Story by Patricia Dubiel on 09/20/2019Military doctrine supports a health services system called the "four roles of care" to triage, treat, evacuate and return casualties to duty in a time-effective manner. Each role denotes a more expanded capability than the previous one, according to Joint Publication 4-02, Joint Health Services. These roles include:
Role 1 First-responder, unit-level care. This level covers self-aid, buddy aid, combat lifesavers and combat medics.
Role 2 Trauma management and emergency medical treatment. This includes limited x-ray capability, laboratory, dental support, combat and operational stress control, veterinary medicine and resuscitative surgical support.
Role 3 Theater hospital. These are staffed and equipped to provide care to all categories of patients, including military working animals and local nationals (depending on the current rules of engagement), resuscitation, initial wound surgery, specialty surgery (ears-nose-throat, thoracic, urogenital, orthopedic, neurosurgical and general) and post-operation treatment.
Role 4 Definitive care. These are U.S.-based hospitals and robust overseas medical treatment facilities.
For the first time in nearly 20 years, a Role 3 hospital set up shop at the Joint Readiness Training Center in preparation for an upcoming training event at the National Training Center at Fort Irwin, California. The unit running the hospital: Fort Polk's own 32nd Hospital Center.
Lt. Col. Jason Marquart, commander of the 115th Field Hospital, 32nd HC, said the field exercise was an opportunity for the unit to validate its operational planning following the force design update that took place in March the update converted all combat support hospital units into deployable units to enhance combatant commander flexibility and deliver optimal health service support to the operational force.
"With a conversion, you always have to validate that the unit is able to preform the mission in any environment. Within six months of the conversion we have validated to be an operational unit ready for deployment world wide," said Marquart.
"The validation (at JRTC) was for the 32nd Hospital Center, the 115th Field Hospital and the 190th Medical Detachment (Intermediate Care Ward). This validation shows we are an operational unit by doctrine. We have the equipment and the knowledge to execute a real-world mission, be it humanitarian or combat."
Marquart said the unit was evaluated by its higher headquarters, the 1st Medical Brigade, and the JRTC ahead of their Fort Irwin rotation.
"We will go to NTC next month for a rotation, and are the first Role 3 (unit) to go there in a long time," he said.
"We will be combining with a brigade-level fight, which is unusual because we are usually a corps-level asset. This is a new training modality to ensure the brigade and the operational support understands how the Role 3 would work into the plan. This offers a combined training affect."
The 32nd HC will support the 3rd Armored Cavalry Regiment during the NTC rotation.
The 32nd relied on JRTC support to provide convoy and security operations.
"We are not a self-mover and JRTC has provided us prime mover and base defense assets. With all those people helping us, it has allowed us to focus on our mission. We are thankful for that support," said Marquart. "Including movement and internalization, we were fully operational in 72 hours. The Soldiers did an excellent job."
The unit tested its operational plans for patient care and cohesion with higher headquarters.
"We had an operational cell tracking the battle so we could see when patient flow was most likely to occur, and we are supporting he warfighter by doing that," Marquart said. "We also have a clinical aspect that is receiving and stabilizing patients, and preparing them for movement to the next role (Role 4) if required."
Soldiers with artificial wounds played the role of injured patients, and simulation mannequins were used for high-risk or invasive medical modalities.
"We are a full hospital and we train to the highest fidelity possible," said Marquart. "Our preparation at JRTC has prepared us for future success, both at NTC and real world missions."
Command Sgt. Maj. Dolores Kiyoshi, 32nd HC command sergeant major, said the Soldiers in the unit did well during the exercise.
"The unit is motivated," she said. "This is what they look forward to. They want to provide world class medical care and this (exercise) was their opportunity to do that."
The 32nd HC Role 3 hospital set up included:
92 patient beds total, distributed into one intensive care unit and four intermediate care wards
Surgical suites with sterilization facility
Full lab and blood bank
Medical maintenance/mechanic area
Five 100K generators
Staff support assets (chow, showers, sleeping area)