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The Omaha MCD concept.

Many chemical, biological, radiological, and nuclear (CBRN) company commanders have dreaded the Defense Civil Response Force mission for years. This mission requires more than 100 percent of the manpower allocated by the modified table of organization and equipment, which has decreased with the recent force design update (FDU). This article describes a tested, proven, and more efficient way to accomplish the Defense Civil Response Force mission with half the manpower. It represents an essential decrease in required personnel because current mass casualty decontamination (MCD) guidance prescribes more personnel than a company at 100 percent strength can provide. This method, the Omaha MCD concept, allows accomplishment of the mission at the new FDU personnel levels.

As the name implies, the commander may need to call a football-like "audible" to accomplish the mission. The commander instructs an MCD line shift, from a prescribed doctrine configuration to an Omaha MCD configuration. Current guidelines suggest at least 100 CBRN Soldiers be divided into four rotations to sustain an MCD line for 12 hours; however, this number exceeds the new FDU personnel levels allocated to the modified table of organization and equipment. Furthermore, Soldiers who are unavailable due to medical or legal reasons must be accounted for. This could leave the average CBRN company with only 80 deployable Soldiers. The mission is further constrained by positions that require Soldiers to be out of suit, Soldiers who are unable to pass medical monitoring, and/or Soldiers who become casualties themselves. This results in a worst-case scenario of approximately 70 Soldiers available to complete the mission. The Omaha MCD configuration provides a reduced personnel burden and increases efficiency, only requiring 68 Soldiers divided into four shifts. This meets typical real-world numbers of deployable Soldiers available to a CBRN company to complete the mission.

The occurrence of a CBRN event is only a matter of time. Unfortunately, most CBRN company personnel levels are far below that suggested to complete the mission. A fully deployable CBRN company needs augmentees in order to sustain rotations. The Omaha MCD concept eliminates this need by cutting the ambulatory positions in half and closing the technical decontamination line until it is needed. Doffing is also conducted in the ambulatory line. This allows for a third and fourth rotation, which aids in preventing heat casualties.

The key enabler of the Omaha MCD configuration is the removal of the privacy barrier in the ambulatory decontamination tent. First and foremost, the notion of privacy should be dismissed during a mass casualty event; it results in a fundamental flaw in casualty processing times. Upon removal of the privacy barrier, the ambulatory line can process two casualties, with one Soldier at each station. However, two Soldiers remain at the monitoring station. The only addition is that the platoon leader or platoon sergeant of the ambulatory line assumes a management role between the casualty collection point (CCP) and the front of the undress tent. He or she receives the casualties from the CCP and guides them into the tent. This provides additional command and control to assist the ambulatory line Soldiers who are processing two casualties at once. In the event of unruly casualties, the platoon leader/platoon sergeant notifies the CCP to hold casualties and he or she steps into the tent to handle one casualty while the undress Soldier assists the other. If needed, the platoon leader/platoon sergeant assists the wash-and-rinse station Soldier until the unruly casualty has been decontaminated. Lastly, the technical decontamination line remains unmanned unless manning is necessary.

When a shift change is called, the ambulatory casualty processing adjusts to one casualty at a time, while the previous rotation Soldiers wash and rinse. They are monitored using the now-vacated lane. The platoon leader/platoon sergeant supervises this process. This cuts Soldier's doffing times considerably, while ambulatory casualties continue to process and space constraints on the nonambulatory line are reduced.

There are pros and cons to the doctrine guidelines and the Omaha MCD concept. But with proper planning and training, the drawbacks can be mitigated.

As previously described, modestly is a key issue. Men, women, and children are expected to remove all clothing in order to be decontaminated. Without the privacy barrier, genders are mixed. However, the survival of a casualty is more important than modesty. In response to criticism, U.S. Army North posed this question: "Would you want your 10-year-old daughter seen by a man while they are decontaminated?" The answer is a resounding yes--because the removal of the privacy barrier increases the girl's chances of survival since she is decontaminated sooner. A lack of modesty is not deadly, but waiting too long to be decontaminated is.

A second key issue of the Omaha MCD concept is that one Soldier assists two casualties at once. In theory, this seems impossible; however, the platoon leader/platoon sergeant mitigates this issue so that it becomes a nonissue--even with some of the most unruly casualties. The proof of concept was confirmed over the course of six exercises, including Vibrant Response 2014, in which 74 properly decontaminated casualties were processed with half the normal manpower per hour.

Further building on the increased efficiency without the privacy barrier, the Omaha MCD concept focuses on the principles of decontamination--for example, only decontaminating what is necessary. If deemed appropriate by the commander, CCP Soldiers should premonitor casualties to detect contamination during triage of ambulatory casualties. If no contamination is found, the casualty then proceeds through the technical decontamination line, where clothes are removed and Soldiers conduct final monitoring. Casualties are then processed to the medical unit if no contamination is detected during final monitoring.

Current MCD training focuses on water as the only means of decontamination, but water is not the only decontaminant. CBRN commanders and leaders at all levels must realize that each chemical reacts differently to water and other decontaminants. For example, water alone will not effectively decontaminate mustard agent due to its poor water solubility.

Additionally, water should not be used during a radiation event, as it creates an extremely dangerous situation that results in radiated water. In these cases, vacuums with proper high-efficiency particulate arrestance (HEPA) filters should be used in lieu of water.

This article presents only a brief overview of the Omaha MCD concept. However, specific standard operating procedures and implementation guidance is available. With the new lower FDU personnel numbers, it is imperative that MCD lines operate in a sustainable way. The Omaha MCD concept enables the commander to process casualties with half the available manpower while concurrently increasing efficiency. Also, increasing the number of rotations and decreasing doffing time allow downtime to be maximized, which decreases the possibility that a Soldier will become a heat casualty. Lastly, the Omaha MCD concept saves lives; it is a proven, tested, and more efficient way to decontaminate casualties should the mission require it.

References:

ATP 3-11.41, Multi-Service Tactics, Techniques, and Procedures for Chemical, Biological, Radiological, and Nuclear Consequence Management Operations, 30 July 2015.

U.S. Army North, Civil Support Readiness GroupCentral, CBRN Technical Support Force (TSF) Mass Casualty Decontamination Smart Book.

Captain Ratchford is the company commander for the 95th Chemical Company, Joint Base Elmendorf-Richardson, Alaska. He holds a bachelor's degree in political science, international relations, and military affairs from The Citadel, The Military College of South Carolina, and a master's degree in environmental management from Webster University.

Sergeant First Class Beels is a CBRN Advanced Individual Training and CBRN Basic Officer's Leader Course instructor, Fort Leonard Wood, Missouri.
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Author:Ratchford, Gerald W.; Beels, John A.
Publication:CML Army Chemical Review
Geographic Code:1U4NE
Date:Jun 22, 2017
Words:1246
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