The 21st Combat Support Hospital (CSH) was responsible for the Health Service Support (HSS) to the Army's largest training event in the United States, the Reserve Officer Training Corps (ROTC) Cadet Summer Training (CST) 16. The CSH is the first field hospital to set up the facility and provide the Command and Control for the Medical Task Force.
CST 16 is a training event that prepares and develops future 2nd lieutenants for the U.S. Army. The training is conducted at Fort Knox, Ky, from May to August. More than 15,000 cadre and cadets travel across the country, to support or receive training, respectively.
The 21st CSH, at Fort Hood, Texas received this mission in September 2015. During the initial months, the mission analysis and concept was developed. During the following eight months multiple planning conferences and terrain walkthroughs were conducted at Fort Knox and Fort Hood. This was an integrated medical planning effort of Army Reserve Medical Command (ARMEDCOM), U.S. Army Medical Command (MEDCOM), Forces Command (FORSCOM) and Cadet Command to orchestrate the HSS plan for the training. Prior to the implementation of the CST HSS plan, the 21st CSH conducted a combined training exercise to validate the hospital and Soldiers in establishing a role III facility. Medical teams from the 4th Infantry Division and MEDCOM participated in the rock drill and establishment of standard operating procedures (SOPs).
In the beginning of May, Soldiers from FORSCOM units began to arrive to support CST 16. The team established the CSH in the cantonment area in preparation for receiving patient starting on May 15. The medical support for CST 16 comprised of 86 Soldiers from the 21st CSH, over 120 FORSCOM medics, 98 MEDCOM Soldiers, and over 500 ARMEDCOM (5-20 day rotations) who integrated as part of TF MED 21. During this training exercise the focus for TF MED 21 was the Preventive Medicine readiness strategy that was developed due to medical threats identified prior and during CST 16. The team also focused on an integrated and synchronized HSS plan that was adaptable in an operational environment.
During the four month mission, the medical task force executed more than 7,300 medical encounters between the Field Health Service Support and the CSH. In addition, the CSH conducted 1,473 laboratory transactions including the shipment of more than 1,000 tick kits to the Tick Testing Laboratory at the Army Institute of Public Health. The Pharmacy department dispensed more than 8,900 prescriptions and the Radiology section conducted 446 X-rays. As part of the cadets' readiness initiatives 5,889 Advance Course cadets went through the Soldier Readiness Program (SRP) where 234 flight physicals were conducted and 6,548 immunizations were given. Furthermore, 2,824 Basic Course cadets received a safe-to-train physical ensuring they were medically safe to conduct training. The Medical Records Review Team reviewed 9,422 cadets' records ensuring cadets met all the medical criteria for commissioning.
A key takeaway from the preventive medicine strategy was to maintain the health readiness of the cadets and keep them in training. An initiative that TF MED 21 implemented was medical leader engagement with regular site visits throughout the CST training areas. This provided real-time feedback from cadets and cadre evaluating current mitigation strategies to prevent heat injuries and identify field hazards across the area of operations. This information also included reviewing disease and nonbattle injuries to conduct analysis of trends and threats. Weekly medical threat updates were provided to regimental medics and cadre to prepare for upcoming training. The second initiative was the implementation of the cadet hydration protocol. This protocol was designed to assess the cadet hydration level. The testing was conducted prior to cadets going into the field and also prior to the 6-mile road march at the conclusion of the field training. This program identified cadets that could become heat causalities due to dehydration. Over 12,000 tests were completed and no heat causalities resulted from the 6-mile road march.
TF MED 21's HSS to CST 16 was a success, and medical operations and planning transcended at its best. From the planning phase to execution it took a team of Army professionals to integrate a health system to ensure mission success. Utilizing multiple capabilities from prevention, performance triad, treatment, and evacuation resulted in "One Team," Army Medical Team, focused on "One Purpose," FEAR NOT!
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