E-1 NATO UNCLASSIFIED Dear colleagues You can find below the latest draft of PD5.4 (ex PD 7.1.), after our last meeting in Brussels (3 – 4 – 5 September 2008), and remarks about the delegate of MMT (NL). First, the matrix, broken down by MMSOP, is also presented (in red, modules without medical capabilities). According with the different discussions and the proposal of COMEDS LO, the non medical modules (administrative tasks) which aren’t treated in this draft could be taken in charge by EP or MMSOP. Medical capabilities for Forward, Tactical and Strategic Aeromedevac Evacuation are the same. The engine capacities could be different (helicopter, plane…) but the medical personnel are the same. The advice of Aeromedevac EP could be asked. The capabilities for skill sets are organized into 5 parts in each module: 1- Pre-hospital and arrival of patient (assessment) 2- Treatment 3- Post-treatment (post-operative) care 4- Transfer (communication, preparation and practical conduct) 5- Logistic and administrative tasks These modules and skill sets could be the basis for training and education of medical personnel prior to deployment Sincerely yours Colonel (TA) Gilbert VERSIER MD PhD Representative of France (head of delegation) Custodian of PD5.4 MHCWG
Transcript
E-1
NATO UNCLASSIFIED
Dear colleagues You can find below the latest draft of PD5.4 (ex PD 7.1.), after our last meeting in Brussels (3 – 4 – 5 September 2008), and remarks about the delegate of MMT (NL). First, the matrix, broken down by MMSOP, is also presented (in red, modules without medical capabilities). According with the different discussions and the proposal of COMEDS LO, the non medical modules (administrative tasks) which aren’t treated in this draft could be taken in charge by EP or MMSOP. Medical capabilities for Forward, Tactical and Strategic Aeromedevac Evacuation are the same. The engine capacities could be different (helicopter, plane…) but the medical personnel are the same. The advice of Aeromedevac EP could be asked. The capabilities for skill sets are organized into 5 parts in each module:
1- Pre-hospital and arrival of patient (assessment) 2- Treatment 3- Post-treatment (post-operative) care 4- Transfer (communication, preparation and practical conduct) 5- Logistic and administrative tasks
These modules and skill sets could be the basis for training and education of medical personnel prior to deployment Sincerely yours Colonel (TA) Gilbert VERSIER MD PhD Representative of France (head of delegation) Custodian of PD5.4 MHCWG
E-2
NATO UNCLASSIFIED
Certification of Medical Capabilities
Role/Capability Module Remarks
Pre-hospital Emergency Care
Provision of incident response and ‘blue-light’ matrix capability
1- Response Ambulance Trained medical personnel and appropriate medical equipment with ‘blue-light’ matrix capability
2- Forward AE Trained medical personnel and appropriate medical equipment (AJP 4.10.2)
3- Incident response team Tailor-made team Trained medical personnel and appropriate medical equipment
Role 1 1- Primary Health Care (medical)
Provides PHC, specialized first aid, triage, resuscitation and stabilization, may provide primary dental care*, minimum patient holding capacity, basic laboratory testing*, initial stress management*
Non medical Command, Control, Communications, Computers and Information capability Reception/Administration, Logistic support
Role 2 LM 1- Resuscitation and Pre-/post-operative Module
Provides specialist led resuscitation
2- DCS Module Provides equipment to undertake DCS
3- Diagnostic Module Provides field laboratory and basic imaging capability to support DCS
Patient holding Limited holding capacity
Role 2 E 1- Surgical Module Provides equipment to undertake primary surgery
2- ICU Provides surgical and medical intensive care capability
3- Sterilisation
4- Mobile Mental Health Module
Capable of providing peripatetic services*
5- Forward Medical Equipment Module
Pharmacy, maintenance, blood provision
6- CBRN Med Module Decontamination of casualties prior to treatment Mission dependent
7- Ward nursed beds
Higher Roles consists of capabilities of lower Roles
E-3
NATO UNCLASSIFIED
Role/Capability Module Remarks
8- Diagnostic Module Enhanced Diagnostics to support primary surgery and other specialties May include Telemedicine
Enhanced Support Capability to support lower Roles
Enhanced C4I May include PECC
Role 3 (in addition to Role 2 E)
Clinical Specialist Modules Mission tailored Neurosurgical, Ophthalmology, OMFS, Burns, Paediatrics, Obstetrics/Gynaecology, Mental Health Care
Enhanced Holding capacity
Preventive Medicine Preventive Medicine Team and Environmental health capability
May be attached to Role 2 E or Role 3
Ground MEDEVAC Transfer Ambulance Includes appropriate in-transit medical support for stabilised patients
AE (same capabilities than Forward AE)
Tactical AE Trained medical personnel and appropriate medical equipment (AJP 4.10.2)
Strategic AE With and without CCAST
Trained medical personnel and appropriate medical equipment Provision of specialist in transit support for critical care patients (AJP 4.10.2)
CSU Capable of holding a number of patients equivalent to the maximum aircraft load in a 24 hr period, capable of holding a small number of ICU patients Co-located to another MTF
Patient Evacuation Coordination,
PECC Directing/co-coordinating blue-light’ matrix capability Co-ordination of ground evacuation and AE (forward, tactical and strategic) Patient Regulation, Patient Tracking Coordination with other functions (Engineers/MP etc)
Medical C2, Ops/Plans
MedDir/MEDAD/Ops/Plans Medical Information Collection Advice to commanders on health risks Establishment and management of multinational epidemiological surveillance system
E-4
NATO UNCLASSIFIED
Role/Capability Module Remarks
Establishment and conduct of a preventive medicine information exchange and education system Conduct of medical force protection Assessment of medical support readiness Medical emergency response organisation Development and establishment of medical policies and plans for the theatre Medical interface/liaison with relevant local authorities, IOs and NGOs Development and establishment of MASCAL plan Provide CBRN Med advice
Humanitarian Assistance/Disaster Relief
HA/DR Module, if required Mission tailored to an appropriate MTF
NATO MILITARY HEALTHCARE WORKING GROUP
PLANNED MULTINATIONAL MEDICAL SUPPORT
FOR EXPEDITIONARY OPERATIONS
PD5.4
E-5
NATO UNCLASSIFIED
Assist nations
in the accreditation / certification of medical personnel.
(ex PD 7.1)
CUSTODIAN: FRANCE SUPPORTING NATIONS: HUNGARY, LATVIA, POLAND, UNITED KINGDOM
PRE-HOSPITAL EMERGENCY CARE
This role, according to the MMSOP Matrix, is defined as the provision of incident response and a ‘blue-light’ matrix capability. Trained medical personnel and the appropriate medical equipment are often included in role 1, 2 or 3. Medical capabilities and general requirements of this module are the same in all the other roles.
E-6
NATO UNCLASSIFIED
For Response ambulance, the personnel may be drawn from role 1 (see Role 1). For Forward Aeromedical Evacuation, capabilities are the same as for Response Ambulance, but enhanced by adequate qualification/training in aeromedicine.
E-7
NATO UNCLASSIFIED
PRE-HOSPITAL EMERGENCY CARE
This level contains 3 modules: 1- Response Ambulance 2- Forward Aero-Medevac 3- Incidence response team
E-8
NATO UNCLASSIFIED
Module 1: Response ambulance capabilities
Task/Sub Task Number
Performance
Standard
Personnel Identified by nation
1.1 Manage pre hospital care and life support
a. Pre hospital advance life support procedures b. Minor Incident Medical Management and Support (MIMMS) organisation c. Knowledge of : triage, radio operations, decontamination procedures (contaminated and infectious) and medevac d. Medical record keeping including procedures to be followed in case of death e. give appropriate vaccination to patient
1.2 Manage severe Casualties (Trauma and wound injuries) from field or MTF1 to Role 2LM/E or Role 3 (directly)
a. Assess a patient b. Establish monitoring and specialised first aid
(Advanced Trauma Life Support and Battle ATLS)
c. Conduct resuscitation d. Perform general anaesthesia e. Perform analgesia (intravenous) and femoral
nerve block f. Perform immobilization
1.3 Manage patient tracking and transfer to higher MTF level.
a. Inform higher MTF level and commanders (MEDEVAC procedure)
b. Prepare patient for transfer c. Complete medical records and transfer
documentation d. Be able to conduct decontamination/CBRN
procedures,
1.4 Manage nursing care.
a. Assist and inform physician b. Assess patient and deliver nursing care c. Dress and bandage wounds d. Manage clinical waste e. Check comfort and fit of plasters and splints f. Prepare and administer medical treatment and blood packing (compression) to avoid haemorrhagae g. Ensure cleanliness and comfort of patient h. Provide adequate pain relief
1.5 Manage field sterile services.
a. Receive contaminated equipment b. Clean and disinfect equipment c. Inspect and service equipment d. Pack and sterilise equipment
E-9
NATO UNCLASSIFIED
Module 1: Response ambulance capabilities
Task/Sub Task Number
Performance
Standard
Personnel Identified by nation
e. Maintain stock levels
1.6
Prepare patient for evacuation
a. Assist physician in medical and care recording before evacuation b. Assist in preparation of equipment for casualty evacuation d. Assist in preparation of packing and movement of casualties
1.7 Manage transport
a. Hold an appropriate driving licence b. Control state and revise vehicles (minimum mechanic vehicle control) c. Basic knowledge of medevac d. Know techniques for immobilization, mobilization and transport of patients
1.8 Perform administrative tasks
a. Record medical activities b. Know command procedures c. Understand the use of maps, gps and radio
1.9 Supervise stock levels in transport assets and manage stores
a. Control stocks of drugs and other materiel b. Control oxygen stock c. Manage stores
1.10 MASCAL and MEDEVAC procedures
a. Understand the functions and actions of the Medical Incident Officer in Major Incident or MASCAL
b. Knowledge of the use and limitations medical transport (ground, air and sea)
c. Explain transport procedures to patients
E-10
NATO UNCLASSIFIED
Module 2: Forward aero medevac capabilities
Task/Sub Task Number
Performance
Standard
Personnel Identified by nation
2.1 Manage pre hospital care and life support
a. Pre hospital advance life support procedures
b. Minor Incident Medical Management and Support (MIMMS) organisation
c. Knowledge of: triage, radio operations, decontamination procedures (contaminated and infectious) and medevac
d. Medical record keeping, including procedures to be followed in case of death
e.Give appropriate vaccination to patient
2.2 Manage severe Casualties (Trauma and wound injuries) from field or MTF1 to Role 2LM/E or Role 3 (directly)
a. Assess a patient b. Establish monitoring and specialised first aid (Advanced Trauma Life Support and Battle ATLS)
c. Conduct resuscitation d. Perform general anaesthesia e. Perform analgesia (intravenous) and femoral nerve block Perform immobilization
2.3 Manage patient tracking and transfer to higher MTF level.
e. Inform higher MTF level and commanders (MEDEVAC procedure)
f. Prepare patient for transfer g. Complete medical records and transfer
documentation h. Be able to conduct
decontamination/CBRN procedures
2.4 Manage nursing care.
a. Assist and inform physician b. Assess patient and deliver nursing care c. Dress and bandage wounds d. Manage clinical waste e. Check comfort and fit of plasters and splints f. Prepare and administer medical treatment and blood transfusion g. Ensure cleanliness and comfort of patient h. Provide adequate pain relief
E-11
NATO UNCLASSIFIED
Module 2: Forward aero medevac capabilities
Task/Sub Task Number
Performance
Standard
Personnel Identified by nation
2.5 Manage field sterile services.
a. Receive contaminated equipment b. Clean and disinfect equipment c. Inspect and service equipment d. Pack and sterilise equipment e. Maintain stock levels f. Manage stores
2.6 Prepare patient for evacuation
a. Assist physician in documenting medical care given before evacuation b. Assist in preparation of equipment for casualty evacuation d. Assist in preparation and movement of casualties
2.7 conduct administrative tasks
a. Record medical activities b. Know command procedures c. Understand the use of maps, gps and radio
2.8 Supervise stock levels in transport assets
a. Control stocks of drugs and other materiel b. Control oxygen stocks
2.9 MASCAL and MEDEVAC procedures
a. Understand the functions and actions of the Medical Incident Officer in Major Incident or MASCAL. b- Knowledge of the use, rules and limitations medical transport (ground, air and sea). c- Explain transport procedures to patients.
2.10 Conduct Aero-medical Transfer
a. Aero-medical transport qualification or training
E-12
NATO UNCLASSIFIED
DRAFT OPERATIONAL PERFORMANCE
STATEMENT IN ROLE 1
E-13
NATO UNCLASSIFIED
ROLE 1 MTF: 1- Medical capabilities derived from the matrix provided by MMSOP:
The Role 1 MTF provides primary health care, specialised first aid, triage, resuscitation and stabilisation. Also included within the basic Role 1, are a basic occupational and preventive medical advice service to the chain of command, a routine sick call and the management of minor sick and injured personnel for immediate return to duty, as well as casualty collection from the point of wounding and preparation of casualties for evacuation to the higher level MTF. In accordance with the mission, Role 1 medical capabilities may include:
a. Minimal patient holding capacity b. Primary dental care (probably only medical treatment) “ c. Basic laboratory testing* (in fact only stick or hemocue test)
d. Initial stress management. (diagnosis and medical treatment, no psychiatrist) * defined by the DS EP, MP EP, EM EP and MMMP EP. To above-mentioned tasks it is necessary to add decontamination of the Chemical Warfare (CW) and Biological Warfare (BW) contaminated patients. 2- General requirements of module
Conditions Unless otherwise stated, the terms and conditions of the individual nations, together with the following conditions apply throughout the document: Physical Environment • As an individual or as part of a team. • Worldwide. • In all operational environments. • Possibly at sea or CBRN environment. • In a mobile operating theatre. • With or without access to references. Social/Political Conditions • At Role 1 • In an operational theatre • Utilising equipment in module for role 1 • Any scaled module for Role 1. Orders • Manufacturer’s instructions. • NATO References and STANAGS. • National Doctrine, standards and subordinate publications. • Formation Standing Operating Procedures and References. Knowledge of English • According STANAG 6001 • Officers level: 3-3-3-2 • SNCO’s level: 2-2-2-1 Junior ranks level according NATO requirements
E-14
NATO UNCLASSIFIED
Role 1 / Module 1: Primary Health Care capabilities
Task/Sub Task Number
Performance
Standard
Personnel Identified by nation
1.1
Provision of basic occupational medical advice
a. Assess a patient. b. Manage minor sickness c. Treat a minor injury d. Prescribe medical treatment e. Deliver preventive medical treatment f. Control and realize tetanos vaccination g. Organize the MTF, preparing and training the medical team
1.2 Manage pre hospital care and life support
a. Pre hospital advance life support procedures b. Minor Incident Medical Management and Support (MIMMS) organisation c. Knowledge of: triage, radio operations, decontamination procedures (contaminated and infectious) and medevac d. Medical record keeping, including procedures to be followed in case of death
1.3
Assist in pre hospital care and life support
a. Basic Life Support (BLS) b. Basic knowledge of decontamination procedures (contaminated and infectious) c. Assist in patient tracking d. Assist medical personnel in Advance Life Support (Trauma)
1.4 Manage severe Casualties (Trauma and wound injuries)
a. Assess a patient b. Establish monitoring and specialised first aid (Advanced Trauma Life Support and Battle ATLS) c. Conduct resuscitation d. Perform general anaesthesia e. Perform analgesia (intravenous and femoral nerve block ) f. Perform immobilization
1.5 Manage patient tracking and transfer to higher MTF level.
a. Inform higher MTF level and commanders (MEDEVAC procedure) b. Prepare patient for transfer c. Complete medical records and transfer documentation d. Be able to conduct decontamination/CBRN procedures
E-15
NATO UNCLASSIFIED
Role 1 / Module 1: Primary Health Care capabilities
Task/Sub Task Number
Performance
Standard
Personnel Identified by nation
1.6 Manage nursing care.
a. Assist and inform physician b. Assess patient and deliver nursing care c. Dress and bandage wounds d. Manage clinical waste e. Check comfort and fit of plasters and splints f. Prepare and administer medical treatment and blood packing (compression) to avoid haemorrhage g. Ensure cleanliness and comfort of patient h. Provide adequate pain relief
1.7 Assist in hospital care
a. Assist in nursing care and immobilization b. Basic knowledge of radio operations
1.8 Manage field sterile services and manage store
a. Receive contaminated equipment b. Clean and disinfect equipment c. Inspect and service equipment d. Pack and sterilise equipment e. Maintain stock levels f. Manage store
1.9 Prepare patient for evacuation
a. Assist physician in documenting medical care given before evacuation b. Assist in preparation of equipment for casualty evacuation. d. Assist in preparation and movement of casualties.
1.10 Manage transport
a. Hold an appropriate driving licence b. Control state and revise vehicles (minimum knowledgment on repairing and revising on vehicle (oil, wheels, ...) c. Basic knowledge of medevac d. Know techniques for immobilization, mobilization and transport of patients.
1.11 Conduct administrative tasks
a. Produce all technical and administrative documents for patient (minimum core data, epidemiologic table) b. Record medical activities c. Issue medical certificates d. Understand procedures to be followed in case of death e. Knowledge of command procedures f. Inform PECC g. Understand the use of maps, gps and radio
E-16
NATO UNCLASSIFIED
Role 1 / Module 1: Primary Health Care capabilities
Task/Sub Task Number
Performance
Standard
Personnel Identified by nation
1.12 Supervise stocks level of R1
a. Control stocks of drugs and other materiel stock
b. Control oxygen stocks
1.13 MASCAL and MEDEVAC procedures
a. Understand the functions and actions of the Medical Incident Officer in Major Incident or MASCAL.
b. Knowledge of the use and limitations medical transport (ground, air and sea).
c. Explain transport procedures to patients.
E-17
NATO UNCLASSIFIED
DRAFT OPERATIONAL PERFORMANCE
STATEMENT IN ROLE 2 LM and 2 E
E-18
NATO UNCLASSIFIED
ROLE 2LM MTF: 1- Medical capabilities derived from the matrix provided by MMSOP:
The Role 2LM MTF provides specialist-led resuscitation and stabilisation with adequate equipment to undertake and support DCS (surgical treatment), including field laboratory and basic imaging capabilities. Role 2 LM MTF also includes also the capabilities of role 1 facility, a limited holding capacity and can prepare and conduct evacuation to a higher level MTF. 2- General requirements of module
Conditions Unless otherwise stated, the terms and conditions of the individual nations, together with the following conditions apply throughout the document:
Physical Environment
• As an individual or as part of a team. • Worldwide. • In all operational environments. • Possibly at sea or CBRN environment. • In a mobile operating theatre. • With or without access to references.
Social/Political Conditions
• At Role 2LM, Role 2E and Role 3 • In an operational theatre. • Utilising equipment in modules for Forward Surgical Team, Intensive Care,
Anaesthesia, Recovery • Any scaled module for Role 2LM, Role 2E and Role 3 facilities.
Orders
• Manufacturer’s instructions. • NATO References and STANAGS. • National Doctrine, standards and subordinate publications. • Formation Standing Operating Procedures and References. Knowledge of English • According STANAG 6001 • Officers level: 3-3-3-2 • SNCO’s level: 2-2-2-1 • Junior ranks level according NATO requirements
E-19
NATO UNCLASSIFIED
In Role 2LM, 4 modules are identified:
1- Resuscitation and Pre / Post-operative Module 2- Damage Control Surgery 3- Diagnosis Module 4- Patient Holding
ROLE 2 LM / Module 1 : Resuscitation and Pre / Post operative module’s
capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified by nation
1.1 Manage critically ill patients or critically wounded casualties
a. Recognise critically ill patients b. Treat critically ill patients c. Manage critically ill patients in ICU d. Perform blood transfusion and control blood bank e. Provide general ward clinical support f. Maintain communications
1.2 Manage nursing intensive care
a. Assist and inform intensive care Consultant b. Assess patient and deliver nursing care c. Conduct resuscitation (Oro Tracheal Intubation) d. Manage clinical waste e. Understand and manage monitoring equipment and respiratory support (including ventilators) and other technical equipment as required (haemofiltration, haemodialysis, cell saver etc) f. Prepare and administer medical treatment and blood transfusion g. Ensure cleanliness and comfort of patient h. Provide adequate pain relief and adjust treatment as necessary
E-20
NATO UNCLASSIFIED
1.3
Manage post-operative nursing care.
a. Assist and inform physician b. Assess patient and deliver nursing care c. Dress and bandage wounds d. Manage clinical waste e. Check comfort and fit of plasters and splints f. Prepare and administer medical treatment and blood transfusion g. Ensure cleanliness and comfort of patient h. Provide adequate pain relief
1.4
Assist in pre, per and post hospital care and life support
Manage transport
a. Perform Basic Life Support (BLS) b. Basic knowledge of triage procedures c. Basic knowledge of decontamination procedures (contaminated and infectious) d. Assist medical personnel in Advance Life Support (Trauma)
1.5 Manage post-operative casualties with limb injury
a. Immobilise with splint or plaster of Paris b. Dress and bandage wounds c. Assist in preparation and movement of casualties
1.6 Supervise stock levels
a. Maintain adequate stock levels of: blood and blood products oxygen drugs ( all types)
b. Manage stores
1.7 Prepare patient for evacuation
a. Assist physician in documenting medical care given before evacuation b. Assist in preparation of equipment for casualty evacuation d. Assist in preparation and movement of casualties
1.8
Manage patient transfer (MEDEVAC)
a. Knowledge of the use and limitations medical transport (ground, air and sea). b. Explain transport procedures to patients. c. Capability to undertake transfer of critically ill patients d. Prepare patient for transfer. e. Produce all technical and administrative documents (general ward clinical support, operative report) f. Manage an in-hospital transfer g. Manage an inter-hospital transfer
E-21
NATO UNCLASSIFIED
h. Manage a pre-hospital transfer
1.9 MASCAL procedures
a. Understand the functions and actions of the Medical Incident Officer in Major Incident or MASCAL.
b. be able to take command in a MASCAL situation
1.10
Prepare the movement of packed field anaesthetic modules.
a. Produce a manifest for the movement of anaesthetic modules by air, sea or land
b. Identify, pack and mark dangerous air cargo
c. Mark refrigerated items d. Pack, mark and document
controlled drugs e. Supervise packaging, movement
and reception of scaled anaesthetic items
1.11
Prepare the movement of packed field surgical modules.
a. Produce a manifest for the movement of surgical modules by air, sea or land
b. Pack, mark and document controlled drugs
c. Supervise packaging, movement and reception of scaled surgical items
1.12 Manage field sterile services.
a. Receive contaminated equipment b. Clean and disinfect equipment c. Inspect and service equipment d. Pack and sterilise equipment e. Maintain stock levels
1.13 Manage transport
a. Hold and appropropriate driving licence b. Control state and revise vehicles (minimum knowledgment on repairing and revising on vehicle (oil, wheels ...) c. Basic knowledge of medevac d. Know techniques for immobilization, mobilization and transport of patients.
E-22
NATO UNCLASSIFIED
ROLE 2 LM / Module 2 : DCS Module’s capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified
by nations
2.1
Manage Trauma. a. Assess a patient. b. Manage a trauma patient. c. Perform triage
2.2
Assist in peri-operative care management.
a. Prepare and/or supervise the preparation of the operating room b. Assist surgeon in pre and post operative care c. Assist in preparation and movement of casualties
2.3 Anaesthetise a patient.
a. Perform pre-operative assessment b. Perform general anaesthesia c. Perform local anaesthetic technique d. Perform regional anaesthesia e. Manage peri-operative analgesia f. Manage care in the recovery area g. Manage post-operative ward care h. Prescribe medical treatment
2.4
Manage peri-operative care and advanced life support
a. Assist anaesthetist. b. Perform basic airway techniques and provide support for advanced airway techniques and casualty resuscitation c. Assist in preparation of equipment for casualty evacuation d. Assist in preparation and movement of casualties e. Assist in provision of analgesia and assessment of its efficiency
2.5 Manage critically injured trauma patient in operating room
a. Assess a critically injured patient b. Perform ultrasonography c. Perform damage control surgery including: 1. insertion of thoracic drain and control of thoracic haemorrhagae 2. vascular haemostasis and external haemorrhage control 3. intestinal exclusion and derivation, bile and pancreatic drainage, intestinal clamp and/or stomia, drain for
E-23
NATO UNCLASSIFIED
pancreatic and/or hepatic secretion 4. solid organ inspection and abdominal packing (liver, splenic, retroperitoneal and pelvic haemorrhage) 5. DC orthopaedic surgery - limb (parage and external fixation) - spine (parage and external spine stabilization - external bone fixation - amputation d. Perform second look surgery
2.6 Manage operating room (OR).
a. Organize OR equipment and stores b. Prepare specific equipment for casualty treatment c. Assist surgeon during operation d. Control and dispose of contaminated waste and equipment e. Maintain and clean OR f. Maintain stock levels (drugs, blood and materials)
2.7 Manage field sterile services for anaesthesia
a. Receive contaminated equipment. b. Control, clean and disinfect equipment. c. Inspect and service equipment. e. Maintain stores (drugs, blood & materials) f. Manage clinical waste
2.8 Manage field sterile services for operating room.
a. Receive contaminated equipment b. Clean and disinfect equipment c. Inspect and service equipment d. Pack and sterilise equipment e. Maintain stock levels
E-24
NATO UNCLASSIFIED
Role 2LM / Module 3: Diagnosis module’s capabilities
Task/Sub Task Number
Standard
Personnel
identified
by nation
3.1
Provide field radiography and echo ultrasonography services.
a. Basic knowledge in radiography, imaging and radio protection
b. Provide standard x-ray views c. Develop x-ray films d. Ensure supply of consumables e. Control and dispose of contaminated
waste and equipment
3.2 Provide field laboratory service
a. Basic knowledge of field laboratory procedures
b. Collect clinical samples c. Analyse clinical samples d. Ensure supply of consumables e. Basic maintenance of laboratory
equipment f. Dispose of biological waste correctly
ROLE 2 LM / Module 4 : Holding patient’s capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified
by nation
4.1
Manage post-operative nursing care.
a. Assist and inform physician b. Assess patient and deliver nursing care c. Dress and bandage wounds d. Manage clinical waste e. Check comfort and fit of plasters and splints f. Prepare and administer medical treatment and blood perfusion g. Ensure cleanliness and comfort of patient h. Provide adequate pain relief
E-25
NATO UNCLASSIFIED
4.2
Assist in holding care and transport
a. Perform Basic Life Support (BLS) b. Basic knowledge of triage procedures c. Basic knowledge of decontamination procedures (contaminated and infectious) d. Assist medical personnel in Advance Life Support (Trauma)
4.3
Conduct administrative tasks
a. Record medical activities b. Knowledge of the command procedures c. Understand the use of maps, gps and radio
4.4 Supervise stock levels in transport asset
a. Control stocks of drugs and other materiel b. Control oxygen stock
4.5 Prepare patient for evacuation
a. Assist physician in documenting medical care given before evacuation b. Assist in preparation of equipment for casualty evacuation. d. Assist in preparation and movement of casualties.
4.6 Manage transport
a. Hold an appropriate driving licence b. Control state and revise vehicles (minimum knowledgment on repairing and revising on vehicle (oil, wheels ...) c. Basic knowledge of medevac d. Know techniques for immobilization, mobilization and transport of patients.
E-26
NATO UNCLASSIFIED
ROLE 2 ENHANCED MTF: 1- Medical capabilities derived from the matrix provided by MMSOP:
The Role 2 Enhanced MTF provides specialist-led resuscitation and stabilisation with adequate equipment and specialist personnel to undertake and support DCS, including a field laboratory, basic imaging capability and may include Telemedicine. The capabilities include those of role 1 and role 2 LM for surgical treatment of casualties, with nursed beds, a mobile mental health module, an Intensive Care Unit, and sterilisation, pharmacy, blood bank and maintenance services. Role 2 Enhanced MTF must be able to prepare and conduct evacuation to a higher level MTF. 2- General requirements of module
Conditions Unless otherwise stated, the terms and conditions of the individual nations, together with the following conditions apply throughout the document:
Physical Environment
• As an individual or as part of a team. • Worldwide. • In all operational environments. • Possibly at sea or CBRN environment. • In a mobile operating theatre. • With or without access to references.
Social/Political Conditions
• At Role 2E and Role 3 • In an operational theatre. • Utilising equipment in modules for Forward Surgical Team, Intensive Care,
Anaesthesia, Recovery • Any scaled module for Role 2E and Role 3 facilities.
Orders
• Manufacturer’s instructions. • NATO References and STANAGS. • National Doctrine, standards and subordinate publications. • Formation Standing Operating Procedures and References. Knowledge of English • According STANAG 6001 • Officers level: 3-3-3-2 • SNCO’s level: 2-2-2-1 Junior ranks level according NATO requirements
E-27
NATO UNCLASSIFIED
Modules in R2Enhanced include all modules in R2 LM (with enhancements to ….as appropriate.), a Mobile mental health module and whichever other modules are new at R2E: • Sterilisation and forward medical equipment capability (pharmacy, blood
and maintenance) • Mobile mental health capability • CBRN medical module • Ward module with nursed beds
o Internist practitioner capability o Emergency practitioner capability o General Nursing Capability (R2 LM) o Medical Assistant Capability (R2 LM)
• Diagnostic module
E-28
NATO UNCLASSIFIED
ROLE 2 E / Module 1 : Surgical Module’s capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified
by nations
1.1
Manage Trauma. a. Assess a patient b. Manage a trauma patient c. Perform triage
1.2 Anaesthetise a patient.
a. Perform pre-operative assessment b. Perform general anaesthesia c. Perform local anaesthetic technique d. Perform regional anaesthesia e. Manage peri-operative analgesia f. Manage care in the recovery area g. Manage post-operative ward care h. Prescribe medical treatment
1.3
Manage peri-operative care and advanced life support
a. Assist anaesthetist. b. Perform basic airway techniques and provide support for advanced airway techniques and casualty resuscitation c. Assist in preparation of equipment for casualty evacuation. d. Assist in preparation and movement of casualties. e. Assist in provision of analgesia and assessment of its efficiency
1.4
Assist in Management in peri-operative care.
a. Prepare and/or supervise the preparation of the operating room b. Assist surgeon in pre and post operative care c. Assist in preparation and movement of casualties.
1.5 Manage critically injured trauma patient in operating room
a. Assess a critically injured patient b. Perform ultrasonography c. Perform damage control surgery including: 1. insertion of thoracic drain and control of thoracic haemorrhagae 2. vascular haemostasis and external haemorrhage control 3. intestinal exclusion and derivation, bile and pancreatic drainage, intestinal clamp and/or stomia, drain for pancreatic and/or hepatic secretion
E-29
NATO UNCLASSIFIED
4. solid organ inspection and abdominal packing (liver, splenic, retroperitoneal and pelvic haemorrhage) 5. DC orthopaedic surgery - limb (parage and external fixation) - spine (parage and external spine stabilization - external bone fixation - amputation d. Perform second look surgery
1.6 Manage primary surgery
a. Perform pre-operative assessment b. Perform primary general surgery - soft tissue - abdominal - thoracic - vascular - uro-genital - amputation c. Brain trauma (trepanation, drain
haematoma) d. Manage post-operative ward care e. Prescribe medical treatment
1.7 Manage trauma patient
a. Perform pre-operative assessment. b. Perform emergency orthopaedic surgery - soft tissues - limb (parage and external bone fixation) - spine(parage and external spine stabilization) - vascular - brain trauma (trepanation, drain haematoma) - amputation c. Perform all bone trauma treatment (included all surgical osteosynthesis) d. Manage and treat sport injuries e. Manage post-operative trauma ward care f. Prescribe medical treatment
1.8 Manage operating room (OR).
a. Organize OR equipment and stores b. Prepare specific equipment for casualty treatment c. Assist surgeon during operation d. Control and dispose of contaminated waste and equipment e. Maintain and clean OR f. Maintain other stock levels (drugs, blood and materials)
E-30
NATO UNCLASSIFIED
1.9 MASCAL procedures c. Understand the functions and actions of the Medical Incident Officer in Major Incident or MASCAL.
d. Be able to take command in a MASCAL situation
1.10
Manage trauma patient transfer (MEDEVAC)
a. Prepare patient for transfer. b. Manage an in-hospital transfer. c. Manage an inter-hospital transfer. d. Manage a pre-hospital transfer. e. Produce all technical and administrative documents (general ward clinical support, operative report)
R2E / Module 2: Intensive Care Unit Module’s capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified by nation
2.1
Manage Trauma. a. Assess a patient b. Manage a trauma patient c. Perform triage d. Pre-hospital life support
2.2 Manage critically ill patient.
a. Recognise a critically ill or injured trauma patient b. Treat a critically ill patient. c. Manage a critically ill or injured patient in ICU d. Perform blood suppleance (transfusion) e. Provide general ward clinical support f. Maintain communications
2.3 Provide sedative care a. Perform patient assessment b. Prescribe sedative regime c. Monitor level of sedation and adjust regime, if necessary
2.4
Manage patient transfer.
a. Prepare patient for transfer b. Manage an in-hospital transfer c. Manage an inter-hospital transfer d. Manage a pre-hospital transfer
E-31
NATO UNCLASSIFIED
2.5 MEDEVAC a. Knowledge of the use and limitations medical transport (ground, air and sea). b. Explain transport procedures to patients. c. Capability to undertake transfer of critically ill patients
2.6 Provide pre-hospital care.
a. Manage pre-hospital response team. b. Manage incident response in disaster medicine (mass casualties incident, decontamination unit for CBRN attack) c. Manage patient.
2.7 Supervise stock levels.
a. Ensure adequate stock levels of: Blood and blood products Oxygen Drugs (all types)
2.8 MASCAL procedures a. Understand the functions and actions of the Medical Incident Officer in Major Incident or MASCAL. b. Be able to take command in a MASCAL situation
a. Receive contaminated equipment. b. Control, clean and disinfect equipment. c. Inspect and service equipment. d. Maintain stock (drugs, blood & materials) levels. e. Manage clinical waste.
3.2 Manage field sterile services for the operating room.
a. Receive contaminated equipment. b. Clean and disinfect equipment. c. Inspect and service equipment. d. Pack and sterilise equipment. e. Maintain stock levels.
E-32
NATO UNCLASSIFIED
3.3 Manage equipment.
a. agent holder of materials of operating room theatre b. Store and operate operating room equipment correctly c. Ensure equipment is maintained and defects are rectified
Role 2E / Module 4 : Mobile Mental Health Module ‘s capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified by nation
4.1
Provision of operational Mental Health (MH) advice to the Chain of Command (CoC)
a. Assess operational MH issues b. Brief CoC
4.2
Provision of Liaison Service to medical, nursing and paramedical colleagues.
a. Assess operational MH issues b. Brief medical chain of command and medical personnel
4.3
Provision of operational MH briefings to military forces
a. Understand scope of available briefing materials b. Brief military forces as required
4.4
Manage MH problems in military forces
4.5
Manage violent mentally disturbed patient
4.6
Manage substance related problems
4.7 Manage suicidal patient
4.8 Manage depressed patient
4.9 Manage acute psychotic patient
a. Assess referred patients b. Formulate problem c. Apply general principles of management of mentally disturbed patients in accordance with PIE principles
d. Include evidence based pharmacological, psychological, social methods.
e. Decide management/ treatment plan.
f. Deliver management/ treatment plan.
E-33
NATO UNCLASSIFIED
4.10 Manage acute stress reaction and PTSD
4.11
Manage any other mental health problems
4.12
Contribute to Aero-medical Evacuation (AE) Procedures.
a. Assess need for AE of patients b. Produce required documentation c. Provide treatment for patient to ensure fitness for AE
R2E / Module 5: forward medical equipment module’s capabilities
Task/Sub Task Number
Standard
Personnel
identified
by nation
5.1 Manage all drugs and medical devices
a. Hold adequate stocks of drugs and medical devices b. Dispense of drugs and medical devices c. Maintain stock levels of in-date drugs and medical devices appropriate to the operational circumstances (DOS) d. Establish re-supply chain
5.2
Manage oxygen stocks
a. Hold adequate stocks of oxygen b. Dispense oxygen as required c. Establish re-supply chain/ cylinder re-fill facility
5.3 Manage clinical waste
a. Ensure correct disposal
5.4 Manage short shelf-life blood products
a. Receive short shelf-life blood products and dispense to anaesthetist b. Ensure correct disposal of out-of-date or out-of-limits blood products
5.5 Manage blood a. Receive blood products and dispense to anaesthetist b. Ensure correct disposal of out-of-date blood products c. Control, document and ensure resupply of blood stocks
5.6 Manage equipment
a- agent holder of materials of operating room theatre
E-34
NATO UNCLASSIFIED
b- Store and install equipment correctly c- ensure equipment is maintained and defects are rectified
5.7 Manage medical devices maintenance (sterile or not) related to the medical field settlement
a. In charge of preventive maintenance : Medical devices control and checkout in order to assert a good troubleshooting
b. In charge of corrective maintenance : Medical devices reparation
c. Medical devices to support are limited to the health service supply catalogue
d. Awry devices elimination e. Manage equipment swapping
5.8
Working field a. Electronic and biomedical devices used in the medical field settlement
b. Gas producing and distribution networks c. sterilization devices d. Assay office devices e. Air conditioning and heaters systems f. Blood and drugs refrigeration systems
5.9 Administration tools
a. Manage and maintain a medical equipment maintenance database
5.10 Advising users a. Provide user training b. Provide risk training
5.11 Measuring devices
a. Undertake regular calibration of measuring devices b. Participate in Quality Assurance processes
5.12 Manage medical devices maintenance (sterile or not) related to the medical field settlement
a. In charge of preventive maintenance : Medical devices control and checkout in order to assert a good troubleshooting
b. In charge of corrective maintenance : Medical devices reparation
c. Medical devices to support are limited to the health service supply catalogue
d. Awry devices elimination e. Manage equipment swapping
5.13
Working field
E-35
NATO UNCLASSIFIED
R2E / Module 6: NRBC (Decon) capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified by nation
6.1
Manage Trauma and intoxication under IPE.
a. Assess a CRB patient. b. Manage an R or C patient. c. Perform appropriate triage d. Provide Pre hospital live
supports and stabilization
6.2 Manage contamination risk
a. perform dry decon and shower
b. Provide appropriate antidotes
c. Perform appropriate initial samples or detection
6.3 Manage critically ill patient.
a. Recognise critically intoxicated or trauma patient.
b. Treat patient under CBRN threat
6.4 Supervise stocks level
a. Control oxygen stock b. Control antidotes and
anaesthetist, haemodynamic and analgesic drugs stocks
6.5 Manage equipments and personal
a. store and manage operational equipments
b. ensure control procedures, and detector reliability
c. manage human resource
6.6 CBRN MASCAL procedures
a. Knowledge in Weapons mass destructions
b. Knowledge about functions and actions Medical Incident Officer CBRN incident
c. To have capability to command in MASCAL CBRN situation
E-36
NATO UNCLASSIFIED
6.7
Logistic and administrative functions
a. Supply consumables (water, soap, etc.) b. Provide activity reports c. Provide traceability for reported results
ROLE 2 E / Module 7: Ward module’s capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified by nation
7.1 Manage patient before and after treatment
a. Assess patient b. Recognize a critically ill patient and inform appropriate physician c. Manage patients in post-operative recovery area d. Perform resuscitation e. Perform blood suppleance (transfusion) and control blood stock f. Provide general clinical support t ward o and organize patient holding g. Prepare patients for medevac h. Maintain communications
7.2
Manage post-operative nursing care.
a. Assist and inform physician b. Assess patients and deliver nursing care c. Dress and bandage wounds d. Manage clinical waste e. Check comfort and fit of plasters and splints f. Prepare and administer medical treatment and blood transfusion g. Ensure cleanliness and comfort of patient h. Provide adequate pain relief
7.3
Assist in holding care and transport
a. Perform Basic Life Support (BLS) b. Basic knowledge of triage procedures c. Basic knowledge of decontamination procedures (contaminated and infectious) d. Assist medical personnel in Advance Life Support (Trauma)
E-37
NATO UNCLASSIFIED
7.4
Conduct administrative tasks
a. Record medical activities b. Knowledge of command procedures c. Understand the use of maps, gps and radio
7.5 Supervise stock levels in ward
a. Control stock levels of drugs and other materiel b. Control oxygen stock
7.6 Prepare patient for evacuation
a. Assist physician in documenting medical care given before evacuation b. Assist in preparation of equipment for casualty evacuation. d. Assist in preparation and movement of casualties.
7.7 Manage transport
a. Hold an appropriate driving licence b. Control state and revise vehicles c. Basic knowledge of medevac d. Know techniques for immobilization, mobilization and transport of patients.
7.8
Manage trauma patient transfer (MEDEVAC)
a. Prepare patient for transfer. b. Manage an in-hospital transfer. c. Manage an inter-hospital transfer. d. Manage a pre-hospital transfer. e. Produce all technical and administrative documents (general ward clinical support, operative report)
E-38
NATO UNCLASSIFIED
R2E / Module 8: Diagnostic module’s capabilities
Task/Sub Task Number
Performance
Standard
Personnel identified by nation
8.1
Biological sampling
a. Collect clinical samples b. Develop sampling protocols c. Process samples (shipment, storage) according to international regulations d. Develop sample processing procedures
8.2 Biological analysis
a. Analyse clinical samples b. Analyse water samples c. Undertake quality assurance procedures d. Provide technical validation of results e. Provide auditable record of reported results f. Maintain communication with reference laboratories g. Provide laboratory support for food inspection
8.3
Logistic and administrative functions for biomedical laboratory
a. Ensure adequate supply of consumables b. Maintain laboratory equipment (first echelon) c. Dispose of biological waste correctly. d. Provide biological activity reports
8.4
Radiological examination services
a. Provide standard x-ray views b. Develop x-ray films c. Give intravenous contrast d. Perform fluoroscopy examination e. Perform CT-scan examination e. Perform ultrasonography examination
8.5
Logistic functions for radiological services
a. Ensure adequate supply of consumables b. Organize maintenance of radiological equipment c. Provide radiological activity reports d. Maintain communications e. Provide reporting service for x-ray findings
E-39
NATO UNCLASSIFIED
8.6 Manage radiology room
a. Organize x-ray room and control entry during radiological exposure b. Prepare equipment for special radiological examinations c. Assist radiologist during special procedures d. Control and dispose of contaminated waste and equipment d. Maintain and clean x-ray room and equipment e. Manage stock levels
8.7 Manage telemedicine
a. Organize telemedicine service b. Control technical validation of results c. Provide auditable record of reported results d. Maintain communication with reference laboratories
E-40
NATO UNCLASSIFIED
LIST OF SPECIALITIES REQUIRING OPERATIONAL PERFORMANCE STATEMENT FOR CERTIFICATION PURPOSES.
In role 3
Capabilities of R2E and Subsequent Specialities:
NATO Biologist/ Preventist Capabilities NATO Neurosurgery Capabilities NATO Ophthalmic Capabilities NATO Paediatrics Capabilities NATO Internist and Tropical Medicine Capabilities NATO Head and Neck surgery Capabilities NATO Burns, Plastic surgery and Oral Facial Maxillary surgery NATO Gynaecology and Obstetrics Capabilities
Formatiert: Schriftartfarbe:Schwarz
Formatiert: Schriftartfarbe:
Schwarz
E-41
NATO UNCLASSIFIED
NATO Biologist/ Preventist (MD) Capability
Task/Sub
Task
Number
Performance
Standard
Personnel
identified by
nation
1.0
Biological sampling
a. Collect clinical samples b. Develop sampling protocols c. Process samples (shipment, storage) according to international regulations d. Develop sample processing procedures
2.0 Biological analysis
a. Analyse clinical samples b. Analyse water samples c. Undertake quality assurance procedures d. Provide technical validation of methods and results e. Provide auditable record of reported results
3.0 Medical adviser a. Develop requirements for biological analysis b. Provide advice for transfusion management c. Provide advice for infectious diseases management to commanders at all levels d. Provide advice for defence against toxins and biological weapons to commanders at all levels e. Provide biological information within theatre f. Maintain communication with reference laboratories
4.0
Supervision Organization
a. Supervision of laboratory team b. Supervision of laboratory equipment c. Supervision of consumable re-supply d. Redaction of procedures and protocols e. Provide activity reports
Point 1.0 & 2.0 are included in skill set “laboratory capability” and point 3.0 &
4.0 could correspond to skill set “Preventive MD capability”. In ROLE 3, a
biologist MD could be present and have a preventive function with or without
laboratory function, depending on laboratory staff presence.
E-43
NATO UNCLASSIFIED
NATO Neurosurgery Capability
Task/
Sub Task
Number
Performance
Standard
Personnel
identified
by nation
1.0
Manage Trauma.
a. Perform triage b. Assess a patient. c. Manage a trauma patient.
2.0 Emergency management of a patient
a. Perform pre-operative assessment b. Perform emergency neurosurgical procedures including: - management of wounds of the scalp and skull - cranio-cerebral wound (open or closed) : • extradural haematomas • subdural haematomas • penetrating wound of the brain • intracerebral haematomas • sinus wounds • cerebrospinal fluid leaks c. Perform spinal surgery (included cervical, dorsal and lumbar spine) : • laminectomy • spinal instrumentation • spinal fusion • management of penetrating spinal
cord injury d. Management of cerebral oedema and hydrocephalus e. Manage post-operative ward care. f. Prescribe medical treatment
3.0 Manage critically injured trauma patient.
a. Thoracic drain insertion b. Perform tracheotomy
4.0
Manage patient transfer.
a. Prepare patient for transfer b. Manage and in-hospital transfer. c. Manage an inter-hospital transfer d. Manage a pre-hospital transfer
E-44
NATO UNCLASSIFIED
NATO Ophthalmic capabilities
Task/Sub Task Number
Performance
Standard
Personnel
identified
by nation
1.0
Manage Trauma. (contusion of eye and annex)
a. Assess a patient b. Perform ultrasonography examination of ocular lesions c. Manage a trauma patient
2.0 Emergency management of a patient
a. Perform pre-operative assessment and ocular ultrasonography b. Perform emergency ophthalmic surgery for : - Corneal or scleral laceration or rupture - Lens dislocation - injuries to eyelids and/or lachrymal ducts c. Manage post-operative ward care. d. Prescribe medical treatment
3.0 Manage critically injured trauma patient (severe open globe injury with foreign body in posterior segment, retinal detachment )
a. Perform damage control surgery 1. Closure of open globe injuries 2. Intravitreal antibiotics injection
4.0
Manage patient transfer.
a. Prepare patient for transfer. b. Manage an in-hospital transfer. c. Manage an inter-hospital transfer. d. Manage a pre-hospital transfer.
E-45
NATO UNCLASSIFIED
NATO head and neck surgery capabilities
Task/Sub Task Number
Standard
Personnel
identified
by nation
1.0 Manage trauma a. Assess a patient b. Manage a trauma patient
2.0 Manage patient in emergency
a. Perform pre-operative assessment b. Perform emergency surgery for
b. Provide humanitarian assistance and paediatric primary health care
c. Prescribe medical treatment d. Manage heat and cold injuries e. Manage battle stress and psychiatric casualties f. Manage decontamination (contaminated or infected patient)
3.0
Preventive Medicine Organization
a. Perform vaccinations b. Supervise of malaria chemoprophylaxis c. Advise on the prevention of vector borne diseases
1. Supervision of the medical team 2. Perform telemedicine 3. Redaction of guidelines 4. Provide medical surveillance data
E-47
NATO UNCLASSIFIED
4.0
Manage medical patient transfer.
a. Prepare patient for medical evacuation b. Produce all technical and administrative documents (general ward clinical support, operative report)
NATO paediatric capabilities
Task sub Task Number
Standard
Personnel
identified
by nation
1.0 Manage ill or injured child
a) Perform triage b) Assess a patient c) Refer a trauma or surgical patient to appropriate surgical staff
2.0 Manage child in emergency
a) Perform clinical assessment b) Perform critical care : - intravenous infusion - ventilation - cardio vascular and respiratory monitoring c) Prescribe medical treatment
3.0 Manage critically ill child
Undertake critical care management for: - shock - coma - respiratory distress - acute renal failure
4.0 Manage child transfer
a) Prepare child for transfer b) Manage an in-hospital transfer c) Manage an inter-hospital transfer d) Manage a pre-hospital transfer
E-48
NATO UNCLASSIFIED
NATO Burn Plastic Surgery and Oral Facial Maxillary Surgery
Task/Sub Task Number
Standard
Personnel
identified
by nation
1.0 Manage Maxillofacial trauma
a. Assess a patient b. Manage a trauma patient
2.0 Manage burn patient in emergency
a. Perform pre-operative assessment b. Perform emergency surgery for
-. Necrosectomy/escharotomy -. Tracheotomy
c. Burn dressing
3.0 Plastic surgery management of critically injured trauma patient
a. Perform damage control surgery 1. Tracheotomy 2. Fasciotomy
b. Perform second look surgery 1. graft 2. flaps
4.0 Manage patient transfer
a. Prepare patient for transfer b. Manage in-hospital transfer c. Manage an inter-hospital transfer d. Manage pre-hospital transfer
E-49
NATO UNCLASSIFIED
NATO GYNAECOLOGY AND OBSTETRICS capabilities
Task/Sub Task Number
Standard
Personnel
identified
by nation
1.0 Manage pregnancy or gynaecology
a. Assess a patient b. Manage the pre-partum, inter-partum and post-partum care of a pregnant woman c. Diagnose and manage gynaecologic disease
2.0 Manage patient in emergency
a. Perform pre-operative assessment b. Perform emergency surgery for: curettage abcess incision total hysterectomy ectopic pregnancy acute ovarian cyst or tumor caesarean section haemostatic hysterectomy c. Manage post operative ward care d. Prescribe medical treatment
3.0 Manage critically ill patient
a. Perform second look surgery b. Achieve haemostasis in an obstetric or gynaecological emergency
4.0 Manage patient transfer
a. Prepare patient for transfer b. Manage an in-hospital transfer c. Manage an inter-hospital transfer d. Manage pre-hospital transfer
