Forward surgical teams
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In the United States Army, forward surgical teams (FST) are small, mobile surgical units fielded since the 1990s. FSTs are utilized in a variety of ways, and can be attached to 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 (with appropriate support) to provide a surgical capability for those patients unable to survive MEDEVAC to a Role 2 or 3 (hospital) care. Surgeons perform hemorrhage control on combat casualties within the "golden hour" of injury. 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 Field Manual 4-02-25 (March 2003) 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 that function independently. A functional operating room can be established within one hour 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.
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.
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. There currently are only 3 airborne-capable FSTs in the Army today. (All 3 stationed in Ft. Bragg)
- Field hospital
- Combat Support Hospital
- Battalion Aid Stations
- Mobile Army Surgical Hospital
- Portable Surgical Hospital