Chapter XXIV: Section II: Employment of the Chemically Biologically Protected

SHELTER SYSTEM

F-3. Establish a Battalion Aid Station in a Chemically Biologically Protected Shelter

To establish a BAS in a CBPS, use one CBPS per treatment team for conventional operations in a split-team mode. When operating in a squad configuration and in the conventional mode, the two CBPS systems may be complexed to provide more workspace. However, keep in mind that the treatment squad is not staffed to operate the two systems in the CB mode. Therefore, when the two systems are complexed and the treatment squad must convert and operate in the CB mode, they may want to close the complexing door and only use one system. When initially setting up the CBPS for operations in the CB mode, only one CBPS is setup; see Note 2 below. Set up the system as described in TM 10-5410-228-10. To be operational as a BAS, set up medical supplies and equipment as required or as designated in the TSOP. A PDS consisting of a contaminated ambulance point, contaminated triage point, a patient decontamination area, and a contaminated treatment area is established on the downwind (prevailing wind) side of the CBPS. An overhead cover of plastic sheeting (approximately 20 feet wide by 50 feet long) is set up over the PDS, the hot line, and the clean treatment/waiting area; the cover overlaps the air locks. The clean treatment/waiting area should have an area at least 20 feet wide by 15 feet long to allow space for placing patients into the litter air lock without crossing the hot line. A second area covered with 20 × 25 feet of plastic sheeting (the evacuation holding area) is set up beside the shelter on the opposite side from the generator. The clean treatment area is separated from the decontamination area by a hot line with a shuffle pit. Only clean (decontaminated) patients or personnel are allowed to cross the hot line into the clean treatment area, or are admitted into the CBPS. Figure F-1 presents one layout of a BAS using the CBPS. See TM 10-5410-228-10 for complete details on setting up, operating, and maintaining the CBPS. Each CBPS provides 300 square feet of work area.

NOTES

1. The overhead cover is not needed when the wind speed exceeds
10 knots per hour. The plastic will not stay in place.

2. Although each treatment team of the BAS has a CBPS; only one
system is set up when operating in the CB mode. This is due to
the lack of authorized personnel to operate all systems at one
time in the CB mode. =Eight medical= personnel are required to
operate the BAS (employing one CBPS) in the CB mode. At least
eight nonmedical personnel are required to perform patient
decontamination =under medical supervision=. Also, only setting
up one system in the CB mode provides the BAS the ability to
retain its flexibility in order to maintain its support mission
of being where it is needed and when it is needed. The CBPS can
be used as the treatment shelter in the conventional mode as
well. When the treatment squad is operating in the split-team
mode, each team will have a CBPS for use as its treatment
shelter. When operating one system in the CB mode, the other
system provides a replacement in the event the one in use in
the CB mode is damaged beyond repair. This ensures continued
HSS to the command.

F-4. Division Clearing Station in a Chemically Biologically Protected Shelter

To establish a DCS using the CBPS, set up four shelters as described in the TM. To be operational, medical supplies and equipment are set up as outlined in the unit TSOP. The four shelters are complexed as shown in Figure F-2. With four CBPS systems set up and operational, a total of 1,200 square feet of work area is available. The contaminated triage, decontamination, and contaminated treatment areas are separated from the clean treatment/waiting area by a hot line with a shuffle pit. Overhead covering is provided as described for the BAS. Patients are admitted through the EMT litter or ambulatory air lock. Patients are released through the patient holding air locks. This aids in controlling entry and exits; thus preventing the introduction of contamination into the systems. At least eight nonmedical personnel from supported units are required to perform patient decontamination under medical supervision at the DCS.

NOTE

In the event that the overpressure system fails on a system
that is in use with entry/exit air locks, move to the available
shelter with an entry/exit air lock in the same direction
for use as the entry/exit until the failed system can be
restored. Example 1: At the DCS the EMT system fails, move to
the ATM shelter to receive patients until the EMT system has
been restored. Example 2: At the DCS the patient hold system
fails, move exits to the dental/lab/x-ray shelter until the
patient hold system can be restored. Example 3: At the FST the
postoperative system fails, use the preoperative shelter until
the postoperative system can be restored. These options will
allow patient care operations to continue until the failed
systems can be restored.

F-5. Forward Surgical Team in a Chemically Biologically Protected Shelter

To establish a FST using the CBPSs, follow the procedures for the DCS except set up three CBPSs. All equipment is set up inside the CBPS as required by your unit TSOP. With three CBPSs set up and operational, a total of 900 square feet of work area is available (Figure F-3). When the FST is forward in support of a medical company and operating in the CB mode, the FST systems are connected to the DCS of the supported medical company. Figure F-4 shows the FST and DCS connected. When operating in the CB mode with the medical company, all patients are received through the EMT air lock of the DCS. The patients are triaged in the DCS and, based upon their injuries, they are routed to the DCS treatment area or to the FST for surgical care. Patients released from the FST for evacuation are placed in a PPW and processed through the litter air lock in the FST recovery section. Patient decontamination is performed at the PDS operated by the DCS. The FST cannot operate in a CB environment without being complexed with the DCS. They do not have any patient decontamination capabilities.