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Diversified Support to Field Forces

Annual Report of the Surgeon General United States Army Fiscal Year 1961

DIVERSIFIED SUPPORT TO FIELD FORCES

Tactical Forces Program

The mission of The Surgeon General in the realm of rendering medical support in the field is to assemble, equip, and have available mobile and well-trained medical troops and units for field medical support to combatant units. In regard to the matter of field training medical troops, the problem of insufficient medical play or medical support play which received insufficient command attention has continued in all DA and USCONARC directed field exercises. This situation has persisted despite final After Action reports on exercises submitted to DCSLOG in which was emphasized the inadequacy of planning, control, organization, and conduct of the exercises, especially as they pertain to the medical play therein. To bring this matter further to the attention of USCONARC, The Surgeon General has submitted to DCSLOG comprehensive recommendations to improve the medical support aspects of future directed field training exercises.

In September 1960, USCONARC went from a monthly readiness port requirement to a quarterly one for STRAC and an annual report STRAF. An exception to this policy was made in the personnel area, and the Reports Control Symbol ATPER-48, Personnel Readiness of the U.S. Strategic Force Units in STRAC and STRAF, was an outgrowth of this change. The Troops Branch, Plans Division, OTSG, continued to receive and monitor both ATPER-48 and CSGPO-175, Readiness of U.S. Army Forces Report, until May 1961. At that time, responsibility for ATPER-48 was transferred to the Directorate of Personnel and Training as the more appropriate office to receive and monitor such a report.

Changes Affecting Tables of Organization and Equipment

The current series of hospital TOE revisions include recommendations for improving and standardizing the internal functional structure. The proposed structure, being designed to permit more efficient operation, establishes an administrative service consisting of all support activities for hospital personnel and patients, excluding those related to treatment of patients. This will permit personnel of the professional services to devote full-time duty to patient treatment and related activities.

Development of a more realistic grade spread for ANC officers in TOE’s was accomplished as suggested by DCSPER. Attempt is being made to integrate required changes in current TOE revisions. Recommended


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Operating room setup, 3d Surgical Hospital (Mobile Army), Fort George G. Meade, Md.


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change was submitted to The Adjutant General and Commanding General, USCONARC, to incorporate recently approved MOS’s for Nurse Administrator (3430), Army Health Service Nurse (3431), Neuropsychiatric Service Nurse (3437), Pediatric Nurse (3442), Operating Room Nurse (3443), Anesthetist (3445), Obstetric Nurse (3446), Medical-Surgical Nurse (3448), and General Duty Nurse (3449). Concurrently, Communicable Disease Nurse was recommended for deletion since MOS 3441 will be eliminated from the MOS structure.

A draft TOE (8-119D, Armored Medical Company), including concept of operation, has been developed and submitted to Headquarters, USCONARC, to provide a unit with division level medical support capabilities for an armored cavalry regiment or separate task force.

Studies related to organization of administrative support elements were undertaken during the year and are reported as follows:

1. The status of the concept of medical support organization for the combat zone furnished to DCSLOG, 7 April 1960, by The Surgeon General to implement DCSLOG’s approved organizational principles remains essentially unchanged for the fiscal year 1961 reporting period. Attempts to obtain approval of recommendations to revise AMEDS tables of organization and equipment based on these organizational

concepts are continuing. One revised table, TOE 8-126D, Headquarters and Headquarters Detachment, Medical Battalion, subordinate to the Medical Group, has been approved and published. TOE 8- 122D, Headquarters and Headquarters Detachment, Medical Group, intended to direct implementation of the command surgeon’s operational responsibilities within the field army, is expected to be published in the near future. Personnel originally proposed were reduced to the extent that further reductions would make the TOE insufficient to control widely dispersed medical elements supporting widely dispersed combat elements as intended.

2. In the interest of providing sound medical care, The Surgeon General continues to express nonconcurrence in any organizational concept which interposes an additional command echelon between the command surgeon and AMEDS operating elements as proposed in the support command concept. The assistance required by commanders in exercising command responsibilities pertinent to medical service must be provided by the command surgeon. The creation of either another command or another staff echelon, or both, between the surgeon and the medical support elements reduces the responsiveness of the medical


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support service to meet the requirements for support generated by combat elements.

3.  More detailed guidance in further defining the concept of missions and functions of administrative support operation centers has been suggested by DCSLOG to Commanding General, USCONARC. The guidance recommended is consistent with OTSG position that establishment of an additional command or a staff echelon, or both, within the major command is not acceptable.

Doctrinal guidance.—Along with other data pertaining to military operations against resistance forces, doctrinal guidance statements regarding complicating factors affecting medical evacuation and hospitalization to support irregular forces and measures that may be adopted to cope with them were prepared and have been promulgated in FM 31-15, “Operations Against Airborne Attack, Guerrilla Action, and Infiltration.”

Two specific requirements for revised doctrinal guidance statements developed in the functional areas of aeromedical evacuation and AMEDS support of civil affairs operations. These requirements will be studied during fiscal year 1962 and appropriate guidance statements issued.

It is proposed that a group of AMEDS personnel with special qualifications needed to evaluate the accuracy and relevancy of all currently published doctrinal statements pertaining to nuclear warfare operations be appointed. Thereafter, the data pertinent to the Army Medical Service will be consolidated and published as a single document.

Changes Affecting Tables of Allowances

Changes of particular significance which were under study during the past year have either resulted in definitive action, in compliance with published directives, or are the subject of further discussion and staff study. These changes affecting TA’s (tables of allowances) are commented upon in the following paragraphs:

TA 8-35, Air Defense Missile Sites, First Aid Stations.—TA-35 was scheduled for revision in April 1961. However, it was considered that a more appropriate manner of authorizing this equipment and supplies would be to utilize TA 8-100 for expendable items and the current TOE-44 series for nonexpendable equipment. A letter containing this recommendation was forwarded to Commanding General, US ARADCOM (U.S. Army Air Defense Command) and Commanding General, USCONARC, for consideration, recommendation, and approval. Both commands concurred in the proposal. Action will


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Admitting Office, 3d Surgical Hospital (Mobile Army), receiving simulated surgical casualties during field training exercises


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36th Evacuation Hospital, 68th Medical Group, Fort George G. Meade, Md.


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be taken to include expendable medical items for the first aid stations at air defense missile sites in the next revision of TA 8-100. Nonexpendable items will be included in appropriate TOE’s as they are revised. Scheduled revision of TA 8-35 was canceled; however, the TA will not be rescinded until allowances have been included in TA 8-100 and appropriate TOE’s.

DA Circular 725-4, Cancellation of Authorizations for Items Issued in Excess of Authorized Allowances.—Action required by DA Circular 725-4, 28 June 1960, has been completed. All authorizations in excess of allowances have now been included in appropriate TA’s. As provided by the circular, future authorizations for items in excess of allowances will be included in published changes within 180 days following authorization.

Common type TA for class I installations and activities.—During this year, allowances for Army area laboratories and dental clinics were incorporated into TA 8-34. Concurrently, the title of this TA was changed to “United States Army Class I Medical Activities.”

Changes Affecting Supply Manuals

Publication of major medical assemblages in the DA supply manual format has been completed with the exception of the medical maintenance units.

Since the medical maintenance units were in need of modernization, it was decided to replace the current six medical maintenance units with three medical resupply units. The resulting medical resupply units will contain 30 days of resupply for—

1. Support of the battle group (regiment, brigade), reinforced.— Items to be included are those necessary for replacement of the types found in a clearing company and a mobile army surgical hospital for a troop strength of 2,500 to 3,000.

2. Support of a division, reinforced.—Items to be included are those necessary for replacement of the types found in a clearing company, a mobile army surgical hospital, an evacuation hospital, a field hospital, a mobile laboratory, and a dental service detachment for a troop strength of 10,000 to 15,000.

3. General support in Communications Zone.—Items to be included are those necessary for replacement of the types found in a clearing company, a mobile army surgical hospital, an evacuation hospital, a field hospital, a dental service detachment, an Army laboratory, a general hospital, a central dental laboratory, a 25-chair dental clinic, and in general dispensary and dispensary detachments for a troop strength of 10,000 to 15,000.


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Nine new medical assemblage sets were developed during this year. These were—

Medical Equipment Set, Ward, 20-Bed.—The set provides supplies and equipment to establish and initially operate a 20-bed ward, field, in a theater of operations. As the year ended, “Type Classification” was still pending.

Medical Equipment Set, Hospital Expansion, 20-Bed.—This assemblage included those medical items required throughout the treatment facility to support additional 20-bed units.

Book Set, Preventive Medicine.—A book set for use by preventive medicine units in the field as reference and source material was recommended for standardization. As the year ended, “Type Classification” was still pending.

Blood Donor Sets.—Six medical instrument and supply sets, Zone of Interior Blood Donor Centers, were developed and published. The purpose of these assemblages is to provide equipment and supplies for operation of Blood Donor Centers, Zone of Interior, as an activity consisting of a collecting element and a laboratory element.

Atropine Authorization for Theaters of Operations

As the year began, the only remaining action on atropine authorization was the need to establish an authorized allowance for the item. During the year, three bottles of atropine (25 cc. bottle atropine sulfate, injectable, 2 mg. (1/32 gr.) per cc.) were approved for inclusion in each Surgical Instrument and Supply Set, Combat; Medical Instrument and Supply Set, Dispensary, Field; and Medical Supply Set, Field, Supplemental Supplies. This action authorizes each battle group medical platoon 1,200 cc. of atropine in addition to the allowance of syrettes authorized in TA 8-100.

Broad-Spectrum Antibiotics Authorization for Theaters of Operations

In the annual report for fiscal year 1960, it was indicated that a Drug Set, Antibiotics, was being developed. It was planned to include equal amounts of chlortetracycline hydrochloride capsules, tetracycline hydrochloride tablets, and oxytetracycline tablets, or any combination thereof.

Since the item of supply concept was not fixed (item may consist varyingly of one of three antibiotics or a combination of the three), MMSA (Military Medical Supply Agency) recommended that this item not be adopted and indicated the price of this item would be


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impossible to establish. The Army member, ASMMCC (Armed Services Medical Materiel Coordination Committee), was advised to type­classify this antibiotic set which would consist of “144 bottles of FSN 6505-286-7302 Tetracycline Hydrochloride Tablets, USP, 0.25 Gm (4 gr.), 100s,” and he recommended that chlortetracycline hydrochloride capsules and oxytetracycline tablets be designated as authorized substitutes for tetracycline hydrochloride. This eliminated the problem regarding establishment of a unit price.

AMEDS Display at JCS Demonstration

A Joint Chiefs of Staff directed weapons demonstration was conducted in Puerto Rico for Latin American military leaders, 19-22 February 1961. The AMEDS display consisted of the following exhibits:

1. “United States Army Medical Training Aids.” This exhibit depicted types of visual, graphic, and three-dimensional training aids that are available for training in first aid and emergency medical treatment.

2. “United States Armed Forces Medical Services Emergency Medical Treatment Unit, Phase I.” A sample of each of the items contained in the master pack, fracture pack, and burn pack, designed to care for casualties occurring among 100 personnel during the first 72 hours after a natural or manmade disaster, was displayed.

3. “New Material for Combat Support.” This exhibit depicted ceetain items of medical equipment under development or recently standardized.

4.  “One Hospitalization Unit (—), of the 28th Field Hospital, Fort Bragg, North Carolina.” This exhibit presented the major functional elements of a hospitalization unit (three per field hospital). The hospitalization unit (—) on display was the same type of medical treatment facility airlifted to Chile during the Chilean earthquake disaster in May 1960.

Troop Test, Air Ambulance Support of an Airborne Corps

Arrangements were made to subject the Air Ambulance Company, TOE 8-137D, and its concept of employment, to a troop test during Exercise Swift Strike. The exercise will be conducted during the period 6-20 August 1961 in the vicinity of Fort Bragg, N.C., Fort Campbell, Ky., and Fort Jackson, S.C. It is estimated that 30,000 troops will participate in this exercise.


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USCONARC STRAC Superior Unit Award

The following units located at Brooke Army Medical Center received the USCONARC STRAC Superior Unit Award:

520th Medical Company (Clearing).

566th Medical Company (Ambulance).

712th Medical Company (Preventive Medicine).