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To define shipboard medical procedures for the Naval Surface Forces, U. Atlantic and Pacific Fleets. While the directives and the information in this instruction are not all encompassing, they address the common medical administrative situations and issues encountered by Medical Department Officers and enlisted Medical Department Representatives of the Surface Forces.

Medical department personnel will use this instruction as their basic shipboard procedures manual. This instruction represents a significant change from previous guidance and should be reviewed in its entirety. Changes to the Manual. Recommendations for changes or suggestions intended to increase the effectiveness and completeness of this instruction are encouraged and should be forwarded through the administrative chain of command.

Since medical policy and procedures evolve dynamically, medical instructions change frequently. Each medical department representative is expected to post such changes as they are issued. Unit commanders and commanding officers will implement the provisions of this instruction within their commands.

It is designed to replace many ship-specific instructions and may be adopted verbatim, with a minimum of additions, to compensate for varied ship types by execution of the letter of promulgation on page i. H-1 I-1 Article Force Medical Officer. The Force Medical Officer is available, whenever assistance is required. Appendix A contains a list of acronyms used in this instruction.

Required References. This Shipboard Medical Procedures Manual is not intended to be an all-inclusive reference. Each Medical Department must maintain a library of reference materials from a variety of sources to be used as guidance in accomplishing departmental business.

Key categories of references include: a. Navy Regulations, Fleet Commander Regulations. Pertinent SOPA guidance is often forwarded via message prior to port calls.

These instructions contain valuable information for medical department personnel and should be reviewed as soon as possible upon receipt. Medical Department. The medical department is charged with the responsibility of safeguarding the health of personnel and maintaining emergency medical capability. In order to fulfill this responsibility, the medical department makes recommendations and advises all departments on matters that may affect the health and readiness of all personnel.

The medical department is composed of the medical personnel, facilities, and administrative structure allocated to provide comprehensive health care. Its mission is to promote, maintain, and preserve the health of the crew aboard ship. The discharge of this responsibility is affected by contingency planning, delivery of preventive medicine, delivery of primary medical care, maintenance of medical department spaces and equipment, and completion of associated administrative requirements.

Medical department members advise the Commanding Officer on how best to accomplish the medical mission in relation to the command's overall mission. All medical records of embarked personnel will be maintained in sickbay. Embarked personnel are included on the ship's medical reports. A medical department organization manual will be maintained for each ship. It will provide detailed and amplified instructions covering all duties and responsibilities within the department.

Personnel a. Medical Department Personnel Watchstanding. Due to the requirements for completing shipboard PQS and the expansion of inport duty sections, Commanding Officers often require medical department personnel to stand non-medical shipboard watches.

This decision is supported by Navy Regulations, , Article , which prohibits medical department personnel from standing non-medically related watches only while assigned to a combat area during a period of armed conflict. Of utmost importance when assigning medical department personnel to non-medical watches, is the ability of the individual to respond in case of an actual medical emergency. Commands that utilize medical department personnel for any shipboard watches must establish procedures for immediate relief of these individuals, if the need arises.

The practice of utilizing Hospital Corpsmen for duties that require them to be off the ship, such as pier sentry and duty driver, is strongly discouraged due to their inability to respond to emergencies.

Additionally, due to the limited number of Hospital Corpsmen assigned to each ship, assignment for extended periods to duties such as food service attendant FSA is highly discouraged. Off-duty Employment. Medical Department Officers assigned to Force commands will refrain from engaging in professional off-duty employment without prior approval of their Commanding Officer.

Medical officers will not perform duties nor stand watch for commands outside the TYCOM without the specific prior approval of the Force Medical Officer. Medical Augmentation. Additional medical personnel may be assigned temporarily to platforms in order to support deployments and contingencies. Guidelines for procurement, use and integration are provided in Article SMDO duties include, but are not limited to, the following: a. Collect and disseminate medical intelligence, and submit required reports per current directives.

Although the bulk of consultative services for shipboard medical departments should be provided by shore MTFs, group staffs should assist with medical consultations, PFA screens and physical examinations to the extent of their ability. Ensure medical departments maintain the highest state of medical readiness.

Ensure medical departments maintain viable health promotion, preventive medicine, and sanitation programs per current directives. Periodically observe sick call on units, ensuring the appropriate delivery of quality health care to all personnel, including proper documentation. Ensure medical departments understand and comply with the naval supply system with regard medical material. Advise and assist the MO on all medical administrative matters, particularly those involving procedures, methodology, and procurement.

Jointly, with the MO, provide technical supervision of all subordinate enlisted personnel. Coordinate and monitor shipboard HM required certification and training. Provide counseling and leadership to all subordinate enlisted medical personnel. Assist in coordinating replacement, or serves as a short-term normally not more than 30 days TEMADD assist resource, in the event of an un-programmed loss of a shipboard IDC.

Coordinate tracking and resolution of any identified discrepancy. Coordinate, monitor, and assist medical departments as needed during routine overhaul ROH , selected restricted availability SRA , and similar evolutions. Jointly, with the MO, identify and resolve medical department manning shortages. Serve as a training observer, evaluator, and training resource as required during shipboard medical training. Assist in all commissioning and decommissioning evolutions involving loading or offloading of medical material and equipment.

Jointly, with the MO, keep unit commanding officers informed as to the status of their respective medical departments. Coordinate one-time reporting requirements to higher commands. Senior medical enlisted personnel are expected to visit ships under their cognizance no less than once per quarter; more often as necessary on ships requiring assistance in the implementation of various medical programs.

The ship's SMO is designated as the department head for the medical department. In addition to those duties prescribed by Navy Regulations for a head of department, the SMO will be responsible, under the commanding officer, for maintaining the health of all embarked personnel, conducting inspections incident thereto, and advising the commanding officer with respect to matters of health and sanitation affecting the ship. The SMO will be responsible for all medical department material on board and will be in charge of the sick and injured.

The SMO may be required to give medical support to other ships in port or underway, to include training and oversight of all medical department personnel. The MAO will serve as medical division "H" Division officer and will be assigned as the medical department training officer, ensuring that all medical and non-medical personnel of the ship's company are trained in first aid and other appropriate health matters as outlined in NWP A and other applicable directives.

The RHO may be assigned other medical administrative duties as well. The RHO assists the engineering and weapons departments in carrying out primary duties. Physician Assistant PA a. Duties and Responsibilities. Physician Assistants PAs serving on ships under the direct supervision of an assigned ship's medical officer will function as physician extenders.

The SMDR is responsible to the commanding officer for the care of the sick and injured, the sanitation and hygiene of the command, the health of personnel, the preparation of medical reports and records, the maintenance of medical supplies and equipment, and the training of medical and non-medical personnel.

The SMDR will at all times have direct access, and in fact report to, the CO in matters relating to the health of members of the command. SMDRs will seek MO advice whenever they are in doubt about a patient's condition or when conditions exist as discussed in article As senior medical authority afloat, serve as medical advisor to the CATF, the staff, and the ships of the task force.

Also serve as de facto medical director of the task force, ensuring that all medical administrative requirements are met. Maximize the medical readiness of all units in the task force. Regular exercise of shipboard medical facilities, including the provision of specialty medical and surgical services both afloat and pier side, is encouraged in support of this readiness goal.

Exercise the oversight necessary to ensure that all medical personnel of the task force, including civilian, foreign national, and TAD 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.

Ensure medical personnel of the landing force augment the ship's medical departments in which they are embarked. Request any required medical augmentation. Ensure the use of task force medical departments and supplies to provide appropriate medical support to all embarked personnel, reserving landing force supplies for ultimate use ashore. Establish standards of medical policy, practice and triage within the task force. Ensure most effective use of all embarked medical personnel, equipment, and supplies throughout the task force.

Ensure all personnel are properly trained in self and buddy first aid. Ensure the practice of health promotion and preventive medicine throughout the task force. Coordinate medical mass casualty evacuation from shore, using dedicated communications whenever feasible. Coordinate medical support among ships.

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