Forward surgical teams

In the United States Army, Medical Detachments (Forward Surgical), popularly known as Forward Surgical Teams (FST), are small, mobile surgical units fielded since the 1990s. FSTs are utilized in a variety of ways, and can fielded with support elements, including a Forward Support Medical Company (FSMC), Area Support Medical Company (ASMC), Brigade Medical Company also known as C-Med or in some cases stand alone (although The FST is not designed, staffed, or equipped for standalone operations or for conducting sick-call operations. Augmentation requirements are discussed in FM 4-02.25) to provide a surgical capability at Role 2 for those patients unable to survive MEDEVAC to Role 3 (hospital) care. Surgeons perform damage control surgery on combat casualties within the "golden hour" of injury whenever possible. Casualties can then be packaged for medical evacuation to a higher level of care. The FST typically includes 20 staff members: 4 surgeons, 3 RNs, 2 certified registered nurse anesthetists (CRNAs), 1 administrative officer, 1 detachment sergeant, 3 licensed practical nurses (LPN)'s, 3 surgical techs and 3 medics.

By doctrine, given in ATP 4-02.5 (May 2013) Chapter 3 section 10,^[1] and ARTEP 8-518-10, the team is capable of continuous operations with a divisional or non-divisional medical company for up to 72 hours with a planned caseload of 30 critical patients. The FST can sustain surgery for 24 total operating table hours and has the ability to separate into two teams while jumping from one site to another. Sustained split operations are common in Iraq and Afghanistan, although not supported by current doctrine in FM 8-10-25. A functional operating room can be established within one and a half hours of being on scene and break down to move to a new location within two hours of ceasing operations.

FSTs are currently deployed in both Afghanistan and Iraq.

Organization

The forward surgical team is organized into four functional areas:

HEADQUARTERS – Communications, Command and Control, and administrative functions.
ATLS (advanced trauma life support) – Triages and prepares multiple casualties for surgery or transport and has a total of up to 4 beds or treatment areas with litter stands.
OR (operating room) – Sets up and begins surgery within one hour, can be at full functioning capacity within two hours of establishing an area of operations. The OR has two separate OR tables that can be used at the same time allowing treatment for a greater number of casualties in a given time.
RECOVERY post-anesthesia care unit (PACU) – Number of beds available varies based on mission, deployment and available resources, for post-surgical care; Most beds will be for patients awaiting medical evacuation. FSTs forward deployed typically do not hold patients beyond recovery.

Equipment

The Forward Surgical Team equipment and supplies are packed into four HMMWVs each with an M1101 trailer and two LMTV 2.5 ton cargo trucks each with a M1082 cargo trailer. Units are normally augmented with two trailers mounting a power generator and an air conditioning system. These trailers are referred to as ECU [Environmental Control Units] or GET [Generator/ECU Trailers]. When so equipped, two of the M1101 trailers are removed.

The airborne Forward Surgical Team can be slingloaded onto cargo helicopters and moved by the headquarters unit.

References

↑ http://armypubs.army.mil/doctrine/DR_pubs/dr_a/pdf/atp4_02x5.pdf

Hospitals	Bassett ACH Bayne Jones ACH Blanchfield ACH Brian Allgood ACH DeWitt ACH Evans ACH General Leonard Wood ACH Ireland ACH Irwin ACH Keller ACH Martin ACH McDonald ACH Moncrief ACH Reynolds ACH Weed ACH Winn ACH

Clinics	Bliss AHC Barquist AHC Bavaria MEDDAC DiLorenzo TRICARE HC Dunham AHC Fairfax FHC Fox AHC Guthrie MEDDAC Heidelberg MEDDAC Kimbrough ACC Kenner AHC Kirk AHC Lyster AHC Munson AHC Rader AHC Woodbridge AHC Camp Zama

Field medical units

Medical Commands	AR-MEDCOM 807th MCDS 3rd MCDS

Medical Groups	55th Med Gp 67th Med Gp

Medical Brigades	1st Med BDE 2nd Med BDE 5th Med BDE 8th Med BDE 30th Med BDE 32nd Med BDE 44th Med BDE 62nd Med BDE 65th Med BDE 176th Med BDE 139th Med BDE 307th Med BDE 330th Med BDE 332nd Med BDE 338th Med BDE 804th Med BDE

Combat Support Hospitals	10th CSH 14th CSH 21st CSH 28th CSH 31th CSH 47th CSH 48th CSH 75th CSH 115th CSH 121st CSH 212th CSH 228th CSH 256th CSH 325th CSH 328th CSH 345th CSH 349th CSH 352d CSH 396th CSH 399th CSH 405th CSH 452th CSH 801th CSH 865th CSH

Forward Surgical Teams	1st FST 2nd FST 8th FST 67th FST 102nd FST 126th FST 135th FST 160th FST 240th FST 250th FST 274th FST (ABN) 402nd FST 541th FST (ABN) 555th FST 624th FST 628th FST 629th FST 691st FST 745th FST 758th FST 759th FST (ABN) 772nd FST 848th FST 874th FST 909th FST 911th FST 912th FST 915th FST 932nd FST 933rd FST 934th FST 936th FST 945th FST 946th FST 947th FST 948th FST 1980th FST 1982nd FST

Education

Centers, schools, etc	AMEDD Center & School U.S. Army School of Aviation Medicine Borden Institute

Museums	National Museum of Health and Medicine AMEDD Museum

Courses	Captains Career Course Walter Reed Tropical Medicine Course

Products	Textbook of Military Medicine War Surgery in Afghanistan and Iraq

Research Institutes & Centers

Stateside	Walter Reed Army Institute of Research (WRAIR) U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) U.S. Army Medical Research Institute of Chemical Defense (USAMRICD) U.S. Army Institute of Surgical Research (ISR) U.S. Army Research Institute of Environmental Medicine (USARIEM) U.S. Army Center for Environmental Health Research

Overseas	Armed Forces Research Institute of Medical Science (AFRIMS) United States Army Medical Research Unit- Europe (USAMRU-E) U.S. Army Medical Research Unit-Kenya (USAMRU-K) Makerere University Walter Reed Project (MUWRP)

Historical

List of former United States Army medical units

Other

Walter Reed Health Care System
Military Vaccine Agency
Medical Communications for Combat Casualty Care
U.S. Army Medical Information Technology Center (USAMITC)

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Forward surgical teams

Organization

Equipment

References

See also