A combat support hospital (CSH, pronounced "cash") is a type of modern United States militaryfield hospital. The CSH is transportable by aircraft and trucks and is normally delivered to the Corps Support Area in standard military-owned Demountable Containers (MILVAN) cargo containers. Once transported, it is assembled by the staff into a tent hospital to treat patients. Depending upon the operational environment (e.g., battlefield), a CSH might also treat civilians and wounded enemy soldiers.[citation needed] The CSH is the successor to the Mobile Army Surgical Hospital. As of November 2017, the United States Army and United States Army Reserve is in the process of reorganizing the Combat Support Hospitals into smaller, modular units called 'Field Hospitals'.
The United States Armed Forces are the military forces of the United States of America. It consists of the Army, Marine Corps, Navy, Air Force, and Coast Guard. The president of the United States is the commander-in-chief of the Armed Forces and forms military policy with the Department of Defense (DoD) and Department of Homeland Security (DHS), both federal executive departments, acting as the principal organs by which military policy is carried out. All five armed services are among the seven uniformed services of the United States.
A field hospital is a small mobile medical unit, or mini hospital, that temporarily takes care of casualties on-site before they can be safely transported to more permanent facilities. This term is used overwhelmingly with reference to military situations, but may also be used in times of disaster. The concept was inherited from the battlefield and is now applied in case of disasters or major accidents, as well as with traditional military medicine.
A Corps area was a geographically-based organizational structure of the United States Army used to accomplish administrative, training and tactical tasks from 1920 to 1942. Each corps area included divisions of the Regular Army, Organized Reserve and National Guard of the United States. Developed as a result of serious mobilization problems during World War I, this organizational scheme provided a framework to rapidly expand the Army in time of war or national emergency such as the Great Depression.
The size of a combat support hospital is not limited, since tents can be chained together; it will typically deploy with between 44 and 248 hospital beds, with 44 beds being most common (ATP 4.02-5 Casualty Care, May 2013) For patient care the CSH is climate-controlled, and has pharmacy, laboratory, X-Ray (often including a CT Scanner) and dental capabilities (ATP 4-02.5 Casualty Care, May 2013). It provides its own power from generators.
A CT scan or computed tomography scan makes use of computer-processed combinations of many X-ray measurements taken from different angles to produce cross-sectional (tomographic) images of specific areas of a scanned object, allowing the user to see inside the object without cutting. The 1979 Nobel Prize in Physiology or Medicine was awarded jointly to Allan M. Cormack and Godfrey N. Hounsfield "for the development of computer assisted tomography."
The great operational advantage of the DEPloyable MEDical Systems (DEPMEDS) facility is the use of single or double expanding ISO containers/units to create hard sided, air conditioned, sterile operating rooms and intensive care facilities, which can produce surgical outcomes similar to that seen in fixed facility hospitals, and do so in an austere environment.
An intermodal container is a large standardized shipping container, designed and built for intermodal freight transport, meaning these containers can be used across different modes of transport – from ship to rail to truck – without unloading and reloading their cargo. Intermodal containers are primarily used to store and transport materials and products efficiently and securely in the global containerized intermodal freight transport system, but smaller numbers are in regional use as well. These containers are known under a number of names, such as simply container, cargo or freight container, ISO container, shipping, sea or ocean container, sea van or (Conex) box, sea can or c can.
Function
Because they are large and relatively difficult to move, combat support hospitals are not the front line of battlefield medicine. Battalion Aid Stations, Forward Support Medical Battalions and Forward Surgical Teams are usually the first point of contact medical care for wounded soldiers. The CSH receives most patients via helicopter Air Ambulance, and stabilizes these patients for further treatment at fixed facility hospitals. Ideally, the CSH is located as the bridge between incoming helicopter ambulances and outgoing Air Force aircraft.
Battlefield medicine, also called field surgery and later combat casualty care, is the treatment of wounded combatants and non-combatants in or near an area of combat. Civilian medicine has been greatly advanced by procedures that were first developed to treat the wounds inflicted during combat. With the advent of advanced procedures and medical technology, even polytrauma can be survivable in modern wars. Battlefield medicine is a category of military medicine.
In the United States Army and Marine Corps, the Battalion Aid Station is a medical section within a battalion's support company. As such, it is the forwardmost medically staffed treatment location.
In the United States Army, Medical Detachments, popularly known as Forward Surgical Teams (FST), are small, mobile surgical units first fielded during Operation Just Cause in December 1989. FSTs are utilized in a variety of ways, and can be fielded with support elements, including a Forward Support Medical Company (FSMC), Area Support Medical Company (ASMC), Brigade Medical Company also known as C-Med or in some cases stand alone to provide a surgical capability at Role 2 for those patients unable to survive MEDEVAC to Role 3 (hospital) care. Surgeons perform damage control surgery on combat casualties within the "golden hour" of injury whenever possible. Casualties can then be packaged for medical evacuation to a higher level of care. The FST typically includes 20 staff members: 4 surgeons, 3 RNs, 2 certified registered nurse anesthetists (CRNAs), 1 administrative officer, 1 detachment sergeant, 3 licensed practical nurses (LPN)'s, 3 surgical techs and 3 medics.
The CSH is capable of providing definitive care for many cases. Current medical doctrine does not encourage wounded soldiers, if they are not expected to quickly return to operational status, to stay in the combat zone. This is a pragmatic decision as the resources are usually available to bring them home quickly. Military aircraft constantly fly into a theater of operations loaded with equipment and supplies, but often lack a back cargo. Given that adequate "airlift" is usually present, it is easy to evacuate wounded promptly. For this reason the CSH bed capacity is not as heavily used as in past conflicts.
The CSH will generally have a ground ambulance company attached. This company consists of approximately 4 platoons of ground ambulances commanded by a Medical Service Corps officer. The ground ambulance company in cooperation with available air ambulances (MEDEVAC) is responsible for the movement of sick and wounded from the Battalion Aid Station and other forward-deployed locations to the CSH, as well as evacuation through an established medical treatment chain leading ultimately, for those seriously sick or wounded, to hospitals in the Continental United States in cooperation with resources in the U.S. Air Force.
The CSH is larger than its predecessor, the Mobile Army Surgical Hospital. It is commanded by a colonel, rather than a lieutenant colonel.
The Mobile Army Surgical Hospital (MASH) refers to a United States Army medical unit serving as a fully functional hospital in a combat area of operations. The units were first established in August 1945, and were deployed during the Korean War and later conflicts. The term was made famous in the television series M*A*S*H, which depicted a fictional MASH unit. The U.S. Army deactivated the last MASH unit on February 16, 2006. The successor to the Mobile Army Surgical Hospital is the Combat Support Hospital.
A fully manned CSH has over 600 people when fully staffed 248 beds. The modular nature of the organization allows for partial deployments, and the full unit is not often deployed (ATP 4.02-5 Casualty Care, May 2013).
In 1973 and 1974, the 28th Surgical Hospital MASH helped phase-in new designs for operating rooms and patient facilities from the previous canvas tents. Since then all other configurations of army deployable hospitals have been inactivated or reconfigured to the CSH configuration. The last to convert was the 212th Mobile Army Surgical Hospital.[1]
In the mid 1970s the "MUST" designation was applied, (Medical Unit, Self Contained, Transportable). During the "Cold War", with the possible conflict with the Warsaw Pact, active duty MUST units would be staffed by all the basic personnel necessary (Medics, X-Ray Techs, Pharmacist, Cooks, Clerks etc.) Doctors, Nurses and Specialist would be mobilized and mate up with the unit in the Field. The Unit would be flown to West Germany, withdraw Pre-positioned complete Hospital MUST equipment and Military Vehicles from warehouses and then deploy. It contained all necessary functions to provide care for 200 beds, including 2 intensive care units, 8 medical wards, emergency room, 4 operating rooms, orthopedic room, laboratory, X-ray, pharmacy and the Unit's transport vehicles. It consisted of hard containers, which would be transported to the designated site, then the wheels would be removed and then expanded. They housed the operating rooms, laboratory, X-ray, and pharmacy. Inflatable shelters were used to provide double wall insulated areas for the patient care areas of the hospital.[2] These "inflatables" required a power system called a Utility Pack (also known as a U-Pack or power station) to provide utility services, Heat, Cooling, Inflation, Hot Water, Filtered Air from CBR Contaminants. The Utility Pack (Power Plant, Utility, Gas Turbine Engine Driven - Libby Welding Co. Model LPU-71, Airesearch Model PPU85-5, AmerTech Co. Model APP-1, or Hollingsworth Model JHTWX10/96), powered by a centrifugal flow gas turbine engine, provided electricity (60Hz AC, 400Hz AC, and 24vdc). At 250 beds the hospital required 8 U-Packs. Each consumed 30 gallons of jet fuel per hour. After several years of using inflatables they were abandoned in the mid 1980s, largely due to the weight of the inflatables, and the amount of fuel required just to keep the tents from collapsing.
The 67th Combat Support Hospital was the only forward deployed combat support hospital in Europe with both warfighter support and community service missions. Medical readiness was the primary concern for the unit. Located in the heart of the European theater, the 67th Combat Support Hospital stood ready to provide Echelon III health care around the globe.
The 44th Medical Brigade is a US Army unit located at Fort Bragg, North Carolina, providing health care and medical services to the Fort Bragg community, and continuing training in its combat support mission.
The term military medicine has a number of potential connotations. It may mean:
The 1st Close Health Battalion (1CHB) is a unit of the 17th Sustainment Brigade of the Australian Army. It is headquartered at the Robertson Army Barracks in Darwin, but has sub-units located in Darwin, Townsville and Brisbane. The unit traces its lineage back to the 1st Field Hospital, which was raised in the 1960s for service as part of Australia's contribution to the Vietnam War. Since then, the unit has changed names twice and personnel have been deployed on numerous peacekeeping and warlike operations throughout Africa, the Middle East and the Asia-Pacific region.
The 115th Combat Support Hospital is a combat support hospital of the United States Army formed in 1917 and perpetuated until today. The hospital has participated in World War I, World War II, Desert Storm and the Iraq War.
The 3rd Medical Command (MCDS) or "Desert Medics" is headquartered in Atlanta, GA and manages all the Army Reserve deployable field medical units east of Ohio. While the 807th MCDS covers the MTOE medical units to the west and ARMEDCOM provides command and control for all the Table of Distribution and Allowance (TDA) medical units within CONUS.
The PROFIS or Professional Filler System is used by the United States Military to fill voids in personnel when a unit deploys on a combat or humanitarian mission. Due to the high financial cost of employing physicians, civil engineers, lawyers or other "high dollar specialists" in a military unit, usually at the battalion and sometimes at the brigade level a full time "specialist" is not permanently assigned to these units. When a unit deploys to an austere location, the demand for a specialist increases. The military's solution is to have a PROFIS or assigned specialist to these units that only serves with the unit when they deploy.
The 28th Combat Support Hospital is a Combat Support Hospital of the United States Army. It was first constituted in 1943 and served in China during World War II. During the Gulf War in 1990, it was the first Army hospital unit established and deployed into Iraq with combat forces of the XVIII Airborne Corps. More recently it has been involved in relief operations following natural disasters and has undertaken several recent deployments to Iraq. Currently the unit falls under the command of the 44th Medical Brigade and is based at Fort Bragg, North Carolina.
The 10th Field Hospital is a Field Hospital of the United States Army first constituted on 23 June 1942 in the Army of the United States as the 10th Field Hospital.
The 95th Evacuation Hospital was a U.S military hospital during World War II, the Vietnam War, and the Gulf War.
The 16th (Parachute) Field Ambulance was a Royal Army Medical Corps unit of the British airborne forces during the Second World War. The unit was the first parachute field ambulance unit of the British Army. Their first deployment was in Operation Torch the Allied landings in North Africa. This was followed by Operation Fustian during the Allied invasion of Sicily. Their third mission was Operation Slapstick, a seaborne landing at Taranto in Italy.
A mobile hospital is a medical center or a small hospital with full medical equipment that can be moved and settled in a new place and situation swiftly. So it can provide medical services to patients or wounded persons in critical conditions such as war or natural disasters.
The 274th Forward Surgical Team (Airborne) — officially the 274th Medical Detachment, Forward Surgical (Airborne) — is an airborne forward surgical team of the United States Army providing Level II care far forward on the battlefield. It was first constituted in 1944 and served in Europe during World War II. More recently it has been involved in relief operations following natural disasters and has undertaken several recent deployments to Iraq and Afghanistan. The 274th Forward Surgical Team was part of both the initial entry forces of Operation Enduring Freedom in 2001 and Operation Iraqi Freedom in 2003. Currently the unit falls under the command of the 28th Combat Support Hospital and is based at Fort Bragg, North Carolina.
The 14th Combat Support Hospital is a combat support hospital of the United States Army. It participated in World War II, the Korean War and, more recently, deployed to Afghanistan. Additionally, it was involved in the relief operations following Hurricane Katrina. The unit currently falls under the command of the 44th Medical Brigade and is based at Fort Benning, Georgia.
The 1st Medical Brigade is a US Army unit located at Fort Hood, Texas, providing health care and medical services to the Fort Hood community, and continuing training in its combat support mission.
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