

Cholera, Food-borne gastroenteritis, passive transmission.

What is Blackwater Fever?

Complication of malaria that is an acute fatal hemorrhagic state, with kidney failure. Mortality 20-30%

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

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

When is sick call held for detainees?

Daily

Viral Diseases spread by the Andes mosquito

Dengue Fever, Yellow Fever.

Responsibilities of Medic during triage

Depends on tactical and environmental situations, triage & treatment.

People Who Opportunities to Identify Warriors in Need of Care

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

"What NOT To Do"

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

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

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

Retained Person (RP)

Enemy personnel who are medical, chaplains or are in voluntary aid societies.

Treatment of Malaria

Evaluation by MO, Chemoprophylaxis, Avoid mosquitoes.

Attending Behaviors

Eye Contact: maintained but not seen as staring Attentive Posture: attend to your body language, match the Warrior's posture. Verbal Following: respond w/o diverting from original topic.

Signs and Symptoms of Malaria

Fever/chills, Headache, Muscle Aches, Sweats, Abdominal pain with diarrhea.

Why are mosquitoes important to the military?

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

Mites

Found in ares near mammals resting or watering areas. Causes; Scabies, Chiggers

Enemy Combatant (EC)

Global War on Terror (GWOT), detainees who, through their own conduct, are not entitled to the privileges and protection of the Geneva Conventions.

The International Community of the Red Cross

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

Immediate

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

Malaria

Humans get malaria from the bite of a malaria-infected FEMALE mosquito. Chloroquine is a standard anti-malaria medication. Time btn bite and appearance of symptoms is 7-30 days.

Post-Deplyment Health Reassessment (PDHRA)

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

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

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

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

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

Triage Categories

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

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

Inoculation: vector injects saliva; Mosquitoes malaria. Regurgitation: vector vomits; Fleas bubonic plague. Fecal Contamination: vector defecates. Crushing the Vector: vector smashed.

Civilian Internee (CI)

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

Temporary Morgues

It has neither the required equipment nor is it staffed; only a temporary holding area until the quartermaster can assume custody of the body.

Why Warriors May Not Seek Help

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

Lyme disease

Leading cause of vector-borne infectious disease in the U.S.Skin lesion, systemic symptoms and nuerologic, orthopedic and cardiac involvement in months to years. Development of red, slowly expanding "bulls eye" rash(erythema migrans) with tiredness,fever, headache, stiff neck, muscle and joint pain.

Sandflies

Like small mosquitoes. Spreads two main diseases: Sandfly Fever: acute, self-limiting viral disease. Leishmaniasis: disease found in 3rd world countries, also by domestic animals. Treatment by prevention and PPM.

Risk Factors Associated with Suicide

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

Post-Deployment Health Assesment (PDHA)

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

Does Medical Personnel guard detainees?

NO!

Can you cuff a detainee?

No! Detainees will not be handcuffed or tied, EXCEPT to ensure safe custody or when prescribed by a responsible medical officer.

What are the Initial Actions upon Capture?

Non-injured detainees will be humanely evacuated ASAP. Sick and wounded detainees will be evacuated separately. Body exams for valid medical reasons only by authorized individuals.

Skills Needed as a Battlemind Warrior Resiliency Healthcare Provider

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

Enemy Prisoner of War (EPW)

One who, while engaged in combat under orders of his or her government, is captured by the armed forces of the enemy.

Quartmaster

Personnel in charge of transportation and disposition of remains.

What are Civilians specifically protected from under the Geneva Conventions?

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

What are fleas effcient vectors for?

Plague, Typhus, Tularemia, Plague and typhus have been identified as potential bio-warfare agents.

Main Objectives of Battlemind Warrior Resiliency

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

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

Prevention (Avoid bites) the most effective way. Insect Bars (bed nets), Long-sleeved, loose fitting clothing, Chemical repellents (DEET on skin, Permethrin on fabric ) Education on eliminating or destroying mosquito habitats.

The Army Suicide Prevention Program Model is based on?

Prevention, intervention, and the integration of the installation/community resources.

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

Prevention.

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

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

What do the convetions and their protocols specifically protect?

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

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

Red Cross, Red Cresent, Red Crystal, Red Star of David

What are major causes of completed suicides?

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

What are medical aircrafts used for?

Removal of the sick and wounded and transport of medical personnel and equipment.

"What To Do" when confronted with suicide:

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

Five "Ss"

Search, Segregate Silence, Safeguard, Speed.

Two Basic Components of Battlemind

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

Types of Question to Ask

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

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

Small defensive arms.

Triage

Sort casualties to the types and seriousness of injury.

What TAIL Stands for

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

Immediate Danger Signals Related to Suicide

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

Department of Defense Suicide Prevention Programs Study Showed?

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

Resiliency

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

Iternational Humanitarian Law (IHL)

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

Active Transmission (Biological Transmission)

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

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

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

Envenomation

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

Battlemind

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

What is the most effective arthropod and why?

Ticks; can pass pathogen to egg when larva hatches is able to pass the disease upon eating its first meal.

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

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

Healthcare Providers Role in Battlemind Warrior Resiliency

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

Venom

Toxin produced by animals, scorpions, spiders and snakes.

How are human remains to be treated?

Treat human remains with respect, dignity, and reverence.

What are the Medical Standards of care for detaniees?

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

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

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

What Does WIRED Stand for

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

"Tail" Light Effect

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

Passive Transmission (Mechanical Transmission)

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

Three species of lice

body, head and crabs