(4) Alternate facilities. Alternate facilities may be used (if the facility can be configured to ensure continuity of care or provide a protected area for patients) until the relocating activity is up and operating. This is a viable consideration when CPS is not available or the current location is contaminated with a persistent agent. Patient decontamination cannot be performed in an area heavily contaminated with a persistent agent.
(5) Medical evacuation. Consideration must always be given to the patient. Routes of MEDEVAC must be disseminated to supported and supporting units. The ability to evacuate patients during the move must continue. All MEDEVAC considerations must be addressed before any move.
(6) Mobility. An MTF that is not 100 percent mobile requires movement support. Thus, the commander/leader must coordinate movement support requirements with higher headquarters.
(7) Mission. The primary consideration is the support mission of the MTF. The tactical commander requires continuous HSS for his personnel; when a move jeopardizes the quality of care, the move may be delayed.
(8) Sustainability. Hand-in-hand with the mission is sustainability (the ability of the unit to continue its support mission). If the current location of the MTF hinders the unit's ability to sustain its support mission, then the MTFs support to the unit is in question. Similarly, if moving the MTF will result in a disruption of support, then the move may not be viable.
(9) Decontamination. When a nonpersistent agent hazard exists and a CPS is not available, patients may be directed to another MTF until the hazard is gone; or the MTF can move to a contamination free area. Certain facilities may be decontaminated, patient protection procedures applied, and the operation continued. However, an MTF contaminated with a persistent agent requires time-consuming and resource-intensive decontamination operations; it may include replacement of contaminated shelters.
c. Management of Contaminated and "Clean" Facilities. Facilities contaminated with a persistent agent may be too resource intensive to decontaminate. Operating with a combination of contaminated assets and "clean" assets may be necessary. Mark contaminated assets with standard warning tags. Use these assets in contaminated environments and along contaminated routes. Keep clean assets in operation in clean areas. Of primary importance is proper marking and the avoidance of cross contamination.
d. Medical Supplies and Equipment for Patient Treatment. Are sufficient medical supplies and equipment available to perform the anticipated mission? Does the unit have special medical equipment sets available (chemical agent patient decontamination and chemical agent patient treatment medical equipment sets)?
2-6. Leadership on the Contaminated Battlefield
a. Operating on a contaminated battlefield will stress leadership. Heat stress from being in higher levels of MOPP for long periods of time may lead to dehydration. The commander/leader must ensure that his personnel rest, drink, and eat sufficiently to allow them to continue with the mission. In the midst of activity, rest, hydration, and nutrition are often overlooked; however, a good leader will ensure that his personnel needs are met. See FM 21-10 for work/rest cycles and water drinking requirements. Individuals may suffer hyperventilation because of the enclosed feelings. Personnel remaining in MOPP Level 4 around the clock may suffer from increased sleep loss. Use of CPS can reduce this problem by allowing the personnel to rest out of their MOPP gear. Leaders must share leadership responsibilities and delegate responsibilities as much as possible so that each one gets sufficient rest to maintain unit effectiveness. Further, leaders should concentrate on supervision or unit mission, rather than on generation of new procedures during and after an attack. The NBC battlefield will, therefore, require more proactive and dedicated leaders who can balance the needs of their personnel and the mission. Further, leaders will be challenged by an additional logistics burden of providing nontraditional respiratory protection for personnel against TIMs. For detailed information on combat operational stress control (COSC) see FM 8-51 and FM 22-51.