081-831-9000 (SL2) - Implement Preventive Medicine Measures

Note.  Once FST
personnel are selected and trained,
they can be delegated the
responsibility for training other
members of the unit.

1.   Brief personnel on the three reasons a soldier is
vulnerable to disease.

a.
Harshness of the
environment such as deserts,
jungles, and the Arctic.

b.
Reduced natural defenses
due to exposure and fatigue. 
Examples are-

(1) 
Climatic changes.

(2) 
Sleep deprivation.

(3) 
Irregular meals.

c.
Breakdowns in basic
sanitation, such as the lack of
clean water and proper waste
disposal.

2.   Train personnel on the seven major components of
the medical threat to field forces.

a.
Heat. 
Types of heat injuries.

(1) 
Heat cramps.

(2) 
Heat exhaustion.

(3) 
Heatstroke – a
medical emergency.

b.
Cold. 
Types of cold injuries.

(1) 
Chilblain.

(2) 
Immersion foot.

(3) 
Trench foot.

(4) 
Frostbite.

(5) 
General hypothermia.

c.
Arthropods (biting
insects).

(1) 
Diseases transmitted
directly by arthropods.

(a)  
Mosquitoes-malaria,
yellow fever, dengue fever, and
encephalitis.

(b)  
Some ticks, as well
as mosquitoes-encephalitis.

(c)  
Sand flies-sand fly
fever.

(d)  
Body lice-epidemic
typhus.

(e)  
Hard ticks-Lyme
disease.

(2) 
Diseases transmitted by
insects associated with rodents.

(a)  
Fleas-plague and
endemic typhus.

(b)  
Mites-scrub typhus.

d.
Diarrhea.  Diarrheal disease is contracted from contaminated food and
water.

(1) 
Waterborne diarrheal
disease.

(a)  
Typhoid fever.

(b)  
Cholera.

(c)  
Traveler’s diarrhea.

(d)  
Hepatitis A.

(2) 
Food-borne diarrheal
diseases.

(a)  
Traveler’s diarrhea.

(b)  
Cholera.

(c)  
Salmonellosis.

(d)  
Hepatitis.

e.
Non-NBC chemical hazards.

(1) 
Examples of non-NBC
chemical hazards.

(a)  
Carbon monoxide.

(b)  
Hydrogen chloride.

(c)  
Bore/gun gases.

(d)  
Solvents, greases,
insecticides, and oils.

(2)  Harmful effects of
non-NBC chemical hazards.

(a)  
Skin irritation.

(b)  
Asphyxiation (choke,
suffocate).

(c)  
Central nervous
system depression.

(d)  
Death.

f. 
Noise hazards.

(1) 
Examples of noise
hazards.

(a)  
Weapons.

(b)  
Aircraft.

(c)  
Most Army vehicles
and generators.

(2) 
Harmful effects of
hazardous noise exposures.

(a)  
Temporary loss of
hearing-lasts minutes to
hours.

(b)  
Permanent loss of
hearing.

(c)  
Blast over pressure
effects.

g.
Other medical threats to
field forces.

(1) 
Skin disease-common
in extremely dry or humid
climates.

(2) 
Altitude
sickness-locations above 9,000
feet.

(3) 
Harmful animals –
poisonous reptiles, arthropods,
and mollusks and coelenterates
(such as jellyfishes and corals).

(4) 
Tobacco use.

(5) 
Poor medical threat
intelligence.

3.   Train personnel on the seven individual preventive
medicine measures (PMM) necessary to
prevent disease and nonbattle injury (DNBI).

Note.  Once
personnel have received the training
on PMM, leaders should check
periodically for application of PMM as
appropriate for their situation.

a.
Prevent heat injuries.

(1) 
Drink plenty of water.

(2) 
Observe work and/or
rest cycles.

(3) 
Eat all meals to
replace salt.

(4) 
Recognize the risk of
mission-oriented protective
posture (MOPP) for body armor and
armored vehicles.

(5) 
Modify your uniform.

b.
Prevent cold injuries.

(1) 
Drink plenty of water
and warm nonalcoholic fluids.

(2) 
Do NOT sleep in a
vehicle with the engine running or
in an enclosed area where an open
fire is burning.

(3) 
Wear your uniform
properly.

(a)  
Wear clothing as the
commander directs.

(b)  
Keep clothing clean
and dry. 
(Avoid fuel spills.)

(c)  
Avoid overheating by
removing excess clothing when
possible.

(d)  
Wear clothing in
loose layers. 
(Avoid tight-fitting
clothing.)

(4) 
Avoid loss of body
heat.

(a)  
Keep moving when
possible. 
(Exercise big muscles,
toes, feet, fingers, and hands.)

(b)  
Avoid standing
directly on cold, wet ground.

(c)  
Avoid smoking.
(Smoking decreases blood flow to
the skin.)

(d)  
Eat all meals to
maintain energy.

(5) 
Protect feet and hands
by wearing gloves or mittens,
changing socks frequently, and
avoiding skin contact with snow,
fuel, or bare metal.

(6) 
Use the buddy system to
spot frostbite on exposed skin.

c.
Protect against biting
insects.

(1) 
Use insect repellent
according to label directions and
precautions.

(2) 
Wear your uniform as
the commander directs.

(3) 
Keep your uniform
clean.

(4) 
Follow medical advice;
take antimalarial pills when
directed and use insect powder,
cream, and/or shampoo when
prescribed by medical personnel.

(5) 
Protect yourself at
night.

(a)  
Use a bed net when
sleeping.

(b)  
Use aerosol
insecticide inside bed net.

d.
Protect against diarrhea.

(1) 
Follow water sanitation
guidelines.

(a)  
Fill canteen with
treated water, when possible.

(b)  
Treat water (when
treated water is not available)
with iodine tablets, chlorine
ampules, or boil water for 5 to
10 minutes (if iodine or
chlorine is not available).  (Boiling water for only 15 seconds will help.)

(2) 
Follow food sanitation
guidelines.

(a)  
Use approved food
sources.

(b)  
Wash your mess kit
carefully, in a mess kit laundry
and with treated water.

(c)  
Wash hands after
using the latrine and before
touching food or food contact
surfaces.

(d)  
Bury waste or
otherwise properly dispose of
waste to prevent spread of germs
by flies.

e.
Prevent injuries from
non-NBC chemical hazards.

(1) 
Prevent carbon monoxide
poisoning by-

(a)  
Running engines
outside.

(b)  
Using natural
ventilation or tailpipe
extension systems to dispose of
exhaust fumes.

(c)  
Never using engine
exhaust for heat.

(2) 
Prevent hydrogen
chloride (and other propellant
exhaust) injuries by-

(a)  
Positioning yourself
upwind of rocket systems.

(b)  
Holding your breath
(after the blast) until the
cloud passes.

(3) 
Prevent injuries from
bore/gun gases (from conventional
weapons).

(a)  
Use on-board
ventilation systems.

(b)  
Keep the bore
evacuator well maintained on
large weapon systems.

(4) 
Prevent injuries from
solvents, greases, and oils
(liquid chemicals).

(a)  
Minimize worker
exposure by substituting less
harmful chemicals for toxic
chemicals.

(b)  
Use personal
protective equipment and
practice good personal hygiene.

(c)  
Comply with
replacement and medical
surveillance physical
examinations to detect early
signs of occupational disease.

f. 
Prevent noise hazard
injuries.

(1) 
Use protective devices
(earplugs, ear canal caps, or
earmuffs).

(2) 
Use vehicle headgear
such as helicopter crew helmets
and armored vehicle crew helmets.

(3) 
Keep hearing protection
devices clean to avoid ear
infections.

(4) 
Avoid noise and/or
limit the time in noise hazardous
areas.

g.
Prevent other DNBI
(individual PMM).

(1) 
Protect against skin
disease.

(a)  
Protect skin from
elements.

(b)  
Use sunscreen, if
necessary.

(c)  
Keep skin as clean as
possible.

(2) 
Protect against
altitude sickness.

(a)  
Acclimatize to new
elevations.

(b)  
Increase aerobic
exercise prior to exposure.

(c)  
Follow medical
advice.

(3) 
Avoid harmful animals.

(a)  
Avoid habitats of
harmful animals.

(b)  
Do NOT attempt to
capture or make pets of harmful
animals.

(4) 
Refrain from tobacco
use.

4.   Explain the Army’s tobacco use policies.

a.
Effects of tobacco use.

b.
Mission readiness.

c.
Army policies.

(1) 
Army’s Healthy #1
People 2000 Goal: reduce military
smokers to 20 percent.

(2) 
Army’s Healthy #2
People 2000 Goal: reduce smokeless
tobacco use to 4 percent for the
12-to-24 year age group.

(3) 
Regulatory requirements
under AR 600-63.

5.   Ensure training of personnel as members of a field
sanitation team (FST) is provided if
appropriate.

Note.  Training of
FST members enables unit commanders to
provide for limited control of
insects, proper disinfection of water,
and safe food supplies. 
Training of personnel as FST
members will be provided by supporting
medical resources.

a.
FST members, when no
organic medical personnel are
available.

(1) 
Two soldiers are
selected to receive FST training.

(2) 
One soldier must be an
NCO.

(3) 
Neither will have less
than six months of unit time
remaining.

(4) 
These soldiers should
receive training from PM personnel
in accordance with AR 40-5.

Note.  All unit
leaders are expected to perform FST
tasks.

b.
FST tasks and/or
responsibilities. 
The unit FST performs the
following tasks in the unit area:

(1) 
Checks unit water
supplies.

(2) 
Inspects unit water
containers and unit water
trailers.

(3) 
Inspects unit field
food operations for application of
PMM to prevent contamination.

(4) 
Conducts limited
control of insects.

(5) 
Inspects unit waste
disposal for compliance with
accepted PMM.

(6) 
Conducts limited
control of rodents.

(7) 
Provides training for
individual PMM training in the
unit.

(8) 
Advises unit leaders on
construction and maintenance of
field waste disposal and personal
hygiene devices.

1.   Identified the three reasons soldiers are
vulnerable to disease.

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2.   Identified the seven major components of the
medical threat to field forces.

—

—

3.   Identified preventive medicine measures used in the
prevention of various diseases and
nonbattle injuries.

—

—

4.   Identified the Army’s tobacco use policies.

—

—

5.   Identified requirements for FST manning and
training.

—

—

AR
40-5

AR
600-63

FM
4-25.12

FM
21-10