Page 230 - 2022 Ranger Medic Handbook

MEDICAL TREATMENT FACILITIES
Per Allied Joint Publication-4.10(A), the following define the levels of medical treatment facilities in a theater of opera-
tions.
ROLE 1 MTF (Maritime Echelon 1) – provides primary health care, specialized first aid, triage, resuscitation and
stabilization. The basic Role 1 capabilities include basic occupational and preventive medical advice to the chain of
command, 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. Nearly all Ranger health care capabilities are considered Role 1 unless augmented by external assets made
organic to the task force. Generally, the Regiment maintains role-1 capability within the confines of tactical health care/
casualty response on target and aid stations established at forward operating bases.
ROLE 2 MTF – A Role 2 medical facility is an intermediate structure capable of receiving casualties, providing triage
and stabilization for further evacuation, treatment and holding of patients until they can be returned to duty or evacu-
ated. Role 2 minimum capability includes: Re-supply to Role 1, Evacuation from Role 1, Limited holding capacity,
Personnel reinforcement to Role 1, Patient record maintenance, Tracking of evacuated patients, Operational stress
management, Laboratory capability, Basic imaging capability (e.g., radiology, ultrasound), and emergent dental. Under
specific conditions, Ranger units may be augmented by other units to have a Role 2 capability organic to a special
operations task force.
ROLE 2 (+) MTF (Maritime Echelon 2) – Augmented Role 2 (Role 2+) medical facilities consist of Role 2 minimum
capability augmented by any or all the following: Emergency surgery, Intensive care, Essential post operative care,
and Blood replacement.
ROLE 3 MTF – Facilities include the capability of Role 2 extended by surgery, intensive and post-operative care,
medical, dental and nursing care, and relevant diagnostics. Role 3 units can provide lower level units medical person-
nel replacement. Resupply of Role 2 facilities and either control of or ready access to patient evacuation assets are
included within the minimum capability. In addition to beds required for the seriously ill, the holding capacity will be
sufficient to allow diagnosis, treatment and holding of those patients who can receive adequate treatment and be
returned to duty within the evacuation policy.
ROLE 3 (+) MTF (Maritime Echelon 3) – Augmented Role 3 (Role 3+) medical facilities include one or more of the fol-
lowing: specialist surgery (neurosurgery, maxillofacial, burns, etc.), advanced and specialist diagnostic capabilities (CT
scan, arthroscopy, sophisticated lab tests, etc.), major medical, dental and nursing specialties, preventive medicine,
and environmental health capability.
ROLE 4 MTF (Maritime Echelon 4) – A facility that provides definitive care of patients for whom the treatment re-
quired is longer than that dictated by the theatre evacuation policy or for whom the capability usually found at Role 3 is
inadequate. This would normally include definitive care specialist surgical and medical procedures, reconstruction and
rehabilitation. This care is usually highly specialized, time consuming, and normally provided in the casualty’s country
of origin. Under very unusual circumstances, a Role 4 medical facility may be established in the Theater of Operations.
SECTION 7 Face-to-face coordination with appropriate external medical assets is critical. The medical planner must visit the support-
ing medical facilities to gain an understanding of their physical layouts, unique equipment, procedures, casualty manage-
ment, and patient accountability. Also, unit medical personnel must know how to follow up with the unit casualties as
commanders will require serial reports on their status.
Deployed troops will suffer routine illnesses and noncombat injuries that may require medical attention exceeding the tacti-
cal Medic’s scope of practice. Area medical support assets are those facilities that provide medical services other than
combat trauma care to meet these needs. Established policies and procedures for Operators’ care at area medical support
facilities should be conveyed to unit leaders and medical personnel.

216 SECTION 7 MEDICAL PLANNING & CASUALTY COLLECTION OPERATIONS