Bancroft D, Lattimore M
10th Mountain Division, Fort Drum, NY 13602-5004, USA.
Mil Med. 2001 Jan;166(1):71-4.
Existing U.S. Army personnel and equipment authorization documents do not recognize the need for optometry services at deployed combat support hospitals (CSHs). The specific hospital tasked with the mission of supporting Operation Joint Endeavor from a support base in Taszar, Hungary, did not have any documentation authorizing the assignment of ophthalmology assets. Current Army doctrine stipulates the presence of an area support medical battalion, with assigned optometry assets, to deploy and operate near a CSH. However, in the winter of 1995, when Operation Joint Endeavor began, there were no area support medical battalions staffed in Europe, and none deployed to the Taszar support base. Therefore, the 67th CSH's mission to provide comprehensive inpatient and outpatient care on a contingency basis to all personnel in the area of operations did not have a doctrinal means of supporting an eye care requirement.
To meet this eye care shortfall between doctrinal policy and actual operational needs or requirements, the optometry staff of the 67th CSH scavenged two optometry field sets from old Operation Desert Storm war stock and deployed with the main body of hospital personnel to Taszar, Hungary, on December 18, 1995. In doing so, the Table of Organization and Equipment was thus supplemented with extra equipment and personnel, beyond doctrinal guidelines, to accomplish the assigned mission.
This report is a prospectively gathered summary of the eye care provided from December 18, 1995, to September 15, 1996.
A total of 1,471 patients were examined and treated, averaging 7 patients per day. Less than half of the case load was medical in nature, with the remaining being refractive in nature or for periodic examination. The most common pathologies seen were soft contact lens complications, non-contact lens corneal pathology, conjunctivitis (bacterial, viral, and adenoviral), and ocular trauma (foreign bodies, chemical splashes, blunt injury). Refractive cases during the entire deployment involved primarily myopes requiring increased correction. However, close to half of the refractive cases in the first month involved habitually uncorrected low hyperopes and early presbyopes.
Based on the productivity presented by the case load demand of this CSH's area medical support mission, an eye care need was clearly met, adding to the overall mission success of the 67th CSH.
美国陆军现有的人员和装备授权文件未认识到在部署的战斗支援医院(CSH)提供验光服务的必要性。负责从匈牙利塔萨尔的一个支援基地为“联合努力行动”提供支持任务的特定医院,没有任何文件授权分配眼科资产。当前陆军条令规定要有一个配备了验光资产的地区支援医疗营,在CSH附近展开行动。然而,在1995年冬季“联合努力行动”开始时,欧洲没有人员配备齐全的地区支援医疗营,也没有部署到塔萨尔支援基地。因此,第67战斗支援医院在应急情况下为行动区内所有人员提供全面住院和门诊护理的任务,没有条令规定的方式来满足眼部护理需求。
为了弥补条令政策与实际行动需求之间的眼部护理缺口,第67战斗支援医院的验光人员从旧的“沙漠风暴行动”战争储备中搜罗了两套验光野外设备,并于1995年12月18日随医院主要人员部署到匈牙利塔萨尔。这样做时,编制和装备表因此在超出条令准则的情况下补充了额外的设备和人员,以完成指定任务。
本报告是对1995年12月18日至1996年9月15日期间提供的眼部护理进行前瞻性收集的总结。
共检查和治疗了1471名患者,平均每天7名患者。病例负荷中不到一半本质上是医疗性的,其余为屈光性或定期检查。最常见的病症是软性隐形眼镜并发症、非隐形眼镜角膜病变、结膜炎(细菌性、病毒性和腺病毒性)以及眼外伤(异物、化学飞溅、钝器伤)。整个部署期间的屈光病例主要涉及需要增加矫正度数的近视患者。然而,第一个月近一半的屈光病例涉及习惯性未矫正的低度远视者和早期老花眼患者。
根据该战斗支援医院地区医疗支援任务的病例负荷需求所呈现的工作效率,眼部护理需求显然得到了满足,这为第67战斗支援医院的整体任务成功增添了助力。