TOLERANCIA DE LA TERAPIA COMPRESIVA Y ADHERENCIA AL TRATAMIENTO

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5-56. Civil support operations use Army forces to assist civil authorities, foreign and domestic, as they prepare to respond to crises and relieve suffering within the US and its territories. In civil support operations, Army forces provide essential support, services, assets, or specialized resources to help civil authorities deal with situations beyond their capabilities (Table 5-4). The purpose of civil support operations is to meet the immediate needs of designated groups for a limited time, until civil authorities can

do so without Army assistance. In civil support operations, Army forces always support civil authorities—

local, state, and federal. For additional information on support operations refer to FM 3-0.

Table 5-4. Civil support operations—primary tasks, purposes, and key medical considerations Primary tasks Purposes Key medical considerations

● Provide support in

● Maintain or restore law and order

● Protect infrastructure and property

● Maintain and restore local government

● Shape the environment for interagency success

● Medical command and control to coordinate, integrate, and synchronize Army Health System resources into the interagency efforts. Further, providing medical expertise to identify and analyze critical needs emerging within the operational area.

● Medical information management to facilitate medical regulating of victims to facilities outside of the

disaster/incident site and to document medical treatment.

● Support is provided to assist affected medical infrastructure in saving lives, reducing long-term disability, and alleviating human suffering.

● Support is provided to assist the local government in conducting rescue operations and providing medical evacuation of victims to facilities capable of providing the required care.

● Preventive measures to respond to and resolve emerging health threats caused by the disaster/incident.

5-57. Army support to civil support operations supplements the efforts and resources of state and local governments and organizations. A presidential declaration of a major disaster or emergency usually precedes civil support operations. Civil support operations require extensive coordination and liaison among many organizations—interagency, joint, active Army, reserve, and National Guard units—as well as with state and local governments. The National Response Framework provides a national level architecture to coordinate the actions of all supporting federal agencies. The National Response Framework uses the foundation provided by the Homeland Security Act, Homeland Security Presidential Directive-5, and the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act) to provide a comprehensive, all-hazards approach to domestic incident management. For more information on CBRN response guidelines, refer to the National Response Framework, DODI 2000.18 and FM 4-02.7.

5-58. The Constitution permits the use of Army forces to protect the states against invasion and, upon request of a state, to provide the nation with critical capabilities, such as missile defense, necessary to secure and defend the homeland. It is the responsibility of civil authorities to preserve public order and carry out governmental operations within their jurisdiction. Restrictions on the use of Army forces providing assistance to civil authorities are contained in the Posse Comitatus Act, as amended, and the Stafford Act. The primary reference for military assistance to civil authorities is DODD 3025.15. It is wide-ranging, addressing such actions as civil disturbance control, counterdrug activities, combating terrorism, and law enforcement.

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5-59. During civil support operations, Army forces perform relief operations, support to CBRN consequence management, support to civil law enforcement, and community assistance.

Relief Operations

5-60. Relief operations may be required in response to natural or man-made disasters. Civil authorities are responsible for restoring essential services in the wake of the incident. To assist the civil authorities in accomplishing this action, the President can deploy Army forces. Relief operations consist of—

z Disaster relief. Disaster relief involves the restoration of critical infrastructure such as hospitals and other health care facilities, water and sewage systems, electricity, and communications capabilities. It includes establishing and maintaining the minimum safe working conditions necessary to protect relief workers and the affected population.

z Humanitarian relief. This focuses on those lifesaving measures that alleviate the immediate needs of the population in crisis. Civilian relief organizations (governmental or nongovernmental) are best suited to provide this type of relief. Army forces conducting humanitarian relief usually facilitate civil relief efforts. Activities within these types of operations include the provision of medical care and medications, food, water, clothing, blankets, and shelter.

Support to Civil Chemical, Biological, Radiological, and Nuclear Consequence Management 5-61. Support to CBRN incidents may be required due to the deliberate or unintentional events involving a release or use of CBRN agents that produce catastrophic loss of life and property.

Civil Preparedness

5-62. This encompasses all activities that prepare the nation to rapidly respond to natural or man-made disasters and to terrorist or weapons of mass destruction incidents. The pillars of civil preparedness include training, exercises, expert assistance, and response.

Protection of Critical Assets

5-63. Hostile forces (including terrorists) may attack facilities essential to society, the government, and the military. These assaults can disrupt civilian commerce, government operations, and military capabilities.

In order for the Army to conduct full spectrum operations, this infrastructure must be protected. In conjunction with civil law enforcement, Army forces may protect these assets and temporarily restore lost capability.

Response to Chemical, Biological, Radiological, and Nuclear Incidents

5-64. The National Response Framework is the key plan that affects the use of Army forces in CBRN incidents. The resources required to deal with CBRN incidents differ from those needed during conventional disasters. Mass casualties may require decontamination and a surge of medical resources (to include MEDLOG, such as antidotes, vaccines, and antibiotics). The sudden onset of a large number of casualties may pose public health threats related to food, vectors, water, waste, and mental health. Damage to chemical and industrial plants and secondary hazards such as fires may cause toxic environmental hazards. Mass evacuation may be necessary. The Army possesses capabilities suited to respond to CBRN incidents. The MEDCOM has the capability, through its experienced clinicians, planners, and support staffs to accomplish assessments, triage, medical treatment (for conventional and CBRN casualties), hospitalization, and follow-up care, and provide consultation and advice.

Support to Civil Law Enforcement

5-65. Support to civil law enforcement involves activities related to counterterrorism, counterdrug operations, military assistance to civil disturbances, and general support. Although the AMEDD does not

directly participate in these operations, they do provide medical support to those forces participating.

Further, veterinary personnel may also be required to support government-owned animals engaged in these