FM 8-10-14

CHAPTER 2

THE COMBAT SUPPORT HOSPITAL

2-1. Mission and Allocation

The mission of this hospital is to provideresuscitation, initial wound surgery, post-operative treatment, and RTD those soldiers inthe CZ who fall within the corps evacuationpolicy, or to stabilize patients for further evacua-tion. This hospital is capable of handling all typesof patients. It has a basis of allocation of 2.4hospitals per division.

2-2. Assignment and Capabilities

a. The CSH is assigned to the Head-quarters and Headquarters Company (HHC),Medical Brigade, TOE 08-422L100. The hospitalmay be further attached to the Headquartersand Headquarters Detachment (HHD), MedicalGroup, TOE 08-432L000.

b. This unit provides hospitalizationfor up to 296 patients. The hospital has eightwards providing intensive nursing care for up to96 patients, seven wards providing intermediatenursing care for up to 140 patients, one wardproviding neuropsychiatric (NP) care for up to 20patients, and two wards providing minimalnursing care for up to 40 patients.

c. Surgical capacity is based on eightoperating room (OR) tables for a surgical capacityof 144 OR table hours per day.

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d. Other capabilities include—

• Consultation services forpatients referred from other medical treatmentfacilities (MTFs).

• Unit-level CHS for organicpersonnel only.

• Pharmacy, clinical laboratory,blood banking, radiology, physical therapy, andnutrition care services.

• Medical administrative andlogistical services to support work loads.

• Dental treatment to staff andpatients and oral and maxillofacial surgery sup-port for military personnel in the immediate areaplus patients referred by the area CHS units.

2-3. Hospital Support Requirements

In deployment and sustainment of operations,this unit is dependent upon appropriate elementsof the corps for—

• Personnel

• Finance.

administrative services.

• Mortuary affairs and legal services.

• Transportation services (unit is 35percent mobile with organic assets).

• Laundry services for other thanpatient-related linen.

Security and enemy prisoner of war(EPW) security during processing and evacu-ation.

• Transportation for discharged pa-tients.

• Class I supplies (rations) to includethe Medical B Rations required for patient feed-ing.

• Engineer supporttion, waste disposal, and minor

for site prepara-construction.

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• Veterinary support for zoonoticdisease control and investigation; inspection ofmedical and nonmedical rations, to includesuspected contaminated rations and dispositionrecommendations; and animal bites.

• PVNTMED support for food facilityinspection, vector control, and control of medicaland nonmedical waste.

2-4. Hospital Organization and Func-tions

The CSH is a modular-designed facility whichconsists of a HUB and HUS. It can be furtheraugmented with specialty surgical/medical teamsto increase its capabilities. It may become adesignated specialty center as the work load ormission dictates (Figure 2-1).

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a. The HUB is a 236-bed facility whichhas 36 intensive, 140 intermediate, 40 minimal,and 20 NP care beds. It has two OR modules, onesurgical and the other orthopedic, which arestaffed to provide a total of 72 OR table hours perday. It also allows for attachment of specialtysurgical teams. The HUB is an independentorganization which includes all hospital services(Figure 2-2).

b. The HUS is comprised of 60 intensivecare beds, two OR modules, one x-ray module,one triage/preoperative/EMT module, and theappropriate staffs (Figure 2-3, page 2-5). TheHUS is dependent on the HUB for food service,maintenance, and administration.

c. When the HUB and HUS are em-ployed to form a single hospital, half of the ORtables are staffed for two 12-hour shifts with theother half only staffed for one 12-hour shift perday.

2-5. The Hospital Unit, Base

The HUB provides a solid infrastructure for theCSH operations. The HUB contains the followingsections:

a. Hospital Headquarters Section.This section provides internal command andcontrol (C2) and management of all hospitalservices. Personnel of this section supervise andcoordinate the surgical, nursing, medical,pastoral, and administrative services. Stafflngincludes the HUB commander, the chiefs ofsurgery, nursing, and medicine, an executiveofficer (XO), a chaplain, a command sergeantmajor (CSM), and an administrative specialist(Table 2-1). When the HUB and the HUS jointo function as a CSH, the HUB commander isthe CSH commander unless otherwise desig-nated.

(1) Hospital commander (60A00).Command and control is the process throughwhich the activities of the hospital are directed,coordinated, and controlled to accomplish themission. This process begins and ends with thecommander. An effective commander must havea thorough knowledge and understanding ofplanning and implementing CHS (FM 8-55). Heis decisive and provides specific guidance to hisstaff in the execution of the mission. The success-ful commander delegates authority and fostersan organizational climate of mutual trust, co-operation, and teamwork. He has the overallresponsibility for coordination of CHS within thehospital’s AO. Additionally, he is responsible forthe structural layout of the hospital.

(2) Chief, surgical service (61J00).The chief surgeon is the principal advisor to thehospital commander for surgical activities. Heprovides supervision and control over the surgi-cal services to include the ORs. He prescribescourses of treatment and surgery for patientshaving injuries or disorders with surgical condi-tions and participates in surgical procedures asrequired. He coordinates and is responsible forall matters pertaining to the evaluation, manage-ment, and disposition of patients received by thesection. He is responsible for the evaluation andtraining programs for his professional staff. Healso functions as the Deputy Commander forProfessional Services.

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(3) Chief nurse (66A00). The chiefnurse is the principal advisor to the hospitalcommander for nursing activities. This officerplans, organizes, supervises, and directs nursingcare practices and activities of the hospital. Thisofficer is also responsible for the orientation andprofessional development programs for thenursing staff.

(4) Chief, medicine services(61F00). This officer is responsible for the exami-nation, diagnoses, and treatment, or recom-mended course of management for patients with

medical illnesses. He controls the length of patientstay through continuous patient evaluation, earlydetermination of disposition, or evacuation to thenext echelon of care.

(5) Executive officer (67A00). Thehospital XO advises the commander on matterspertaining to health care delivery. He plans,directs, and coordinates administrative activitiesfor the hospital. He provides guidance to thetactical operations center (TOC) staff in planningfor future operations. He also functions as theChief, Administrative Service.

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(6) Hospital chaplain (56A00).The chaplain functions as the staff officer for allmatters in which religion impacts on commandprograms, personnel, policy, and procedures. Heprovides for the spiritual well-being and moraleof patients and hospital personnel. He also pro-vides religious services and pastoral counselingto soldiers in the AO.

(7) Command sergeant major(00Z50). The CSM is the principal enlistedrepresentative to the commander. He advises thecommander and staff on all matters pertaining towelfare and morale of enlisted personnel in termsof assignment, reassignment, promotion, anddiscipline. He provides counsel and guidance toNCOs and other enlisted personnel of thehospital. He is also responsible for the receptionof newly assigned enlisted personnel into theunit. The CSM evaluates the implementation ofindividual soldier training on common soldiertasks and supervises the hospital’s NCO pro-fessional development.

(8) Administrative specialist(71L20). The administrative specialist performstyping, clerical, and administrative duties for thehospital headquarters. He proofreads corre-spondence for proper spelling, grammar, punc-tuation, format, and content accuracy. Heestablishes and maintains files, logs, and otherstatistical information for the command. He isthe light-vehicle driver and radio operator for thecommand section.

b. Hospital Operations Section. Thissection is responsible for communications (in-ternal and external), security, plans and opera-tions, deployment, and relocation of the hospital.The staff is composed of a medical operationsofficer, a field medical assistant, an operationsNCO, a nuclear, biological, and chemical (NBC)NCO, an administrative specialist, and appro-priate communications personnel (Table 2-2).The authorization for the field medical assistantis counted in the HUS.

(1) Medical operations officer(70H67). This officer is responsible to the XO forthe Intelligence Officer/Operations and TrainingOfficer (S2/S3) functions of the hospital. Hesupervises all tactical operations conducted bythe hospital to include planning and relocation.He is responsible for the formulation of the tacti-cal standing operating procedures (TSOP) andhospital planning factors (refer to Appendix A foran example of a TSOP format and Appendix B foran estimate of hospital planning factors).

(2) Field Medical Assistant(70B67). This officer is responsible to the medicaloperations officer for planning and coordinatingsite selection and convoy operations duringhospital deployment and relocation. He alsofunctions as the operations security (OPSEC) andcommunications security (COMSEC) officer forthe hospital. The requirement for this position iscounted in the unit headquarters section (HUS).When the HUB and HUS form a CSH, the fieldmedical assistant, HUS becomes the field medicalassistant in this section.

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(3) Operations sergeant (91B40).The operations sergeant is responsible to themedical operations officer for physical security,to include the hospital defense plan; preparationof unit plans, operation orders (OPORDs) andmap overlays; and intelligence information andrecords. He also supervises subordinate staff.

(4) Section chief (31U40). ThisNCO serves as the principal signal advisor to thehospital commander and medical operations offi-cer on all communications matters. He is respon-sible to the medical operation and plans officersfor the planning, supervising, coordinating, andtechnical assistance in the installation, operation,management, and operator-level maintenance ofradio, field wire, and switchboard communica-tions systems. He supervises all subordinatecommunications personnel.

(5) Nuclear, biological, and chem-ical noncommissioned officer (54B40). This NCOis the technical advisor to the hospital command-er and medical operations officer on matters per-taining to NBC operations. He is responsible tothe medical operations officer for the planning,training, NBC decontamination (less patient),and other aspects of hospital NBC defensive op-erations.

(6) Electronic switch systems op-erator (31F20). This operator is responsible tothe section chief for the installation, operation,and operator-level maintenance of switchboardsand switching systems.

(7) Electronic switch systems op-erator (31FI0). These operators are responsibleto the section chief for the installation, opera-tion, and unit-level maintenance on switchboards,switching assemblages, and associated communi-cations equipment.

(8) Signal information service spe-cialist (31UIO). This individual is responsible to

the section chief for installation and operation ofunit wire systems, associated equipment, andfrequency modulated (FM) radios.

(9) Administrative specialist (7L10).This individual is responsible to the operationssergeant for general typing and administrativefunctions for the section.

(10) Signal support systems special-ist (31UI0). This individual is responsible to thesection chief for installing wire for field tele-phones and assisting in the operation of the hos-pital FM radios.

c. Company Headquarters. This sec-tion is responsible for company-level command,duty rosters, weapons control, and mandatorytraining. Staffing includes the company head-quarters commander, the first sergeant, a decon-tamination specialist, an administrative clerk,and an armorer (Table 2-3).

(1) Company commander (70B67).The company commander is responsible to theXO for all activities in the company headquarters.He administers Uniform Code of Military Justice(UCMJ) actions for enlisted personnel; plans andconducts common task training; and functions asthe commander of the medical holding detach-ment, when assigned. When the HUB and HUSare employed to form the CSH, the medical hold-ing detachment is assigned as dictated by themedical mission.

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(2) First sergeant (91B5M). Thefirst sergeant is responsible to the company com-mander for enlisted matters. He also assists insupervising company administration and trainingactivities. He provides guidance to the enlistedmembers of the company and represents them tothe company commander. He also functions asthe reenlistment NCO.

(3) Decontamination specialist(54B10). This specialist is responsible to the firstsergeant for training the company’s NBC teamson the operation of NBC detection and decontami-nation equipment and for the operator main-tenance on this equipment. He assists the NBCNCO in the establishment, administration, train-ing, and application of NBC defense measures.He also performs NBC reconnaissance and isdesignated as a light-vehicle operator.

(4) Administrative clerk (71LI0).The clerk-typist is responsible to the firstsergeant for providing the personnel and unitadministration support for the company head-quarters. His duties consist of general admin-istration and personnel actions.

(5) Armorer (92YI0). The armor-er’s primary duty is that of maintaining the wea-pons storage area, small arms, and ammunitionand performing small arms unit maintenance.He is designated as the light-vehicle operator forthe section.

d. Administrative Division. This divi-sion provides overall administrative services forthe hospital to include personnel administration,mail distribution, awards and decorations, leaves,and typing support. The staff is composed of thehospital adjutant, personnel sergeant, personneladministrative sergeant, an administrative spe-cialist, mail delivery clerks, and an administra-tive clerk (Table 2-4). This section coordinates withelements of corps support command (COSCOM)for finance, personnel, and administrative services.

(1) Hospital adjutant (70F67).This officer is responsible to the hospital XO forthe adjutant functions within the hospital. Healso advises the commander and staff in the areaof personnel management for patients and staff.

(2) Personnel sergeant (75240).The personnel sergeant is responsible to theadjutant for specific personnel functions whichinclude personnel management, records, actions,and preparation of Standard Installation/DivisionPersonnel System (SIDPERS) changes. He en-sures coordination between the medical brigadeand/or medical group Personnel and Adminis-tration Center (PAC) and the hospital. Headvises the hospital commander, adjutant, andother staff members on personnel administrativematters. He also supervises the activities ofsubordinate personnel.

(3) Personnel administrative ser-geant (75B20). This individual is responsible tothe personnel sergeant for personnel and admin-istrative functions for the hospital.

(4) Administrative specialists(71L10). These specialists are responsible to thepersonnel sergeant for general typing and admin-istrative functions for the division.

(5) Mail delivery clerks (71L10).These administrative specialists are responsible

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to the personnel staff NCO for establishing andoperating the unit mail room. They also assistthe personnel staff NCO with personnel andclerical duties. They are the designated light-vehicle operators for the division.

e. Patient Administration Division(PAD). This division is responsible for the admis-sion and disposition of patients, maintenance ofpatient records, security of patient valuables, andpreparation of patient statistical reports for thehospital. The staff is composed of the patientadministration officers, NCOs, and specialists(Table 2-5).

(1) Patient administration officer(70E67). As chief of the PAD, this officer is re-sponsible to the hospital XO for planning, orga-nizing, directing, and controlling the patient ad-ministration aspects of the hospital. He advisesthe commander on patient administration matters.He maintains close liaison with the chiefs ofservices, attending physicians, and chiefs of ad-ministrative sections and offices to ensure timelydecisions on patient administration matters.

(2) Patient administration officer(70E67). This officer assists the chief, PAD indeveloping plans and procedures for patient ad-ministration support, to include patient statisticalreports and medical regulation of patient disposi-tions (refer to FM 8-10-6).

(3) Patient administration non-commissioned officer (71G30). This NCO is re-sponsible to the patient administration officer forpatient administration and disposition proce-dures, inpatient records, and security of patients’personal effects. He works in concert with thesupply sergeant (company headquarters) on re-equipping the RTD soldier. He also supervisesthe application of the Theater Army MedicalManagement Information System (TAMMIS) forthe Medical Patient Accounting and Reporting(MEDPAR) System and for the Medical Regula-ting (MEDREG) System.

(1) Patient administration non-commissioned officers (71G20). These NCOs areresponsible to the principal patient administra-tion NCO for implementing the TAMMIS for thehospital. They process correspondence receivedfor medical information. They also assist insupervising subordinate specialists.

(5) Patient administration special-ists (7IG10). These specialists are responsible tothe patient administration NCOs for preparing,consolidating, and maintaining medical recordsand statistics pertaining to patient data. Theyalso implement the TAMMIS for the division.

f. Nutrition Care Division. This divi-sion is responsible for providing hospital nutritionservices, meal preparation and distribution topatients and staff; dietetic planning; and super-vision and control of overall operations. Hospitalstaff will be fed in accordance with the theaterration policy. The field medical feeding standardfor hospitals is to prepare three hot meals perday plus nourishments and forced fluids usingMedical B (or A) Rations. Meals, ready to eat(MRE) are not authorized for patient use.Rations will be obtained from the supportingCOSCOM. Patient meals, nourishments, andforced fluids will be distributed to the wards threetimes per day; tube feedings are provided inter-mittently as patient’s nutritional needs require.

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(Refer to FM 8-505, Technical Manual [TM] 8-500, and Appendix B of this manual.) The staffis composed of dietitians, hospital food serviceNCO, and hospital food service specialists (Table2-6).

(1) Chief nutrition care division(65C00). This officer is responsible to the Chief,Administrative Services for the operation of thisdivision. He directs and supervises the operationof nutrition care services.

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(2) Dietitian (65C00). This officeris responsible to the Chief, Nutrition Care forformulating policies, developing procedures, andassisting in supervising the operation of nutritioncare. This officer also assists physicians indietary management of patients.

(3) Hospital food service noncom-missioned officer (91M40). This NCO serves asthe principal NCO for the nutrition care division.He is responsible to the Chief, Nutrition Care forthe implementation of policies and proceduresand for supervision of subordinate personnel.

(4) Hospital food service noncom-missioned officer (91M30). This NCO is respon-sible to and serves as an assistant to the principalNCO in nutrition care operations. He imple-ments and directs contingency and combat feed-ing plans.

(5) Hospital food service sergeants(91M20). These sergeants are responsible to theprincipal NCO and assist with the clinical andadministrative management of nutritional careprograms.

(6) Hospital food service special-ists (91M10). These hospital food service special-ists are responsible to the hospital food servicesergeants for performing basic clinical dieteticfunctions in the dietary management and treat-ment of patients. They prepare, cook, and serveregular and modified food. They also performlight-vehicle operator/driver duties for the divi-sion, to include operator maintenance.

g. Supply and Service Division. Thisdivision provides logistics functions throughoutthe hospital, to include laundry, general andmedical supplies, and maintenance; blood man-agement (see Appendix B [paragraph B-4utilities such as water distribution, waste dis-posal, and environmental control of patient treat-ment areas; power and vehicle maintenance;equipment records and repair parts; fuel distri-bution; and transportation to include ground/airmovement operations. The logistics division re-quests resupply from the supporting medicallogistics (MEDLOG) battalion (forward) andCOSCOM elements using whatever communica-tion links are available and compatible with theTheater Army Medical Management InformationSystem-Medical Logistics (TAMMIS-MEDLOG).Medical logistics and medical maintenance(MEDMNT) will be managed utilizing TAMMIS-MEDLOG and TAMMIS-MEDMNT. This divi-sion coordinates with COSCOM elements formateriels handling equipment (MHE) capable ofmoving DEPMEDS equipment, environmentalcontrol units, and power distribution equipmentfor the hospital. This division is also responsiblefor maintaining the unit property book and forestablishing a temporary morgue for handlingremains until transported to supporting mortuaryaffairs organization. This section coordinates

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with elements of the corps and COSCOMs for will also coordinate with the COSCOM for themovement control, nonmedical supplies and transportation of these soldiers to the replace-equipment, and field services. This section will ment companies. Table 2-7 lists the staffing forprovide one basic uniform to RTD soldiers and this division.

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(l) Health service materiel officer(70K67). This officer irresponsible to the Chief,Administrative Services. He plans, coordinates,and manages the entire logistics system for thehospital. Additionally, he controls and managesthe budget for the hospital commander. He isalso responsible for hospital field waste and safetyprocedures (refer to Appendixes C and D forexamples of these programs).

(2) Health service materiel officer(70K67). This officer is responsible to the Chief,Supply and Services Division. He has primaryresponsibility for the medical supply area andfunctions as the supply officer for the hospital.This officer is also responsible for managing thecontrolled substances stored by the medical sup-ply section.

(3) Power systems technician(210A5). This warrant officer is responsible tothe Chief, Supply and Services Division. Headvises the command on the status, maintenance,and repairs of general support (GS) equipment.He supervises organizational maintenance ofwheeled vehicles, associated support equipment,and power support equipment. He is responsiblefor the preparation of log books, maintenancerecords, and associated reports.

(4) Health service maintenancetechnician (670A0). This warrant officer is re-sponsible to the Chief, Supply and Services Divi-sion. He supervises and assists in the installationand maintenance of hospital equipment. Heserves as the technical consultant to all membersof the hospital staff on medical maintenance mat-ters. He also supervises scheduled (preventivemaintenance) and unscheduled (repair) serviceson medical and related equipment within hisscope of responsibility.

(5) Medical supply noncommis-sioned officer (76J40). This NCO assists thedivision chief in the supervision of the logistics

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division, to include medical supply operations,stock control, and medical assemblage manage-ment. He is responsible for the development andpreparation of plans, maps, overlays, sketches,arid other administrative procedures related toemployment of the supply and service division.

(6) Motor sergeant (63B40). ThisNCO is responsible to the power systems techni-cian for unit maintenance on wheeled vehiclesand MHE and the upkeep of hand and powertools. He supervises, trains, advises, and inspectssubordinate personnel in the use of the ArmyMaintenance Management System (TAMMS),prescribed load list (PLL), and automated sys-tems output. He is also responsible for super-vising the training and licensing of vehicle andequipment operators and ensuring their skillsqualification.

(7) Medical equipment repairer/supervisor (91A30). This NCO is responsible tothe health service maintenance technician forperforming and supervising hospital medicalmaintenance operations. He is responsible forinterpreting technical publications that apply toinspection, troubleshooting, maintenance, repair,calibration, and testing of medical equipment.He also supervises the operation of TAMMIS-MEDMNT.

(8) Senior utilities equipment re-pairer (52C30). This NCO is responsible to thepower systems technician for supervising andperforming unit maintenance of utilities quarter-master equipment. He inspects the installationand condition of power generation and distri-bution equipment systems.

(9) Shower noncommissioned offi-cer (57E30). This NCO is responsible to themedical supply sergeant for the supervision oflaundry and bath operations for the hospital. Hesupervises the subordinate laundry specialists.He coordinates with the supporting engineer unit

FM 8-10-14

and quartermaster unit for water support andwastewater disposal.

(10) Senior mechanic (63B30). ThisNCO assists the motor sergeant in the perfor-mance of his duties. He instructs and supervisessubordinate personnel in proper unit mainte-nance practices and procedures.

(11) Medical storage supervisor(76J30). This NCO is responsible to the medicalsupply sergeant for supervising and planninghospital storage activities. He operates theTAMMIS-MEDLOG for the hospital.

(12) Supply sergeant (92Y30). Thesupply sergeant is responsible to the medicalsupply NCO for the requisitioning, accountabili-ty, and issuing of general supplies and equipmentfor the hospital. He keeps the property book forthe hospital on the Tactical Army Combat ServiceSupport (CSS) Computer System (TACCS), usingthe standard property book supply revised (SPBS-R} system. He works in concert with the PADand requests, from the supporting direct support(DS) supply company, those minimum Class IIsupply items authorized for issue to RTD soldiers(to include mission-oriented protective posture[MOPPI gear, if required). He ensures that RTDsoldiers are provided transportation to the re-placement company. The supply sergeant super-vises the activities of the supply specialists.

(13) Medical equipment repairer(91A20). This NCO assists the medical equip-ment repairer/supervisor in the performance ofhis duties. He advises and assists equipmentoperators in the assembly and disassembly of fieldmedical equipment.

(14) Utilities equipment repairers(52C20). These NCOs are responsible to thesenior utilities equipment repairer for repair andmaintenance of utilities-type equipment. They in-stall heating, refrigeration, and air-conditioning

equipment. They are also light-vehicle operatorsfor the section.

(15) Power-generator equipment re-pairer (52D20). This NCO is responsible to thepower systems technician for performing unit-level maintenance functions on power generationequipment and associated items. He also super-vises the subordinate power-generator equipmentrepairer.

(16) Team chiefs (57E20). TheseNCOs assist the shower NCO in performing hisduties. They also conduct laundry site recon-naissance to determine the best site based ondrainage, water supply, hospital layout, cover,and concealment.

(17) Light-wheeled vehicle mechanic(63B20). This mechanic iS responsible tO themotor sergeant for those mechanical duties with-in his scope of responsibility. He also performsdriver operator duties.

(18) Quartermaster and chemicalequipment repairer (63J20). This NCO is respon-sible to the senior utilities equipment repairer fortroubleshooting and repairing quartermaster andchemical equipment malfunctions.

(19) Medical supply sergeants (76J20).These NCOs are responsible to the medical sup-ply NCO in performing medical supply duties.They supervise the medical supply specialists.

(20) Equipment receiver/parts spe-cialist (92A20). This soldier is responsible to themotor sergeant for maintaining equipment rec-ords and repair parts list and performing mainte-nance control duties. He also performs driveroperator duties.

(21) Signal support systems main-tainer (31U10). This individual is responsible tothe medical supply sergeant for removing,

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installing, and providing unit-level maintenanceof tactical radio communications systems, fieldwire equipment, and other electronic items ofequipment. He works in coordination with theChief, Hospital Operations Section.

(22) Medical equipment repairers(91A10). These repairers are responsible to themedical equipment repairer/supervisor for per-forming unit-level maintenance on assignedmedical equipment. They also assist in trainingequipment operators in the performance ofoperator-level preventive maintenance checksand services (PMCS).

(23) Utilities equipment repairers(52C10). These repairers are responsible to thesenior equipment repairer for unit maintenanceof refrigeration equipment, air-conditioning units,and gasoline engines used as prime movers ofrefrigeration units. They are also vehicle opera-tors for their section.

(24) Power generator equipment re-pairers (52D10). These equipment repairers areresponsible to the power generator equipmentrepairer NCO for operator and unit maintenanceof tactical utility and power generation equip-ment and associated items.

(25) Laundry specialists (57E10).These specialists are responsible to the showerNCO for performing their designated duties.

(26) Light-wheeled vehicle mechanics(63B10). These specialists are responsible to thelight-wheeled vehicle mechanic NCO for perform-ing their designated duties. They are vehicleoperators for the division.

(27) Recovery vehicle operator(63B10). This specialist is responsible to thesenior mechanic for unit-level maintenance andrecovery operations on light- and heavy-wheeledvehicles, MHE, and associated items.

(28) Medical supply specialists(76J10). These specialists are responsible to themedical supply sergeants for performing desig-nated medical supply and equipment functions.They are designated light-vehicle operators fortheir section.

(29) Petroleum light-vehicle opera-tors (77F10). These petroleum light-vehicle op-erators are responsible to the motor sergeant.They receive, store, account and care for, dis-pense, issue, and ship bulk and packagedpetroleum, oil, and lubricant (POL) supplies.They also operate and maintain the petroleumvehicles.

(30) Supply specialists (92Y10).These supply specialists assist the supply ser-geant in the accomplishment of his duties.

(31) Quartermaster and chemicalequipment repairer (63J10). This equipmentrepairer is responsible to the quartermaster andchemical equipment repairer NCO for unit main-tenance on quartermaster and chemical equip-ment.

(32) Equipment receiver/parts spe-cialist (92A10). This specialist is responsible tothe motor sergeant for maintaining equipmentrecords and repair parts lists and performingmaintenance control duties.

h. Nursing Service Control Team. Thisteam is responsible to the Chief, Nursing Servicefor supervision of all nursing service personnelregardless of organizational placement. Thisteam also provides daily patient reports to thechief nurse and PAD and is responsible for thestandards of nursing practice and nursing carethroughout the facility. The staff to provide thiscontrol are the assistant chief nurse, chief andassistant chief wardmasters, and a respiratoryNCO (Table 2-8).

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(1) Assistant chief nurse (66A00).The assistant chief nurse works in concert withthe Chief, Nursing Service. This nurse plans,organizes, executes, and directs nursing carepractices for the hospital. This officer holds theadditional skill identifier (ASI) 8J as an infectioncontrol officer.

(2) Chief wardmaster (91C50).This master sergeant manages and supervisesenlisted personnel and assists in the planningand operation of nursing service. He coordinateswith the operations section in planning thehospital layout. He is responsible to the chiefnurse for the erection of the hospital clinicalfacilities.

(3) Assistant chief wardmaster(91C40). This NCO assists the chief wardmasterin supervision of enlisted personnel and operationof nursing service.

(4) Respiratory noncommissionedofficer (91V40). Under the technical guidance ofa physician or nurse anesthetist, this NCO super-vises the respiratory activities within nursingservice.

i. Triage/Preoperative/Emergency Medi-cal Treatment. This section provides for thereceiving, triaging, and stabilizing of incomingpatients. The staff will receive patients, assesstheir medical condition, provide EMT, andtransfer them to the appropriate areas of the

hospital The staff will be trained in both ad-vanced cardiac life support (ACLS) and ATM.The staff monitors patient conditions and pre-pares those requiring immediate surgery for theOR. Sick call for organic staff is conducted bythis section. Table 2-9 lists the staffing for thissection.

(1) Emergency physician (62A00).This physician is responsible to the Chief,Professional Services (or the designated chief ofemergency medical services) for management andoperations of this section. He examines, diag-noses, and treats or prescribes courses of treat-ment for the initial phase of diseases and injuries.This officer is the physician primarily responsiblefor triage.

(2) Head nurse (66H00). Thisnurse manages the operations of the EMT sec-tion, to include staffing and supervising nursingpersonnel and developing nursing policies andprocedures. He is also responsible for the stan-dard of nursing care provided and assists in pro-viding patient care.

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(3) Primary care physician(61H00). This physician provides care to patientsin the areas of general medicine, obstetrics/gynecology (OB/GYN), psychiatry, PVNTMED,pediatrics, and orthopedics. When the EMT/surgical patient load is heavy, this officer canassume the duties of triage and preoperativeevaluation/care.

(4) Emergency physician (62A00).This physician examines, diagnoses, and treatsor prescribes course of treatment for the initialphase of disease and injuries.

(5) Medical-surgical nurses (66H00).These nurses plan and implement nursing careunder the supervision of the head nurse. Theyprovide direct supervision to subordinate nursingservice personnel.

(6) Emergency treatment noncom-missioned officer (91B40). This NCO is respon-sible to the senior nurse. He manages andsupervises the enlisted nursing staff. He is alsoresponsible for supplies and equipment.

(7) Emergency treatment non-commissioned officers (91B30/91B20). TheseNCOs are supervised by the principal NCO. Theyperform direct patient care within their scopeof practice and under professional supervision.They supervise subordinate nursing staff.

(8) Medical specialists (91B10).Under professional supervision, these specialistsare responsible for providing nursing care withintheir scope of practice.

j. Litter Bearer Section. This sectionis responsible to the triage/preoperative/EMTsection for the transportation of patients withinthe hospital on a 24-hour basis. The staffing isidentified in Table 2-10.

(1) Senior litter bearers (91B20).These NCOs are responsible to the emergencytreatment NCO (triage/preoperative/EMT sec-tion). They supervise and coordinate the acti-vities of the subordinate litter bearers.

(2) Litter bearers (91B10). Theselitter bearers are responsible for transportingpatients internally in the hospital. They are alsoresponsible for loading and off-loading air andground ambulances.

k. Operating Room/Central MaterielService (CMS) Control Team. This team providessupervision of the OR and CMS. It is responsiblefor the scheduling of nursing staff, preparing andmaintaining the OR and CMS, and the main-taining of surgical, anesthetic, and nursing stand-ards within these areas. The OR/CMS controlteam is composed of an anesthesiologist, a clinicalhead nurse, an OR NCO, and a CMS NCO (Table2-11).

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(1) Anesthesiologist (60N00). Thisphysician supervises team members and is re-sponsible to the Chief, Surgical Services. Heestablishes the hospital’s anesthesiology program.He administers or supervises administration ofanesthetics to patients in the ORs.

(2) Operating room clinical headnurse (66E00). This officer is responsible to thechief nurse for the management of daily opera-tions of the OR and CMS to include schedulingand supervision of nursing staff. He coordinateswith the Chief, Surgical Services in the sched-uling of patient cases. He is responsible for thequality of nursing care provided.

(3) Central materiel service non-commissioned officer (91D40). This NCO is re-sponsible to the clinical head nurse for supplies,equipment maintenance, and supervision of en-listed CMS nursing staff.

(4) Operating room noncommis-sioned officer (91D40). This NCO is responsibleto the clinical head nurse for the supervision andmanagement of the enlisted OR nursing staff. Healso manages supplies and equipment.

l. Operating Room A. This section pro-vides general surgical services with two OR tablesfor a total of 36 hours of table time per day. Thestaff is composed of general surgeons, OR nurses,nurse anesthetists, and OR specialists (Table 2-12).

(1) General surgeon (61J00). Thesenior physician is responsible to the Chief, Sur-gical Service for the operations of the surgeryteam. These physicians examine, diagnose, andtreat or prescribe courses of treatment and sur-gery for patients having injuries or disorders withsurgical conditions.

(2) Operating room nurse (66E00).This nurse is responsible to the OR clinical headnurse for all nursing activities of this section. Hesupervises the OR enlisted staff. This officerperforms nursing duties in any phase of the op-erative process for patients undergoing surgery;he ensures that safe supplies and equipment areavailable for operative services.

(3) Operating room nurse (66E00).This nurse performs nursing duties in any phaseof the operative process for patients undergoingsurgery; he also ensures that safe supplies andequipment are available for operative services.He supervises the OR enlisted nursing staff. Heis responsible to the chief OR nurse.

(4) Clinical nurse, anesthetists(66F00). These two anesthetists perform nursingduties of a specialized nature in the care of pa-tients requiring general or regional anesthesia,respiratory care, cardiopulmonary resuscitation,and/or fluid therapy. Under the supervision ofthe anesthesiologist (OR/CMS control team), theyadminister general and regional anesthesia forsurgical patients.

(5) Operating room noncommis-sioned officer (91D30). This NCO is responsibleto the chief OR nurse for supplies, equipmentmaintenance, and supervision of enlisted nursingstaff.

(6) Operating room specialists(91D20/91D10). Under professional supervision,these specialists provide patient care within theirscope of practice.

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m. Operating Room B. This sectionprovides orthopedic surgical services with two ORtables for a total of 36 hours of table time per day.The staff is composed of orthopedic surgeons, ORnurses, nurse anesthetists, OR NCO, and ORspecialists (Table 2-13). This OR may be used bythe oral surgeon in performing oral and maxillo-facial surgery.

(1) Orthopedic surgeons (61M00).The senior physician is responsible to the Chief,Surgical Service for operations of the OR. Thesephysicians examine, diagnose, and treat orprescribe courses of treatment and surgeryfor patients having disorders, malfunctions,diseases, and/or injuries of the musculoskeletalsystem.

(2) Remaining staff. The dutiesand responsibilities of the remaining OR B staffare the same as the corresponding staff identifiedin paragraph l. The OR specialist (91D10) is thedesignated vehicle operator for this section.

n. Orthopedic Cast Clinic. This clinicis responsible to the senior orthopedic surgeonfor casting, splinting, and traction services forthe hospital. The staff is composed of anorthopedic NCO and orthopedic specialists (Table2-14).

(1) Orthopedic noncommissionedofficer (91B20, ASI P1). This NCO is responsibleto the senior orthopedic surgeon for the operationof this clinic. He supervises the other specialists.

(2) Orthopedic specialists (91B10,ASI P1). Under professional supervision, thesespecialists provide patient care within their scopeof practice.

o. Central Materiel Service. This sec-tion operates two CMS units which provide steri-lization of OR equipment, surgical instruments,and supplies, as well as sterile supplies for otherpatient care areas. The staff is composed of twoCMS sergeants and six CMS specialists (Table2-15).

(1) Central materiel service spe-cialists (91D20). These NCOs work under thesupervision of the CMS NCO of the OR/CMScontrol team. They supervise the activities of theCMS specialists. They ensure that sterilizationtechniques and procedures are applied and fur-ther ensure that safe sterile supplies are provided

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FM 8-10-14

to users on a timely basis. They also superviseoperator-level maintenance on CMS equipment.

(2) Central materiel service spe-cialists (91D10). These CMS specialists are re-sponsible to the CMS section sergeants. Theyperform CMS functions within their scope ofresponsibility.

P. Dental Services. This section pro-vides dental services and consultation for patientsand staff. During mass casualty situations, thedentists assist in the delivery of ATM. The oralsurgeon uses the ORB or the dental operatory toperform oral and maxillofacial surgery. The staffis composed of an oral surgeon, a comprehensivedental officer, a preventive dental NCO, and adental specialist (Table 2-16).

(1) Oral and maxillofacial surgeon(63N00). This officer examines, diagnoses, andtreats or prescribes courses of treatment for con-ditions which involve oral surgical procedures,including oral and maxillofacial injuries, wounds,and infections. Additionally, treatment is pro-vided to patients referred by other dental andmedical facilities when required oral and maxillo-facial care is beyond the capability of the refer-ring facility. This officer is responsible to theChief, Professional Services for the technical andadministrative management of the section.

(2) Comprehensive dental officer(63B00). This officer provides emergency care to

staff and in-patients. When work load permits,this officer provides maintaining-level dental careto the same population and to patients referredfrom other dental and medical facilities whenthe required dental treatment is beyond the ca-pability of the referring facility. In addition, heprovides OR assistance and support to the oraland maxillofacial surgeon, when requested. Healso augments the ATM capability of the hospital,particularly during mass casualty situations.

(3) Preventive dental noncommis-sioned officer (91E20). This NCO assists thedental officers in prevention, examination, andtreatment of diseases of teeth and oral region.He also performs those administrative tasks asdirected by the oral surgeon. He supervisesoperator-level maintenance of the dental equip-ment. This NCO holds the ASI X2, designatingformal dental hygiene training.

(4) Dental specialist (91E10). Thisspecialist is responsible to the preventive dentalNCO. He assists in the prevention, examination,and treatment of diseases of teeth and oral re-gion. He performs operator-level maintenance ofdental equipment.

q. Inpatient Medicine A. This sectionprovides medical services such as consultations,as requested; evaluation and treatment of infec-tious disease and internal medicine disorders;evaluation and treatment of skin disorders; andtreatment of patients with gynecological disease,injury, or disorders. Staffing includes internists,primary care physicians, and an obstetrician andgynecologist (Table 2-17).

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(1) Obstetrician/gynecologist(60J00). This physician provides medical careduring pregnancy, performs obstetric deliveries,and examines, diagnoses, and treats or prescribescourses of treatment for patients who have gyne-cological disease, injury, or disorders. He is re-sponsible to the Chief, Professional Services forthe technical and administrative management ofthis section.

(2) Internists (61F00). These in-ternists examine, diagnose, and treat patientswith medical illnesses and recommend courses ofmanagement for those illnesses.

(3) Primary care physicians(61H00). These physicians provide comprehen-sive health care to patients in the areas of generalmedicine, OB/GYN, psychiatry, PVNTMED, pe-diatrics, and orthopedics in both inpatient andoutpatient care. They may be used to augmentsurgical specialties in triage and preoperativecare.

r. Intensive Care Unit Wards. Thesethree 12-bed intensive care units (ICUs) providefor critically injured or ill patients. As ICUnurses, the clinical nurses hold an ASI of 8A.This section is under the supervision of the nurs-ing service control team. Nursing care is per-formed for those patients who require close ob-servation and vital sign monitoring, complexnursing care, and mechanical respiratory assis-tance. The ICU is also used as a postanesthesiarecovery area for patients after surgery. Inten-sive care is provided by a staff of a clinical headnurse, clinical nurses, a wardmaster, practicalnurses, and medical and respiratory specialists(Table 2-18).

(1) Clinical head nurses, intensivecare unit (66H00). These officers are responsibleto the nursing service control team for managingthe operations of the ICU to include the develop-ment of nursing policies and procedures and the

scheduling and supervision of nursing staff. Theyare responsible for the quality of nursing care.They supervise all other ICU nursing personnel.

(2) Clinical nurses, intensive careunit (66H00). These clinical nurses are respon-sible to the clinical head nurse for planning andproviding nursing care of a specialized and tech-nical nature for the care and treatment of criti-cally injured or ill and postanesthesia patients.They supervise enlisted nursing personnel.

(3) Wardmasters (91C40). TheseNCOs work under the supervision of the ICUhead nurses. They also work in concert with thechief wardmaster of the nursing control team.They manage and supervise enlisted personneland assist in the planning and operation of theICU.

(4) Practical nurses (91C30).These practical nurses are responsible to thewardmaster. They provide direct patient careunder professional supervision within their scopeof practice. They also assist in supervising thesubordinate enlisted nursing staff.

(5) Respiratory noncommissionedofficers (91V30). These NCOs provide technicalguidance and training of subordinate personnel.

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They manage the respiratory care functionsunder the supervision of a physician or nurseanesthetist.

(6) Practical nurses (91C20). Thesepractical nurses perform preventive, therapeutic,and emergency nursing care procedures underprofessional supervision within their scope ofpractice.

(7) Respiratory sergeants (91V20).These respiratory sergeants provide treatmentfor patients with cardiopulmonary problemsunder the supervision of a physician or nurseanesthetist. Included is emergency care in casesof heart failure, shock, treatment of acuterespiratory symptoms in cases of head injuries,and respiratory complications in patients havingthoracic or abdominal surgery.

(8) Medical specialists (91B10).These specialists provide direct patient carewithin their scope of practice under thesupervision of a clinical or practical nurse.

s. Intermediate Care Wards. Theseseven intermediate care wards (ICWs) with 20beds per ward are identical in personnel andequipment. They are under the supervision ofthe nursing service control team. These wardsprovide care for patients whose conditions varyfrom acute to moderate. The nursing care staffconsists of a clinical head nurse, clinical nurses,a wardmaster, practical nurses, and medical spe-cialists (Table 2-19). The responsibilities andfunctions of the clinical head nurses, clinicalnurses (66H00), wardmasters, practical nurses,and medical specialists are the same as thoseidentified in paragraph r above, The clinicalnurses (66J00) assist the clinical head nurse intheir duty performance. They perform first-levelnursing care duties within their scope of clinicalnursing activities. The lowest-grade medicalspecialist is the designated vehicle operator forthe section.

t. Neuropsychiatric Ward and Consul-tation Service. This section provides NP diag-nosis and consultation to all areas of the hospital;it staffs a 20-bed ward for inpatient stabilizationof NP patients. The staff for this section consistsof a psychiatrist, psychiatric nurses, clinicalnurses, a social worker, a behavioral scienceNCO, an occupational therapy NCO, and psy-chiatric specialists (Table 2-20). Medical groupand brigade headquarters integrate the CSH NPsection’s operations with those of the division andASMB mental health sections, and with the CSCunits in the area. To the extent possible, theCSH NP ward should receive only those NP and/or stress casualties who are too disturbed to re-ceive restoration treatment at Echelon II MTFsor CSC fatigue centers. These casualtiesinclude—

• Cases of psychosis, paranoia,mania, and suicidal depression.

• Substance overdose or with-drawal requiring detoxification.

• Mental or bodily symptomswhich require CSH laboratory and x-ray capabili-ty to rule out life- or limb-threatening organiccauses.

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The mission of the NP ward is to provide brief (2to 4 days) stabilization. The patients are thenreevaluated to determine if they should be—

• Evacuated to a GH in theCOMMZ (or to CONUS) for further stabilizationand evacuation, definitive treatment, or admin-istrative discharge.

• Evacuated to a FH or CSCcompany in the COMMZ for RTD after 14 to 28days of further reconditioning (depending on thetheater evacuation policy).

• Returned to duty in the CZ,usually after transfer to a CSC unit’s recondi-tioning center for 4 to 10 days further treatment.

The CSC reconditioning center may be collocatedwith the CSH. The CSC center will maintain itsseparate, nonhospital identity, but coordinatesclosely with the CSHs NP service. The CSCreconditioning center, if attached to the CSH, willrequire administrative and logistical support.The NP section’s consultation mission provides—

• Diagnosis and recommenda-tions for treatment for medical/surgical patientswith organic mental disorders on all other CSHwards and in-patient admissions (emergencyroom).

• Assistance, including stressdebriefings, to all RTD and NRTD patients withstress issues.

• Assistance, including routineand special stress debriefings, to all CSH staff, inclose cooperation with leadership and thechaplains.

Stress casualties (battle fatigue and misconductstress behaviors) may be brought to the hospitalwho do not require in-patient admission. Thosecases must be triaged by the NP service and

treated and released to their units for duty, ad-ministrative action, or rest and outpatient follow-up.

(1) Psychiatrist (60W00). This offi-cer is responsible to the Chief, ProfessionalServices for the technical and administrativemanagement of this section. He supervises theNP service staff, advises the CSH commander,and provides technical supervision of NP/mentalhealth activities throughout the CSH. Heexamines, diagnoses, treats and or prescribestreatment, and recommends disposition forpatients and staff with NP and stress disorders.

(2) Psychiatric/mental health nurse(66C00). This officer is responsible for the tech-nical and professional management of the NPward nursing staff He provides psychiatric nurs-ing consultation to all other wards of the CSH.He provides specialized nursing services forpatients with psychiatric and emotional problemsand promotes mental health within the hospitaland support area. This nurse performs liaison,

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consultative, and training functions throughoutthe CSH to enhance the continuity and quality ofpatient care.

(3) Psychiatric/mental health nurses(66C00). These officers are responsible to thepsychiatrist and head nurse in the operation ofthe ward and consultation throughout thehospital. They develop and carry out nursingcare plans for each NP ward patient. Thesenurses also assist in the training, supervising,and technical management of subordinate NPward staff, including the nonpsychiatricallytrained nurses and augmenting technicians.

(4) Social work officer (73A67).This officer is responsible to the psychiatrist. Heprovides stress control prevention and treatmentthroughout the hospital, and especially to theminimum care (RTD-oriented) wards. Hesupports the NP ward by evaluating the RTDpotential of patients, based on interviews withthe soldier, plus data from the soldier’s unit. Hecoordinates RTD, administrative disposition, ortransfer to the CSC reconditioning center. Thesocial work officer also assures effective use ofsocial service support agencies for patients andCSH staff members.

(5) Clinical nurse (66H00). Thisclinical nurse is responsible to the head nurse fordirect and surgical nursing care to patients onthe ward. He is cross-trained in stress controltechniques and procedures.

(6) Psychiatric noncommissionedofficer (91F30). This NCO assists the wardmasterin the performance of his duties. He providespsychiatric nursing care duties within his scopeof practice under professional supervision.

(7) Psychiatric wardmaster (91F30).This NCO assists the psychiatrist and nursingstaff with the management and administrative

functions of the ward. He provides psychiatricnursing care duties within his scope of practiceunder professional supervision.

(8) Psychiatric noncommissionedofficers (91F20). Under professional supervision,these NCOs provide psychiatric nursing carewithin their scope of practice.

(9) Behavioral science noncommis-sioned officer (91G20). Under professional super-vision, this NCO provides mental health assess-ment and care within his scope of practice.

(10) Occupational therapy noncom-missioned officer (91B20, ASI N3). This NCO iSresponsible to the head nurse for establishing andconducting the work therapy and recreationalprograms throughout the CSH, and especially theminimal care wards. Under professional super-vision, he provides occupational therapy withinhis scope of practice. If additional clinicalguidance is required for planning and imple-menting occupational therapy programs, occupa-tional therapists (65A) are assigned to CSC com-panies and detachments, FHs, and GHs.

(11) Psychiatric specialists (91F10).These specialists are responsible to the psy-chiatric NCOs. Under professional supervision,they provide care and treatment for psychiatric,drug, and alcohol patients within their scope ofpractice.

u. Minimal Care Wards. These twominimal care wards of 20 beds each provide carefor patients whose conditions vary from moderateto minimal. These are convalescent patients withminimal requirements for nursing and medicaltreatment. Staffing is composed of clinicalnurses, a wardmaster, practical nurses, andmedical specialists (Table 2-21). Resupply ofconsumables is similar to that described for theICU.

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(1) Clinical nurses (66H00). Thesenurses are responsible to the nursing servicecontrol team for management and operations ofthe ward. They supervise the enlisted nursingstaff and perform appropriate nursing duties.

(2) Wardmaster (91C30). ThisNCO assists the clinical nurses in ward manage-ment. He provides nursing care leadership andsupervises subordinate staff. This NCO alsoworks in concert with the chief wardmaster ofthe nursing service control team.

(3) Practical nurse (91C20). Thispractical nurse is responsible to the wardmasterand, under professional supervision, performsnursing care duties within his scope of practice.

(4) Medical specialists (91B10).Under professional supervision, these specialistsprovide medical treatment to patients withintheir scope of practice.

u. Pharmacy Services. The pharmacyis responsible for quality control of pharmaceu-ticals, distribution of bulk drugs, maintenanceand publication of the hospital formulary, and theintravenous (IV)-additive program. This sectionmaintains a registry for controlled drugs. Thepharmacy provides discharge medications for therequired number of days to complete therapy and/or a 5-day supply of medications required for airevacuation out of theater. The pharmacy requisi-tions required supplies through the logisticssection to the supporting MEDLOG battalion

(forward). The staff is composed of pharmacyofficers, NCOs, and specialists (Table 2-22).Three of the enlisted staff hold the ASI Y7 (sterilepharmacy specialty) for the IV-additive program.

(1) Chief, pharmacy services(67E00). This officer is responsible to the Chief,Professional Services (or the designated chief ofancillary service). He directs, plans, and partici-pates in all hospital pharmaceutical activities. Heis responsible for and maintains security withinthe pharmacy area and monitors the storage,security, and control to include inventories andaudit trails of controlled substances. He also actsas a liaison between the professional staff andthe logistics office for requisition of pharmaceu-tical items.

(2) Pharmacy-officer (67E00). Thisofficer assists the Chief, Pharmacy Services inthe performance of his duties. He supervisesother pharmaceutical staff and collects data forrequired reports.

(3) Pharmacy noncommissionedofficer (91Q40). This NCO serves as the non-commissioned officer in charge (NCOIC), phar-macy services. He is responsible for the workschedule of subordinate specialists; he is alsoresponsible for ensuring adequate training for all

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FM 8-10-14

subordinate specialists. He prepares, controls,and issues pharmaceutical products under thesupervision of a pharmacist. He also assists withthe supervision of the section, providing technicalguidance to subordinate personnel.

(4) Pharmacy and sterile pharma-cy noncommissioned officers (91Q30). These NCOsassist the pharmacy officer and NCO in their dutyperformance. They prepare, control, and issuepharmaceutical products, ensuring compliancewith Army and Federal rules, laws, andregulations relative to pharmacy operations. Oneof these specialists holds the Y7 ASI. Thisspecialist serves as the NCOIC of the sterileproducts service. He performs sterile techniqueprocedures in the preparation of items such asIV-additives which are used to combat infectionand to restore and maintain electrolyte and nutri-tional balance.

(5) Pharmacy/sterile pharmacyspecialists (91Q10). Under professional super-vision, these specialists perform pharmaceuticalduties within their scope of duties. Two of thesespecialists will hold the Y7 ASI. Their duties assterile pharmacy specialists will be the same asthose identified in paragraph (4) above.

w. Laboratory Services. This sectionperforms a limited array of analytical proceduresin hematology, urinalysis, chemistry, micro-biology, and blood bank. The staff is composed ofa clinical laboratory officer, laboratory NCOs, andmedical laboratory specialists (Table 2-23). The91K10 specialists hold the M4 ASI in bloodbanking procedures in order to provide back upcapability for the blood bank section.

(1) Clinical laboratory officer(71E67). This officer is responsible to the Chief,Professional Services (or the designated chief ofancillary services) for management and operationof the laboratory section. He directs the per-formance of laboratory procedures used in the

detection, diagnosis, treatment, and preventionof disease. He establishes and supervises anappropriate laboratory quality control program.He also supervises the blood bank activities.

(2) Medical laboratory noncom-missioned officer (91K40). This NCO advises andassists the laboratory officer in laboratory opera-tions, supply economy and inventory manage-ment, advanced technical procedures, and ad-ministrative requirements. He provides technicalguidance and supervision to the subordinate staff.

(3) Medical laboratory specialists(91K30). These specialists Perform elementaryand advanced examinations of patient-derivedspecimens (including suspect biological warfarespecimens) to aid in the diagnosis, treatment, andprevention of disease.

(4) Medical laboratory specialist(91K20). This laboratory specialist performs clini-cal laboratory procedures in hematology, bio-chemistry, serology, bacteriology, parasitology,and urinalysis. He collects and processes speci-mens for shipment to supporting laboratories andstores and issues blood.

(5) Medical laboratory specialists(9IK10) (ASI M4). These specialists performelementary clinical laboratory and blood bankingprocedures under the supervision of the labora-tory NCO.

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x. Blood Bank. This section providesall routine blood grouping and typing, ab-breviated cross-matching procedures, emergencyblood collection, and blood inventory man-agement. It has the capacity to store and issueliquid blood components and fresh frozen plasma.Staffing for this section includes a medical lab-oratory NCO and medical laboratory specialists(Table 2-24). All blood bank personnel hold theM4 ASI.

(l) Medical laboratory noncom-missioned officer (91K30). This NCO is respon-sible to the Chief, Laboratory Services for themanagement and operation of this section. Heperforms advanced procedures in all phases ofblood banking. He supervises subordinate spe-cialists in the performance of their duties.

(2) Medical laboratory specialists(91K20/91K10). The duties and functions of theremaining staff are the same as the correspond-ing staff in paragraphs w(4) and (5).

y. Radiology Service. This sectionprovides radiological services to all areas of thehospital and operates on a 24-hour basis. Staffingincludes a radiologist, x-ray NCOs, and x-rayspecialists (Table 2-25).

(1) Diagnostic radiologist (61R00).This officer is responsible to the Chief, Profes-sional Services (or the designated chief of ancil-lary service) for the management and operation

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of this section. He performs and interprets alldiagnostic radiological and fluoroscopic proce-dures, including special vascular studies andimaging, on patients referred by other physicians.

(2) Radiology specialist (91P30).This specialist assists the radiologist in the per-formance of his duties, to include technical guid-ance to subordinate personnel. He assists in thetechnical and administrative management of thissection.

(3) Radiology sergeant (91P20).This NCO performs duties within his scope oftraining under the supervision of the radiologyspecialist.

(4) Radiology specialists (91P10).These specialists perform duties within theirscope of training under the supervision of thex-ray NCOs. They also perform vehicle operatorduties for the section.

z. Physical Therapy Service. This sec-tion provides inpatient physical therapy servicesand consultation for patients. The primarywartime role of this section is evaluating andtreating neuromusculoskeletal conditions andproviding burn/wound care to patients withpotential for RTD within the corps evacuationpolicy. During mass casualty situations, physicaltherapy personnel may be utilized in managingminimal or delayed patients, or augmenting the

FM 8-10-14

orthopedic staff. The staff is composed of aphysical therapist and physical therapy sergeants(Table 2-26).

(1) Physical therapist (65B00).This officer is responsible to the Chief, Profes-sional Services (or the designated chief of ancil-lary service) for the management and supervisionof physical therapy services. The physical thera-pist plans and supervises physical therapy pro-grams upon referral from medical officers. Thisofficer also provides guidance in the areas ofphysical fitness, physical training, and injuryprevention.

(2) Physical therapy sergeants(91B20, ASI N9). These physical therapy ser-geants are responsible to the physical therapist.They provide physical therapy treatment to pa-tients within their scope of practice.

aa. Hospital Ministry Team. This sec-tion is composed of a chaplain, a senior chaplain’sassistant, and a chaplain’s assistant to providereligious support and pastoral care ministry forassigned staff and patients (Table 2-27).

(1) Hospital chaplain (56A00).This chaplain, supervised by the hospital head-quarters chaplain, coordinates the program ofreligious ministries, including workshops, pas-toral counseling, and religious education for thehospital. He supervises the activities of the otherministry team staff.

(2) Senior chaplain’s assistant(71M20). This senior chaplain’s assistant is re-sponsible to the hospital chaplain and assists himin his duties. He also supervises the activities ofthe chaplain’s assistant.

(3) Chaplain’s assistant (71M10).This assistant is responsible to the senior chap-lain’s assistant. He prepares the chapel forworship and prepares sacraments of Protestant,Catholic, Orthodox, and Jewish faiths.

2-6. The Hospital Unit, Surgical

The HUS augments the HUB to form the CSH.The HUS is composed of the following sections:

a. Unit Headquarters. This sectionprovides augmentation to the HUB to assist innursing supervision, hospital operation, andcompany headquarters operation. The staff iscomposed of the HUS commander, an assistantchief nurse, a field medical assistant, a detach-ment NCO, and a patient administration spe-cialist (Table 2-28).

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(1) Hospital commander (61J00).This officer, in his capacity as the HUS com-mander, ensures a smooth and functional inte-gration of unity of the HUS with the HUB. Oncethe two units are combined to form a CSH, thisofficer performs the duties of a surgeon in OR C.

(2) Assistant chief nursing service(66A00). This officer functions in unison withthe chief nurse of the HUB in providing thenecessary planning, execution, and direction forthe HUS.

(3) Field medical assistant (70B67).This officer assists the HUS commander in theareas of organizational administration, supply,training, operation, transportation, and patientevacuation. When collocated with the HUB, thisofficer will perform duties as the hospital plansofficer.

(4) Detachment noncommissionedofficer (91B40). The detachment NCO is theprincipal enlisted assistant to the HUS com-mander. He maintains liaison between the HUScommander and assigned NCOs, provides guid-ance to enlisted members of the HUS, and repre-sents them to the commander. When the HUBand HUS unite to form a CSH, he also functionsas the first sergeant of the medical holding de-tachment. As such, he is supervised by the HUBcompany headquarters commander who func-tions as the commander, medical holding detach-ment.

(5) Patient administration special-ist (71G10). This specialist works in concert withthe PAD of the HUB in preparing and main-taining patient records, to include statistical datafor required reports.

b. Supply and Service Division (Aug-mentation). Because of the increased work loadassociated with the HUS, this section augmentsthe supply and service division of the HUB.

Staffing includes a medical supply sergeant, asupply sergeant, medical supply specialists, andsupply specialists (Table 2-29).

(1) Medical supply sergeant(76J20). This NCO is responsible to the medicalsupply NCO (HUB) for medical supply operations,stock control, and medical assemblage manage-ment. He is responsible for the development andpreparation of plans, maps, overlays, sketches,and other administrative procedures related toemployment of the HUS supply and servicedivision.

(2) Supply sergeant (92Y20). ThisNCO is responsible for general supply operations,to include supervision of the supply specialists.He maintains accountability for all equipmentorganic to the HUS.

(3) Medical supply specialists(76J10). These specialists are responsible to themedical supply sergeant for performing desig-nated medical supply and equipment functions.

(4) Supply specialists (92Y10).These supply specialists assist the supply ser-geant in his duty performance. They request,receive, inspect, load, unload, segregate, store,issue, and turn in organizational supplies andequipment. One of the specialists will functionas the armorer. The armorer maintains theweapons storage area, issues and receives small

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arms and ammunitions, and performs small armsunit maintenance.

c. Operating Room/Central MaterialService Control Team. This team provides aug-mentation to the HUB to assist in supervisingand scheduling the nursing staff and in preparingand maintaining the OR/CMS. The ranks andtitles of the personnel (Table 2-30) are designedto interface with the HUB OR/CMS control team(Table 2-11) to provide support without dupli-cating duties and responsibilities.

(1) Anesthesiologists (60N00). Thisphysician administers or supervises administra-tion of anesthetics to patients.

(2) Clinical head nurse, anesthe-tist (66F00). This officer performs nursing dutiesin the care of patients requiring general or re-gional anesthesia, respiratory care, cardiopul-monary resuscitation, and/or fluid therapy.Under the supervision of an anesthesiologist, headministers general and regional anesthesia forsurgical patients as required.

i (1)--(8).

(3) Assistant head nurse, operat-ing room (66E00). This assistant head nurseperforms nursing duties in any phase of the op-erative process for patients undergoing all typesof surgery and provides safe supplies and equip-ment for operative services.

d. Triage/Preoperative/EmergencyMedical Treatment Section. This section providesfor the receiving, triaging, and stabilizing of in-coming patients. The staff receives patients,assesses their medical condition, provides EMT,and triages them to the appropriate nursing unitor health service. The staff will be trained inboth advanced ACLS and ATM. The staff moni-tors patient conditions and prepares those re-quiring immediate surgery for the OR. Thissection works in conjunction with the triage/preoperative/EMT section, located in the HUB,to handle the overall work load for the hospital.This section gives the hospital commanderseveral options:

• Personnel can be used to sup-plement HUB EMT with its equipment remainingloaded for use as a jump or movement echelon.

• Part of the equipment and staffcan be used to have a sick call or minor injuryarea with all major trauma sent to the mainEMT.

• The hospital can have two fullyoperational EMTs. This would require the head-quarters to carefully monitor and evaluate theadmissions and OR requirements of these twosections if both were treating major traumapatients.

The staffing of this section is identical to that ofthe HUB (Table 2-9). The duties and responsi-bilities are the same for the corresponding posi-tions as identified in paragraphs 2-5

e. Operating Room C. This sectionprovides general and ear, nose, and throat (ENT)surgical services with two OR tables for a total of36 hours of table time per day. The staff for thissection includes general surgeons, clinical andOR nurses, an OR NCO, and OR specialists(Table 2-31).

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(1) General surgeons (61J00).These surgeons examine, diagnose, treat or pre-scribe courses of treatment and surgery for pa-tients having injuries or disorders with surgicalconditions, and perform required surgery. Asnoted in Table 2-31, the commander, HUS alsofunctions as a general surgeon in OR C. Thisrequirement is accounted for in the unit head-quarters and is not included in the total authori-zations for the OR.

(2) Other assigned personnel. Theduties and responsibilities of the OR nurse, clini-cal nurse (anesthetist), OR NCO, and OR spe-cialists are the same as identified in paragraphs

l (3) through (6). 2-5

f. Operating Room D. This sectionprovides primarily orthopedic, thoracic, and uro-logical surgical services with two OR tables for atotal of 36 hours of table time per day. Staffingfor this section includes a thoracic surgeon, aurologist, an orthopedic surgeon, a clinical nurse(anesthetist), an OR nurse, an OR NCO, and ORspecialists (Table 2-32).

(1) Urologist (60K00). The urolo-gist examines, diagnoses, and treats or prescribescourses of treatment or surgery for patients

having diseases, injuries, or disorders of the geni-tourinary tract. He performs required surgery.

(2) Thoracic surgeon (61K00).This physician examines, diagnoses, and treatsor prescribes courses of treatment and surgeryfor patients having surgical diseases or injuriesof the thorax and vascular system. He performsrequired surgery.

(3) Orthopedic surgeons (61M00).These surgeons examine, diagnose, and treat orprescribe courses of treatment and surgery forpatients having disorders, malformations, dis-eases, or injuries of the musculoskeletal systems.They perform surgical operations as required.

(4) Clinical nurse, anesthetists(66F00). These anesthetists perform nursingduties in the care of patients requiring general orregional anesthesia, respiratory care, cardio-pulmonary resuscitation, and/or fluid therapy.Under the supervision of an anesthesiologist,they administer general and regional anesthesiafor surgical patients, as required.

(5) Operating room nurses (66E00).These nurses perform nursing duties in anyphase of the operative process for patients under-going surgery. They also provide safe suppliesand equipment for operative services.

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(6) Other assigned personnel. Theduties and responsibilities of the remaining ORD staff will be the same as the corresponding staff

l, with one exception. The ORspecialist, 91D10, is the designated vehicle op-erator for this section.

n.

in paragraph 2-5

g. Orthopedic Cast Clinic. This sectionaugments the orthopedic cast clinic of the HUBto provide casting, splinting, and traction servicesthroughout the hospital. As with the multipletriage, preoperative, and EMT sections, thissecond orthopedic and cast clinic gives the hos-pital commander various employment options.The staffing consists of orthopedic NCOs and anorthopedic specialist (Table 2-33).

o (1) and (2).

(1) Orthopedic noncommissionedofficer (91B30, ASI P1). This NCO supervisesthe orthopedic personnel in both the HUB andHUS and performs technical and administrativeduties as directed by the orthopedic surgeon.

r (1) through (8).

(2) Orthopedic noncommissionedofficer (91B20, ASI P1). This NCO helps in thetreatment of orthopedic patients and supervisionof subordinate orthopedic specialists. He or-ganizes work schedules, assigns duties, counselspersonnel, and prepares evaluation reports underthe supervision of the orthopedic NCO.

(3) Orthopedic specialist (91B10,ASI P1). The duties and responsibilities of this

specialist are identical to those listed inparagraph 2-5

h. Central Materiel Service. This sec-tion operates two CMS units which provide forthe sterilization of OR equipment, surgical instru-ments, and supplies, as well as for sterile suppliesfor other patient care areas. This section operatesin conjunction with the CMS section of the HUBunder the control of the OR/CMS control team.Normally, each CMS would function primarily tosupport the activities of its associated OR andwards. The staffing, duties, and responsibilitiesare identical to those identified in Table 2-15 andparagraphs 2-5

i. Intensive Care Ward. These nursingunits provide five ICUs of 12 beds each for criti-cally injured or ill patients. The clinical nurseshold an ASI (8A) as ICU nurses. When func-tioning as a CSH, this section is under the super-vision of the Nursing Service Control Team(HUB). The staff performs recovery room nursingcare for those patients who require close observa-tion, vital sign monitoring, IV fluid replacement,and respiratory assistance. The staff consist of aclinical head nurse, clinical nurses, a wardmaster,practical nurses, and medical and respiratoryspecialists (Table 2-34). The duties and respon-sibilities are the same as the corresponding posi-tions identified in paragraphs 2-5

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J. Radiology Service. This section pro-vides augmentation to the radiology section of theHUB. Staffing consists of a radiologist, x-rayNCOs, and x-ray specialists (Table 2-35).

(1) Diagnostic radiologist (61R00).This officer conducts, interprets, and directsx-ray and fluoroscope examinations to includeadministration of ionizing radiation and patientcare. He assists the radiologist, radiology service,HUB with the management of the section. Healso provides technical supervision to the sub-ordinate staff.

(2) Other assigned personnel. Theduties and responsibilities of the remaining staffare the same as those identified in paragraphs

y (2), (3), and (4). 2-5

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