(4) Mission-oriented protective posture reduces the efficiency of all personnel.
(5) Without CPS systems, hospitals may operate for a limited time in a nonpersistent agent environment, but are incapable of operating in a persistent agent environment.
- Chemical/biological filters for fixed site hospital ventilation systems will be a critical item of supply. Controlled entry and exit point with sufficient space to permit placement of litter patients and/or numbers of personnel that permit purge of vapors will have to be established. All windows, doors, and other points that may have air leaks will have to be sealed (use tape and plastic sheeting) to enable the facility to have a positive overpressure to keep CB agents out.
- Liquid chemical agents can penetrate the TEMPER in about 6 hours or general purpose (GP) tentage in a shorter period of time. These agents will penetrate the wrappings on medical supplies and equipment; especially, sterilized equipment and supplies, paper-wrapped cotton sponges, and open or lightly closed medications/solutions. They can also contaminate water/food supplies. Therefore, equipment and supplies must be stored in protected areas or under protective coverings.
- Without a CPS system, treatment procedures involving open wounds or the respiratory tract in the presence of a CB agent hazard is limited. Exposing open wounds and the respiratory tract to the agent increases the effects of these agents on the patient.
- Without hardened protection, the hospital, staff, and patients are susceptible to the effects (blast, thermal, radiation, and missiling) of nuclear weapons.
- Hospital electrical and electronic medical equipment is vulnerable to the effects of the EMP produced by nuclear weapons. The EMP is not harmful to humans, animals, or plants, but is very damaging to electronic equipment.
- Hospital equipment is very difficult to decontaminate. Aging (allowing the agent to off-gas) may be the only means of decontamination.
- Hospitals are not kept in reserve. All personnel and equipment losses due to NBC contamination or radiation will have to be replaced.
b. There are currently two force modernization initiative hospital systems in the force structure. The Medical Force 2000 (MF2K) system consists of the CSH, the field hospital (FH), and the general hospital (GH). The Medical Reengineering Initiative (MRI) consists of only one hospital system—the CSH. The MF2K CSH is a corps asset, whereas, the FH and GH are the echelon above corps hospital systems. The MRI CSH will be located in the corps and at echelons above corps. The MRI CSH will replace the FH and GH at echelons above corps. See FM 4-02.10, FM 8-10-14, and FM 8-10-15 for detailed information on these hospital systems.
4-2. Protection
a. Protection of hospital assets requires intensive use of intelligence information and careful planning. The limited mobility of hospitals makes their site selection vital to minimize collateral damage from attacks on other units.
- Hospitals must be located as close to the supported units as possible to provide responsive care in support of the tactical commander's plan. However, their limited mobility must be considered when selecting their locations.
- Protective factors (distance from other support units and interposed terrain features) must be balanced against the operational factors (accessibility and time required for patient transport).
- Depending on the weapon systems used, local topography, and meteorological conditions, relatively large portions of the tactical area may remain uncontaminated.
b. Many defensive measures will either impede or preclude performance of the hospital mission. Successful hospital defense against an NBC threat is dependent upon accurate, timely receipt of information via the nuclear, biological, and chemical warning and reporting system (NBCWRS). This information will allow the hospital to operate longer without the limitations and problems associated with the use of the CPS and personnel assuming MOPP Levels 3 and 4. The detailed information (provided in the NBC 5 and 6 reports respectively) on the areas affected and the types of agents used allows the hospital staff to—
- Project the number and types of patients to be expected.
- Establish a patient decontamination area.
- Request patient decontamination assistance.
(1) Protective procedures.