ATP-4-90 Brigade Support Battalion Download
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Chapter 8 8-4 ATP 4-90 18 June 2020 number of aircraft available, time to return to base and return to the forward area, distance, load time, and available security. A ground evacuation plan supplements the air evacuation plan and creates a cohesive, encompassing evacuation plan for the BCT. AMBULANCE EXCHANGE POINTS An ambulance exchange point (AXP) is an effective and efficient way to expedite medical evacuation along the lines of communication between the roles of medical care and the point of injury on the battlefield. It expedites medical evacuation, especially when transferring from tracked to wheeled ambulance or from ground to air evacuation platforms. An AXP is a predetermined location where a patient is transferred from one ambulance to another enroute to a medical treatment facility. This may be an established point in an ambulance shuttle system or units may designate AXPs independently. However, units may perform casualty evacuation through nonstandard evacuation platforms and vehicles. Medical planners in the BCT must template the locations of AXPs on the battlefield before and during operations as the situation changes. Brigade planners must be include AXPs in the BCT’s sustainment concept of support, map graphics, and rehearsals. The BCT may need to frequently change the locations of AXPs based on mission variables as the operation progresses. As with all evacuations, the higher role of care evacuates patients from the lower role of care. The BSMC evacuation platoon establishes AXPs in order to keep up with maneuver elements. Battalion aid stations usually do not establish AXPs. In an ABCT, tracked ambulances or vehicles carry patients from the battalion aid station to an AXP where the brigade wheeled ambulances take over for the relatively longer trip to the rear. Ambulance exchange points are not limited to ground evacuation assets. Threat air defense artillery capability may limit air ambulances’ ability to fly as far forward as the battalion aid stations. In such a case, the BSMC can establish an AXP as far forward as possible and the BCT’s tracked or wheeled ambulances then transfer the patients to the air assets, facilitating the rapid evacuation of patients. The use of AXPs allows evacuation assets to return to their unit more rapidly. Crews with a habitual support relationship with maneuver units are familiar with the road network and the supported unit’s tactical situation. Medical planners consider the requirement for AXPs and evacuation routes security and request security from the BCT as required. When possible, once tasked, AXP or evacuation route security should be these maneuver forces’ primary task. ROLES OF MEDICAL PLANNERS IN THE BCT In order for medical support to be successful for the BCT, several medical planners across the brigade must synchronize and oversee the organization, employment, and operations of medical units across the BCT’s AO. The roles and responsibilities of the brigade surgeon section, BSB SPO medical planners, BSMC commander, and task force surgeons and medical platoon leaders are identified in the following paragraphs. Brigade Surgeon The brigade surgeon is responsible for the medical support for the BCT. The surgeon is a brigade-level special staff officer that coordinates medical support activities with the brigade S-1, SPO, and other headquarters elements that affect medical support in the brigade. The brigade surgeon is responsible for the technical supervision of all medical activities in the command. The brigade surgeon is part of the brigade commander’s special staff, and as such, provides advice to the brigade commander on all medical or related issues. The brigade surgeon keeps the brigade commander informed on the status of medical support for the brigade and the health of the command. The brigade surgeon section is responsible for determining the patient estimate for operations and identifying the requirements needed to meet the BCT’s commander’s intent. The BCT S-1 is responsible for producing a casualty estimate for operations. The brigade surgeon section uses tools (such as the Medical Course of Action Tool, Medical and Casualty Estimator, Logistics Estimate Worksheet, and OPLOG Planner) to estimate patient estimates and workload for medical elements. The brigade surgeon’s staff is comprised of a medical operations officer and a health care noncommissioned officer.