Title: Health Service Support in a Nuclear, Biological, and Chemical Environment
Author: United States. Department of the Army
Release date: May 24, 2015 [eBook #49037]
Most recently updated: October 24, 2024
Language: English
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FM 4-02.7 (FM 8-10-7)
TACTICS, TECHNIQUES, AND PROCEDURES
OCTOBER 2002
HEADQUARTERS, DEPARTMENT OF THE ARMY
DISTRIBUTION RESTRICTION: Approved for public release; distribution is unlimited.
[*]FM 4-02.7 (FM 8-10-7)
FIELD MANUAL
HEADQUARTERS
NO. 4-02.7 (8-10-7)
DEPARTMENT OF THE ARMY
Washington, DC, 1 October 2002
HEALTH SERVICE SUPPORT IN A NUCLEAR, BIOLOGICAL,
AND CHEMICAL ENVIRONMENT
TACTICS, TECHNIQUES AND PROCEDURES
| Page | |||
| Preface | viii | ||
| CHAPTER | 1. | NUCLEAR, BIOLOGICAL, AND CHEMICAL WARFARE ASPECT OF THE MEDICAL THREAT | 1-1 |
| 1-1. | General | 1-1 | |
| 1-2. | Medical Threat | 1-1 | |
| 1-3. | Nuclear, Biological, Chemical, and Radiological Dispersal Device Threats—The Health Service Perspective | 1-2 | |
| CHAPTER | 2. | COMMAND AND CONTROL | 2-1 |
| 2-1. | General | 2-1 | |
| 2-2. | Health Service Support Command and Control Planning Considerations | 2-1 | |
| 2-3. | Health Service Support Command and Control Appraisal of the Support Mission | 2-2 | |
| 2-4. | Health Service Support Units | 2-2 | |
| 2-5. | Movement/Management of Contaminated Facilities | 2-3 | |
| 2-6. | Leadership on the Contaminated Battlefield | 2-5 | |
| 2-7. | Homeland Security | 2-6 | |
| CHAPTER | 3. | LEVELS I AND II HEALTH SERVICE SUPPORT | 3-1 |
| 3-1. | General | 3-1 | |
| 3-2. | Level I Health Service Support | 3-2 | |
| 3-3. | Level II Health Service Support | 3-2 | |
| 3-4. | Forward Surgical Team | 3-3 | |
| 3-5. | Actions Before a Nuclear, Biological, or Chemical Attack | 3-3 | |
| 3-6. | Actions During a Nuclear, Biological, or Chemical Attack | 3-4 | |
| 3-7. | Actions After a Nuclear, Biological, or Chemical Attack | 3-4 | |
| 3-8. | Logistical Considerations | 3-5 | |
| 3-9. | Personnel Considerations | 3-5 | |
| 3-10. | Disposition and Employment of Treatment Elements | 3-6 | |
| 3-11. | Civilian Casualties | 3-6 | |
| 3-12. | Nuclear Environment | 3-7 | |
| 3-13. | Medical Triage | 3-8 | |
| 3-14. | Biological Environment | 3-8 | |
| 3-15. | Chemical Environment | 3-9 | |
| 3-16. | Operations in Extreme Environments | 3-10 | |
| 3-17. | Medical Evacuation in a Nuclear, Biological, and Chemical Environment | 3-10 | |
| CHAPTER | 4. | LEVELS III AND IV HOSPITALIZATION | 4-1 |
| 4-1. | General | 4-1 | |
| 4-2. | Protection | 4-3 | |
| 4-3. | Decontamination | 4-8 | |
| 4-4. | Emergency Services | 4-10 | |
| 4-5. | General Medical Services | 4-11 | |
| 4-6. | Surgical Services | 4-11 | |
| 4-7. | Nursing Services | 4-12 | |
| 4-8. | Conventional Operations | 4-13 | |
| CHAPTER | 5. | OTHER HEALTH SERVICE SUPPORT | 5-1 |
| Section | I. | Preventive Medicine Services | 5-1 |
| 5-1. | General | 5-1 | |
| 5-2. | Disease Incidence Following the Use of Nuclear, Biological, and Chemical Weapons | 5-1 | |
| 5-3. | Preventive Medicine Section | 5-3 | |
| 5-4. | Preventive Medicine Detachment | 5-3 | |
| Section | II. | Veterinary Services | 5-4 |
| 5-5. | General | 5-4 | |
| 5-6. | Food Protection | 5-4 | |
| 5-7. | Food Decontamination | 5-4 | |
| 5-8. | Animal Care | 5-5 | |
| Section | III. | Laboratory Services | 5-5 |
| 5-9. | General | 5-5 | |
| 5-10. | Level II | 5-5 | |
| 5-11. | Level III | 5-5 | |
| 5-12. | Level IV | 5-6 | |
| 5-13. | Level V (Continental United States) | 5-6 | |
| 5-14. | Field Samples | 5-6 | |
| Section | IV. | Dental Services | 5-7 |
| 5-15. | General | 5-7 | |
| 5-16. | Mission in a Nuclear, Biological, or Chemical Environment | 5-7 | |
| 5-17. | Dental Treatment Operations | 5-7 | |
| 5-18. | Patient Treatment Considerations | 5-7 | |
| 5-19. | Patient Protection | 5-8 | |
| Section | V. | Combat Operational Stress Control | 5-9 |
| 5-20. | General | 5-9 | |
| 5-21. | Leadership Actions | 5-9 | |
| 5-22. | Individual Responsibilities | 5-10 | |
| 5-23. | Mental Health Personnel Responsibilities | 5-11 | |
| Section | VI. | Health Service Logistics | 5-11 |
| 5-24. | General | 5-11 | |
| 5-25. | Protecting Supplies In Storage | 5-12 | |
| 5-26. | Protecting Supplies During Shipment | 5-12 | |
| 5-27. | Organizational Maintenance | 5-12 | |
| Section | VII. | Homeland Security Response | 5-13 |
| 5-28. | Chemical, Biological, Radiological, Nuclear, and High-Yield Explosive Response | 5-13 | |
| 5-29. | Capabilities of Response Elements | 5-14 | |
| APPENDIX | A. | MEDICAL EFFECTS OF NUCLEAR, BIOLOGICAL, AND CHEMICAL WEAPONS AND TOXIC INDUSTRIAL MATERIAL | A-1 |
| A-1. | General | A-1 | |
| A-2. | Physical Effects of Nuclear Weapons | A-1 | |
| A-3. | Physiological Effects of Nuclear Weapons | A-4 | |
| A-4. | Biological Effects of Thermal Radiation | A-7 | |
| A-5. | Physiological Effects of Ionizing Radiation | A-8 | |
| A-6. | Handling and Managing Radiologically Contaminated Patients | A-10 | |
| A-7. | Radiological Patients in Stability Operations and Support Operations | A-13 | |
| A-8. | Effects of Biological Weapons | A-14 | |
| A-9. | Behavior of Biological Weapons | A-15 | |
| A-10. | Management of Biological Warfare Patients | A-16 | |
| A-11. | Effects of Chemical Weapons | A-17 | |
| A-12. | Behavior of Chemical Weapons | A-17 | |
| A-13. | Characteristics of Chemical Agents | A-19 | |
| A-14. | Management of Chemical Agent Patients | A-23 | |
| A-15. | Management of Toxic Industrial Material Patients | A-23 | |
| APPENDIX | B. | SAMPLE/SPECIMEN COLLECTION AND MANAGEMENT | B-1 |
| Section | I. | Introduction | B-1 |
| B-1. | General | B-1 | |
| B-2. | Sample/Specimen Background Information | B-2 | |
| B-3. | Sample/Specimen Collection and Preservation | B-3 | |
| B-4. | Chain of Custody | B-8 | |
| Section | II. | Sampling Techniques and Procedures | B-9 |
| B-5. | General | B-9 | |
| B-6. | Expended Material | B-11 | |
| B-7. | Environmental Samples | B-11 | |
| B-8. | Collection of Air and Vapors | B-12 | |
| B-9. | Collection of Water Samples | B-13 | |
| B-10. | Collection of Soil Samples | B-15 | |
| B-11. | Collection of Contaminated Vegetation | B-16 | |
| B-12. | Medical Specimens | B-16 | |
| B-13. | Collection of Medical Specimens | B-17 | |
| B-14. | Post Mortem Specimens | B-19 | |
| B-15. | Reporting, Packaging, and Shipment | B-20 | |
| B-16. | Handling and Packaging Materials | B-21 | |
| B-17. | Collection Reporting | B-23 | |
| B-18. | Sample/Specimen Background Documents | B-27 | |
| APPENDIX | C. | GUIDELINES FOR OPERATIONAL PLANNING FOR HEALTH SERVICE SUPPORT IN A NUCLEAR, BIOLOGICAL, AND CHEMICAL ENVIRONMENT | C-1 |
| C-1. | General | C-1 | |
| C-2. | Predeployment | C-1 | |
| C-3. | Mobilization | C-2 | |
| C-4. | Establish a Medical Treatment Facility | C-3 | |
| C-5. | Operate a Medical Treatment Facility Receiving Contaminated Patients. | C-4 | |
| C-6. | Preventive Medicine Services | C-5 | |
| C-7. | Veterinary Services | C-6 | |
| C-8. | Dental Services | C-6 | |
| C-9. | Combat Operational Stress Control | C-6 | |
| C-10. | Medical Laboratory Services | C-6 | |
| C-11. | Health Service Logistics | C-7 | |
| C-12. | Homeland Security | C-8 | |
| APPENDIX | D. | MEDICAL PLANNING GUIDE FOR THE ESTIMATION OF NUCLEAR, BIOLOGICAL, AND CHEMICAL BATTLE CASUALTIES | D-1 |
| Section | I. | Introduction | D-1 |
| D-1. | General | D-1 | |
| D-2. | Medical Planners' Tool | D-1 | |
| Section | II. | Medical Planning Guide for the Estimation of Nuclear, Biological, and Chemical Battle Casualties (Nuclear)—AMedP-8(A), Volume I | D-1 |
| D-3. | General | D-1 | |
| D-4. | Medical Planning Considerations | D-2 | |
| D-5. | Triage | D-3 | |
| D-6. | Evacuation | D-3 | |
| D-7. | In-Unit Care | D-3 | |
| D-8. | Hospital Bed Requirements | D-4 | |
| D-9. | Medical Logistics | D-4 | |
| D-10. | Medical Force Planning | D-4 | |
| Section | III. | Medical Planning Guide for the Estimation of Nuclear, Biological, and Chemical Battle Casualties (Biological)—AMedP-8(A), Volume II | D-4 |
| D-11. | General | D-4 | |
| D-12. | Medical Planning Considerations | D-6 | |
| D-13. | Triage | D-6 | |
| D-14. | Evacuation | D-6 | |
| D-15. | In-Unit Care | D-7 | |
| D-16. | Patient Bed Requirements | D-7 | |
| D-17. | Medical Logistics | D-7 | |
| D-18. | Medical Force Planning | D-8 | |
| Section | IV. | Medical Planning Guide for the Estimation of Nuclear, Biological, and Chemical Battle Casualties (Chemical)—AMedP-8(A), Volume III | D-8 |
| D-19. | General | D-8 | |
| D-20. | Medical Planning Considerations | D-10 | |
| D-21. | Triage | D-11 | |
| D-22. | Evacuation | D-11 | |
| D-23. | In-Unit Care | D-11 | |
| D-24. | Patient Bed Requirements | D-12 | |
| D-25. | Medical Logistics | D-12 | |
| D-26. | Medical Force Planning | D-12 | |
| APPENDIX | E. | EXAMPLE X-__, ANNEX__, TO HSS PLAN/OPERATION ORDER__, MEDICAL NBC STAFF OFFICER PLANNING FOR HSS IN AN NBC ENVIRONMENT | E-1 |
| APPENDIX | F. | EMPLOYMENT OF CHEMICAL AND BIOLOGICAL COLLECTIVE PROTECTION SHELTER SYSTEMS BY MEDICAL UNITS | F-1 |
| Section | I. | Introduction | F-1 |
| F-1. | General | F-1 | |
| F-2. | Types of Collective Protection Shelter Systems | F-1 | |
| Section | II. | Employment of the Chemically and Biologically Protected Shelter System | F-2 |
| F-3. | Establish a Battalion Aid Station in a Chemically Biologically Protected Shelter | F-2 | |
| F-4. | Division Clearing Station in a Chemically Biologically Protected Shelter | F-4 | |
| F-5. | Forward Surgical Team in a Chemically Biologically Protected Shelter | F-6 | |
| Section | III. | Employment of the Chemically Protected Deployable Medical Systems and Simplified Collective Protection Systems | F-8 |
| F-6. | Collective Protection in a Deployable Medical System-Equipped Hospital | F-8 | |
| F-7. | Chemically/Biologically Protecting the International Organization for Standardization Shelter | F-11 | |
| F-8. | Chemically/Biologically Protecting the Vestibules | F-12 | |
| F-9. | Chemically/Biologically Protecting Air Handler Equipment | F-12 | |
| F-10. | Establish Collective Protection Shelter Using the M20 Simplified Collective Protection System | F-12 | |
| F-11. | Casualty Decontamination | F-12 | |
| Section | IV. | Operations, Entry, and Exit Guidelines | F-13 |
| F-12. | Operations | F-13 | |
| F-13. | Decontamination of Entrance Area | F-13 | |
| F-14. | Procedures Prior to Entry | F-14 | |
| F-15. | Entry/Exit for the Collective Protection Shelter System | F-14 | |
| F-16. | Resupply of Protected Areas | F-17 | |
| APPENDIX | G. | PATIENT DECONTAMINATION | G-1 |
| Section | I. | Introduction | G-1 |
| G-1. | General | G-1 | |
| G-2. | Immediate Decontamination | G-2 | |
| G-3. | Patient Decontamination and Thorough Decontamination Collocation | G-2 | |
| G-4. | Patient Decontamination at the Battalion Aid Station (Level I) | G-5 | |
| G-5. | Patient Decontamination at the Medical Company Clearing Station (Level II) | G-5 | |
| G-6. | Patient Decontamination at a Hospital (Level III and IV) | G-5 | |
| G-7. | Prepare Hypochlorite Solutions for Patient Decontamination | G-5 | |
| G-8. | Classification of Patients | G-6 | |
| G-9. | Patient Treatment | G-6 | |
| Section | II. | Patient Decontamination Procedures | G-7 |
| G-10. | Decontaminate a Litter Chemical Agent Patient | G-7 | |
| G-11. | Decontaminate an Ambulatory Chemical Agent Patient | G-14 | |
| G-12. | Biological Patient Decontamination Procedures | G-18 | |
| G-13. | Decontaminate a Litter Biological Agent Patient | G-18 | |
| G-14. | Decontaminate an Ambulatory Biological Agent Patient | G-19 | |
| G-15. | Decontaminate Nuclear-Contaminated Patients | G-20 | |
| G-16. | Decontaminate a Litter Nuclear-Contaminated Patient | G-21 | |
| G-17. | Decontaminate an Ambulatory Nuclear-Contaminated Patient | G-21 | |
| APPENDIX | H. | FIELD EXPEDIENT PROTECTIVE SYSTEMS AGAINST NUCLEAR, BIOLOGICAL, AND CHEMICAL ATTACK | H-1 |
| H-1. | General | H-1 | |
| H-2. | Protection Against Radiation | H-1 | |
| H-3. | Expedient Shelters for Protection Against Radiation | H-2 | |
| H-4. | Expedient Shelters Against Biological and Chemical Agents | H-5 | |
| APPENDIX | I. | DETECTION AND TREATMENT OF NUCLEAR, BIOLOGICAL, AND CHEMICAL CONTAMINATION IN WATER | I-1 |
| I-1. | General | I-1 | |
| I-2. | Detection of Contamination in Water | I-1 | |
| I-3. | Procedures on Discovery of Contamination in Water | I-1 | |
| I-4. | Treatment of Contaminated Water | I-2 | |
| APPENDIX | J. | FOOD CONTAMINATION AND DECONTAMINATION | J-1 |
| J-1. | General | J-1 | |
| J-2. | Protection of Food From Contamination | J-2 | |
| J-3. | Nuclear | J-3 | |
| J-4. | Biological | J-4 | |
| J-5. | Chemical | J-5 | |
| GLOSSARY | Glossary-1 | ||
| REFERENCES | References-1 | ||
| INDEX | Index-1 | ||
DISTRIBUTION RESTRICTION: Approved for public release; distribution is unlimited.