Multiservice Tactics, Techniques, and Procedures for Health Service Support in a Chemical, Biological, Radiological, and Nuclear Environment July 2009 Field Manual FM 4-02.7 MCRP 4-11.1F NTTP 4-02.7

This publication establishes doctrinal multiservice tactics, techniques, and procedures (MTTPs) for health service support (HSS) units operating in a chemical, biological, radiological, and nuclear (CBRN) and toxic industrial material (TIM) environment. It is the intent of this document to inform the combatant commanders (CCDRs), joint force commanders (JFCs), joint force medical commanders and medical planners, and component commanders and their staffs on the tools available to provide the best quality of force health protection (FHP) and HSS in a CBRN environment to enhance mission success. This publication bridges the gaps between Service and joint HSS publications.

This publication provides information for use by the component commanders and their staffs, command surgeons, medical planners, and individuals responsible for FHP and HSS in a CBRN environment. Commanders have the direct responsibility for protecting their forces within a CBRN environment. On future battlefields, failure to properly plan and execute CBRN defensive operations may result in significant casualties, disruption of operations, and even mission degradation. Further, the commander’s mission and execution plans must address the implications of HSS in a CBRN environment.

This publication contains MTTPs relative to HSS in the following specific areas:
Chemical, biological, radiological, and nuclear aspect of HSS.
Casualty prevention.
Casualty care and management.
Patient movement.
Patient decontamination.
Veterinary service support and food and water safety.
Medical laboratory support.
Combat and operational stress control (COSC).
Health service logistic (HSL) support (HSLS).
Homeland defense.
Individual and collective protection systems.

Ch1 discusses the current policy, health threat, and HSS planning considerations in a CBRN environment.

Ch2 discusses medical surveillance and occupational and environmental health surveillance activities and pre-deployment, deployment, and post-deployment activities.

Ch3 discusses CBRN mass casualty, triage, taxonomy of care, roles of care, and medical treatment facility activities.

Ch4 discusses medical evacuation in CBRN environment, medical evacuation under high level biosafety containment, patient isolation unit, and medical evacuation capabilities.

Ch5 discusses levels of decontamination, zones of contamination, safety, and the patient decontamination process.

Ch6 discusses food protection, food defense, support for subsistence, medical and treatment care for government-owned animals/military working dogs, and water safety and management.

Ch7 discusses samples/specimen collection and management of CBRN contaminants, handling and storage of sample within the laboratory, confidence levels of laboratory analysis, joint biological agent identification and diagnostic system, definitive laboratories, other DOD laboratories and the laboratory response network.

Ch8 discusses combat and operational stress reaction, combat and operational stress control under reactions, combat and operational stress reaction leader risks and actions, individual responsibilities, behavioral health personnel responsibilities, and conducting combat and operational stress control in a CBRN environment.

Ch9 discusses logistics support in a CBRN environment, HSLS considerations in a CBRN environment, protecting supplies in storage and during shipment, and movement control.

Ch10 discusses homeland defense CBRN response, US Army role, US Coast Guard role, US Navy role, US Marine Corps role, US Air Force role, and other DOD response assets.

Ch11 discusses types of collective protection systems, collectively protected field hospital, joint expeditionary collective protection (JECP), employment of the chemical biological protective shelter system.