The FIELD MEDICAL SERVICE TECHNICIAN provides medical and dental services for personnel in field units; also provides technical and administrative assistance to support the mission and functions of the Navy and Marine Corps field units. Maintains organizational level AMAL’s and ADAL’s. Assits in the procurement and distribution of supplies and equipment for field use and combat areas. Maintains field treatment facilities. Renders first aid and emergency medical and dental treatment to unt personnel/combatants. Coordinates and performs medical evacuation procedures. Ensures observance of field sanitary measures and preventive measures in specialized warfare. Conducts first aid and health education training programs. COURSE DESCRIPTION: During this 8 week course, you will have a mix of classroom and field training. Emphasis is placed on learning field medicine by using the principles of Tactical Combat Casualty Care (TCCC). This includes familiarization with USMC organization and procedures, logistics, and administrative support in a field environment. Additionally, training will include general military subjects, individual and small unit tactics, military drills, physical training/conditioning, and weapons familiarization with the opportunity to fire the rifle. Completion of FMST results in the student receiving Navy Enlisted Classification HM-8404.

Over 2,300 total pages ... OVERVIEW Tactical Combat Casualty Care (TCCC) was developed to emphasize the need for continued improvement in combat pre-hospital care. The Committee on Tactical Combat Casualty Care (CoTCCC) was established in 2001 and is part of the Defense Health Board. CoTCCC is a standing multi-service committee charged with monitoring medical developments in regards to practice, technology, pharmacology and doctrine. New concepts in hemorrhage control, airway management, fluid resuscitation, analgesia, antibiotics and other lifesaving techniques are important steps in providing the best possible care for our Marines and Sailors in combat. The TCCC guidelines are published every 4 years in the Prehospital Trauma Life Support manual. It has been recognized that TCCC guidelines and curriculum will need to change more often than the 4-year cycle of the PHTLS textbook publication. The National Association of Emergency Medical Technicians (NAEMT) will include the updated TCCC guidelines and curriculum on its website as they are approved as a way to help get this new information out to the combat medical personnel in the military that need it. PRINCIPLES OF TACTICAL COMBAT CASUALTY CARE (TCCC) The principles of Tactical Combat Casualty Care are fundamentally different from those of traditional civilian trauma care, where most medical providers and medics train. These differences are based on both the unique patterns and types of wounds that are suffered in combat and the tactical conditions medical personnel face in combat. Unique combat wounds and tactical conditions make it difficult to determine which intervention to perform at what time. Besides addressing a casualty’s medical condition, responding medical personnel must also address the tactical problems faced while providing care in combat. A medically correct intervention at the wrong time may lead to further casualties. Put another way, “good medicine may be a bad tactical decision” which can get the rescuer and the casualty killed. To successfully navigate these issues, medical providers must have skills and training oriented to combat trauma care, as opposed to civilian trauma care. The specifics of casualty care in the tactical setting will depend on the tactical situation, the injuries sustained by the casualty, the knowledge and skills of the first responder, and the medical equipment at hand. In contrast to a hospital Emergency Department setting where the patient IS the mission, on the battlefield, care of casualties sustained is only PART of the mission. TCCC recognizes this fact and structures its guidelines to accomplish three primary goals: 1. Treat the casualty 2. Prevent additional casualties 3. Complete the mission In thinking about the management of combat casualties, it is helpful to divide care into three distinct phases, each with its own characteristics and limitations.

Over 3,000 total pages ... Contents: FIELD MEDICAL SERVICE OFFICER STUDENT HANDBOOK FIELD MEDICAL SERVICE TECHNICIAN STUDENT HANDBOOK Version 4.1 Block 1 Student Outlines For Version 4.1 Block 2 Student Outlines For Version 4.1 FIELD MEDICAL SERVICE TECHNICIAN STUDENT HANDBOOK Version 4.0 FIELD MEDICAL SERVICE TECHNICIAN STUDENT HANDBOOK (June 2013) FMST STUDY GUIDE (2015) Fleet Medicine Pocket Reference 2016 MCRP 4-11.1D FIELD HYGIENE AND SANITATION PREVENTION AND TREATMENT OF FIELD RELATED INJURIES STUDENT HANDOUT CASUALTY EVALUATION AND EVACUATION STUDENT HANDOUT COMBAT LIFESAVER / TACTICAL COMBAT CASUALTY CARE STUDENT HANDOUT Combat Lifesaver / Tactical Combat Casualty Care Instructor Course Student Handbook Command Philosophy My philosophy is basic…provide the highest quality service possible to every person you encounter. We are an institution of higher learning; we need to be the best with everything we do. We are preparing the next generation of heroes for the greatest fighting force on the planet - the 8404 Hospital Corpsman assigned to the United States Marine Corps. They operate at the tip-of-the spear providing combat medicine to our operational forces; they are critical to the success of the Navy & Marine Corps Medicine Team. What each one of us does on a daily basis matters, regardless of our job. We all contribute to the mission. No one job is more important than the other. If just one link (team member) in this chain fails to perform a portion of the mission to standard, we all fail. You have the ability to make a positive difference in peoples’ lives every day. Every member of this team should ask themselves, “Am I living by our core values and making decisions that are consistent with these values when I interact with students, staff and the American public.” Key points: - Know your chain of command and how to use it. You have not exhausted your chain of command at FMTB-West until the issue reaches me. - If you are lacking something to perform your mission, bring it to the attention of leadership so we can promptly address it. - Any safety issue should immediately be brought to leadership. - Continually strive to improve processes; ask for help before it’s too late (in all aspects of your life and career). - If you see a problem, fix it or bring it to the attention of someone who can. Don't ignore it. - Supporting each other is just as important as supporting the mission. - Continue the relentless pursuit of customer satisfaction; feedback is a valuable tool in life and career. - Basic military courtesy should be a part of everyday life. - Always strive to do the right thing, even when no one is looking or when tempted to take the “easy” wrong. As a leader, I believe all members of the team are important. Our civilian shipmates are essential to the success of our mission. As a military leader, I believe, as the Sailor creed says, “I proudly serve my country's Navy combat team with Honor, Courage and Commitment. I am committed to excellence and the fair treatment of all”. I cannot over emphasize the importance of leadership from E-1 to O-6, everyone has a part; I expect officers to lead from the front by setting the example. Be sure that regularly scheduled performance counseling sessions are conducted for military and civilian employees. Cover the good which should be sustained as well as the areas which need improvement. Although I like to be informed, I believe in allowing leaders to lead, managers to manage. A big part of my job is to provide you the support systems necessary for you to accomplish your mission. Tell me what you need and don't worry how it will be resourced. Let me worry about that.

The FIELD MEDICAL SERVICE TECHNICIAN provides medical and dental services for personnel in field units; also provides technical and administrative assistance to support the mission and functions of the Navy and Marine Corps field units. Maintains organizational level AMAL’s and ADAL’s. Assits in the procurement and distribution of supplies and equipment for field use and combat areas. Maintains field treatment facilities. Renders first aid and emergency medical and dental treatment to unt personnel/combatants. Coordinates and performs medical evacuation procedures. Ensures observance of field sanitary measures and preventive measures in specialized warfare. Conducts first aid and health education training programs. COURSE DESCRIPTION: During this 8 week course, you will have a mix of classroom and field training. Emphasis is placed on learning field medicine by using the principles of Tactical Combat Casualty Care (TCCC). This includes familiarization with USMC organization and procedures, logistics, and administrative support in a field environment. Additionally, training will include general military subjects, individual and small unit tactics, military drills, physical training/conditioning, and weapons familiarization with the opportunity to fire the rifle. Completion of FMST results in the student receiving Navy Enlisted Classification HM-8404. MEDICAL-SPECIFIC CONTENT: PREVENTIVE MEDICINE Treat Dehydration FMST 201 Treat Environmental Heat Injuries FMST 202 Manage Environmental Cold Injuries FMST 203 Perform Care of the Feet FMST 204 Perform Water Purification for Individual Use FMST 205 Supervise Field Waste Disposal FMST 206 Manage Envenomation Injuries FMST 207 Review Questions COMBAT MEDICINE Introduction to Tactical Combat Casualty Care FMST 401 Manage Shock Casualties FMST 402 Manage Hemorrhage FMST 403 Maintain Airway FMST 404 Perform Emergency Cricothyroidotomy FMST 405 Manage Respiratory Trauma FMST 406 Manage Abdominal Injuries FMST 407 Manage Musculoskeletal Injuries FMST 408 Manage Head, Neck and Face Injuries FMST 409 Tactical Fluid Resuscitation FMST 410 Perform Casualty Assessment FMST 411 Medication Appendix Review Questions COMPONENTS OF FIELD MEDICINE Blast Related Injuries FMST 501 Traumatic Brain Injury (TBI) FMST 502 Manage Burn Casualties FMST 503 Conduct Triage FMST 504 Coordinate Casualty/Tactical Evacuation FMST 505 Perform Aid Station Procedures FMST 506 Medical Support for Military Operations in Urban Terrain (MOUT) FMST 507 Review Questions

Over 2,400 presentation slides combined ... The Field Medical Service Technician (FMST) course is designed for E1 to E6 Hospital Corpsmen though more senior personnel are occasionally enrolled. For over 100 years, young men and women have been answering the call to save lives on the battlefield. For the past 65 years, Corpsmen have been receiving training here at Field Medical Training Battalion. The information below will help you prepare for your training. Vision To be the best training command within the United States Marine Corps; producing the best trained, best prepared, and battle ready Fleet Marine Force Hospital Corpsman. He will be prepared to meet the challenges of present and future operational environments. Mission Develop, coordinate, resource, execute and evaluate training and education concepts, policies, plans and programs to ensure the Fleet Marine Force Hospital Corpsman is prepared for assignment with the operational forces. BLOCK 1 Table of Contents FMST 101 Rank Structure of the USMC FMST 102 Marine Corps History FMST 103 USMC Organizational Structure/Chain of Command FMST 104 Traits and Principles of Marine Corps Leadership FMST 105 USMC Uniform Regulations FMST 106 Individual Combat Equipment FMST 107 Code of Conduct and the Rights of POWs FMST 108 M16/M4 Service Rifle FMST 109 Treat Dehydration Casualties FMST 110 Manage Environmental Heat Injuries FMST 111 Manage Environmental Cold Injuries FMST 112 Perform Care of the Feet BLOCK 2 Table of Contents FMST 201 Perform Water Purification for Individual Use FMST 202 Supervise Field Waste Disposal FMST 203 Field Communications FMST 204 Individual Movement Techniques FMST 205 Patrolling FMST 206 Land Navigation FMST 207 Improvised Explosive Device FMST 208 Manage Envenomation Injuries FMST 209 Five Paragraph Order BLOCK 3 Table of Contents FMST 301 M-40 Field Protective Mask FMST 302 Don Mission-Oriented Protective Posture (MOPP) Gear FMST 303 Manage Chemical Agent Casualties FMST 304 Manage Biological Agent Casualties FMST 305 Manage Radiological Warfare Casualties BLOCK 4 Table of Contents FMST 401 Introduction to Tactical Combat Casualty Care FMST 402 Manage Hemorrhage FMST 403 Maintain Airway FMST 404 Perform Emergency Cricothyroidotomy FMST 405 Manage Respiratory Trauma FMST 406 Manage Shock Casualties FMST 407 Tactical Fluid Resuscitation FMST 408 Manage Head, Neck, and Face Injuries FMST 409 Manage Abdominal Injuries FMST 410 Manage Musculoskeletal Injuries BLOCK 5 Table of Contents FMST 501 Blast Related Injuries FMST 502 Evaluate Traumatic Brain Injury FMST 503 Manage Burn Casualties FMST 504 Conduct Triage FMST 505 Coordinate Casualty Tactical Evacuation (TACEVAC) FMST 506 Perform Aid Station Procedures FMST 507 Medical Support for Military Operations in Urban Terrain (MOUT) FMST 508 Recognize Combat Stress Disorders FMST 509 Perform Casualty Assessment

BACKGROUND IN 1996, THE NAVAL SPECIAL WARFARE COMMAND DEVELOPED A NEW SET OF TACTICALLY APPROPRIATE BATTLEFIELD TRAUMA CARE GUIDELINES NAMED TCCC. THE TCCC GUIDELINES WERE ADOPTED BY THE U.S. SPECIAL OPERATIONS COMMAND (USSOCOM) AND APPROVED BY THE AMERICAN COLLEGE OF SURGEONS (ACS) AND THE NATIONAL ASSOCIATION OF EMERGENCY MEDICAL TECHNICIANS. THE COMMITTEE ON TCCC WAS ESTABLISHED IN 2001 AND WAS DIRECTED TO FURTHER DEVELOP THE TCCC STANDARDS AND GUIDELINES. THE COMMITTEE ON TCCC FUNCTIONS AS A WORKING GROUP OF THE TRAUMA AND INJURY SUBCOMMITTEE OF THE DEFENSE HEALTH BOARD (DHB), WHICH HAS A CHARTER TO PROVIDE MEDICAL RECOMMENDATIONS TO ASD (HA) AND THE SERVICE SURGEONS GENERAL. TCCC CONCEPTS WERE INCORPORATED INTO THE 8404 CORPSMAN TRAINING CURRICULUM IN 2005. THE TCCC/CLS TRAINER COURSE WAS DEVELOPED IN 2006 TO PROVIDE CORPSMEN AS TRAINERS TO TEACH AND SUSTAIN TCCC STANDARDS TO CORPSMEN AND CLS SKILLS TO SELECTED MARINES WITHIN THE OPERATING FORCES. THE IMPLEMENTATION OF TCCC ACROSS ALL SERVICES HAS BEEN IDENTIFIED AS ONE OF THE CONTRIBUTING FACTORS TO THE HIGHEST COMBAT CASUALTY SURVIVAL RATES IN HISTORY AND IS RECOMMENDED BY ASD (HA) FOR USE WHEN TRAINING COMBAT MEDICAL PERSONNEL, REF B. TCCC INFORMATION IS PUBLISHED IN THE PREHOSPITAL TRAUMA LIFE SUPPORT MANUAL (PHTLS), MILITARY EDITION, WHICH IS UPDATED EVERY FOUR YEARS. DEPARTMENT OF DEFENSE (DOD) APPROVED TCCC TRAINING CURRICULA ARE UPDATED ON THE DOD WEBSITE MHS.OSD.MIL/EDUCATION AND TRAINING/TCCC.ASPX AS THE TCCC GUIDELINES CHANGE. GOAL. ELIMINATE PREVENTABLE LOSS OF LIFE ON THE BATTLEFIELD. IN ACCOMPLISHING THIS GOAL, THE MOST RECENT TCCC GUIDELINES APPROVED BY DOD ARE TO BE UTILIZED AS A MEANS OF PROVIDING STANDARDIZED TRAINING TO THE MARINE CORPS AND IMPROVING FIRST RESPONDER CARE AT THE POINT OF INJURY. HISTORY OF TCCC: a. It is important to realize that civilian trauma care in a non-tactical setting is dissimilar to trauma care in a combat environment. TCCC and CLS are an attempt to better prepare medical and non-medical personnel for the unique factors associated with combat trauma casualties. b. Historical data shows that 90% of combat wound fatalities die on the battlefield before reaching a military treatment facility. This fact illustrates the importance of first responder care at the point of injury. c. TCCC was originally a US Special Operations research project which was composed of trauma management guidelines focusing on casualty care at the point of injury. d. TCCC guidelines are currently used throughout the US Military and various allied countries. e. TCCC guidelines were first introduced in 1996 for use by Special Operations corpsmen, medics, and pararescue (PJs). f. The TCCC guidelines are currently endorsed by the American College of Surgeons, Committee on Trauma and the National Association of Emergency Medical Technicians. The guidelines have been incorporated into the Prehospital Trauma Life Support (PHTLS) text since the 4th edition. STUDENT CURRICULUM: Tactical Combat Casualty Care/CLS Overview Identify Medical Fundamentals Manage Hemorrhage Maintain Casualty Airway Manage Penetrating Chest Injuries Manage Hemorrhagic Shock Manage Burn Casualties Perform Splinting Techniques Administer Battlefield Medications Perform Casualty Movement Perform Combat Lifesaver Triage Perform Combat Lifesaver Care