CONCEPT OF OPERATIONS BUMEDINST 3400 1

File: 123096_sep96_decls22_0002.txt
Page: 0002
Total Pages: 3

Subject: CONCEPT OF OPERATIONS BUMEDINST 3400 1                          

Unit: VAR. BUMED  

Parent Organization: BUMED       

Box  ID: BX303801

Folder Title: VARIOUS BUMED DOCUMENTS FOLDER 1                                                                

Document Number:         17

Folder Seq  #:          1










         BUMEDINST 3400.1

             c. Echelon 3. HSS at echelon 3 has surgical and holding
         capabilities for stabilization before further evacuation. This
         echelon includes medical assets external to the amphibious task
         force or landing force. Hospital ships (T-AH), combat zone
         (CBTZ) fleet hospitals, and in-theater naval hospitals comprise
         these assets. To function in a contaminated environment, echelon
         3 facilities shall be protected and develop ambulatory and
         nonambulatory casualty decontamination stations. Additional
         requirements include staff decontamination stations with entry
         and exit airlocks and a CB detection capability to monitor the
         medical treatment areas for carry-over contaminants.

             d. Echelon 4. Longer term definitive and specialized care
         is provided by echelon 4 facilities. These include out-of-
         theater naval hospitals or the communication zone (COMZ) fleet
         hospitals. These medical facilities should have CB agent moni-
         toring capabilities for patients arriving from potentially con-
         taminated areas or via contaminated modes of transport. Patients
         requiring further evacuation will go to continental
         United States (CONUS) or other out-of-theater echelon 4 hospi-
         tals. Echelon 4 medical facilities shall be protected in case
         they become echelon 3 support in a threat area.

             e. Echelon 5. Provides full restorative and rehabilitative
         care to patients returning to CONUS.

         2. scenarios

             a. General Conditions. In naval operations there are three
         environments; shipboard, fixed shore, and amphibious operations.
         Figures 2, 3, and 4 depict casualty flow and handling between
         each echelon in a contaminated environment. Naval operations
         present unique problems in that casualty flow may cross from one
triage is required at all
         echelons to minimize bottlenecks at casualty decontamination
         stations.

             b. Shipboard. Ships may become contaminated directly as a
         result of an actual hit or nearby airburst. They may also become
         contaminated indirectly by clouds of vapor or aerosols which
         drift offshore. As noted in figure 2, initial casualties, which
         will primarily be exposed deck personnel or personnel within
         spaces contaminated by penetrating chemical munitions, should be
         moved to a collection area where initial triage and hasty decon-
         tamination can be performed before transfer to the medical space.
         Aboard ships in a contaminated environment, without collective
         protection, medical treatment will be limited, but should include
         administration of additional atropine and intravenous fluids,
         splinting of limbs, and control of bleeding. Since all personnel
         are presumed to be in IPE, additional lifesaving procedures would
         require a compromise of the protective mask and overgarments
         which would place both the patient and medical provider at
         significant risk. CRTS shall have protected medical spaces to

         Enclosure (1)                   2

Document 3 f:/Week-37/BX303801/VARIOUS BUMED DOCUMENTS FOLDER 1/concept of operations bumedinst 3400 1:12179609563221
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-37
Box ID = BX303801
Unit = VAR. BUMED
Parent Organization = BUMED
Folder Title = VARIOUS BUMED DOCUMENTS FOLDER 1
Folder Seq # = 1
Subject = CONCEPT OF OPERATIONS BUMEDINST 3400 1
Document Seq # = 17
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996