OPM (Operational Preventive Medicine)*

Medical Threat

Wounds, injuries or sickness incurred while engaged in a joint operation IAW FM 4-02.17

Disease and NOn-Battle Injury (DNBI)

Describes a person who is not a battle casualty, but who is lost to his/her organization by reason of disease or injury.

Mortality rate

Is a measure of the event of death IAW FM 8-55

Incidence

the occurrence of a disease in a population free of the disease during a specific time span

Prevalence

A measure of the number of cases of a specified disease during a specific time span

Medical non-effective

excused from duty for medical reasons

How do Commanders gain a new awareness of the importance of PVNTMED?

With the guidance of the PMT

Three components of the Medical threats:

1 Environmental Factors: including humidity, significant elevations above sea level, heat, and cold

2. Disease caused by zoontic/animal bites

3. DIsease endemic to the area of opeations

Four Major Medical Threats

1. Heat

2. Cold

3. Arthropod-borne illness

4. Diarrheal Disease

The Most lethal Medical Threat?

Heat

A specific incapacitation medical threat on the battlefield

Cold

Three Minor Medical Threats

1. Toxic Industrial Materials (TIM)

2. Noise

   1. Pests other than arthropods

Four reasos personnel have increased vulnerability to disease and non battle injuries (DNBI)

1. The harshness of the environment and the tactical situation

2. Disruption of the body’s natural defenses

3. Breakdown in basic sanitation

   1. Consumption of unauthorized rations including locally procured and scavenged food

Three Principles of Preventive Medicine Measures

1. YOU! Individual service members responsible for putting individual PMM into practice

2. The Commander

   1. Field Sanitation Team

WBGT (Wet Bulb Globe Temperature Index)

Number derived mathematically from three distinct temperatire measurements

1. Wet Bulb temp(WB)

2. Dry Bulb temp(DB)

3. Black Globe temp (BG)

Cold Injury

Tissue damage produced by exposure to cold

Non-freezing wet cold injury

Associated with prolonged exposure to cold water, dampness, or high humidity

Environmental Factors of HEAT:

1. High Ambient air temp

2. Low wind velocity

3. High Humidity

4. Thermal radiation

Dry Bulb (DB) measures what?

Air Temp

Anemometer measures what?

Low Wind velocity

Wet Bulb Thermometers (WB) measures what?

Humidity with a wet wick

Black Globe thermometer (BG) measures what?

Radiant Heat

White Flag indicates:

78-9-81.9F

Green Flag indicates:

82-84.9

Yellow Flag indicates:

85-87.9F

Red Flag indicates:

88-89.9F

Black flag indicates:

90F

Activity Levels meanings:

White flag

Caution in performing extremely intense physical exertion

Activity Levels meanings:

Green Flag

Marginal heat stress limit for all personnel

Discretion required in heavy exervise for non-acclimatized personnel

Activity Levels meanings:

Yellow Flag

Curtail strenous exercise and activity for new and non0acclimatized personnel for first three weeks of heat exposure

Activity Levels meanings:

Red flag

Curtail strenuous exercise for personnel with less than 12 weeks of training in hot weather

Black flag

suspend all physical training and strenuous excerise

Types of cold injuries/ NON-freezing

Chilblains (pernio)

Superficial Tissue injury after prolonged exposure to low but non-freezing temp and high humdity

Types of cold injuries/ NON-freezing

Hypothermia

Cooling of the bodys core temperature to dangerous levels

Types of cold injuries/ NON-freezing

Immersion syndrome

Prolonged exposure to cold water, pale, damaging underlying tissues and may require amputation

Types of cold injuries/FREEZING

Frostbite

From exposure to ambient or wind-chill temperature below freezing

Heat Injuries

Heat Cramps

Excess loss of salt through sweating

Heat Injuries:

Heat syncope

Excessive blood pools in the extremities, caused by stading after marching or excercisng

Heat Injuries:

Heat exhaustion

Excessive water and salt depletion

Symptoms: profuse sweating, headache, weakness, pallor, nausea, vomitting, mild dyspnea and palpitations, pupil dilation

Heat Injuries:

Heat Stroke

Medical emergency,

NO LONGER SWEATING = Dehydration

Specific IPPM a service memebr may emply against against:

Heat Injuries

1. Following acclimatization guidance

2. Avoiding alcoholic and caffeinated drinks

3. Keeping physical fit

4. Avoid medications

Specific IPPM a service memebr may emply against against:

Diarrheal diseases:

1. Avoiding food, drink, or ice from unapproved sources

   1. Drinking approved water supplies

Treatment for Heat injuries:

Heat cramps

1. Cooling

   1. Hydration

Treatment for Heat injuries:

Heat Exhaustion:

1. Move patient to a shaded place to rest

2. Cooling

3. Fluid replacement

   1. monitor RECTAL temperature

Treatment for Heat injuries:

Heat Stroke

1. Cool the body

2. Administer IV normal saline as soon as possible

3. Mintor RECTAL temp

   1. Immediate evaction to hosptial

Treatment for Cold injuries:

Divided into two phases

1. First aid (buddy system)

2. Initial treatment in forward areas

PPM responsibilites of the unit headquarters staff:

Prior to Deployment

1. Requesting medical threat information from the USAPHC, NMCPHC, or NCMI

2. Confirming all personnel have have up-to-date prescribed immunization for the AO

3. Ensuring that FST members are trained and equipped

PPM responsibilites of the unit headquarters staff:

During Deployment

1. Coordinating with supply and logistics for food, water and ice from US military approved sources

2. Ensuring personnel take prophylaxis and pretreatment as prescribed

PPM responsibilites of the unit headquarters staff:

Post-deployment

1. ENsuring personnel contine taking prescribed medications

2. PLanning a unit and family gathering upon return to reduce the stress associated with the reunion

3. Monitoring personnel for signs of illness, ensuring affected personnel receive medical attention

   1. Continuing post-deploymentmedical surveillance.

PMM responsibiltes of the COMMAND staff:

Prior Deployment

1. Meet with FST members early and regulary to ensure requirements and guidence is clear

2. Esure required field santiation devices are on hand and operational

3. Ensure personnel receive personal and organizational supplies and equipment packing guidelines

4. Reinforce command emphasis regarding immunizations

5. Eliminate rumors by ensuring info is passed down quickly

PMM responsibiltes of the COMMAND staff:

During Deployment

Ensure Food,Water, shelter, and you are safe from non-medical threats

PMM responsibiltes of the COMMAND staff:

Post-deployment

1. Reinforce command emphasis regarding continued use of prophylaxis and medical screening

2. Provide encouragement and support to personnel during reunions

3. Mintor personnel for signs of illness, ensuring affected personnel recive medical attention

4. ENsure FST materials are checked and resticked

What is waste?

All types of refuse resulting from living activities of humans and animals

Types of Waste:

Human

Feces and Urine

Types of Waste:

Garbage

Waste generated by preparation, cooking, and serving of food (solid food waste)

Types of Waste:

Rubbish

The combustible or no combustible solid waste generated for non infectious operations (boxes, cans, papers, old rags)

Types of Waste:

Liquid Waste

Waste which comes from showers, sinks, kitchens, etc (also known as grey water)

Types of Waste:

Infectious Waste

Refuse containing readily communicated disease causing organisms and/or offensive materials

Types of Waste (Think GHIRL)

GHIRL

GARBAGE

HUMAN

INFECTIOUS WASTE

RUBBISH

LIQUID WASTE

Distances of latrines:

____ downstream and down gradient from water source

100 feet

Distance of Lateines:

_____ downwind and down gradient from unit dining facility

100 yards

Distances of Latrines:

Reasonably accessible ____ from unit area

30 yards

Required number of devices for proper disposal of human waste:

Males

4%

Required number of devices for proper disposal of human waste:

Female

6%

Burn-out latrine characteristics:

Uses 55-gallon drum whole or in half

Uses one seat latrine box w/self closing lid

Recommended for hard, rocky, and/or frozen soil.

Not used when regulations prohibit open fires

Waste is burned daily: Every 12-18 hours

Four parts diesel to 1 part gasolinE

Must stir contents continuously to ensure complete combustion

Remanning ash must be buried

Grease Traps:

Filter grease trap

1. 55 gallon drum filled w/rocks, gravel, and sand l

2. Screen on top/bottom perforated

3. Method of introduction: Direct

Grease Traps:

Barrel grease trap

1. 55-gallon drum

2. Grease rises to top of barrel

3. Method of introduction:Pipe

Grease Traps:

Baffle grease trap

1. Watertight box or barrel

2. Grease floats to top of entrance chamber

3. Method of introduction:Pipe

Garbage Pit

1. 4 feet square and 4 feet deep

2. Suitable for 1 day for a unit of 100 persons or less

3. Closed out faulty or when pit is filled to 1 foot below ground surface

Operation, Construction , and Maintenance and close out procedures for disposal of waste

IAW FM 21-10 and NAVMED P-5010-9

Considerations when inspecting field facilities

1. Urinals must have soakage pits andMOI

2. Must have toilet paper, holder with cover

3. Handwashing devices constructed at every latrine

4. Must have adequate drainage

5. Scrub latrine boxes daily

6. Spray residual insecticide as needed to control flies

7. Protect with canvas or brush screens

Operational Sanitation

When permanent type facilities are not available. The sanitary practices and principles which must be observed in order to main the health of a grou[

Sanitation:

Effective use of measure which will create and maintain healthful environmental conditions

What is the primary mission of the operational mission

Prevent disease non battle injuries

What are the pre-deployment responsibilities

Education, medical threat brief in the location, ensures other unit deparmtnets have required supplies

Deployment Responsiblites

1. Assists in the recogniation and elimination of existing or potential health hazards

2. Arrange for laboratory support of epidemiological investigations

3. Provide inservice training to medical and non medical personnel concerning relevant preventive medicine topics

4. Draft instructions, notices, and other directives as appropriate, to convey preventive medicine and environmental health information and requirements

5. Provide unit commanders with timely status reports

What are the 3 elements of the Health services Appendix of the Operational Plan (OPLAN)

1. Task organization including attachments to specific combat units

2. SPecific missions for the next subordinate medical echelon

3. Methods, supplies, and personnel to implement sanitation programs and information about health hazards.

PMT Journal

A collection of previous documents, broken down into two sections:

1. Opening page

   1. Narrative summary section

REsponsibility for equipment and supplies:

Marine Logistic Group (MLG)

Maintain preventive medicine and vector control AMAL for use in a MEF size operation

Responsiblity for equipment and supplies:

NEPMU/NECE

Maintain FDPMU AMAL

Responsibilites of the AML PVNTMED Section

1. Analyze and evalualte food, drinking water and wastewater samples

2. Identify pests and asses the efficacy of pesticides

3. Recieve, compile and analzue theather wide medical suriveeillance data

4. Determine the frequency and distribution of infections agents and disease

5. Provide related consultative services.

Presenation Methods:

Extremporaneous speaking

Most popular method

Speaker appears to use no notes or other prompts and just seems to be speaking comfortably to the grou[

Presentation Methods:

Memorization

Most difficult method to master

Can easily become confused if word is missed or distracted

Presentation Methods:

Reading

Insulting when not done well

Presenter must be excellent, highly honed to be an effective speaker using this method

Presentation Methods:

Combination

Combining methods of extemporaneous, memorization, reading, combination

The Four Characteristics of Effective Speaker

(TSCF)

1. Thoroughness

2. Sincerity

3. Confidence

4. Friendliness

Verbal and NOn-Verbal Communication influences?

1. You must be aware of

2. What your audience sees:

   1. environment,

   2. personel apperance

   3. your posture

   4. facial expressions

3. What your audience hears

   1. Lack of pitch (Monotone)

   2. Lack of variation

   3. Lack of voice emphasis

When was the Field Sanitation Team created?

1. the concept was created During World War 2

2. 1958 in Lebanon led to the creation of the Field Sanitation Team

ATP 4-25.12

Unit Field Sanitation Teams

Specific Criteria for the unit FST

1. ONe service member must be a NCO (CPL or ABove)

2. ALl personnel will have a minimum of 6 months in the unit upon appointment to the FST

Types of stability or DSCA operations:

Stability & Civil Support

___conducted in the political-military environment labor peace and conflict. In both, the role of the Armed Forced is to aid in the protection and promotion of national objectives without resorting to war

CHS operations can play a significant and proactive role in Marion assistance by:

1. Assisting with the development and refinement of host-nation(HN) medical infrastructure l

2. Providing and maintaining the basic necessities of life for the general population through HN civilian medical programs

3. Providing assistance in establishing, repairing, or improving basic health and sanitation services

Foreign Humanitarian Assistance, are responses to requests for immediate help and rehabilitation from foreign governments these include:

1. Refugee Assistance

2. Food Programs

3. Medical treatment and care

4. Other civilian welfare programs

Refugee operations may entail the rescue:

Individuals fleeing a nation and the establishment of temporary safe havens to house and care for these people

Preventive Medicine support resources may be required to ensure that:

1. Sufficient sanitation facilities are provided

2. Disease surveillance is conducted and disease vectors are controlled

3. Water sources used in the camps are inspected and water is treated

4. Food wholesomeness standards are maintained

Types of Environmental surveys:

Many operations require fixed facilities, structures or other real property as ___,___,____,_____,_____,_____,____

1. Logistics

2. Command and control

3. Administration

4. Communications

5. Billeting

6. Maintenance areas

An Environmental Baseline Survey (EBS) typically performed by or with support from engineer elements HOWEVER:

1. Units conduct an initial site assessment without assistance from engineer elements

2. Ideally will conduct a full EBS in conjunction with an Environmental Health Short-Term Assessment

Safeguarding and Purpose of the EBS:

EBS is defined as:

1. Protection of Service personnel health risks to Service members

2. Sustainability determination of a designated location

3. Includes encroachment considerations and potential requirements to increase the population of service members or actions

The three types of environmental surveillance assessments:

1. Environmental Health Short-Term Assessment (Phase 1)

2. Environmental Health Long-Term Assessment (Phase II)

3. Environmental Reconnaissance

Types of Environmental Surveillance Assessments l:

Environmental Health short term assessment(Phase1)

Short term = more than 30 days

1. Base camps

2. Police Stations

3. Headquarters

4. Checkpoints

5. Communications points