Development of a medical supply set for corpsmen in the field.

Fleet Marine Force corpsmen are the first medical responders to treat casualties in the field. They carry an outdated bag of supplies called the surgical instrument and supply set. The purpose of this investigation is to develop an updated supply set for field corpsmen by linking each supply item to specific medical tasks conducted in the field, which then creates an audit trail. The review of medical supplies generated an updated list of supplies to be carried by corpsmen in a new medical module and a list of items that corpsmen can pull from the battalion aid station authorized medical allowance lists as needed. Items without a clinical requirement were not included. This improved set of supplies for corpsmen will greatly enhance treatment capability in the field. As technology and needs change, replacements, additions, and deletions of the items can easily be made.

A descriptive analysis of patient encounter data from the Fleet Hospital FIVE humanitarian relief mission in Haiti.

Fleet Hospital FIVE personnel treated more than 24,000 patients during a 1997 military operation other than war in Haiti. Sample data were analyzed for 10,215 Haitians who received humanitarian assistance care at field treatment sites and for 353 military, United Nations personnel, and Haitian nationals who were treated at the fleet hospital. Demographic data, type of encounter, diagnoses, and prescriptions were tabulated. Children aged 1 to 10 years accounted for 31% of humanitarian assistance visits. Females outnumbered males; in adults aged 21 to 30 years, the proportion was almost three to one. Most (97%) were initial encounters. Infectious and parasitic diseases, such as worms or scabies, accounted for 25% of diagnoses. At the fleet hospital, more than 80% of patients were males; these were most often older than 21 years. Injuries and aftercare procedures constituted 51.5% of diagnoses. Of 18,100 prescriptions, 57% were for anti-inflammatories, vitamins, or anti-parasitics. Implications for medical planning are described.

Estimating supply requirements for forward medical treatment facilities.

The Naval Health Research Center designed, developed, and used a systematic process to review Marine Corps medical supply requirements. This approach consisted of identifying the medical tasks required to treat patients with specific injuries and illnesses and determining the supplies and equipment required to perform each task. Subject matter experts reviewed treatment briefs, tasks, supplies, and equipment and examined their value to Marine Corps medical providers in forward areas of care. By establishing the clinical requirement for each item pushed forward, the Naval Health Research Center model was able to reduce the logistical burden carried by Marine Corps units and enhance far-forward clinical capability. The result of this effort is a model to estimate supplies and equipment based on a given casualty stream distribution. This approach produces an audit trail for each item and allows current authorized medical allowance list configurations to be revised using information such as type of conflict anticipated, expected duration, and changes in medical doctrine.

MARC ES: a computer program for estimating medical information storage requirements.

During combat, documentation of medical treatment information is critical for maintaining continuity of patient care. However, knowledge of prior status and treatment of patients is limited to the information noted on a paper field medical card. The Multi-technology Automated Reader Card (MARC), a smart card, has been identified as a potential storage mechanism for casualty medical information. Focusing on data capture and storage technology, this effort developed a Windows program, MARC ES, to estimate storage requirements for the MARC. The program calculates storage requirements for a variety of scenarios using medical documentation requirements, casualty rates, and casualty flows and provides the user with a tool to estimate the space required to store medical data at each echelon of care for selected operational theaters. The program can also be used to identify the point at which data must be uploaded from the MARC if size constraints are imposed. Furthermore, this model can be readily extended to other systems that store or transmit medical information.