6000_1.pdf - DEPARTMENT OF THE NAVY COMMANDER NAVAL SURFACE FORCE UNITED STATES PACIFIC FLEET 2841 RENDOVA ROAD SAN DIEGO CALIFORNIA 92155-5490

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Unformatted text preview: DEPARTMENT OF THE NAVY COMMANDER, NAVAL SURFACE FORCE UNITED STATES PACIFIC FLEET 2841 RENDOVA ROAD SAN DIEGO, CALIFORNIA 92155-5490 COMMANDER NAVAL SURFACE FORCE ATLANTIC BOX 168, 1751 MORRIS STREET NORFOLK, VA 23511-2808 IN REPLY REFER TO COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 N01H 6 Mar 14 COMNAVSURFPAC/COMNAVSURFLANT INSTRUCTION 6000.1 From: Commander, Naval Surface Force, U.S. Pacific Fleet Commander, Naval Surface Force Atlantic SUBJ: SHIPBOARD MEDICAL DEPARTMENT PROCEDURES MANUAL Encl: (1) Shipboard Medical Department Procedures Manual 1. Purpose. To establish policies for the operation of Medical Departments within the Surface Forces. 2. Cancellation. COMNAVSURFORINST 6000.1. 3. Scope. This manual applies to all Medical Departments under Commander, Naval Surface Force, U.S. Pacific Fleet (COMNAVSURFPAC) and Commander, Naval Surface Force Atlantic (COMNAVSURFLANT). 4. Administration. COMNAVSURFPAC and COMNAVSURFLANT are responsible for the administration and update of this instruction. 5. Action. Ensure widest dissemination and implementation of this instruction. 6. Records Management. Records created as a result of this instruction, regardless of media and format, shall be managed per Secretary of the Navy (SECNAV) Manual 5210.1. D. M. NASHOLD Chief of Staff F. J. OLMO Chief of Staff Distribution: Electronic only, via COMNAVSURPAC Directives Web site, COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 SHIPBOARD MEDICAL DEPARTMENT PROCEDURES MANUAL PUBLISHED BY: COMMANDER, NAVAL SURFACE FORCE, U.S. PACIFIC FLEET AND COMMANDER, NAVAL SURFACE FORCE ATLANTIC (N01H) FORCE HEALTH OFFICES Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 Table of Revisions/Changes COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 Basic Consolation and Reissuance Date Change Number Revision Date ii Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 EXECUTIVE SUMMARY While the directives and the information the Shipboard Medical Department Procedures Manual (SMDPM) are not all encompassing, they address the common medical administrative situations and issues encountered by Medical Departments within the Surface Forces. This instruction is a complete revision from the previous guidance and should be reviewed in its entirety. Since medical policy and procedures evolve dynamically causing medical instructions to change frequently, each Medical Department is expected to post such changes as they are issued. The SMDPM has been designed to replace many ship-specific instructions and may be adopted verbatim, with a minimum of additions, to compensate for varied ship types. As such, Medical Department personnel will use this instruction supplemented by the various references listed within this manual for the basic operation of their departments. Forward recommended changes to this instruction to: Pacific Fleet Command Atlantic Fleet Command COMMANDER NAVAL SURFACE FORCE US PACIFIC FLEET FORCE HEALTH OFFICE 2841 RENDOVA ROAD SAN DIEGO CA 92155-5490 COMMANDER NAVAL SURFACE FORCE ATLANTIC FORCE HEALTH OFFICE 1430 MITSCHER AVE NORFOLK VA 23551-2494 iii Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 TABLE OF CONTENTS Executive Summary...............................................ii Record of Changes...............................................iii Table of Contents...............................................iv Chapter 1 Section Section Section Section General.............................................1 1 – Introduction....................................2 2 – Organization and Responsibilities...............3 3 – Medical Department Administration...............13 4 – Quality Assurance, Certification, Training and Review......................................27 Section 5 – Medical Readiness Inspection (MRI)..............29 Chapter 2 - Training............................................31 Section 1 – General Medical Training........................32 Section 2 – Medical Department Personnel Training...........38 Chapter 3 Section Section Section Fiscal/Supply Management............................43 1 – Supply Administration...........................44 2 – Drugs Requiring Special Custodial Care..........53 3 – Medical Equipment Maintenance and Repair and Repair Program/3M System....................60 Chapter 4 Section Section Section Health Care.........................................63 1 – Administration..................................65 2 – Clinical Health Care............................81 3 – Shipboard Emergency Medical Readiness...........98 Chapter 5 - Environmental Health and Preventative Medicine Afloat..........................................................109 Section 1 – Preventive Medicine.............................110 Section 2 – Food Safety.....................................112 Section 3 – Water Supply Afloat.............................114 Section 4 – Habitability....................................118 Section 5 – Insect and Rodent Control.......................119 Section 6 – Communicable Diseases...........................121 Section 7 – Industrial Hygiene and Occupational Health......123 Chapter 6 - Medical Planning....................................126 Section 1 – Responsibilities................................127 Section 2 – Casualty Handling...............................131 Chapter 7 Section Section Section Blood Program.......................................134 1 – Administration..................................134 2 – Usage of Blood Products.........................137 3 – Walking Blood Bank..............................140 iv Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 APPENDICIES Appendix Appendix Appendix Appendix A B C D - Appendix E Appendix F Appendix Appendix Appendix Appendix G H I J - Appendix Appendix Appendix Appendix Appendix Appendix Appendix K L M N O P Q - Acronyms..............................................A-1 Safe-to-Sail Checklist................................B-1 TEMADD Assist Message Template........................C-1 Plan of Action and Milestone (POA&M) for Hull Swap Preparation of Afloat Medical Departments.............D-1 Plan of Action and Milestone (POA&M) for Routine Overhaul (ROH) Preparation of Afloat Medical Departments...........................................E-1 Deployment Plan of Action and Milestone (POA&M) for Pre-Deployment Preparation of Afloat Medical Departments...........................................F-1 Mass Casualty Bill Template...........................G-1 Medical Department Battle Bill Template...............H-1 Crew Medical Training Requirements....................I-1 Medical Department Personnel Qualification Standards (PQS) for Junior Hospital Corpsman..........J-1 SERP Equipment List...................................K-1 Fleet Instrument Sets Matrix..........................L-1 Diving Accidents......................................M-1 Aviation Medicine and Accidents.......................N-1 Emergency Medical Requirements........................O-1 Non-Combatant Evacuation Operation (NEO) Material.....P-1 Oxygen Handling and Stowage Precautions...............Q-1 V Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 CHAPTER 1 - GENERAL Ref: (a) BUMEDINST 1520.34A, Continuing Education Programs for Medical Corps and Nurse Corps Officers (b) BUMEDINST 6320.66E CH-4, Credentials Review and Privileging Program (c) BUMEDINST 6440.5C, Health Services Augmentation Program (HSAP) (d) COMNAVSURFOR MSG DTG 111532Z MAY 06, Policy on Employment of Medical Personnel on VBSS Teams (e) COMNAVSURFORINST 5400.1, Naval Surface Forces, Force Regulations (f) COMFLTFORCOMINST 6600.1, Dental Standard Operating Procedures (SOP) for Operational Units (g) COMNAVSURFPAC/COMNAVSURFLANTINST 3502.3, Surface Force Readiness Manual (h) COMNAVSURFPAC/COMNAVSURFLANTINST 6000.2B CH-1, Medical Readiness Inspection Program (i) COMNAVSURFPAC/COMNAVSURFLANTINST 6320.2, Health Services, Credentials Review/Privileging and Quality Assurance Programs (j) COMNAVSURFPAC/COMNAVSURFLANTINST 6400.1, Training Certification, Supervision, and Employment of Independent Duty Corpsmen (IDC) in Commander Naval Surface Forces Pacific (CNSP) and Atlantic (CNSL) (k) COMUSFLTFORCOM/COMPACFLTINST 6320.2B, Credentials, Review and Privileging Program (l) COMUSFLTFORCOM 6820.1B/COMPACFLTINST 6820.1A, Medical Professional Books, Publication, and Instructions (m) NAVMED P-117, Manual of the Medical Department (MANMED) (n) NAVMED P-5055, Radiation Health Protection Manual (o) NAVPERS 15560D, Naval Military Personnel Manual (p) Navy Warfare Publication (NWP) 4-02 Jan 08, Naval Expeditionary Health Service Support Afloat and Ashore (q) OPNAVINST 3120.32D, Standard Organization and Regulations of the U.S. Navy (r) OPNAVINST 6100.3, Deployment Health Assessment Process (s) OPNAVINST 6320.7A, Health Care Quality Assurance Policies for Operating Forces Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 (t) OPNAVINST 6400.1C, Training, Certification, Supervision Program, and Employment of Independent Duty Hospital Corpsmen (IDCs) (u) SECNAVINST 5210.8, Department of the Navy Records Management Program (v) SECNAV M-5210.1, Department of the Navy Records Management Program, records Management Manual (w) SECNAVINST 5216.5, Navy Correspondence Manual (x) SECNAVINST 6120.3 CH-1, Periodic Health Assessment for Individual Medical Readiness (y) United States Navy Regulations 1990 SECTION 1 – INTRODUCTION 1. Shipboard Medical Department Procedures Manual. The Shipboard Medical Department Procedures Manual (SMDPM) provides guidance and direction for Medical Department personnel assigned to the Surface Forces. 2. Surface Force Healthcare System. The goal of this health service system is to promote health and wellness, increase medical readiness, and provide optimal healthcare to the fleet. The Type Commander (TYCOM) has ultimate responsibility for attaining this goal. 3. Acronyms. Appendix A contains a list of acronyms used in this instruction. 4. References a. References are listed at the beginning of each chapter for further guidance and clarification. b. Each Medical Department will maintain the materials listed in reference (l). 2 Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 SECTION 2 – ORGANIZATION AND RESPONSIBILITIES 1. TYCOM/Immediate Superior in Command (ISIC) a. TYCOM Force Surgeon. Commander, Naval Surface Force, U.S. Pacific Fleet (COMNAVSURFPAC) and Commander, Naval Surface Force Atlantic (COMNAVSURFLANT) Force Surgeons are the senior Medical Corps Officers for Surface Forces. (1) The Force Surgeons are the special assistant and principle advisor to their respective TYCOMs for all healthcare issues, and the staff advisor to the subordinate commands. The Force Surgeons provide professional oversight and expertise in shaping the surface force healthcare system, formulation of policy, and measured assessment to assist COMNAVSURFPAC/COMNAVSURFLANT in achieving a combat ready, responsive and flexible Surface Force. (2) The Force Surgeons are assisted by a healthcare team, which may include Medical Corps, Nurse Corps and Medical Service Corps officers and senior enlisted staff professionals that provide health services leadership. (3) Coordinates Health Services Augmentation Program (HSAP) training for Casualty Receiving and Treatment Ship (CRTS) platforms in accordance with reference (c). (4) Medical Readiness Division (MRD) located in heavy fleet concentrated areas of San Diego, Norfolk and Mayport are reportable to the respective TYCOM Fleet Surgeon; MRD San Diego to COMNAVSURFPAC, MRD Norfolk and MRD Mayport to COMNAVSURFLANT. (a) These units will have the same responsibilities listed in sections 2.c. and 2.d. (b) Conduct a Safe-to-Sail inspection on all new pre-commissioned vessels utilizing Appendix B prior to sail away and submit results to the Force Surgeon. b. Commander, Amphibious Task Force/Expeditionary Strike Group (CATF/ESG) Surgeon. In addition to the duties defined in chapter 6 of reference (e) and Appendix F of reference (p), the responsibilities of the CATF Surgeon will include, but are not limited to, the following: 3 Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 (1) As the Senior Medical Authority Afloat, serves as medical advisor to the Task Force/Expeditionary Strike Group (TF/ESG), the staff, and the ships of the task force. The TF/ESG Surgeon also serves as the health services advisor of the task force, ensuring that all medical and dental administrative requirements are met. Ultimately responsible for all care provided within the TF/ESG. (2) Ensure, as officer in charge (OIC) of the Fleet Surgical Team (FST), that all members of the FST meet professional requirements through ongoing training. (3) Maximizes the medical and dental readiness of all units in the TF/ESG. Shall regularly exercise shipboard medical facilities, including the provision of specialty medical and surgical services both afloat and pier side in support of readiness. (4) Collaborate with the Marine Expeditionary Unit (MEU) Surgeon and/or the MEU medical planner in preparing the medical annex to Operational Plans (OPLAN) and Operational Orders (OPORDs). (5) Coordinate and ensure compliance of the Performance Assessment and Improvement (PA&I) program within the TF/ESG in accordance with reference (i). (6) Exercise the oversight necessary to ensure that all medical personnel of the TF/ESG, including civilian, foreign national, and Temporary Additional Duty (TEMADD) military providers, are properly credentialed and privileged to exercise only those clinical privileges that can be supported by the platforms upon which they are embarked. (7) Ensure medical personnel of the MEU augment the ship's Medical Department in which they are embarked. (8) Request any required medical augmentation. (9) Ensure shipboard medical supplies are used to provide appropriate medical support to all embarked personnel, reserving MEU medical supplies for ultimate use ashore. (10) Establish standards of medical policy, practice and triage within the TF/ESG. 4 Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 (11) Ensure most effective use of all embarked medical personnel and equipment throughout the TF/ESG. (12) Ensure all personnel are properly trained in self and buddy first aid. (13) Ensure a proactive practice of health promotion and preventive medicine throughout the TF/ESG. (14) Establish the medical regulating plan with the MEU surgeon and/or the MEU staff medical planner and other staff officers. (15) Coordinate medical mass casualty evacuation from shore, using dedicated communications whenever feasible. (16) Coordinate medical support among ships of the TF/ESG. (17) Coordinate medical supply/resupply among ships of the TF/ESG. (18) Coordinate Medical Evacuation (MEDEVAC) of casualties from the TF/ESG to outside of the amphibious objective area. (19) Establish a blood bank for the TF/ESG and act as the TF/ESG blood bank director. (20) Keep the Commander, TF/ESG, the Fleet Surgeon, and the Force Surgeon informed concerning the medical and dental status of the TF/ESG. (21) Submit a post-deployment/after-action critique pursuant to section 3.8. c. Regional Medical Representative, Senior Medical Officer (RMRSMO). A senior medical officer (SMO) assigned to the Immediate Superior in Command (ISIC) of the units or to regional support areas will act as agents for the Force Surgeon in administering established policies. RMRSMO duties include, but are not limited to, the following: 5 Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 (1) Serves as special assistant to the ISIC Commander and reports to the chief of staff or chief staff officer for administrative purposes. (2) Provides medical liaison between the ISIC chain of command and medical and dental departments ashore and afloat. (3) Coordinates with the Force Surgeon to ensure medical assets under their purview are maintained in a high state of medical readiness. (4) Advises ISIC commander and unit commanders on matters affecting the health of assigned personnel. (5) Prepares medical annexes to ISIC commanders OPORDs as required. (6) Collects and disseminates medical intelligence, and submits required reports per current directives. (7) Coordinates all health care support within the ISIC command or the regional support area. Although the bulk of consultative services should be provided by shore Military Treatment Facilities (MTF), Regional Medical Representative (RMR) staffs should assist with medical consultations, Physical Fitness Assessment (PFA) screens and physical examinations to the extent of their ability. Note: Although RMR administrative spaces may include offices for conducting medical consultations, performing clinical or invasive procedures in these spaces is not permitted. (8) Ensure Medical Department maintain the highest state of medical readiness through periodic Medical Readiness Inspections (MRI), monthly administrative quality assurance, and performance assessment and improvement programs in accordance with references (h) and (i). (9) Ensure Medical Department assist commands in maintaining a viable health promotion, preventive medicine, and sanitation program per current directives. (10) Ensure performance and review of semiannual audit of radiation health protection programs in accordance with reference (n) for commands with radiology capability. 6 Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 (11) Periodically observes sick call on units, ensuring the appropriate delivery of quality health care to all personnel, including proper documentation and follow-up. (12) Ensure Medical Department personnel understand and comply with the Navy supply system with regard to medical material. (13) Coordinates annual medical and dental Shipboard Equipment Replacement Program (SERP) submission to the TYCOM per current guidance. Assists in coordinating emergency equipment procurement for the units as may be necessary. (14) Coordinates and manages health care training for all Group/Squadron personnel to include self-aid, buddy aid, and Basic Life Support (BLS) courses. (15) Provides counseling, mentorship and training to all medical and dental personnel within the RMR office. (16) Arranges emergency relief, as necessary, for Medical Department’s within the ISIC organization or regional support area in response to TEMADD assist request. (17) Facilitates medical/dental evacuations (DENEVAC) as may be necessary. d. Regional Medical Representative (RMR). When serving independently, without on-site medical officer supervision, the senior medical enlisted staff member is responsible for providing medical guidance to their ISIC commander and ensuring subordinate commands are in a high state of medical readiness. When serving with a CATF surgeon or RMRSMO, the senior regional medical enlisted representative assists the RMRSMO in the details of Medical Department administration and all aspects of medical readiness. The RMR staff will perform the following duties: (1) Advise and assist the shipboard Senior Medical Department Representative (SMDR) on all medical administrative matters, particularly those involving procedures, methodology, and procurement. (2) Jointly, with the SMDR, provide technical supervision of all subordinate enlisted personnel. 7 Enclosure (1) COMNAVSURFPACINST 6000.1/ COMNAVSURFLANTINST 6000.1 6 Mar 14 (3) Coordinate, monitor and assist cognizant Medical Department's other procurement, Navy (OPN)/centrally managed equipment inventory and annual budget call submissions. (4) Coordinate and monitor required personnel shipboard certifications and training in accordance with chapter 3 of reference (g). (5) Provide counseling, mentorship and leadership to all subordinate enliste...
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