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The Busiest Brigade Support
Medical Company on the Battlefield

A brigade support medical company deployed to Afghanistan exhibited
flexibility and durability while providing support to a widely dispersed force.

After arriving in Logar Province, Afghanistan, C Company, 125th Brigade Support Battalion, 3d Infantry Brigade Combat Team (IBCT), was responsible for providing medical support to more
than 3,600 Soldiers spread across 17 operating bases throughout the Wardak and Logar Provinces. Within the first 30 days of the deployment, C Company treated more than 1,400 patients for conditions ranging from urgent surgery to routine sick call.

During this time, C Company established a medical compound that included a forward surgical team (FST), a Jordanian FST, and level II medical assets. The company also established the brigade medical supply office to provide the 3d IBCT with more than $800,000 worth of medical supplies.

An aeromedevac helicopter drops off a patient.

Unit Training
C Company’s medics conducted more than 50 blood drives, 2 realworld mass casualty events, and
several Afghanpartnered field training exercises. It also conducted the battalion’s firstever first responder course for all nonmedical brigade personnel.

During this training, Soldiers learned how to establish a landing zone, submit a 9-line medevac
request, conduct improved first aid kit familiarization, apply a tourniquet properly, recognize the signs and symptoms of mild traumatic brain injuries (mTBIs), and fill out tactical casualty care cards (formerly known as field medical cards). C Company also trained its Afghan National Army partner units on how to execute independent medical support for their supported units.

Capabilities and Missions
Colocating with the FST, Jordanian FST, and mTBI clinic on the battlefield vastly improved C Company’s medical support to the BCT. The company became more robust than a normal
level II facility. Radiology and laboratory capabilities were colocated with the FST to ensure more effective and responsive treatment and give the doctors more insight into injuries. The facility lacked only a CT-scan machine to be classified as a level III facility. Since no Army guidance was available on how to command or operate such a robust outfit, after-action reviews were conducted regularly to ensure that the lessons learned were captured for future operations.

A specialist treats a patient during sick call.

In addition to working with an already high operating tempo, C Company had to support different missions, such as the quick-reaction force, logistics convoys, and detainee screenings, throughout its deployment. The different types of operations forced the company’s leaders to think outside of conventional doctrine to accomplish these missions. This ensured that the unit remained flexible.

To bridge the cultural gap with the Afghan people, the Army’s new female engagement teams helped
relieve male medics from treating or conversing with the local Afghan females unless the situation threatened life, limb, or eyesight. Measures like these made working relationships better and built on the company’s counterinsurgency concept. The trust gained from exhibiting cultural awareness led to fewer attacks on Soldiers, fostered a more welcoming Afghan community, and strengthened the information operations campaign.

Technicians review an x-ray to ensure that it is usable for the doctor.

Unit Organization
C Company’s mission in Afghanistan was to operate four medical sections—treatment, area support, medical evacuation, and the headquarters—with the intent to run 24-hour operations.

The treatment section had 8 to 12 medics working at any given time, along with a medical provider, a patient hold representative, patient administration specialists, a pharmacist, and the mission squad. The area support section was made up of the physical therapy, dental, radiology, lab, combat stress, mTBI, and preventive medicine sections.

The medical evacuation section was needed to provide responsive force health protection to U.S. and coalition Soldiers and Afghan partners. The headquarters section consisted of the brigade medical supply and company supply sections. Together, they supported over 10,000 coalition force and Afghan National Army soldiers and contractors serving in the area of operations (AO).

One of the most important sections was patient administration. To ensure 100-percent accuracy in tracking patients, all patients came through this section to be screened before seeing any provider. Two patient administration specialists were responsible for tracking all brigade personnel; they quickly became a very valued asset. They worked 12-hour shifts, 24 hours a day, 7 days a week, and they were called in for every medical evacuation that involved a coalition Soldier, contractor,
or local national. All information they gathered was sent to the brigade surgeon cell and disseminated to all units within the AO.

Along with providing care on a daily basis, C Company was tasked with providing medical care for
logistics convoys to outlying forward operating bases. The convoy teams were made up of two medics: one dismounted medic who could exit the vehicle to provide care at a moment’s notice and a second medic who was on standby. With the unit averaging two to three convoy missions per week, the mission squad was often left with only two medics to conduct day-to-day tasks.

The physical therapist assigned to C Company often conducted a battlefield circulation, visiting every location in the AO over a period of 3 weeks. The need for physical therapy was so great at some locations that the therapist often stayed for extended periods. To maintain continuous care, the physical therapy technician, a cross-trained Soldier in military occupational specialty 68W (healthcare specialist), remained at the aid station to ensure that all patients received the highest level of care.

A forward surgical team stabilizes an injured patient.

The personnel in the preventive medicine section spent most of their time on the road making
monthly visits to each major forward operating base. They also traveled to each combat outpost to ensure that all Soldiers were living and working in healthy conditions. In addition to providing care to U.S. Soldiers, they conducted assessments in local villages and Afghan National Army compounds.

Because of the large amount of equipment required to provide dental services and the mobility issues and power requirements associated with that equipment, the dental team was primarily assigned to the aid station. This team traveled only on a limited basis with limited tools, mainly to provide basic dental services and dental care classes.

Valued Attachments
Four sections that normally are not part of C Company’s modified table of organization and equipment— mTBI, FST, Jordanian FST, and aeromedevac—made the company unique. These sections were combat multipliers for C Company and the 3d IBCT. After C Company’s relief in place, the mTBI clinic treated 961 patients, 349 of whom returned to duty.

The mTBI section was an important commodity in the forward fight. Being colocated with a combat stress team enabled the unit to provide oversight for suicidal and depressed patients around the clock. Without this capability, Soldiers would have had to be evacuated to a location with a higher level of care, taking them out of the fight for at least a week because of travel time and reducing their units’ efficiency.

The C Company tactical operations center serves as the central point for all battlefield tracking.

The mTBI team was a mobile commodity that could be at any location within 24 hours of an event. The standard operating procedure specified that all Soldiers exposed to a blast must be cleared by the mTBI team. This not only protected the Soldiers’ near-term health but also protected them from possible future complications.

Having the aeromedevac capabilities colocated increased communication, created better working relationships, and aided in training. Patient loads can be a major issue for rotary-wing aircraft. Having both units located in the same AO created an advantage for coldstart training events, which improved load times and simplified patient-weight distribution.

During medevacs, Soldiers at the point of injury often sent false reports because of heightened emotions; having a great working relationship often became an asset. Once the pilots and in-flight medics arrived at the site, they relayed accurate information to C Company, which led to better medical services and treatment.

C Company is a prime example of how the Army Medical Department is constantly changing and
adapting to the challenges faced by today’s Soldiers. It proves that the Army’s medical community is truly committed to preserving the fighting strength of our Soldiers.

Captain Michael A. Miller is the commander of C Company, 125th Brigade Support Battalion, 3d
Infantry Brigade Combat Team, 1st Armored Division. He holds a B.S. degree in food and nutrition from Fort Valley State University and is a graduate of the Health Materiel Officer Course and the Combined Logistics Captains Career Course.

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