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GWOT V - California Field Hospital
GWOT V - California Field Hospital
TS/SCI NOFORN
PROJECT LIBERTY
This product contains primarily open-source intelligence (OSI) which is widely known and in some cases popularized. However, the analysis of this OSI is considered a secure product at the same leel as the requesting entity.
A California field hospital is a unit of personnel. It may or may not be assigned equipment or vehicles but always travels with man-portable equipment sufficient to provide a nominal capability. (Cf. USAF 'SPEARR' team.)
The unit is staffed with five 'squads' of personnel and is considered fully staffed with 12 per squad, overstaffed with 14, and minimally staffed with 8-9, so long as at least two physicians remain per squad.
The five types of squads are, and attached specialists may include:
Assessment: ER physician, battle surgeon, physician's assistant, combat nurse (*), four paramedics, scout-soldier paramedic, security operations specialist (*).
Diagnostics: radiologist, abdominal surgeon, sonotech, X-ray tech, diagnostic nurse, internist, records technician.
Interventions: thoracic surgeon, battle surgeon, anesthesiologist, pharmacologist, dental surgeon, blood tech.
Stabilization: cosmetic surgeon (#), nurse manager, nurse practitioner, six nurses, chart clerk, transportation clerk, pharmacy tech.
Preventative: veterinarian, pathologist or thanatosist (*), public health physician, radiation health specialist, OB/GYN, midwife, Psyche (*), community health paramedic.
• = no equivalent in Federal service.
The intent is that each team have cross-training in capabilities with the other teams so that the loss of an entire team leaves the hospital with reduced rather than zero functionality.
The hospital unit is designed to provide intermediate lifesaving care for fifty shock-trauma patients or twenty salvageable burn patients. It is also intended to establish primary medical care including preventative care for up to one thousand persons.
The capabilities of a California field hospital are dramatically increased with the addition of one to five pallets of cargo. Typically only the most austere shelters (tarps and cordage) are part of this setup, and host organizations are asked to arrange for sheltering at least for surgical and recovery.
Three combat field hospitals deployed into Iowa as part of the unpleasantness there. One accompanied the Expeditionary Force in the field and two arrived after the conflict ended.
Part of the agreement for admission to advanced medical training can be to serve two years in a combat field hospital. This concession by an applicant may cause a marginal candidate to be admitted, tuition to be waived, and in some cases both.
At least fourteen (14) field hospitals are presently known to have been deployed in China. It is not clear what California intends to gain from this exercise in 'medical diplomacy.'
The Red Lion Society does not participate in Red Cross / Red Crescent operations outside North America. However, Red Lion members often consist of up to a third of the staffing of a California field hospital, without particular comment by either organization.
All California field hospitals are under the command of a California Republic commissioned officer who is also a physician. No exception to this practice has been observed. (Implication: while Red Lion does deploy 'clinics' forward, some with surgical stabilization capabilities rough equivalent to a SPEARR team or USA battalion surgical team, Red Lion does not deploy field hospitals in a man-portable format. "Go big or go home.")
The early establishment of medical logistics is a high priority for a California field hospital. They require "push" (pre-planned shipments of supplies) as well as "pull" (the ability to order to meet unexpected needs), and both rotate in replacements (typically on a 21 day cycle) as well as evacuating casualties who would benefit from casevac. This last is an absolute imperative. Only casualties who would medically benefit from casevac through better treatment upstream may be evacuated.
A particular emphasis in medical logistics is the use of local resources. From beds to bedpans, dressings to drugs, a California hospital uses what can obtain, not necessariy what would be most beneficial in a pre-Firecracker world where both medical and non-medical supplies were abundant.
A California field hospital is notably weak in aeromedical medicine. They are not a return-to-duty military medical organization, but a humanitarian one. They neither practice reverse triage nor distinguish between combatants and noncombatants. This is apparently a condition of Red Lion participation in the field hospital program.
One side effect of this is that patients for further aeromedical evacuation 'should' be further evaluated prior to flight. CA field hospitals explicitly do not screen for US military aeromedical transport criteria and fatalities have resulted.
A California field hospital is particularly suited for public health surveillance and the treatment of mass CBRNE casualties. All team members wear dosimeter badges and at least three members are trained in radiation instrumentation. An effort is made to cross train at least two weather technicians. The field hospital is also set up for mass inoculations which they give frequently, particularly for MMP and for cholera.
There is a heavy emphasis on the reusable and the austere over the single-use and the expensive. Instruments are more likely to be boiled than to be autoclaved and much of a 21st century California field hospital would be readily recognizable to a 1st American Civil War surgeon, let alone one from the 1st or 2nd World Wars.
California makes what seems to be an extreme effort to _not_ identify and _not_ keep track of patients. Except for raw case totals and individual patient care records given directly to patients or upstream providers, a California field hospital destroys its internal paper records in a drunken bonfire celebration at the end of the deployment cycle.
It is suspected that the deployment of California field hospitals may have some correlation with the operations of ""Bear Force" (insurgents / special operations troops / cadre). The habit of treating all sides of a conflict, inherited from Medicos Sin Fronteres, makes this possible but not likely, as enemy personnel would be as likely to benefit as California covert personnel.
Definitions:
Psyche - a paramedic trained in advanced mental health skills, authorized to prescribe as if a nurse practitioner, and treated with the deference of a licensed physician. Focus is primarily on mental health stabilization. This is one of many frank recognitions by the California Republic that mental health among the general population is at all time lows.
thanatosist - a medical professional trained in the processes of death and dying. Capable of functioning as a hospice nurse, a hands-on medical examiner, and performing a skilled layman's autopsy. Some thanatosists specialize in the treatment of mass radiation casualties. This is alarming as it signals that California expects to be the subject of further nuclear attacks. Most thanatosists are trained by the California Republic but operate as members of the Red Lion Society. They are authorized to offer consenusal euthanasia within California borders (!) and have been suspected of this practice in other conflict zones.
combat nurse - a nurse trained in triage and in assisting a battle surgeon, including the recognition of and firm assertion of expectant patients in a tactical environment. A combat nurse must maintain "arduous duty" certification as if they were a scout-soldier, but may not openly carry any weapon. All combat nurses are Geneva Convention military medical personnel, but some are California Republic armed forces and others are commissioned by the Red Lion medical aid society. It is not clear what the distinction is.
security operations specialist - in the medical context, capable of establishing physical security in a 'hospital without walls' environment. Trained in security and medical intelligence gathering, typically oversees a host nation or third party security detachment . Compare US fire service "security manager." A SecOp is a civilian employee of the California Republic military and carries a Geneva Card as a noncombatant contractor.
# Cosmetic surgeons in California practice in the repair of trauma, of which there is plenty. Elective plastic surgery is frowned upon and considered decadent.
TS/SCI NOFORN
PROJECT LIBERTY
This product contains primarily open-source intelligence (OSI) which is widely known and in some cases popularized. However, the analysis of this OSI is considered a secure product at the same leel as the requesting entity.
A California field hospital is a unit of personnel. It may or may not be assigned equipment or vehicles but always travels with man-portable equipment sufficient to provide a nominal capability. (Cf. USAF 'SPEARR' team.)
The unit is staffed with five 'squads' of personnel and is considered fully staffed with 12 per squad, overstaffed with 14, and minimally staffed with 8-9, so long as at least two physicians remain per squad.
The five types of squads are, and attached specialists may include:
Assessment: ER physician, battle surgeon, physician's assistant, combat nurse (*), four paramedics, scout-soldier paramedic, security operations specialist (*).
Diagnostics: radiologist, abdominal surgeon, sonotech, X-ray tech, diagnostic nurse, internist, records technician.
Interventions: thoracic surgeon, battle surgeon, anesthesiologist, pharmacologist, dental surgeon, blood tech.
Stabilization: cosmetic surgeon (#), nurse manager, nurse practitioner, six nurses, chart clerk, transportation clerk, pharmacy tech.
Preventative: veterinarian, pathologist or thanatosist (*), public health physician, radiation health specialist, OB/GYN, midwife, Psyche (*), community health paramedic.
• = no equivalent in Federal service.
The intent is that each team have cross-training in capabilities with the other teams so that the loss of an entire team leaves the hospital with reduced rather than zero functionality.
The hospital unit is designed to provide intermediate lifesaving care for fifty shock-trauma patients or twenty salvageable burn patients. It is also intended to establish primary medical care including preventative care for up to one thousand persons.
The capabilities of a California field hospital are dramatically increased with the addition of one to five pallets of cargo. Typically only the most austere shelters (tarps and cordage) are part of this setup, and host organizations are asked to arrange for sheltering at least for surgical and recovery.
Three combat field hospitals deployed into Iowa as part of the unpleasantness there. One accompanied the Expeditionary Force in the field and two arrived after the conflict ended.
Part of the agreement for admission to advanced medical training can be to serve two years in a combat field hospital. This concession by an applicant may cause a marginal candidate to be admitted, tuition to be waived, and in some cases both.
At least fourteen (14) field hospitals are presently known to have been deployed in China. It is not clear what California intends to gain from this exercise in 'medical diplomacy.'
The Red Lion Society does not participate in Red Cross / Red Crescent operations outside North America. However, Red Lion members often consist of up to a third of the staffing of a California field hospital, without particular comment by either organization.
All California field hospitals are under the command of a California Republic commissioned officer who is also a physician. No exception to this practice has been observed. (Implication: while Red Lion does deploy 'clinics' forward, some with surgical stabilization capabilities rough equivalent to a SPEARR team or USA battalion surgical team, Red Lion does not deploy field hospitals in a man-portable format. "Go big or go home.")
The early establishment of medical logistics is a high priority for a California field hospital. They require "push" (pre-planned shipments of supplies) as well as "pull" (the ability to order to meet unexpected needs), and both rotate in replacements (typically on a 21 day cycle) as well as evacuating casualties who would benefit from casevac. This last is an absolute imperative. Only casualties who would medically benefit from casevac through better treatment upstream may be evacuated.
A particular emphasis in medical logistics is the use of local resources. From beds to bedpans, dressings to drugs, a California hospital uses what can obtain, not necessariy what would be most beneficial in a pre-Firecracker world where both medical and non-medical supplies were abundant.
A California field hospital is notably weak in aeromedical medicine. They are not a return-to-duty military medical organization, but a humanitarian one. They neither practice reverse triage nor distinguish between combatants and noncombatants. This is apparently a condition of Red Lion participation in the field hospital program.
One side effect of this is that patients for further aeromedical evacuation 'should' be further evaluated prior to flight. CA field hospitals explicitly do not screen for US military aeromedical transport criteria and fatalities have resulted.
A California field hospital is particularly suited for public health surveillance and the treatment of mass CBRNE casualties. All team members wear dosimeter badges and at least three members are trained in radiation instrumentation. An effort is made to cross train at least two weather technicians. The field hospital is also set up for mass inoculations which they give frequently, particularly for MMP and for cholera.
There is a heavy emphasis on the reusable and the austere over the single-use and the expensive. Instruments are more likely to be boiled than to be autoclaved and much of a 21st century California field hospital would be readily recognizable to a 1st American Civil War surgeon, let alone one from the 1st or 2nd World Wars.
California makes what seems to be an extreme effort to _not_ identify and _not_ keep track of patients. Except for raw case totals and individual patient care records given directly to patients or upstream providers, a California field hospital destroys its internal paper records in a drunken bonfire celebration at the end of the deployment cycle.
It is suspected that the deployment of California field hospitals may have some correlation with the operations of ""Bear Force" (insurgents / special operations troops / cadre). The habit of treating all sides of a conflict, inherited from Medicos Sin Fronteres, makes this possible but not likely, as enemy personnel would be as likely to benefit as California covert personnel.
Definitions:
Psyche - a paramedic trained in advanced mental health skills, authorized to prescribe as if a nurse practitioner, and treated with the deference of a licensed physician. Focus is primarily on mental health stabilization. This is one of many frank recognitions by the California Republic that mental health among the general population is at all time lows.
thanatosist - a medical professional trained in the processes of death and dying. Capable of functioning as a hospice nurse, a hands-on medical examiner, and performing a skilled layman's autopsy. Some thanatosists specialize in the treatment of mass radiation casualties. This is alarming as it signals that California expects to be the subject of further nuclear attacks. Most thanatosists are trained by the California Republic but operate as members of the Red Lion Society. They are authorized to offer consenusal euthanasia within California borders (!) and have been suspected of this practice in other conflict zones.
combat nurse - a nurse trained in triage and in assisting a battle surgeon, including the recognition of and firm assertion of expectant patients in a tactical environment. A combat nurse must maintain "arduous duty" certification as if they were a scout-soldier, but may not openly carry any weapon. All combat nurses are Geneva Convention military medical personnel, but some are California Republic armed forces and others are commissioned by the Red Lion medical aid society. It is not clear what the distinction is.
security operations specialist - in the medical context, capable of establishing physical security in a 'hospital without walls' environment. Trained in security and medical intelligence gathering, typically oversees a host nation or third party security detachment . Compare US fire service "security manager." A SecOp is a civilian employee of the California Republic military and carries a Geneva Card as a noncombatant contractor.
# Cosmetic surgeons in California practice in the repair of trauma, of which there is plenty. Elective plastic surgery is frowned upon and considered decadent.