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133 Cards in this Set
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1. You are assigned as one of the company’s Field Sanitation Team members. Your commander told you that it is your responsibility to *construct and maintain* field waste disposal facilities. How do you respond to your commander? |
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. They accomplish this by: *SUPERVISING the placement, construction, and maintenance* of unit-level garbage disposal facilities and soakage pits; and the placement, construction, and maintenance of field latrines and urinals and then conducting regular sanitation inspections. |
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2. Calcium Hypochlorite is a method used to disinfect canteens. As a Field Sanitation Team member, how do you instruct your company to purify water in a one-Quart Canteen? (5 steps) |
The following procedures are used to purify water in a one-quart canteen with calcium hypochlorite ampules:
1) Fill the canteen with the cleanest, clearest water available, leaving an air space of an inch or more below the neck of the canteen.
2) 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.
3) 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.
4) Loosen the cap slightly and invert the canteen, letting the treated water leak onto the threads around the neck of the canteen.
5) Tighten the cap on the canteen and wait at least 30 minutes before using the water for any purpose. |
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3. You are a member of the preventative medicine team. Your team was tasked to conduct an inspection of the Dining Facility. During the inspection, your team leader assigned you to inspect all four refrigerators for proper temperature control. The refrigerators contain potentially hazardous food; (HOT/COLD) temperatures are reflected below.
What is your back brief to your team leader for the following? a. Refrigerator#1= 135/41 Degrees Fahrenheit b. Refrigerator#2= 130/45 Degrees Fahrenheit c. Refrigerator#3= 125/42 Degrees Fahrenheit d. Refrigerator#4= 120/50 Degrees Fahrenheit |
Properly maintain potentially hazardous foods; hot foods at a product temperature of 135 degrees Fahrenheit or above and cold foods at a product temperature of 41 degrees Fahrenheit or below.
"Refrigerator#1" is the only "refrigerator" with hot and cold foods held at the proper temperature. |
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4. You have just completed a company FTX. You were assigned as the team leader for the nonhazardous solid waste disposal detail. During the FTX site recovery planning meeting, your commander asked you to explain the primary options for nonhazardous solid waste disposal. How do you respond to your commander? |
The primary options for disposal of nonhazardous solid waste in the field are burning, burial, or backhauling. Within the United States all solid waste generated during field exercises must be backhauled to garrison or picked up by contractors. During overseas training exercises, host-nation requirements must be followed which normally require the same policies of backhauling or contract disposal. If incineration, burning, or landfilling is used during contingency operations, additional security measures must be taken to deter scavenging by local populations. |
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5. You are feeling excellent about all the recommendations you have provided to your commander. Planning for the FTX is going just as expected. The last task is to designate a perfect location for your latrines. What are some of the considerations for the placement of latrines? |
Considerations for the placement of latrines. Latrines must be:
1) Located at least 300 feet (100 yards) downwind and downhill from unit food service facilities and at least 100 feet from any unit ground water source.
2) Latrines are not dug to the ground water level or in places where pit contents may drain into the water source.
3) Located upwind of burn pits and landfills.
4) Lighted at night if the tactical situation permits, or staked off with rope or tape to serve as a guide.
5) Built at least 100 feet from border of the unit billeting areas but within a reasonable distance for easy access for troops.
6) A handwashing device is installed outside each latrine enclosure; these devices should be easy to operate and kept full of water.
7) Dig a drainage ditch around the edges of the latrine to keep out rainwater and other surface water.
Note. Chemical and containerized latrines must be placed so that service vehicles can access them for waste removal and cleaning.
For planning purposes, the number of latrines should be based on one toilet and urinal per 25 male Soldiers (1/25 or 4%), or one toilet per 17 female Soldiers (1/17 or 6%). |
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6. You are a part of the command team assigned to 61MMB. Your company was tasked to participate in the ongoing contingency operations. Which of the following latrines are most suited for this type of mission? Cat-Hole latrines, Portable latrines, Chemical latrines or Containerized latrines |
Containerized latrines are the preferred means of human waste disposal during contingency operations. The containerized latrine system, normally a component of Force Provider units, consists of six privacy stalls with low-water flush toilets, a trough urinal, two waste collection tanks (urinal and toilet waste are stored in separate tanks), two sinks with running hot and cold water, a six-gallon water heater, mirrors, and dispensers for toilet paper, paper towels and soap. An environmental control unit installed in the rear wall regulates internal temperature, and ventilation systems installed in the front wall and ceiling reduce odor. The containerized latrine system provides a private latrine facility with increased sanitation for 150 Soldiers. |
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7. Fill in the blanks. The Department of Defense Insect Repellent System is made up the following three components: ______________ on the uniform, ________________ on the skin, and the ___________________wear of the uniform. |
The Department of Defense Insect Repellent System is made up of the following three components:
1) *Permethrin* on the uniform. (and bed nets) 2) 33% *DEET* on the skin. 3) The *proper* wear of the uniform. |
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8A. Heat Injury: Exposure to the sun’s ultraviolet radiation without protection from clothing or sunscreen. |
Sunburn
Sunburn is caused by exposure to the sun’s ultraviolet radiation without protection from clothing or sunscreen. Over exposure to ultraviolet radiation can kill the cells that form the skin which is the body’s first line of defense for climatic exposure and infection. It can prevent effective sweating and increase a Soldiers risk for heat injury. Symptoms include edema, itching, peeling skin, rash, nausea, fever, syncope (fainting), and either first or second degree burns. Note. Soldiers must use Army approved sunscreen to protect exposed skin in any climate whether hot or cold. Army approved sunscreen can prevent sunburn and reduce the risk of skin cancers when used in accordance with the instructions on the product label. |
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8B. Heat Injury: Medical Emergency; to prevent permanent physiological damage or death, the Soldier’s condition must be quickly identified and treatment must begin immediately. |
Heat Stroke
Heat stroke is the result of the body’s heat balance mechanism collapsing and the primary method of heat loss (cooling by evaporation of sweat) is shut down. Early signs of heat stroke include headache, dizziness, delirium (mental confusion), weakness, nausea, vomiting, and excessive warmth; however, sweating may or may not be absent. The most significant sign of heat stroke is a body core temperature of over 106 degrees Fahrenheit with a rectal temperature exceeding 108 degrees Fahrenheit. Although the casualty may first progress through the symptoms of heat cramps or heat exhaustion, the onset of heat stroke may occur with dramatic suddenness with collapse and loss of consciousness. Profound coma is usually present and convulsions may occur. In the past, heat stroke victims were described as always having hot, red, dry skin. However it has been found that some heat stroke victims may just as often as not be moist from sweat. Therefore, upon initial evaluation, the skin cannot be the differentiating factor in deciding on the degree of the heat injury. Soldiers who have suffered from only one attack remain very susceptible to repeated heat injuries. Therefore, these individuals should avoid subsequent exposure to hot weather conditions. |
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8C. Heat Injury: Caused by restrictive clothing, excessive sweating, and inadequate hygiene. |
Heat Rash
Heat rash (prickly heat) is caused by restrictive clothing, excessive sweating, and inadequate hygiene. It can develop when sweat ducts become blocked and swell and often leads to discomfort and itching. Heat rash can prevent effective sweating and increase a Soldiers risk for heat injury. Heat rash looks like dots or tiny pimples. The affected areas can get irritated by clothing or scratching. In rare cases, a secondary skin infection my present itself and in that case look for signs of infection.
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8D. Heat Injury: Most common form of heat injury and is generally not associated with evidence of organ damage. |
Heat Exhaustion
Heat exhaustion is the most common form of heat injury and is generally not associated with evidence of organ damage. It is a result of peripheral vascular collapse due to excessive salt depletion and dehydration. This condition is the result of excessive loss of both salt and water, usually due to profuse sweating as the body attempts to cool itself. As evidenced by the profuse sweating, with heat exhaustion the body’s heat balance mechanism is still functioning normally. Classic symptoms include profuse sweating, trembling, weakness, loss of coordination. Additional symptoms may include headache, tingling in the hands and feet, paleness, difficulty breathing, irregular heartbeat, loss of appetite, nausea, and vomiting. The skin is generally cool and moist from the evaporation of sweat, the pulse rate is rapid (120 to 200 beats per minute), blood pressure may be low, and body temperature may be lower than normal (as in cases where hyperventilation is present) or slightly elevated, but the rectal temperature is usually elevated.
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9. Fill in the moderate work/rest cycle timelines for the Wet Bulb-globe temperatures (WBGT) below: (picture not included) |
*Review work/rest and water consumption guide. (No limit = NL, quarts per hour = qt/hr, wet bulb globe temperature = WBGT)
Heat Cat 1 - WBGT Index 78-81.9 °F Easy Work: NL work/rest, 1/2 qt/hr water Moderate Work: NL work/rest, 3/4 qt/hr water Hard Work: 40/20 work/rest, 3/4 qt/hr water
Heat Cat 2 (Green) - WBGT Index 82-84.9 °F Easy Work: NL work/rest, 1/2 qt/hr water Moderate Work: 50/10 work/rest, 3/4 qt/hr water Hard Work: 30/30 work/rest, 1 qt/hr water
Heat Cat 3 (Yellow) - WBGT Index 85-87.9 °F Easy Work: NL work/rest, 3/4 qt/hr water Moderate Work: 40/20 work/rest, 3/4 qt/hr water Hard Work: 30/30 work/rest, 1 qt/hr water
Heat Cat 4 (Red) - WBGT Index 88-89.9 °F Easy Work: NL work/rest, 3/4 qt/hr water Moderate Work: 30/30 work/rest, 3/4 qt/hr water Hard Work: 20/40 work/rest, 1 qt/hr water
Heat Cat 5 (Black) - WBGT Index >90 °F Easy Work: 50/10 work/rest, 1 qt/hr water Moderate Work: 20/40 work/rest, 1 qt/hr water Hard Work: 10/50 work/rest, 1 qt/hr water
Notes: The work/rest times and fluid replacement volumes will sustain performance and hydration for at least 4 hours of work in the specified heat category. Individual water needs will vary ± ¼ qt/hr. Rest means minimal physical activity (sitting or standing), accomplished in the shade if possible. CAUTION: Hourly fluid intake should not exceed 1½ quarts. Daily fluid intake should not exceed 12 quarts. Wearing body armor in humid climates adds 5°F to the WBGT index. Wearing chemical, biological, radiological, and nuclear protective ensemble in humid climates adds 10°F to the WBGT index. |
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10A. Noise: this determines pitch; high-pitched noises are more dangerous to hearing than low-pitched noises. |
Frequency
The frequency of a noise determines its pitch, which is that attribute of an auditory sensation in which sounds may be ordered on a scale extending from low to high. High-frequency (high-pitched) noises are more dangerous to hearing than low-frequency (low-pitched) noises.
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10B. Noise: the relative loudness of the noise, expressed in decibels, will play a large part in determining the degree of hazard; the louder the noise, the greater it’s potential for causing hearing loss. |
Intensity
The relative loudness of the noise, expressed in decibels, will play a large part in determining the degree of hazard; the louder the noise, the greater it’s potential for causing hearing loss.
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10C. Noise: may be continuous or intermittent; it may be steady or made up of a series of impact or impulse noises. |
Nature of the Noise
Noise may be continuous or intermittent. It may be steady or made up of a series of impact or impulse noises.
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10D. Noise: the longer the exposure, the greater the damage to the hearing mechanism. |
Exposure Duration
The longer the exposure, the greater the damage to the hearing mechanism. Exposure duration is usually expressed in terms of a time-weighted average, which takes into account both intensity of noise and duration of the exposure. |
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11. You are a member of the Field Sanitation Team. You are responsible for ensuring that the unit water supply is safe for human consumption. From the terms listed below, your task is to select and explain the best term that describes water that is safe for consumption. Non-potable Water, Palatable Water, 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.
Versus...
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.
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.
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12. Iodine Tablet is a method used to disinfect Five-Gallon Water Cans. As a Field Sanitation Team member, how do you instruct your company to purify water in a Five-Gallon Water Can? (5 steps) |
To disinfect a five-gallon water can using iodine tablets you:
1) Fill a five-gallon container with the cleanest, clearest water available. 2) Dissolve 40 iodine tablets in a canteen cup full of water to disinfect any type of water.
3) Add this solution to the five-gallon container of water and agitate the solution.
4) 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. 5) Tighten the cap and wait an additional 25 minutes before using the water for any purpose. |
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13. Historical accounts of wars, battles, and military training consistently show that the majority of losses to armies are not the result of combat injuries but rather disease and non-battle injury. What are some health threats to Soldiers in the field? (8 health threats) |
Health threats to Soldiers in the field include:
1) Endemic diseases.
2) Food and waterborne diseases.
3) Hazardous plants and animals.
4) Entomological hazards (nuisance pests and disease-carrying vectors).
5) Toxic industrial materials (industrial and agricultural). 6) Deployment-related stress. 7) Hazardous noise. 8) Climatic or environmental extremes (heat, cold, wind-blown sand, or other particulates). |
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14. Use _______________ percent N, N-diethyl-meta-toluamide (DEET) insect repellant to exposed skin to prevent disease, pain, and the annoyance caused by bites of arthropods. |
33% DEET insect repellent applied to exposed skin |
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15. During the deployment planning meeting, water consumption in a temperate climate was one of the main topics. To ensure sufficient water is available during the deployment, how much water is needed per man per day? |
A guide for planning to meet water requirements in a temperate climate is 5 gallons per man per day for drinking and cooking. If showering facilities are to be made available, the amount required will be at least 15 gallons per man per day.
(A Soldier performing normal duties in a hot and dry climate may require as much as 2 to 6 gallons of water per day for drinking purposes. In a cooler climate the Soldier may require only 1/2 to 1 gallon of drinking water per day for the same level of exertion.)
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16A. Toxic Industrial Materials: materials that cause inflammation of mucous membranes with which they come in contact. |
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. |
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16B. Toxic Industrial Materials: materials that deprive the respiratory tissues of oxygen; they do not damage the lungs. |
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. |
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16C. Toxic Industrial Materials: agents whose main toxic action is their depressant effect upon the central nervous system, particularly the brain. |
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. |
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16D. Toxic Industrial Materials: cause damage to internal organs such as the liver, kidney, central nervous system, or the cardiovascular system. |
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. |
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17. Maintaining good hearing is critical during garrison as well as in a field environment. What are some of the benefits of good hearing during offensive or defensive operations? (8 benefits) |
Good hearing is critical to the success of the Army mission, both in offensive and defensive operations and is essential for: 1) Aiding in small arms accuracy, weapons identification, and target acquisition.
2) Determining the position, number, and type of friendly or enemy vehicles. 3) Hearing enemy movement. 4) Hearing radio messages and verbal orders. 5) Hearing the activation of perimeter alarms. 6) Localizing snipers. 7) Locating patrol members. 8) Recognizing foreign language being spoken.
Hearing loss caused by loud noise becomes permanent and is not medically treatable. Impaired hearing can cause serious or fatal mistakes at work or during training and in combat. |
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18. Wastewater management plan is essential to ensure proper health of Soldiers in the field. Waste water is organized into two categories---gray and black water. What percentage of all water used for purpose other than human consumption ends up as wastewater? |
Roughly 80% of all water used for purposes other than human consumption ends up as wastewater which requires treatment and disposal. |
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19. Depending on the source, some water may need disinfecting prior to consumption. At unit level, what are some of the chemicals Soldiers rely on to disinfect drinking water? (3 chemicals) |
Members of unit field sanitation teams and Soldiers in the field rely on the following chemicals to disinfect drinking water: 1) Calcium hypochlorite (white powder) 2) Water purification tablets, chlorine 3) Water purification tablets, iodine |
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20. Prevention of waterborne diseases is accomplished by employing field water disinfectants provided in the field sanitation teams equipment sets; _______________________________; conducting inspections; and enforcing simple rules of water discipline which include: Drinking water from approved sources only, ______________________, and _________________________. |
(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.)
They accomplish this task by: 1) employing field water disinfectants provided in the field sanitation teams equipment sets 2) issuing individual water disinfectants 3) conducting inspections 4) and enforcing simple rules of water discipline.
The rules of water discipline are: 1) Drink water from approved sources only. 2) Prevent water waste. 3) Protect water sources with good sanitary practices. |
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21A. Arthropods: represents the most substantial and continuous noncombat threat to Soldiers during deployments. |
Disease Transmission. Transmission of arthropod or vectorborne disease represents the most substantial and continuous noncombat threat to Soldiers during deployments. Historically, vectorborne diseases have produced far more morbidity and mortality (greater than 60 percent) among United States military forces during modern wars than battle injury and nonbattle injury combined. Others with their long convalescent period cause a manpower drain resulting in a major economic loss every year. Mosquitoes, flies, lice, fleas, mites, and ticks are among the most important vectors of arthropodborne diseases. |
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21B. Arthropods: injection of venom (toxins) into the body through bites and/or stings and is perhaps the most rapid and harmful response arthropods can inflict on humans. |
Envenomation is the injection of venom (toxins) into the body through bites and/or stings and is perhaps the most rapid and harmful response arthropods can inflict on humans. The response of such envenomation can range from swelling, irritation, pain, sometimes paralysis, mild irritation and limited necrosis of tissue to systemic failure and death. The venoms producing these conditions are broadly grouped as either neurotoxic or necrotic. Neurotoxic venoms are those that negatively affect the nervous system while necrotic venoms are those that destroy blood and tissue. Occasionally, the venom of some arthropods contains both neurotoxic and necrotic properties. In addition to injecting venom, some caterpillars and beetles produce toxins that cause dermatitis when contacted. |
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21C. Arthropods: invasion of the tissue of man or animals with the larvae (maggots) of certain flies that consume flesh or body fluids for sustenance. |
Myiasis is the invasion of the tissue of man or animals with the larvae (maggots) of certain flies that consume flesh or body fluids for sustenance. Such invasions may be benign or even asymptomatic, or they may result in more destructive disturbances. Cutaneous myiasis is the traumatic invasion of tissue and the most significant form of myiasis. Myiasis has tremendous potential for psychological disturbance among afflicted Soldiers. |
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21D. Arthropods: can be localized and the range of severity, including death, is broad. |
Soldiers may experience allergic reactions (a hypersensitive reaction to insect protein) when they come in contact with the venom, saliva, or certain body parts of arthropods. Reactions can be localized (wheals, swelling) or systemic (anaphylactic shock), and the range of severity, including death, is broad. This condition may occur among people with repeated prolonged exposure to the same type insect, such as beekeepers or workers in insectaries. It may also result from a single exposure to insects with highly allergenic proteins, such as flies or gypsy moth caterpillars. |
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22. You were given the task to instruct your platoon on how to properly compute the wet bulb-globe temperature index. What is a key note to reminder regarding the ambient temperature? |
Measure the wet bulb-globe temperature index when the ambient temperature is over 75 degrees Fahrenheit. |
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23. There are 60 male Soldiers and 20 female Soldiers in your company. How many toilets and urinals are required to accommodate the number of Soldiers assigned to your company? |
(For planning purposes, the number of latrines should be based on 1 toilet and urinal per 25 male Soldiers (1/25 or 4%), or 1 toilet per 17 female Soldiers (1/17 or 6%).
(60 males)x(0.04 latrines/male)=2.4 --> 3 latrines (60 males)x(0.04 urinals/male)=2.4 --> 3 urinals
(20 females)x(0.06 latrines/female)=1.2 --> 2 latrines
*Need 3 male latrines, 3 urinals, and 2 female latrines. Or need 3 urinals and 5 total latrines. |
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24. Fill-in the missing letter. The major diseases caused by the s__n__ f__y are l__i__h__a__i__s__s, s__n__ f__y f__v__r, and b__r__o__e__l__s__s |
The major diseases caused by the sand fly are leishmaniasis, sand fly fever, and bartonellosis.
(Review ATP 4-25.12, Table 6-2. Arthropods of military importance and the major diseases they transmit.) |
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25. You have just deployed your unit to Afghanistan. It is now June and you have only been on ground for one week. On an average, how much longer will it take for your Soldiers to get acclimatized to their new environment? |
It willl take about 1 more week to acclimate, since Soldiers need about 2 weeks to heat acclimate.
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. |
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26. When conducting Detainee Operations, it is a best practice to be familiar with all legal considerations that will affect the way Detainees are handled. As a newly assigned team leader, how do you brief your team on the Law of Land Warfare prior to your upcoming deployment? |
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:
1) Protecting both combatants and noncombatants from unnecessary suffering.
2) 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. 3) Facilitating the restoration of peace.
The Law of Land Warfare places limits on the exercise of a belligerent’s power in the interest of furthering that desire (diminishing the evils of war) and it requires that belligerents:
1) Refrain from employing any kind or degree of violence that is not actually necessary for military purposes.
2) Conduct hostilities with regard for the principles of humanity.
The Law of Land Warfare is derived from two principal sources:
1) Lawmaking treaties or conventions (such as The Hague and Geneva Conventions).
2) 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. |
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27. You are a medic/provider assigned to an Aid Station at FOB Orgun-E Afghanistan. Detainees are being kept in a holding facility located on your FOB. It has being brought to your attention that for the past four days two of the four detainees are refusing to eat the meals they have been provided. Are you required to take any actions? If so, what actions should/must you take? |
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. Health care personnel will isolate the detainee in a single occupancy observation room and deny him contact with other detainees, when medically advisable. If measuring food and liquid intake or output becomes necessary, health care personnel may place the detainee in a special management unit or in a locked MTF room. The detainee may remain in the special management unit, based on the detainee’s medical condition, until health care personnel determine a move advisable. The medical officer will immediately report the hunger strike to the TIF commander.
Medical staff shall monitor the health of a detainee on a hunger strike. If the detainee is engaging in a hunger strike due to a mental condition, appropriate medical action will be taken. During the initial evaluation of a hunger-striking detainee, the medical staff will: 1) Measure and record the detainee’s height and weight. 2) Measure and record vital signs.
3) Perform a urinalysis.
4) Conduct a psychological/psychiatric evaluation.
5) Examine the detainee’s general physical condition and if clinically indicated, proceed with radiographs and or laboratory studies.
6) Take and record weight and vital signs at least once every 24-hours during the hunger strike.
7) Take other medical measures as required. |
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28. You are the commander for an Area Support Medical Company located in Afghanistan. A request for dental support was sent to you from the Aid Station at FOB Orgun-E. This support includes treatment of detainees at the Theater Internment Facility (TIF). You got in a heated discussion with your assigned Dental Provider whether or not dental treatment is a service rendered at the TIF. As the commander, how do you advise your provider on TIF operations specific to dental care? (9 medical services provided at TIF) |
Medical services provided in the TIF to include: 1) Initial medical examinations.
2) Medical treatment (routine care, sick call, emergency services, hospitalization, and medical consultation and specialty care requirements).
3) Medical evacuation. 4) 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).
5) Dental services.
6) Veterinary service support (to include food safety, veterinary preventive medicine, animal health care, and oversight of animal welfare, as required). 7) Neuropsychiatric treatment and stress prevention (as required) and BH support.
8) Medical logistics (to include medical supplies, pharmaceuticals, medical equipment and medical equipment maintenance and repair, blood management, and optical lens fabrication). 9) Medical laboratory services for the clinical diagnosis of infectious diseases. |
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29. You are a team leader working the night shift at a BAS. You were just told that two detainees will be transported to your facility for treatment. You were also told that the detainees are very combative. What are some of the precautions you and your team members should be aware of prior to the arrival and during treatment of the detainees? |
Restraints in addition to the two-point standard (one arm and one leg) 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.
Any patient who becomes combative, or when otherwise medically indicated, may be restrained for his own safety and that of other patients and staff.
A gradually increasing level of appropriate restraint will be used. The first level will be physical restraints and typically will be either standard leather restraints of the wrist and/or ankles or a bed sheet specifically used to secure the patient to the gurney. |
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30. You have just provided treatment to a detainee at the TIF. The detainee will be transferred from your location to another holding facility. How does the Geneva Conventions affect the treatment, management and documentation and release of information of the detainee’s injury? |
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. The procedures outlined in AR 40-66 regarding the release of medical information for official purposes should be followed for detainee/EPW medical records.
Due to responsibilities of the TIF chain of command regarding the care and treatment of detainees/EPWs, they are entitled to some medical information. For example, detainees suspected of having infectious diseases, such as TB, should be separated from other detainees/EPWs. Releasable medical information on detainees and EPWs includes that which is necessary to supervise the general state of health, nutrition, and cleanliness of the security force, detainees, and EPWs, and to detect contagious diseases. The information released should be used to provide health care, to ensure the health and safety of detainees and EPWs, to ensure the health and safety of the personnel operating or working in the TIF, to ensure law enforcement on the premises, and to ensure the administration and maintenance of the safety, security, and good order of the TIF.
Detainees should be entitled to copies of their medical records upon release from the TIF. Copies of medical documentation provided to released detainees will have all U.S. military unit designation, health care provider, and other medical support personnel information (for example, name or provider number) redacted (removed or obliterated). |
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31. Sick call is a daily operation at your BAS. How do you incorporate sick call procedures and distribution of medication for detainees at your FOB? |
SICK CALL PRACTICES. Timeframes are established for sick call and distribution of medication to avoid abuse of the medical system. Medication pass (distribution) should not extend past a 2-hour timeframe, unless there are extreme circumstances. Detainees must present for any sort of medical encounter with his identification band on hand. This aids in confirmation of that detainee’s identity. In addition, the detainee must have water on hand for medication consumption. Absence of either the identification band or water can cause major delays in medication distribution as well as sick call. Allow a certain amount of time for sick call. Usually this should not exceed 3 hours, especially if there is no overhead cover for the personnel performing sick call. Setting limits permits the health care provider to command the situation, in contrast to allowing the detainee to dominate the encounter. Consider using a sign-up sheet, distributed at night, for the next day’s sick call “appointments.” Experience shows that an “open-access” system, now popular in clinics nationwide, can be cumbersome and overwhelming. Allow a standard number of sick call slots and plan for acute illness visits as well. |
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32A. 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. |
Security Internee |
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32B. Security internee of significant intelligence or political value. |
High Value Detainee |
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32C. Any person previously held as a detainee. |
Former Detainee |
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33. During your medical screening of detainees, an eye exam revealed three detainees with 20/50; 20/30; 20/40 vision. A recommendation to produce eyewear for all three detainees was suggested. How do you proceed with this recommendation? |
Detainees with uncorrected visual acuity of worse than 20/40 (with both eyes together) at distance or near are eligible for clear prescription eyewear.
(So only the detainess with 20/40 and 20/50 vision may receive eyewear.) |
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34. You have just been informed of a possible abuse of a detainee. You plan to educate your staff on abuse prevention strategies. How do you educate your staff members on principles of abuse prevention? |
When dealing with detainees, Soldiers need to use their common sense and exercise good judgment. Remember that if: 1) It looks wrong, then it probably is. 2) It is something that would enrage you if you saw a Family member or another Soldier being subjected to, then it is probably wrong. 3) You are confused and you do not know if it is right or wrong, seek help and guidance. |
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35. Fill in the blanks. International law requires that each__________________ be screened_____________ by_________________. This is to ensure continued health of detainees. When conducting _______ ____, health care personnel should also be alert to the signs and symptoms of communicable diseases, ____________________, hydration status, and _____________________. |
International law requires that each detainee be screened monthly by health care personnel. This is to ensure continued health of detainees. When conducting monthly weigh-ins, health care personnel should also be alert to the signs and symptoms of communicable diseases, louse infestations, hydration status, and other indicators of health status. |
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36. You are the Task Force Commander. You have been told that you have the authority to release detainee’s medical information. This is a legitimate request for medical information. Do you have the right to release medical information without the patient consent? |
Patient consent for the release of medical records is not required. The MTF commander or commander’s designee, usually the patient administrator, determines what information is appropriate for release. Only that specific medical information or medical record required to satisfy the terms of a legitimate request will be authorized for disclosure. |
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37. You are conducting RIP TOA with the incoming unit. There are detainees located in the Theater Internment Facility. How do you brief the incoming health care personnel on their roles and responsibilities of the TIF; specifically, what are some of the reasons to enter the TIF? |
Health care personnel may enter the holding areas of the TIF for a variety of reasons. These can include, but are not limited to, conducting sanitary inspections, providing emergency medical treatment, and dispensing medications. When in the holding areas of the TIF, health care personnel must be observant. Should they observe anything suspicious which might indicate that detainees are being mistreated, they should report these suspicions immediately to the chain of command. Should they observe a detainee being mistreated, they should take immediate action to stop the abuse and then report the incident. |
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38. How do you brief the incoming health care personnel on how to handle/treat detainees who are engaged in a hunger strike? |
In the case of a hunger strike, medical treatment or intervention may be directed without the consent of the detainee to prevent death or serious harm. Such action must be based on a medical determination that immediate treatment or intervention is necessary to prevent death or serious harm, and, in addition, must be approved by the TIF commander or other designated senior officer responsible for detainee operations.
Procedures for identifying and referring to the medical staff, a detainee suspected or announced to be on a hunger strike, will include obtaining an assessment from qualified health care personnel of whether the detainee’s action is reasoned and deliberate or the manifestation of a mental illness. Upon medical recommendation, the detainee may be placed in isolation.
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. Health care personnel will isolate the detainee in a single occupancy observation room and deny him contact with other detainees, when medically advisable. If measuring food and liquid intake or output becomes necessary, health care personnel may place the detainee in a special management unit or in a locked MTF room. The detainee may remain in the special management unit, based on the detainee’s medical condition, until health care personnel determine a move advisable. The medical officer will immediately report the hunger strike to the TIF commander.
Medical staff shall monitor the health of a detainee on a hunger strike. If the detainee is engaging in a hunger strike due to a mental condition, appropriate medical action will be taken. During the initial evaluation of a hunger-striking detainee, the medical staff will:
1) Measure and record the detainee’s height and weight.
2) Measure and record vital signs. 3) Perform a urinalysis.
4) Conduct a psychological/psychiatric evaluation. 5) Examine the detainee’s general physical condition and if clinically indicated, proceed with radiographs and or laboratory studies.
6) Take and record weight and vital signs at least once every 24-hours during the hunger strike. 7) Take other medical measures as required.
If a large number of detainees participate in the hunger strike, then additional health care assets may be required to prevent death or serious harm to them.
After the hunger strike, the medical staff will provide follow-up medical and psychiatric care for as long as necessary.
Before medical treatment is administered against the detainee’s will, the staff must make reasonable efforts to convince the detainee to accept treatment voluntarily. Forced medical treatment will be administered only after the medical staff determines that the detainee’s life or long-term health is at risk. |
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39. The Geneva Convention mandates that detainees will receive humane treatment. What are some prohibited and none prohibited acts relative to the treatment of detainees? |
Prohibited acts include killing, torture, medical/scientific experimentation, physical mutilation, removal of tissues/organs for transplantation, and causing serious injury, pain, and suffering.
During wartime with the exception of blood and skin grafts, transplantation of organs is prohibited. Additionally, the transplantation of organs/tissue from cadavers is also prohibited, except for blood and skin grafts obtained for medical purposes, not research or experimentation. The tissue donor must voluntarily consent to the procedure and records must be maintained.
Amputation which is based on a medical necessity and conforms to existing standards of health care is not considered physical mutilation and therefore not prohibited.
Protocol I reiterates the right of an individual to refuse to undergo a surgical procedure, even if that procedure would be lifesaving and falls within existing medical standards.
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40. Documentation of injuries or illness is a requirement on all patients. What is the standard form used by health care personnel to document findings during a patient encounter? |
Standard documentation guidelines should apply, meaning that either a short or expanded SF 600 be completed for each encounter, depending upon the problem’s complexity. Each SF 600 should be reviewed and countersigned by a licensed provider. |
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41. During your medical screening of a detainee, the health care provider directs you to take pictures of the detainee’s wounds to include photographs of the detainee’s face. What are the guidelines concerning the photographing of detainees during treatment? |
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.
Medical photography can also be used for medical diagnosis and treatment and used for the management of a number of medical conditions. |
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42A. Principles of Abuse Prevention: Has a command philosophy that places honor and dignity at the top of priorities been established? |
Priorities |
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42B. Principles of Abuse Prevention: It is not good enough to tell everyone to do the right thing . . . put it in writing. |
Policies |
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42C. Principles of Abuse Prevention: Have systems in place that by nature reduce the potential for abuse. |
Procedures |
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42D. Principles of Abuse Prevention: Continuous exercise of a professional demeanor and conduct is required. |
Practices |
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43. Your commander directs you to develop a Standard Operating Procedures (SOP) that outlines body cavity search as a routine practice during detainee intake. What guidance do you provide to your commander in reference to body cavity searches of detainees? |
Cavity examinations and searches may conflict with the customs of some detainees. Therefore, intake and routine medical examinations will not include body cavity exams or inguinal (hernia) exams. Body cavity examinations may be performed for valid medical reasons with the verbal consent of the patient. 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. |
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44. In the diagram below, can you identify the method being performed? How do you teach this method to your Soldiers?
(a. Open the compass so that the cover forms a straight edge with the base. b. Position the eyepiece lens to the full upright position. c. Place your thumb through the loop. d. Establish a steady base with your third and fourth fingers. e. Extend your index finger along the side of the compass. f. Place the thumb of your other hand between the eyepiece and lens. g. Extend the index finger along the remaining side of the compass. h. Secure the remaining fingers around the fingers of the other hand. i. Place your elbows firmly into your side. Note: This will place the compass between your chin and your belt. j. Turn your entire body toward the object. k. Align the compass cover directly at the object. l. Read the azimuth from beneath the fixed black index line.) |
Centerhold Technique |
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45. You are on a night foot patrol. Enemy forces are in the area. You have lost all possible electronic surveillance equipment. Which of the following techniques should you use to detect enemy activities and why? |
Perform Surveillance without the Aid of Electronic Device. Night vision scan technique:
1) Look from right to left or left to right using a slow, regular scanning movement.
2) At night avoid looking directly at a faintly visible object when trying to confirm its presence.
(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.
3a) View an object by looking 10 degrees above, below, or to either side of it rather than directly at it.
3b) Shift your eyes from one off-center point to another.
3c) Continue to pick-up the object in your peripheral field of vision.
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46A. Made of natural or man-made materials, gives protection from bullets, fragments of exploding rounds, flame, nuclear effects, biological and chemical agents, and enemy observation. |
Position that maximizes available cover |
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46B. Anything that hides personal, equipment and/or vehicles from enemy observation; does not protect you from enemy fire. |
Position that maximizes available concealment |
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46C. Anything you use to keep yourself, your equipment, and your position from being identified. |
camouflage |
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47. You are on a foot patrol. Enemy forces are in the area. How would you use the following techniques to avoid detection and why? (discuss high crawl and low crawl) |
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.
(1) Keep your body off of the ground. (2) Rest your weight on your forearms and lower legs. (3) Cradle your weapon in your arms. (4) Keep the muzzle of the weapon off the ground. (5) Keep your knees well behind your buttocks so it stays low. (6) Move forward by alternately advancing your right elbow and left knee, and left elbow and right knee.
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.
(1) Keep your body as flat as possible to the ground. (2) Grasp the sling of the weapon at the upper sling swivel with your right hand. (3) Let the hand guard rest on your forearm. (4) Keep the muzzle of the weapon off the ground. (5) Move forward. (a) Push both arms forward while pulling your right leg forward. (b) Pull on the ground with both arms while pushing with your right leg. (c) Repeat steps (a) and (b) until you reach your next position. |
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48. Your unit’s morale is among the best and your commander is seeking additional ways to make it even better. You were given the task to create and implement a Comprehensive Soldier Fitness program. What are some key components/elements you need to include in your program? |
5 dimensions of comprehensive Soldier fitness:
1) Physical: maintain physical readiness; excel in physical activities that require strength, endurance, and mobility. 2) Emotional: approach challenges in a positive, optimistic way. 3) Social: build and maintain trusted and valued relationships. 4) Spiritual: strengthen beliefs, principals, and values that sustain a person beyond Family, institutional, and societal sources of strength. 5) Family: grow daily as part of the Army and supportive Family unit; identify issues and help other Soldiers as needed. |
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49. Your squad has just completed the M16/M4 qualification range. One of your squad members fail to qualify due to a malfunction of his/her weapon. You attempt to verify the proper operation of the weapon. How do you teach this technique to your squad? |
Perform a Function Check on an M16-Series Rifle/M4-Series Carbine.
Note: A function check is the final step of maintaining your weapon. It is also performed anytime the proper operation of a weapon is in question. Stop a function check at anytime the weapon does not function properly and turn in the malfunctioning weapon as per unit Standing Operating Procedures.
1. Confirm the M16/M4 is clear. 2. Conduct a function check on the M16/M4. a. Place selector lever on SAFE. b. Pull charging handle to rear and release. c. Pull trigger. Note: Hammer should not fall. d. Place selector lever on SEMI. e. Pull trigger. Note: Hammer should fall. f. Hold trigger to the rear and charge the weapon. g. Release the trigger with a slow, smooth motion, until the trigger is fully forward. Note: An audible click should be heard. (thunk) h. Pull trigger. Note: Hammer should fall. i. Place selector lever on BURST (M16A2, M16A4, and M4 only). j. Charge weapon one time. k. Squeeze trigger. Note: Hammer should fall. l. Hold trigger to the rear. m. Charge weapon three times. n. Release trigger. (thunk) o. Squeeze trigger. Note: Hammer should fall. |
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50A/B. Will not detect chemical-agent vapors. |
M8 (booklet) and M9 (tape) detector paper will not detect chemical-agent vapors. If you observe a color change on M8 or M9 detector paper, assume it is a liquid chemical agent. |
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50C. If you are _____, place a strip of M9 detector paper around your left upper arm, right wrist, and left ankle. |
If you are left-handed, place a strip of M9 detector paper around your left upper arm, right wrist, and left ankle. |
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50D. If you are _____, place a strip of M9 detector paper around your right upper arm, left wrist, and right ankle. |
If you are right-handed, place a strip of M9 detector paper around your right upper arm, left wrist, and right ankle. |
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51A. Transport a casualty: used for an unconscious or severely injured casualty. |
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. |
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51B. Transport a casualty: used in combat, generally for short distances. |
Neck drag
Caution: Do NOT use the neck drag if the casualty has a broken arm or a suspected neck injury. |
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51C. Transport a casualty: used to move a casualty who cannot walk when being moved up or down stairs. |
Cradle-drop drag |
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51D. Transport a casualty: more easily used to move a conscious casualty to cover. |
Hawes carry |
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52. You are conducting medical evacuation operations in preparation for your upcoming NTC rotation. Your task is to submit a medical evacuation request for two wounded casualties. a. Casualty #1 = Urgent b. Casualty #2 = Priority At what point/line during your medical evacuation request are you required to provide this information? What is the correct terminology/phrase used for this line? |
Line 3: Number of Patients by Precedence.
A- Urgent B- Urgent Surgical C- Priority D- Routine E- Convenience
If 2 or more categories must be reported in the same request, insert the word "BREAK" between each category.
Ex. "Line Tree, Wun Alpha, Break, Wun Charlie" |
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53. You are on patrol near a shopping center. Your avenue of advance takes you parallel to buildings. Your team has just come into contact with the enemy. What are three techniques you can use to protect your team from becoming casualties and limit exposure to hostile fire? |
Perform Exterior Movement Techniques during an Urban Operation: Move parallel to buildings.
Note: Moving parallel to buildings is the movement normally associated with moving down a roadway but also includes movement in plazas or other open areas that are between buildings. During contact, utilize smoke, suppressive fires, and individual movement techniques. In moving to adjacent buildings, team members should keep a distance of 3 to 5 meters between themselves, leapfrogging along each side of the street and from cover to cover.
a. Soldier moves parallel to the side of a building. b. Use existing cover and concealment. c. Stay in the shadows. d. Present a low silhouette. e. Use proper techniques to cross door and window openings f. Move rapidly to the next position.
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54A. Map Colors: indicates cultural (manmade) features such as buildings and roads, surveyed spot elevations, and all labels. |
Black |
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54B. Map Colors: classifies cultural features, such as populated areas, main roads, and boundaries, on older maps. |
Red |
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54C. Map Colors: these colors are combined to identify cultural features, all relief features, non-surveyed spot elevations, and elevation such as contour lines on red light readable maps. |
Red-brown |
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54D. Map Colors: identifies all relief features and elevation such as contours on older edition maps and cultivated land on red light readable maps. |
Brown |
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55. You are conducting land navigation training. You decide to orient your map using your Lensatic Compass. What are the two methods used to orient your map when using your Lensatic compass? |
2 techniques to orient the map:
Orient the map using the first technique: -Take the straightedge on the left side of the compass and place it alongside the north-south grid line with the cover of the compass pointing toward the top of the map. Note: This procedure places the fixed black index line of the compass parallel to north-south grid lines of the map. -Keep the compass aligned as directed above while rotating the map and compass together until the magnetic arrow is below the fixed black index line on the compass. Note: At this time, the map is close to being oriented. -Rotate the map and compass in the direction of the declination diagram. -Verify the G-M angle. -If the magnetic north arrow on the map is to the left of the grid north, check the compass reading to see if it equals the G-M angle given in the declination diagram -If the magnetic north is to the right of grid north, check the compass reading to see if it equals 360 degrees minus the G-M angle Note: If the G-M angles are correct the map is oriented.
Orient the map using the second technique: -Draw a magnetic azimuth equal to the G-M angle given in the declination diagram with the protractor using any north-south grid line on the map as a base. -If the declination is easterly (right), the drawn line is equal to the value of the G-M angle: Align the straightedge on the left side of the compass alongside the drawn line on the map; Rotate the map and compass until the magnetic arrow of the compass is below the fixed black index line Note: The map is now oriented. -If the declination is westerly (left), the drawn line will equal 360 degrees minus the value of the G-M angle: Align the straightedge on the left side of the compass alongside the drawn line on the map; Rotate the map and compass until the magnetic arrow of the compass is below the fixed black index line. Note: The map is now oriented. |
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56. You have correctly oriented your map using your Lensatic Compass. You decide to navigate using terrain association. How do you ensure the ground distance is accurate once the actual map distance has been determined? |
Determine the map distance between identified checkpoints and the total distance to be traveled. Determine the actual ground distance by adding 20% to the map distance.
Note: 20% is a general rule of thumb for cross country terrain - road movement and flat terrain do not require this 20% increase. |
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57. When conducting patrols in urban areas, buildings sometimes present challenges that can determine the outcome of the mission. How do you train your Soldiers to properly move past building openings; specifically doors and windows? |
Move past building opening (windows and doors).
Note: The most common mistakes at windows are exposing the head in a firstfloor window and not being aware of basement windows.
Move past an above-knee window: 1) Stay near the side of the building. 2) Stay below the level of the window. 3) Avoid silhouetting self in window.
Move past a below-knee window: 1) Stay near the side of the building. 2) Step or jump past the window without exposing legs.
Move past a full-height window (store type) or open door: Note: A Soldier should not just walk past an adjacent full height window, as he presents a good target to an enemy inside the building. 1) Identify a position on the far side of the window. 2) Determine which technique to use to cross the opening. (a) Run across the opening to the far side. (b) Arc around the opening while covering the opening with your weapon while moving. 3) Move rapidly to the far side position. |
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58. During your patrol, you discover enemy forces preparing to conduct attacks on nearby FOBs. This is a small force of only 10 individuals with RPGs. You must now provide timely intelligence information to your higher headquarters. Prepare your report and forward your findings to your higher headquarters. |
Note: 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).
1. Prepare SPOTREP. a. LINE 1 – date time group (DTG) of report submission. b. LINE 2 – reporting unit (Unit Making Report). Note: After the unit designation, the method of observation must be indicated: unaided, binoculars, infrared, thermal, night vision device (NVD), unmanned aircraft system (UAS), or other. Follow with narrative if needed. c. LINE 3 – size of detected element. (1) Persons: Military, Civilian. (2) Vehicles: Military, Civilian. (3) Equipment: Military, Civilian d. LINE 4 - activity of detected element at DTG of report. Note: The activity type or types must be indicated and an amplifying sub-type if applicable. If necessary add a narrative to clarify, describe, or explain the type of activity. (1) Attacking (direction from). (a) Air defense artillery (ADA) (engaging). (b) Aircraft (engaging) (rotary wing [RW], fixed wing [FW]). (c) Ambush (IED [exploded], IED [unexploded], sniper, anti-armor, other). (d) Indirect fire (point of impact, point of origin). (e) Chemical, biological, radiological or nuclear (CBRN). (2) Defending (direction from). (3) Moving (direction from). (4) Stationary. (5) Cache. (6) Civilian (criminal acts, unrest, infrastructure damage). (7) Personnel recovery (isolating event, observed signal). (8) Other (give name and description). e. LINE 5 - location (universal transverse mercator (UTM) or grid coordinate with military grid reference system (MGRS) grid zone designator of detected element activity or event observed). f. LINE 6 - unit (detected element unit, organization, or facility). Note: The type of unit, organization, or facility detected should be identified. If it cannot be clearly identified is should be described in as much detail as possible to include; the type uniform, vehicle markings, and other identifying information. (1) Conventional. (2) Irregular. (3) Coalition. (4) Host nation. (5) Nongovernmental organization (NGO). (6) Civilian. (7) Facility. g. LINE 7 – time (DTG of observation). h. LINE 8 – equipment (equipment of element observed). Note: The equipment type or types, and amplifying sub-type should be identified, if applicable. A narrative can be added if necessary to clarify, describe, or explain the type of equipment. The nomenclature, type, and quantity of all equipment observed should be provided, if known. If equipment cannot be clearly identified it should be describe in as much detail as possible (1) ADA (missile (man-portable air defense system [MANPADS]), missile (other), gun). (2) Arty (gun (self-propelled [SP]), gun (towed), missile or rocket, mortar). (3) Armored track vehicle (tank, armored personnel carrier [APC], command and control [C2], engineer, transport, other). (4) Armored wheel vehicle (gun, APC, C2, engineer, transport, other). (5) Wheel vehicle (gun, C2, engineer, transport, other). (6) INF weapon (WPN) (anti-armor missile, anti-armor gun, rocketpropelled grenade [RPG], heavy [HVY] machine gun [MG], grenade launcher [GL], small arms, other). (7) Aircraft (RW (attack helicopter [AH]), RW (utility helicopter [UH]), RW (observation helicopter), FW (atk), FW (trans), UAS, other). (8) Mine or IED (buried, surface, vehicle-borne improvised explosive device [VBIED], person-borne improvised explosive device [PBIED], other). (9) CBRN. (10) Supplies (class III, class V, other). (11) Civilian. (12) Other. i. LINE 9 – assessment (apparent reason for or purpose of the activity observed, and apparent threats to or opportunities for friendly forces). j. LINE 10 –narrative (free text for clarifying report). Note: The narrative should describe the actions taken related to the detected activity: attack, withdraw, continue to observe, or other. When feasible, the narrative should also state potential for subsequent reports such as air support request, battle damage assessment (BDA) report, call for fire, casualty report, explosive ordinance disposal (EOD) support, medical evacuation (MEDEVAC) or other reports. k. LINE 11 – authentication (report authentication) per SOP.
2. Send SPOTREP to next higher element. Note: The unit SOP may have additional guidance on who receives the SPOTREP. |
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59A. Detech Chemical Agents: a yellow-gold color. |
Presence of a nerve (G) agent. |
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59B. Detect Chemical Agents: a red-pink color. |
Presence of a blister (H) agent. |
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59C. Detech Chemical Agents: a dark green color. |
Presence of a nerve (V) agent. |
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59D. Detect Chemical Agents: any other color or no color. |
The liquid cannot be identified using M8 detector paper. |
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60. You are conducting CBRNE operations. You have correctly placed M8 and M9 paper on the correct location of your body and equipment. How will the M9 paper react if it comes into contact with Petroleum products, insecticides, and antifreeze? |
M9 detector paper (tape) reacts positively to petroleum products, insecticides, and antifreeze.
M8 detector paper (booklet) reacts positively to petroleum products, ammonia, and decontaminating solution number 2 (DS2). |
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61. During care under fire, you come across a casualty who has unresponsive, no carotid pulse, and no rise and fall in the chest. How should you proceed with this casualty? |
In a combat situation (care under fire), 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.
The only treatment that should be given at the point of injury (care under fire) is a tourniquet to control life-threatening extremity bleeding.
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62. While eating in the DFAC, one of your team members suddenly started to cough forcefully. He tells you something is in his throat. What should your immediate actions be? |
1. Determine if the casualty needs help.
a. If the casualty has a mild airway obstruction (able to speak or cough forcefully, may be wheezing between coughs), do not interfere except to encourage the casualty.
b. If the casualty has a severe airway obstruction (poor air exchange and increased breathing difficulty, a silent cough, cyanosis, or inability to speak or breathe), continue with step 2. Note: You can ask the casualty one question, "Are you choking?" If the casualty nods yes, help is needed. CAUTION: Do not slap a choking casualty on the back. This may cause the object to go down the airway instead of out. 2. Perform abdominal or chest thrusts. Note: Abdominal thrusts should be used unless the victim is in the advanced stages of pregnancy, is very obese, or has a significant abdominal wound. Note: Clearing a conscious casualty's airway obstruction can be performed with the casualty either standing or sitting. a. Abdominal thrusts. (1) Stand behind the casualty. (2) Wrap your arms around the casualty's waist. (3) Make a fist with one hand. (4) Place the thumb side of the fist against the abdomen slightly above the navel and well below the tip of the breastbone. (5) Grasp the fist with the other hand. (6) Give quick backward and upward thrusts. Note: Each thrust should be a separate, distinct movement. Thrusts should be continued until the obstruction is expelled or the casualty becomes unconscious. b. Chest thrusts. (1) Stand behind the casualty. (2) Wrap your arms under the casualty's armpits and around the chest. (3) Make a fist with one hand. (4) Place the thumb side of the fist on the middle of the breastbone. (5) Grasp the fist with the other hand. (6) Give backward thrusts. Note: Each thrust should be performed slowly and distinctly with the intent of relieving the obstruction. 3. Continue to give abdominal or chest thrusts, as required. Give abdominal or chest thrusts until the obstruction is clear, you are relieved by a qualified person, or the casualty becomes unconscious. Note: If the casualty becomes unconscious, lay him/her down and then start mouth-to-mouth resuscitation procedures. 4. If the obstruction is cleared, watch the casualty closely and check for other injuries, if necessary. |
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63. Your team is responsible for security of the FOB. They will be performing security checks at access control point #1. Prior to starting their shift, you emphasize to your team to always employ progressive levels of individual force. How do you explain to your team the rules of the use of force? |
Establish and maintain control of the situation:
1) Comply with the ROE, any host-nation requirements, applicable international treaties and operational agreements.
Note: ROE are directives issued by competent military authority that delineate the circumstances and the limitations under which United States forces will initiate and/or continue combat engagement with other forces encountered. ROE help commanders accomplish the mission by regulating the rules of the use of force. Everyone must understand the ROE and be prepared to execute them properly in every possible confrontation.
2) Minimize casualties and damage.
3) Maintain professional demeanor and appearance. |
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64. While providing security at access control point #1, an identified individual wearing non-US military type uniform approaches your position. It is night time and visibility is poor. What actions should you take to ensure your safety and security of the FOB? |
Challenge Persons Entering Your Area:
1. 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. |
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65. Prior to leaving the FOB for a routine patrol, your team leader decides to refresh the team’s memory by going over few important rules. Three of the rules include: Soldiers only fight enemy combatants, Soldiers treat humanely all who surrender or are captured, and Soldiers do not attack protected places or persons. What are these rules known as? |
Identify the “10 Soldier’s Rules”:
1) Soldiers only fight enemy combatants. 2) Soldiers treat humanely all who surrender or are captured. 3) Soldiers do not kill or torture detained personnel. 4) Soldiers collect and care for the wounded. 5) Soldiers do not attack protected places or persons. 6) Soldiers do not attack medical personnel, facilities or equipment. 7) Soldiers destroy no more than the mission requires. 8) Soldiers treat civilians and noncombatants humanely. 9) Soldiers do not steal. Soldiers respect private property and possessions. 10) Soldiers should do their best to prevent violations of the Law of War. 11?) Soldiers report all violations of the Law of War to their superior. |
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66A. Respiration Quality: difficult or labored breathing. |
Dyspnea |
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66B. Respiration Quality: rapid respiratory rate; usually is a rate exceeding 24 breaths/min (adult). |
Tachypnea |
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66C. Respiration Quality: snoring, rattling, wheezing (whistling), or grunting. |
Noisy |
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67. You are conducting an inspection of a HAZMAT facility. During your inspection, you come in contact with a poisonous substance. The substance is now on your skin and could cause death through absorption. How do you prevent/minimize absorption of this substance? |
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. |
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68. Care under fire is care rendered at the scene of the injury while the combat medic and the casualty are still under effective hostile fire. What are the steps/substeps involved in the "care under fire" phase? |
Perform care under fire:
NOTE: Care under fire is care rendered at the scene of the injury while the combat medic and the casualty are still under effective hostile fire.
A. Return fire as directed before providing medical treatment. This may include wounded Soldiers still able to fight.
B. Provide care to casualty tactically. 1) Suppress enemy fire. 2) Use cover or concealment (smoke). 3) If casualty is unresponsive, move casualty and his equipment to cover as the tactical situation permits. 4) Direct casualty to return fire, move to cover, and administer self-aid, (stop bleeding) if possible. If unable to move casualty to cover and still under direct enemy fire, tell the casualty not to move. 5) Keep the casualty from sustaining additional wounds. 6) Reassure the casualty.
C. Administer only life-saving care while still under enemy fire. 1) Identify and control life-threatening hemorrhage with a tourniquet. 2) Cervical spine control is not necessary.
NOTE: The combat medic rendering care decides treatment on the basis of the relative risk of further injury versus that of exsanguination.
D. Communicate medical situation to team leader.
E. Tactically transport casualty, his weapon, and mission-essential equipment to cover.
F. Recheck bleeding control measures as the tactical situation permits. |
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69. You are requesting medical evacuation for a casualty you have just treated. You determined that the evacuation category is priority. What are some possible injuries that led to your evacuation decision? (5 evacuation priorities and associated injuries) |
Establish MEDEVAC priorities by precedence category:
Urgent. Evacuation is required as soon as possible, but within 1 hour, to save life, limb or eyesight. Generally, casualties whose conditions cannot be controlled and have the greatest opportunity for survival are placed in this category. (1) Cardiorespiratory distress. (2) Shock not responding to IV fluid therapy. (3) Prolonged unconsciousness. (4) Head injuries with signs of increasing intracranial pressure. (5) Burns covering 20% to 85% of the TBSA.
Urgent Surgical. Evacuation is required for casualties who must receive far forward surgical intervention to save life and stabilize for further evacuation. (1) Decreased circulation in the extremities. (2) Open chest and/or abdominal wounds with decreased blood pressure. (3) Penetrating wounds. (4) Uncontrollable hemorrhage or open fractures with severe hemorrhage. (5) Severe facial injuries.
Priority. Evacuation is required within 4 hours or the casualty's condition could get worse and become an "Urgent" or "Urgent Surgical" category condition. Generally, this category applies to any casualty whose condition is not stabilized or who is at risk of trauma-related complications. (1) Closed-chest injuries, such as rib fractures without a flail segment or other injuries that interfere with respiration. (2) Brief periods of unconsciousness. (3) Soft tissue injuries and open or closed fractures. (4) Abdominal injuries without hypotension. (5) Eye injuries that do not threaten eyesight. (6) Spinal injuries. (7) Burns on the hands, face, feet, genitalia, or perineum, even if under 20% of the TBSA.
Routine. Evacuation is required within 24 hours for further care. Immediate evacuation is not critical. Generally, casualties who can be controlled without jeopardizing their condition or who can be managed by the evacuating facility for up to 24 hours. (1) Burns covering 20% - 80% of the TBSA if the casualty is receiving and responding to IV fluid therapy. (2) Simple fractures. (3) Open wounds including chest injuries without respiratory distress. (4) Behavioral emergencies and combat stress casualties. (5) Terminal cases.
Convenience. Evacuation by medical vehicle is a matter of convenience rather than necessity. (1) Minor open wounds. (2) Sprains and strains. (3) Minor burns under 20% of TBSA. |
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70A. Rule of Nines: Head and neck (front and back). |
Head and neck (total) = 9% BSA
Front of head and neck = 4.5% BSA Back of head and neck = 4.5% BSA |
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70B. Rule of Nines: Anterior Trunk |
Anterior (front) Trunk = 18% BSA
Upper half (chest) only = 9% BSA Lower half (belly) only = 9% BSA |
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70C. Rule of Nines: Posterior Trunk. |
Posterior (back) Trunk = 18% BSA
Upper back only = 9% BSA Lower back only = 9% BSA |
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70D. Rule of Nines: Upper Extremities (total). |
Upper Extremities (total) = 18% (each 9%) BSA
one entire arm = 9% BSA
front of arm = 4.5% BSA back of arm = 4.5% BSA |
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70E. Rule of Nines: Lower Extremities (total). |
Lower Extremities (total) = 36% (each 18%) BSA
one entire leg = 18% BSA
front of leg = 9% BSA back of leg = 9% BSA
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70F. Rule of Nines: Perineum. |
Perineum = 1% BSA |
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71. Prior to my upcoming deployment to Afghanistan, my squad leader announces that there will be a pre combat inspection on Monday at 0900. Specifically, the inspection will involve checking for Mobic 15mg po qd, two mg caplets of acetaminophen every 8 hours, and an antibiotic. According to the items listed above, my squad leader is ensuring that I have a ________________________ prior to deployment. |
Administer pain medications as needed to any Soldier wounded in combat:
1) If the casualty is still able to fight, (Item #1) Mobic® 15 mg po qd with (Item #2) two 650 mg caplets of acetaminophen every 8 hours, will control mild to moderate pain and not cause drowsiness. These medications and (Item #3) an antibiotic make up the "Combat Pill Pack", and should be issued to each Soldier prior to deployment.
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.
(d) Ensure there is visible evidence of the amount and time of pain medication given
3) Soldiers should avoid aspirin and some of the older anti-inflammatory medications because of their detrimental effects on blood clotting.
4) Antibiotics should be considered in all Soldiers wounded in combat who have a 3 hour delay in evacuation time since these wounds are prone to infection. (a) In Soldiers who are awake and alert, give an oral antibiotic. (b) In unconscious Soldiers or those who may not be able to take an oral antibiotic, IV antibiotics may be given through the saline lock every 12 hours.
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72. You are treating a casualty that has suffered injuries caused by an explosion. You decided to perform a military acute concussion evaluation (MACE) screening to assess various levels of TBI. You are on step two of the MACE screening, what are you checking during this step? |
There are five domains of neurological function: 1) Orientation 2) Immediate Memory 3) Neurological Screening 4) Concentration 5) Delayed Recall
1) Orientation. (1) Ask the casualty to tell you the present month, date, and day of the week and time. (2) Award one point for each correct response with a maximum of five points. (3) Record the results.
2) Immediate memory. (1) Ask the casualty to remember five words and repeat them in any order. (2) Repeat this two more times for a total of three times. (3) Award one point for each correct response for a maximum of 15
3) Neurological screening. (1) Check eyes for pupillary response and tracking. (2) Check speech for fluency and word finding. (3) Evaluate motor responses, gait and coordination. (4) Do not award points for these, but record any abnormalties.
4) Concentration. (1) Provide the casualty with four strings of numbers and ask him to repeat them back to you in reverse order. (2) Ask the casualty to recite the months of the year in reverse order. (3) Award one point for each string of numbers correctly repeated and one point for the correct reversed sequence of months for a maximum of four points. (4) If the casualty fails to repeat the first two strings of numbers, stop and move to delayed recall.
5) Delayed recall. (1) Ask the casualty to recall the five words from the previous memory test. (2) Award one point for each correct response for a maximum of five points.
Compute the total score on the MACE screening tool and determine whether a concussion has occurred or not.
Refer the casualty for further evaluation if the score is below 25.
NOTE: Scores below 25 may represent clinically relevant neurocognitive impairment and require further evaluation for the possibility of a more serious brain injury. |
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73. During the planning phase of your company’s FTX, your Platoon Leader recommends that you plan for a primary and alternate Patient Decontamination Station. What factors will determine a possible move from primary to alternate sites? What are the requirements for alternate sites? |
Alternate sites must be selected in conjunction with selection of the primary site. If the prevailing winds change direction by more than 30 degrees, use of the primary site may no longer be possible. A wait of 10 to 15 minutes to determine if the change is permanent should precede the move. When the station is moved, it must be moved at least 75 meters upwind from any contaminated area.
Site selection factors: (1) The direction of the prevailing winds. (2) The downwind chemical hazard. (3) The availability of protective shelters or buildings to house clean treatment facilities. (4) The terrain. (5) Availability of cover and concealment. NOTE: The protective shelter may possess visual, audible, and infrared signatures. Therefore, concealment may be compromised. (6) The general tactical situation. (7) The availability of evacuation routes (contaminated and clean). (8) The location of the supported unit's vehicle decontamination point, personnel decontamination point, and MOPP exchange point. NOTE: It is sometimes best to co-locate with these unit decontamination sites. The arrangement of the operational areas must be kept flexible and adaptable to both the medical and tactical situations. |
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74. The area of the body that produces these types of fractures. Rami fractures, acetabular fractures and ring fractures |
There are three types of pelvic fractures: 1) rami fractures 2) acetabular fractures 3) pelvic ring fractures
Pelvic ring fractures usually involve massive hemorrhage and are considered a life threat. |
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75. Initiate a Tactical Combat Casualty Care (TCCC) Card What are the correct procedures for packing wounds with combat gauze? |
Pack the wound with combat gauze:
1) Using the four “P’s” of packing (peel, push, pile, and pressure) pack the gauze directly into the wound. 2) Hold pressure for a minimum of 3 minutes. 3) Pack with kerlix if required. |
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76. You were called to the scene of a HMMWV accident that involved four Soldiers. One Soldier was ejected from the moving HMMWV. While treating the ejected Soldier, your team leader shows up and instructed you to treat the other Soldiers because the ejected Soldier’s mechanism of injury was not significant. How do you respond to your team leader? |
A significant MOI includes ejection from a moving vehicle, death in the same passenger compartment, falls greater than 20 feet, rollover of vehicle, high-speed vehicle collision, vehiclepedestrian collision, motorcycle crash, trauma resulting in a loss of consciousness or altered mental status, and penetrations of the head, chest, abdomen (e.g., stab and gunshot wounds) or pelvis, and significant blunt trauma to the head, chest, abdomen, or pelvis.
Additional significant MOI for a child include falls from more than 10 feet, bicycle collision, and vehicles in medium speed collision. |
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77. You have treated the ejected Soldier from the HMMWV accident. You have documented all injuries on the TCCC card. How do you correctly represent today’s date, time, group (DTG) on the TCCC card? |
DTG: DDTTTT(TimeZone)MMMYYYY
Example: 19 September 2014 at 0900 local time is 190900ZSEP2014.
Hawaii time zone designator is "W". So 19 September 2014 at 0900 Hawaiian time is 190900WSEP2014. |
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78A. Type of Frostbite: No blister or tissue loss; healing occurs in 7-10 days. |
First degree frostbite:
(a) Epidermal injury; limited to skin that has brief contact with cold air or metal. (b) No blister or tissue loss; healing occurs in 7-10 days. |
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78B. Type of Frostbite: No permanent loss of tissue; healing occurs in 3-4 weeks. |
Second degree frostbite:
(a) Involves epidermis and superficial dermis. (b) Redness of the skin in light-skinned individuals and grayish coloring of the skin in dark-skinned individuals, followed by a flaky sloughing of the skin. (c) Blister formation 24 to 36 hours after exposure followed by sheet-like sloughing of the superficial skin. (d) No permanent loss of tissue; healing occurs in 3-4 weeks. |
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78C. Type of Frostbite: Skin loss occurs slowly; healing is delayed. |
Third degree frostbite:
(a) Involves the epidermis and dermis layers. (b) Frozen skin stiff with restricted mobility. (c) After tissue thaws, skin swells along with blood-filled blister. (d) Skin loss occurs slowly; healing is delayed. |
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79. Place the correct resting pulse rates next to the corresponding age groups. Pulse: 70-120 beats/min; 80-140 beats/min; 90-140 beats/min; 60-100 beats/min. a. Adults:____________ b. Children (1-6 years):______________ c. Infants: (6-12 months):____________ d. Infants: (0-5 months):______________ |
The normal pulse rates (at rest) are as follows:
(1) Adults: 60-100 beats/min. (2) Children (1-6 years): 70-120 beats/min. (3) Infants: (6-12 months): 80-140 beats/min. (4) Infants: (0-5 months): 90-140 beats/min.
Pulse rates in an adult patient that exceed 100 beats/min are described as tachycardia.
Pulse rates less than 60 beats/min are described as bradycardia. |
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80A. Initiate Treatment for Burns: Have the casualty STOP, DROP, and ROLL. |
Thermal burns
(1) Have the casualty STOP, DROP, and ROLL. (a) Do not permit the casualty to run, as this will fan the flames. (b) Do not permit the casualty to stand, as the flames may be inhaled or the hair ignited. (c) Place the casualty on the ground or floor and roll the casualty in a blanket or in dirt, and/or splash with water. (2) Remove all smoldering clothing and articles that retain heat, if possible. CAUTION: Do not remove clothing that is stuck to the burned area. If the clothing and skin are still hot, irrigate with copious amounts of room-temperature water or cover with a wet dressing, if available. (3) Cut away clothing to expose the burned area. |
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80B. Initiate Treatment for Burns: Do not directly touch a casualty receiving a shock. To do so will conduct the current to you. |
Electrical burns
WARNING: Do not directly touch a casualty receiving a shock. To do so will conduct the current to you. (1) Turn off the current, if possible. WARNING: Electrical shock may cause the casualty to go into cardiac arrhythmia or arrest. Initiate cardiopulmonary resuscitation (CPR) as appropriate. Casualties of lightening strikes may require prolonged CPR and extended respiratory support. (2) If necessary and/or possible, remove the electrical source from the casualty.
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80C. Initiate Treatment for Burns: Multiple and deep, usually producing second and third degree burns. |
White phosphorus burns
NOTE: White phosphorus (WP) will stick to the skin and continue to burn until it is deprived of air. WP burns are usually multiple and deep, usually producing second and third degree burns. (1) Deprive the WP of oxygen. (a) Splash with a nonpetroleum liquid (such as water, mud, or urine). (b) Submerge the entire area. (c) Cover the affected area with a moistened cloth, if available, or mud. (2) Remove the WP particles from the skin by brushing with a wet cloth or using forceps, stick, or knife.
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81. You have just placed a bandage on a casualty’s left arm. What steps should you take to ensure the bandage does not create a tourniquet like effect? |
Check circulation after application of the bandage:
a. Check pulse distal to the wound. b. Check CSM function to ensure that the bandage is not too tight. c. Check for capillary refill (<2 seconds is normal), if applicable. d. Inspect the skin below the bandaging for pale or cyanotic skin. e. Ask the patient if they are experiencing any numbness, tingling sensation, coldness in the bandaged part or pain. |
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82. The casualty in question #84 also has an amputated right arm. After you have applied the tourniquet and rendered the appropriate treatment to the casualty, how do you care for the amputated part to avoid further injury? |
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. |
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83. You decide to place a tourniquet on the arm of a casualty that is hemorrhaging. What are the steps to properly secure the CAT to the casualty’s arm? |
1. Expose the wound. 2. Place combat application tourniquet (C-A-T), 2-3 inches above the wound on the injured extremity. 3. Pull the free end of the self-adhering band through the buckle and route through the friction adapter buckle. NOTE: On an arm wound, it is not necessary to route the strap through the friction adapter. 4. Pull the self-adhering band tight around the extremity and fasten it back on itself as tightly as possible. 5. Twist the windlass until the bleeding stops. 6. Lock the windlass in place within the windlass clip. 7. Secure the windlass with the windlass strap. 8. Assess for absence of a distal pulse. 9. Place a "T" and the time of the application on the casualty’s forehead with a marker. 10. Secure the C-A-T in place with tape. 11. Record the treatment on a FMC. |
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84. The casualty with the amputated arm is showing signs of Hypovolemic Shock. You decide to administer Hextend as the fluid of choice. What are some of the precautions when administering Hextend to treat for Hypovolemic Shock? |
Infuse Hextend:
a. Give the casualty 500 ml of hextend. (1) The usual amount is 500 ml; you can repeat the dose of 500 ml one time. A total of 1000 ml maximum amount of Hextend can be used for hypovolemia. (2) A palpable radial pulse usually indicates that the casualty has a systolic blood pressure of 80 mm Hg. b. Repeat Hextend. |
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85. You are treating a casualty who states that he was stung by an insect. During your patient assessment, you noticed an Arizona black scorpion still attached to his ACU. What are some of the signs and symptoms associated with this deadly species of scorpion? |
NOTE: There are two general types of scorpions. The arizona (black) scorpion is the only deadly type in the United States.
(a) Sharp pain at the injection site, “pins and needles” sensation. (b) Severe muscle contractions. (c) Drooling. (d) Poor circulation. (e) Hypertension. (f) Cardiac failure. (g) Incontinence. (h) Seizures. |
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86. You are conducting sick call operations at your BAS. Your patient assessment reveals sneezing, swelling and itching, (puritis), of the affected tissue, increased mucous production (rhinorrhea), nasal congestion, hives and rashes. Further assessment reveals that your patient is suffering from a sinus disorder. What is the sinus disorder and what is the treatment? |
Seasonal allergies or allergic rhinitis (hay fever)–rhinitis is an inflammation of the nasal membranes.
NOTE: The sensitized immune system produces antibodies to these allergens, which cause chemicals called histamines to be released into the blood stream.
(1) Common causes–patients often have family history of multiple allergic disorders including hay fever, asthma and eczema. (2) Signs and sypmtoms include sneezing, swelling and itching, (puritis), of the affected tissue, increased mucous production (rhinorrhea), nasal congestion, hives and rashes. NOTE: Signs and symptoms are predominately in the nose and eyes.
Provide treatment for a sinus disorder: a. Increase fluids. b. Decongestant. c. Avoid antihistamines. Antihistamines dry and thicken the nasal mucosal areas. d. Refer to medical officer for antibiotics. |
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87. Your unit is conducting CBRN operations. Patient decontamination stations are set up to ensure casualties are properly decontaminated prior to being evacuated. Your medical equipment set (MES) for chemical agent casualty decontamination contains powdered calcium hypochlorite. How do you prepare the powder for use, and how should the mixture be applied during patient decontamination? |
NOTE: The medical equipment set (MES) for chemical agent casualty decontamination contains powdered calcium hypochlorite (high test hypochlorite or HTH). It is mixed with water to make the 5% and 0.5% decontaminating solutions. Liquid chlorine bleach (household bleach), a 5% solution of sodium hypochlorite, may also be used.
NOTE: After every complete segmental cut, the cutting tools are decontaminated, along with the gloved hands of the Soldier doing the cutting. Do this by dipping gloved hands and cutting tools in a bucket of 5% bleach, or if ample supplies of the M295 or, M291 are available, and water is limited, these can be used to scrub the cutting tools.
CAUTION: Use only the 0.5% solution to decontaminate the skin and the parts of the mask that touch the face. The 5% solution is corrosive and may burn the skin.
Decon steps that involve chlorine solution: -When decontaminating the casualty's hood, wipe off the voicemitter, eyelets, outserts, and the hood using M291 SDK or 5% bleach solution (starting at the top of the head and wiping down towards the litter and shoulders) -Dip your rubber gloves and tools into chlorine solution before and after any clothing/equipment doffing cuts -Decontaminate the casualty's mask and exposed skin using soap and water, M291 skin decontamination kit, or 0.5% bleach solution -After sealing the casualty's FMC in a plastic bag, decontaminate the outside of the bag with the 0.5% chlorine solution -Remove gross contamination on the casualty's overgarment (MOPP/JSLIST) by wiping all visible contamination spots with a sponge soaked in 5% chlorine solution solution CAUTION: Dip and scrub the cutting tool in the 5% solution before doing each cutting procedure to avoid contaminating the inner garment or the casualty's skin. -Decontaminate your own butyl rubber gloves and the casualty's gloves with M295, M291, or 5% chlorine solution -Decontaminate litters using a 5% chlorine solution -ID tags are decontaminated using a 0.5% chlorine solution
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ExtraQuestion#1. _________________waste disposal becomes a problem for both the individual and the unit in the field. |
Human waste disposal becomes a problem for both the individual and the unit in the field. |
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ExtraQuestion#2. In temporary bivouac areas, the _________________ _________________ latrine is used unless more permanent facilities are provided for the unit. |
In temporary bivouac areas, the straddle trench latrine is used unless more permanent facilities are provided for the unit. |
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ExtraQuestion#3. The numbers of latrines are based on 1 commode or urinal per _______ male Soldiers and 1 commode per _______ female Soldiers. |
The numbers of latrines are based on 1 commode or urinal per 25 male Soldiers and 1 commode per 17 female Soldiers. |
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ExtraQuestion#4. _________________ are so constructed to prevent the contamination of food and water. |
Latrines are so constructed to prevent the contamination of food and water. |
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ExtraQuestion#5. To construct a _______ _______ _________________, an oil drum is cut in half, and handles are welded to the sides of the half drum for easy carrying. |
5. To construct a burn out latrine, an oil drum is cut in half, and handles are welded to the sides of the half drum for easy carrying. |
