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Urban Warfare

Urban Warfare. CPT James R. Rice Emergency Medicine Interservice Physician Assistant Program. References. DT 8-MOUT, Combat Health Support for Military Operations on Urban Terrain

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Urban Warfare

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  1. Urban Warfare CPT James R. Rice Emergency Medicine Interservice Physician Assistant Program

  2. References • DT 8-MOUT, Combat Health Support for Military Operations on Urban Terrain • Mars and Hippocrates: Urban Combat and Medical Support, LTC (Ret) Lester W. Grant, CDR Charles J. Gbur Jr, MC USNR Army Medical department Journal PB 8-03-1/2/3 Jan/Feb/Mar • MAJ (Ret) Mark Stevens, 5th Special Forces Group, Lessons Learned in Operation Enduring Freedom • CPT James R. Rice, 566th ASMC, 3ID, Lessons Learned in Operation Iraqi Freedom

  3. Overview • General Concepts • Combat Medic • BAS

  4. General Concepts • Military Operations on Urban Terrain • (MOUT) • Decentralized and isolated environment • Individual first aid/buddy aid is critical • Cross load medical supplies • Get city maps if possible

  5. General Concepts • Complicated mission within the mission • You can’t pre-plan enough • You can’t rehearse enough • Mass casualty planning • Commo • Develop both an external and internal plan

  6. The Combat Medic • The medic needs to be able to operate independent of the PA/MD • Medically • Tactically • They may be a shooter first • Don’t get shot! • Trained on how to enter buildings • Don’t run out into the open to get a casualty • Get close in order to visually eval the casualty • Drag the casualty to safety

  7. The Combat Medic • Providing cover for the casualty • Utilize a rope with a D-ring • Good for dragging • Utilize vehicles as a barrier • Smoke grenades • Treating Casualties • Utilize TC3 approach • Be prepared for a lot of wounded-Triage!!!

  8. The Combat Medic • Evacuating Patients • May not be able utilize MEDEVAC helicopters • May not be able to use FLAs-or won’t have enough • The mission may not allow non-standard vehicle evac • Utilizing litter and manual carries may be the only choice • Labor intensive • Improvised litter material • Litter bearer training

  9. Battalion Aid Station • Site selection • Must be close enough to provide support, but not too close-might interfere with the mission and potentially endanger the element • Progress in the urban fight is often measured in feet and yards • You may be able to create a more established facility • However, be prepared to to jump • Things might go bad • Things might be going great

  10. Not a good site

  11. Battalion Aid Station • Site Selection • Try to pick a site that is accessible by both ground and air • Consider a site just outside the city • Fortify your site if possible • Considerations • Treatment space • Defensive positions

  12. Battalion Aid Station • Acquiring patients • Pre-plan CCPs • Push your FLAs as far forward as possible • Remember, litter carry evac is tough • Treating Patients • Split team operations • Casualties in the MINIMAL category need to be returned to duty ASAP-mission comes first • Be prepared to manage casualties for extended periods

  13. Battalion Aid Station • Treating Patients • May see more closed space blast injuries • TM ruptures • Burns • May see more crush injuries • Plan for extrication equipment

  14. Battalion Aid Station • Evacuating Patients • Utilize air evac if possible • Roof tops may not be stable enough • Coordinate hoist equipment • Good for evac and for bringing in supplies • Ground evac • Pre-plan non-standard evac • Plan primary, secondary and tertiary routes • The enemy may case-out your routes • The battle may flow interfere with a route

  15. Summary • MOUT is the greatest challenge for both the tactical commander and the medical provider • Pre-planning is absolutely critical • Get involved!!! • Develop back-up plans and then back-up plans to your back-up plans

  16. Questions?? The End

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