From FM 8-10
Health Service Support in a Theater of
Operations.
Section II. THE ECHELONS OF MEDICAL
CARE
3-6. Echelon I (Level I)
a. The first medical care a soldier receives is provided at this
echelon. This echelon of care includes the following:
(1) Immediate lifesaving measures.
(2) Disease and nonbattle injury prevention.
(3) Combat stress control preventive measures.
(4) Casualty collection.
(5) Evacuation from supported units to supporting medical
treatment.
(6) Treatment provided by designated individuals or treatment
squad (BAS). Major emphasis is placed on those measures
necessary to stabilize and allow for the evacuation of the
patient to the next echelon of care. These measures include:
maintain the airway, stop bleeding, prevent shock, protect
wounds, immobilize fractures, and other emergency measures, as
indicated.
b. Those patients not requiring a higher level of care are
returned to duty.
c. Medical care is provided by an individual (self-aid, buddy aid,
combat lifesaver, or combat medic) or by personnel in a treatment
squad.
(1) Immediate far forward care consists of those lifesaving
steps that do not require the knowledge and skill of a
physician. The following three different skill levels of
personnel provide the care required in the forward area.
(a) Self-aid/buddy aid. Each individual soldier is
trained to be proficient in a variety of specific first
aid procedures. These procedures include aid for chemical
casualties with particular emphasis on lifesaving tasks.
This training enables the soldier or a buddy to apply
immediate care to alleviate a life threatening situation.
(b) Combat lifesaver. The combat lifesaver is a member
of a nonmedical unit selected by the unit commander for
additional training beyond basic first aid procedures. A
minimum of one individual per squad, crew, team, or
equivalent sized unit should be trained. The primary duty
of this individual does not change. The additional duties
of the combat lifesaver are performed when the situation
permits. The combat lifesaver assists the combat medic by
providing immediate care for injuries. The training is
normally provided by medical personnel assigned to,
attached to, or supporting the unit. The training program
is managed by the senior medical person designated by the
commander.
(c) Combat medic (aidman). This is the first individual
in the HSS chain who makes medically-substantiated
decisions based on medical military occupational
specialty (MOS) specific training. The combat medic is
trained to emergency medical technician (EMT) level. The
combat medic is assigned to the medical platoon or
section of the headquarters and headquarters company, the
headquarters and support company, or the troop of the
appropriate combat or CS battalion. (See paragraph 3-12a
for an explanation of this phase of care.)
(2) The physician and the PA in a treatment squad (aid
station) are trained and equipped to provide ATM or trauma
treatment to the battlefield casualty. This element also
conducts routine sick call when the situation permits. Like
elements provide this echelon of care in division, corps, and
COMMZ units. (See paragraph 3-12b for an explanation of this
phase of care.)
d. Ammunition and individual weapons belonging to patients to be
evacuated from the BAS are disposed of as directed by brigade
(DIVARTY, battalion, or squadron) or division policy. Patients
evacuated to the rear retain individual equipment as prescribed by
division SOP. All excess equipment is collected at the BAS and
disposed of by the battalion S4 or as directed by command SOP.
NOTE
Patients entering the HSS system will retain their protective
mask.
e. Echelon I HSS is provided by the medical platoons/sections of
combat and CS battalions, by divisional medical companies, by corps
area support medical companies, and by other corps medical units.
3-7. Echelon II (Level II)
a. This echelon of care includes the following:
(1) Evacuating patients from Echelon I.
(2) Providing care at the clearing station (division) which
is operated by the area support section of the treatment
platoon of the medical company. (The area support section
consists of a treatment squad, an area support squad, and a
patient holding squad. When these squads are collocated, they
form a clearing station capable of holding up to 40 patients.)
At this echelon of care, the casualty is examined; his wounds
and general status are evaluated; and he is treated and
returned to duty or his priority for continued evacuation is
determined. The area support section (clearing station)
provides HSS on an area basis to all forces within a
geographical area of responsibility. The area support section
normally operates in the brigade support area (BSA), the
division support area (DSA), and areas of high concentration
of troops in the corps support area (CSA) and COMMZ. The area
support and patient holding squads are incapable of
independent operations.
b. This echelon of support duplicates Echelon I (see paragraph 3-6)
and expands services available by adding dental, laboratory, x-ray,
and patient holding capabilities. Emergency care, including
beginning resuscitation procedures, is continued. (No general
anesthesia is available.) If necessary, additional emergency
measures are instituted, however, they do not go beyond the
measures dictated by the immediate need. Those patients who can RTD
within 24 to 72 hours are held for treatment.
c. The above functions are performed by medical companies organic
to:
- Support battalions of separate maneuver brigades.
- Support squadrons of ACRs.
- Support battalions of DISCOMs (heavy division).
- Medical battalions of DISCOMs (airborne and air assault
divisions).
- Nondivisional medical battalions (corps and COMMZ).
Reference: FM 8-10 Health Service Support in the Theater of Operations.