To understand the Health Service Support organization for the USMC, the Echelons of Care must be discussed. There are five echelons of care in the care and evacuation of casualties. The first two are the responsibility of the HSS units supporting USMC activities.
Echelon I:
The triage, treatment basic resuscitation and rapid evacuation of casualties to a higher level of care is the primary goal of echelon I care. Treatment and the return to duty of casualties is another echelon I mission. There is no anesthesia or OR capability at this level. Emergency airway management, initiating IV therapy, wound dressing, control of bleeding, immobilizing fractures and the placement of chest tubes are generally the highest level of medical treatment provided.
Echelon II:
Resuscitation of casualties to include surgery that saves life and limb.
EchelonIII:
Continued care and more definitive surgery.
Marine Division HSS Assets (GCE)
The HSS assets in Marine Division are organic to the battalion.
They provide Echelon I medical care
The line companies have hospital corpsmen that are responsible for the initial treatment and triage of casualties.
The casualties are then evacuated to the Battalion Aid Station.
The BAS has two general medical officers and hospital corpsmen that will retriage and continue with the echelon I care. The BAS will also conduct routine sickcall and are responsible for battalion preventive medicine issues. The BAS can be split in two so they can leapfrog each other. The BAS must be able to keep up with the maneuver of the battalion. Creativity in accomplishing this is essential. Creating a Mobile BAS in some situations may be required to accomplish their mission.
Casualties can be evacuated past the BAS to another care platform.
Marine Air Wing HSS Assets (ACE)
Hospital Corpsmen and physicians are assigned to the ACE assets primarily for aeromedical services and sickcall services. The care of combat casualties is not their primary mission.
Force Service Support Group (CSSE)
Medical Battalion (MedBN)
is the primary medical asset in the FSSG
The Med BN is composed of a Headquarters and Service Company (H&S) and either two or three surgical companies.
The H&S Company provides the logistical and administrative support for the Medical Battalion. It also provides the personnel for the Shock Trauma Platoons (STP).
There are eight Shock Trauma Platoons, each containing 20-25 people. The STP provides echelon I-II care. It can be an augment to a overburdened BAS, it can take over for a BAS that must move forward, it can provide resuscitative surgery further forward if evacuation is delayed or it can be the echelon II asset in the operation plan for small operations. It is the link between the BAS and the surgical company.
A complete Surgical Company consists of three operating rooms, a sixty bed ward and the ancillary services designated to support a casualty for 72 hours. These ancillary services include lab, x-ray, pharmacy, CSR, blood bank etc. Marines are assigned to this company as security elements and technicians to establish and run the field hospital. This facility is mobile and under tentage. Surgical companies can be reconfigured in varying sizes such as just one OR to meet the mission assigned.
Group Aid Station
is designed to provide medical services to FSSG units that do not have organic medical assets.
Medical Logistics Company (Med Log)
Is located in the Supply Battalion of the FSSG.
Med Log provides logistical support and medical/dental repair capabilities for the MAGTF HSS assets.
Med Log provides the Class VIII materials AMALS,ADALS