Role 2 Set-Up in Garrison Operations for COVID-19 Response

By Christina M. Thompson, CPT, MS Commander, Cobra Medical Company 101 BSB, 1 ABCT, 1ID and Savannah W. Smith, MAJ, MC Brigade Surgeon 1ABCT, 1IDMay 3, 2021

April 2021


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In April 2020, Charlie Company, 101st Brigade Support Battalion (BSB), 1st Armored Brigade Combat Team (ABCT) received the following mission to establish a Role 2 Aid Station 1 operation at one of Irwin Army Community Hospital’s (IACH) outlying clinics, Custer Hill Health Clinic (CHHC). The mission was to provide acute medical care and patient hold capabilities to the 1st Infantry Division (1ID) Soldiers at Fort Riley, KS in isolation or quarantine status during the COVID-19 pandemic. During the course of the operation, C/101BSB identified aspects unique to this mission and not previously encountered during their threat analysis, capability assessment, aid station setup, and integration with installation health service support (HSS).


The COVID-19 pandemic provided C/101BSB with an atypical threat and a new operational environment to work in. During conflicts, the Brigade Combat Team (BCT) medical operations see a high percentage of trauma casualties, and most disease and non-battle injuries (DNBI) are musculoskeletal, dermatologic, or heat/cold-weather-related. Per Army Training Pamphlet (ATP) 4-02.55 ARMY Health System Support Planning the Role 2 emphasizes measures including the airway, stopping bleeding, preventing shock, protecting wounds, immobilizing fractures, and providing blood products, limited x-ray, clinical laboratory, operational dental support, combat and operational stress control (COSC), preventive medicine, and physical therapy (PT).

Symptomatic COVID-19 patients require critical care interventions, and a few more patients require hospital admission for non-critical care interventions. Using the Department of Defense (DoD) COVID-19 Practice Management Guide, medical treatment facilities (MTFs) that admit COVID-19 patients need to emphasize measures like supplemental oxygen with nasal cannula, high flow nasal cannula, and face mask with reservoir bag, mechanical ventilation, patient repositioning to include proning 2, daily lab monitoring, oral and enteral feeding, and blood clot and stomach ulcer prevention.

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