ATP-4-90 Brigade Support Battalion Download
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Chapter 8 8-2 ATP 4-90 18 June 2020 higher roles of care. At a Role 2, medical personnel examine and evaluate the patient to determine treatment and evacuation precedence. Medical personnel at Role 2 provide advanced trauma management and tactical combat casualty care and/or emergency medical treatment, but they do not go beyond the measures dictated by immediate necessities. The Role 2 medical treatment facility has the capability to provide packed red blood cells (liquid), limited x-ray, clinical laboratory, dental support, combat and operational stress control, and preventive medicine. Offensive Operations In offensive operations, the major casualty areas are usually located along the battalion movement corridors in the vicinity of the enemy's main defensive positions. BCT Role 1, battalion aid stations, are located as far forward as tactical conditions permit. The BSMC establishes the Role 2 for the BCT in the BSA by occupying the BSB base. Establishing medical treatment facilities as far forward as possible allows for the proximity of medical care and the efficient use of medical and casualty evacuation routes along lines of communication. The use of echelons provides a progressive line of medical care. However, in some cases, planners may arrange medical treatment facilities in nonlinear fashion based on mission variables. Medical planners establish Role 1 and Role 2 facilities using echelon trains to maximum use of these facilities before the lengthening of evacuation routes force the displacement of medical facilities forward. The heaviest patient workloads in offensive operations occur during disruption of enemy main defenses, at natural or emplaced obstacles, during the assault on final objectives, and during enemy counterattacks. As Role 1 and Role 2 facilities displace and reestablish forward, they may acquire additional casualties. This reduces the time elapsed between wounding and treatment. In offensive operations, medical units supporting maneuver forces are prepared to— Maintain contact with the supported unit. Maintain readiness to move Role 1 and Role 2 forward as maneuver forces extend the lines of communication. During offensive operations, the BSMC and attached forward resuscitative and surgical team must remain prepared to displace the Role 2 medical facility and move forward to new locations closer to the forward line of troops. The movement and reestablishment of the BCT’s Role 2 medical facility often occurs simultaneously with the displacement of the BSA as it moves forward. Defensive Operations Medical support is often difficult to provide to maneuver forces in the defense. The patient load reflects lower casualty rates, but enemy actions and the defensive array of maneuver forces complicates forward area patient evacuation to a Role 2 or higher. Maneuver forces may be a considerable distance from the BSA and the Role 2 medical treatment facility. During defensive operations, medical evacuation personnel generally must negotiate extended lines of communications to reach the patient, complete vital tactical combat casualty care, and evacuate the Soldier from the point of injury. Increased casualties due to exposed medical personnel further reduce the medical treatment and evacuation capabilities. BCT and medical planners can expect the heaviest patient workloads during the preparation or initial phase of the enemy attack and in the counterattack during the defense due to enemy artillery and CBRN weapons. A defensive posture by maneuver forces and an enemy attack or counterattack may disrupt ground and air routes and delay evacuation of patients to and from treatment elements. The depth and dispersion of the defense create significant time and distance issues for the evacuation of wounded. The effective integration of air assets into the evacuation plan is essential. The BCT and BSMC must coordinate and synchronize the use of air ambulances with the supporting general support aviation battalion to ensure the synchronized execution of evacuation operations. MEDICAL EVACUATION The brigade surgeon and BSB SPO medical operations officer consider placement of all medical support assets in the brigade and develop the medical evacuation plan for the BCT. The planning considerations and requirements for medical evacuation operations may vary widely depending upon the