(a) Individual protection. When CPS systems are not available, using the correct MOPP level is essential in hospital mission performance. The level of MOPP assumed depends upon the level of threat. An alternative approach for the hospital commander is the use of the mask-only posture. This posture is acceptable when the hazard is from vapor only (except mustard). See FM 3-4 for a description of each MOPP level and mask-only procedures.
- Hospital warning system. The hospital must have a warning system that alerts all personnel of impending or present hazards. This system must include visual and auditory signals; the signals must operate inside and outside the hospital complex. There are numerous problems associated with warning personnel; they include—
- The wide area covered by the hospital operations.
- Some personnel will be asleep at all times of the day or night (two or three shifts).
- The considerable noise from mechanical support equipment; such as the power generation and environmental control equipment.
- Tentage and equipment interrupts line of sight.
- Hospital personnel response. When NBC alarms are activated, all personnel (including off duty personnel) report to their duty stations as soon as they are in the designated MOPP level. This allows for 100 percent personnel accounting and provides additional personnel to secure patients and materiel.
- Unprotected hospital areas. Areas of the hospital without CPS are at their best posture with all openings secured and the ventilation systems turned off. For nonpersistent agents (vapor hazards), personnel and patients stay at the designated MOPP level until the all clear signal is given; then normal operations are resumed.
NOTE
Patients with injuries that prevent their assuming a protective posture must be placed in a PPW or immediately evacuated to a clean MTF.
(b) Environmental protection. As noted previously, hospital complexes without CPS offer some protection against liquid or fallout contamination, but little protection against vapor hazards.
- When MOPP Level 1 must be assumed, close and secure all tent flaps, vents, and doors to prevent the entrance of liquids or particles. All hospital personnel outside of shelters assume MOPP Level 4. Cover or move all equipment and supplies into shelters (tents, hard-walled shipping containers), if possible. Placement under thick foliage trees is better than left out in the open. The best policy is to keep all equipment and supplies not immediately needed covered or in closed containers.
- When MOPP Level 3 or mask-only posture is assumed, shut down the hospital's ventilation system to prevent drawing vapors or fallout contamination into the hospital. This measure also provides some protection of the internal environment during the time required for the vapor to penetrate the tentage.
(c) Patient protection.
- Patient protection depends upon prior planning and timely warning of the chemical threat. Each patient's protective mask must be available and serviceable. If the patient came from a contaminated area, the mask must be decontaminated and the filters changed. The mask decontamination and filter change may have to be performed by hospital personnel. If ambulatory patients' medical conditions permit (minimal care ward), they may be able to perform this task. The hospital supply staff must ensure that mask filters are available at the supporting logistics support facility and can be requisitioned to meet this requirement. Check all masks for serviceability as soon as the mission permits, but always before they are needed. Do not wait until the warning has been received to begin checking the mask. Each area must have an established plan for operations (to include assisting patients assuming MOPP or other protective posture) in the NBC environment. [Appendix F] provides additional information on patient protection.