EFMB WRITTEN EXAM TEST QUESTIONS AND ANSWERS (LATEST 2023 – 2024) COMPLETE SOLUTIONS, Exams of Health sciences

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EFMB WRITTEN EXAM TEST QUESTIONS AND ANSWERS

(LATEST 2023 – 2024) COMPLETE SOLUTIONS

Y ou are assigned as one of the company's Field Sanitation Team members. Your commander told you that it is your responsibility to construct and maintain field waste disposal facilities. How do you respond to your commander? - The mission of the unit field sanitation team is to assist commanders in maintaining the health and the well-being of the Soldiers assigned to the unit. They accomplish this by: SUPERVISING the placement, construction, and maintenance of unit-level garbage disposal facilities and soakage pits; and the placement, construction, and maintenance of field latrines and urinals and then conducting regular sanitation inspections.

2. Calcium Hypochlorite is a method used to disinfect canteens. As a Field Sanitation Team member, how do you instruct your company to purify water in a one-Quart Canteen? (5 steps - The following procedures are used to purify water in a one-quart canteen with calcium hypochlorite ampules:

1. Fill the canteen with the cleanest, clearest water available, leaving an air space of an inch or more below the neck of the canteen.

2. Fill a canteen cup half full of water and add the calcium hypochlorite from one ampule, stirring with a clean utensil until this powder is dissolved.

3. Fill the cap of a plastic canteen half full of the solution in the cup and add it to the water in the

canteen. Then place the cap on the canteen and shake it thoroughly.

4. Loosen the cap slightly and invert the canteen, letting the treated water leak onto the threads

around the neck of the canteen.

5. Tighten the cap on the canteen and wait at least 30 minutes before using the water for any purpose.

You are a member of the preventative medicine team. Your team was tasked to conduct an inspection of the Dining Facility. During the inspection, your team leader assigned you to inspect all four refrigerators for proper temperature control. The refrigerators contain potentially hazardous food; (HOT/COLD) temperatures are reflected below.

What is your back brief to your team leader for the following?

a. Refrigerator#1= 135/41 Degrees Fahrenheit

b. Refrigerator#2= 130/45 Degrees Fahrenheit

c. Refrigerator#3= 125/42 Degrees Fahrenheit

d. Refrigerator#4= 120/50 Degrees Fahrenheit - Properly maintain potentially hazardous foods; hot foods at a product temperature of 135 degrees Fahrenheit or above and cold foods at a product

temperature of 41 degrees Fahrenheit or below.

"Refrigerator#1" is the only "refrigerator" with hot and cold foods held at the proper temperature.

You have just completed a company FTX. You were assigned as the team leader for the nonhazardous solid waste disposal detail. During the FTX site recovery planning meeting, your commander asked you to explain the primary options for nonhazardous solid waste disposal.

How do you respond to your commander? - The primary options for disposal of nonhazardous solid waste in the field are burning, burial, or backhauling. Within the United States all solid waste generated during field exercises must be backhauled to garrison or picked up by contractors. During overseas training exercises, host-nation requirements must be followed which normally require the same policies of backhauling or contract disposal. If incineration, burning, or landfilling is used during contingency operations, additional security measures must be taken to deter scavenging by local populations.

You are feeling excellent about all the recommendations you have provided to your commander. Planning for the FTX is going just as expected. The last task is to designate a perfect location for your latrines.

What are some of the considerations for the placement of latrines? - Considerations for the placement of latrines. Latrines must be:

1. Located at least 300 feet (100 yards) downwind and downhill from unit food service facilities and at least 100 feet from any unit ground water source.

2. Latrines are not dug to the ground water level or in places where pit contents may drain into the water source.

3. Located upwind of burn pits and landfills.

4. Lighted at night if the tactical situation permits, or staked off with rope or tape to serve as a guide.

5. Built at least 100 feet from border of the unit billeting areas but within a reasonable distance for easy access for troops.

6. A handwashing device is installed outside each latrine enclosure; these devices should be easy to operate and kept full of water.

7. Dig a drainage ditch around the edges of the latrine to keep out rainwater and other surface water.

Note. Chemical and containerized latrines must be placed so that service vehicles can access them for waste removal and cleaning.

For planning purposes, the number of latrines should be based on one toilet and urinal per 25 male Soldiers (1/25 or 4%), or one toilet per 17 female Soldiers (1/17 or 6%).

You are a part of the command team assigned to 61MMB. Your company was tasked to participate in the ongoing contingency operations. Which of the following latrines are most suited for this type of mission?

Cat-Hole latrines, Portable latrines, Chemical latrines or Containerized latrines - Containerized latrines are the preferred means of human waste disposal during contingency operations. The containerized latrine system, normally a component of Force Provider units, consists of six privacy stalls with low-water flush toilets, a trough urinal, two waste collection tanks (urinal and toilet waste are stored in separate tanks), two sinks with running hot and cold water, a six-gallon water heater, mirrors, and dispensers for toilet paper, paper towels and soap. An environmental control unit installed in the rear wall regulates internal temperature, and ventilation systems installed in the front wall and ceiling reduce odor. The containerized latrine system provides a private latrine facility with increased sanitation for 150 Soldiers.

Fill in the blanks.

The Department of Defense Insect Repellent System is made up the following three components: ______________ on the uniform, ________________ on the skin, and the ___________________wear of the uniform

• The Department of Defense Insect Repellent System is made up of the following three components:

1. Permethrin on the uniform. (and bed nets)

2. 33% DEET on the skin.

3. The proper wear of the uniform.

Heat Injury: Exposure to the sun's ultraviolet radiation without protection from clothing or sunscreen. - Sunburn

Sunburn is caused by exposure to the sun's ultraviolet radiation without protection from clothing or sunscreen. Over exposure to ultraviolet radiation can kill the cells that form the skin which is the body's first line of defense for climatic exposure and infection. It can prevent effective sweating and increase a Soldiers risk for heat injury. Symptoms include edema, itching, peeling skin, rash, nausea, fever, syncope (fainting), and either first or second degree burns.

Note. Soldiers must use Army approved sunscreen to protect exposed skin in any climate whether hot or cold. Army approved sunscreen can prevent sunburn and reduce the risk of skin cancers when used in accordance with the instructions on the product label.

Heat Injury: Medical Emergency; to prevent permanent physiological damage or death, the Soldier's condition must be quickly identified and treatment must begin immediately. - Heat Stroke

Heat stroke is the result of the body's heat balance mechanism collapsing and the primary method of heat loss (cooling by evaporation of sweat) is shut down. Early signs of heat stroke include headache, dizziness, delirium (mental confusion), weakness, nausea, vomiting, and excessive warmth; however, sweating may or may not be absent. The most significant sign of heat stroke is a body core temperature of over 106 degrees Fahrenheit with a rectal temperature exceeding 108 degrees Fahrenheit. Although the casualty may first progress through the symptoms of heat cramps or heat exhaustion, the onset of heat stroke may occur with dramatic suddenness with collapse and loss of consciousness. Profound coma is usually present and convulsions may occur. In the past,

heat stroke victims were described as always having hot, red, dry skin. However it has been found that some

heat stroke victims may just as often as not be moist from sweat. Therefore, upon initial evaluation, the skin cannot be the differentiating factor in deciding on the degree of the heat injury. Soldiers who have suffered from only one attack remain very susceptible to repeated heat injuries. Therefore, these individuals should avoid subsequent exposure to hot weather conditions

Heat Injury: Caused by restrictive clothing, excessive sweating, and inadequate hygiene - Heat Rash

Heat rash (prickly heat) is caused by restrictive clothing, excessive sweating, and inadequate hygiene. It can develop when sweat ducts become blocked and swell and often leads to discomfort and itching. Heat rash can prevent effective sweating and increase a Soldiers risk for heat injury. Heat rash looks like dots or tiny pimples. The affected areas can get irritated by clothing or scratching. In rare cases, a secondary skin infection my present itself and in that case look for signs of infection.

Heat Injury: Most common form of heat injury and is generally not associated with evidence of organ damage. - Heat Exhaustion

Heat exhaustion is the most common form of heat injury and is generally not associated with evidence of organ damage. It is a result of peripheral vascular collapse due to excessive salt depletion and dehydration. This condition is the result of excessive loss of both salt and water, usually due to profuse sweating as the body attempts to cool itself. As evidenced by the profuse sweating, with heat exhaustion the body's heat balance mechanism is still functioning normally. Classic symptoms include profuse sweating, trembling, weakness, loss of coordination. Additional symptoms may include headache, tingling in the hands and feet, paleness, difficulty breathing, irregular heartbeat, loss of appetite, nausea, and vomiting. The skin is generally cool and moist from the evaporation of sweat, the pulse rate is rapid (120 to 200 beats per minute), blood pressure may be low, and body temperature may be lower than normal (as in cases where hyperventilation is present) or slightly elevated, but the rectal temperature is usually elevated.

Fill in the moderate work/rest cycle timelines for the Wet Bulb-globe temperatures (WBGT) below: (picture not included) - Review work/rest and water consumption guide.

(No limit = NL, quarts per hour = qt/hr, wet bulb globe temperature = WBGT)

Heat Cat 1 - WBGT Index 78-81.9 °F

Easy Work: NL work/rest, 1/2 qt/hr water

Moderate Work: NL work/rest, 3/4 qt/hr water

Hard Work: 40/20 work/rest, 3/4 qt/hr water

Heat Cat 2 (Green) - WBGT Index 82-84.9 °F

Easy Work: NL work/rest, 1/2 qt/hr water

Moderate Work: 50/10 work/rest, 3/4 qt/hr water

Hard Work: 30/30 work/rest, 1 qt/hr water

Heat Cat 3 (Yellow) - WBGT Index 85-87.9 °F

Easy Work: NL work/rest, 3/4 qt/hr water

Moderate Work: 40/20 work/rest, 3/4 qt/hr water

Hard Work: 30/30 work/rest, 1 qt/hr water

Heat Cat 4 (Red) - WBGT Index 88-89.9 °F

Easy Work: NL work/rest, 3/4 qt/hr water

Moderate Work: 30/30 work/rest, 3/4 qt/hr water

Hard Work: 20/40 work/rest, 1 qt/hr water

Heat Cat 5 (Black) - WBGT Index >90 °F

Easy Work: 50/10 work/rest, 1 qt/hr water

Moderate Work: 20/40 work/rest, 1 qt/hr water

Hard Work: 10/50 work/rest, 1 qt/hr water

Notes:

The work/rest times and fluid replacement volumes will sustain performance and hydration for at least 4 hours of work in the specified heat category. Individual water needs will vary ± ¼ qt/hr. Rest means minimal physical activity (sitting or standing), accomplished in the shade if possible. CAUTION: Hourly fluid intake should not exceed 1½ quarts. Daily fluid intake should not exceed 12 quarts. Wearing body armor in humid climates adds 5°F to the WBGT index. Wearing chemical, biological, radiological, and nuclear protective ensemble in humid climates adds 10°F to the WBGT index.

Noise: this determines pitch; high-pitched noises are more dangerous to hearing than low-pitched noises. - Frequency

The frequency of a noise determines its pitch, which is that attribute of an auditory sensation in which sounds may be ordered on a scale extending from low to high. High-frequency (high-pitched) noises are more dangerous to hearing than low-frequency (low-pitched) noises.

Noise: the relative loudness of the noise, expressed in decibels, will play a large part in determining the degree of hazard; the louder the noise, the greater it's potential for causing hearing loss. - Intensity

The relative loudness of the noise, expressed in decibels, will play a large part in determining the degree of hazard; the louder the noise, the greater it's potential for causing hearing loss

Noise: may be continuous or intermittent; it may be steady or made up of a series of impact or impulse noises. - Nature of the Noise

Noise may be continuous or intermittent. It may be steady or made up of a series of impact or impulse noises.

Noise: the longer the exposure, the greater the damage to the hearing mechanism. - Exposure Duration

The longer the exposure, the greater the damage to the hearing mechanism. Exposure duration is

usually expressed in terms of a time-weighted average, which takes into account both intensity of noise and duration of the exposure.

You are a member of the Field Sanitation Team. You are responsible for ensuring that the unit water supply is safe for human consumption. From the terms listed below, your task is to select and explain the best term that describes water that is safe for consumption.

Non-potable Water, Palatable Water, Potable Water - Potable water is water from a source that has been treated and approved by preventive medicine personnel to meet the short-term potability or long-term potability standards, and is therefore considered safest to drink for the period that the standards apply. Potable water may or may not be palatable.

Versus...

Nonpotable water is water from an untreated source or treated source (including bottled water) that is not safe to drink. In the operational environment, water from any source that has not been tested and determined to be safe by preventive medicine personnel or another local medical authority for use as drinking water is considered nonpotable.

Palatable water is cool, aerated, significantly free from color, turbidity, taste, and odor, and is generally pleasing to the senses. Palatable water is not necessarily potable and may contain disease or illness-causing substances.

Iodine Tablet is a method used to disinfect Five-Gallon Water Cans. As a Field Sanitation Team member, how do you instruct your company to purify water in a Five-Gallon Water Can? (5 steps) - To disinfect a five-gallon water can using iodine tablets you:

1. Fill a five-gallon container with the cleanest, clearest water available.

2. Dissolve 40 iodine tablets in a canteen cup full of water to disinfect any type of water.

3. Add this solution to the five-gallon container of water and agitate the solution.

4. Place the cap on the container loosely. Wait five minutes and then agitate the container vigorously to allow leakage to rinse the threads around the neck of the can.

5. Tighten the cap and wait an additional 25 minutes before using the water for any purpose.

Historical accounts of wars, battles, and military training consistently show that the majority of losses to armies are not the result of combat injuries but rather disease and non-battle injury.

What are some health threats to Soldiers in the field? (8 health threats) - Health threats to Soldiers in the field include:

1. Endemic diseases.

2. Food and waterborne diseases.

3. Hazardous plants and animals.

4. Entomological hazards (nuisance pests and disease-carrying vectors).

5. Toxic industrial materials (industrial and agricultural).

6. Deployment-related stress.

7. Hazardous noise.

8. Climatic or environmental extremes (heat, cold, wind-blown sand, or other particulates).

Use _______________ percent N, N-diethyl-meta-toluamide (DEET) insect repellant to exposed skin to prevent disease, pain, and the annoyance caused by bites of arthropods. - 33% DEET insect repellent applied to exposed skin

During the deployment planning meeting, water consumption in a temperate climate was one of the main topics. To ensure sufficient water is available during the deployment, how much water is needed per man per day? - A guide for planning to meet water requirements in a temperate climate is 5 gallons per man per day for drinking and cooking. If showering facilities are to be made available, the amount required will be at least 15 gallons per man per day.

(A Soldier performing normal duties in a hot and dry climate may require as much as 2 to 6 gallons of water per day for drinking purposes. In a cooler climate the Soldier may require only 1/2 to 1 gallon of drinking water per day for the same level of exertion.)

Toxic Industrial Materials: materials that cause inflammation of mucous membranes with which they come in contact. - Irritants are materials that cause inflammation of mucous membranes with which they come in contact. Many irritants are strong acids or alkalis that are corrosive to nonliving things; however, they

cause inflammation to living tissue. Examples are sulfur dioxide, acetic acid, formaldehyde, formic acid, sulfuric acid, iodine, ozone, and oxides of nitrogen.

Toxic Industrial Materials: materials that deprive the respiratory tissues of oxygen; they do not damage the lungs. - Asphyxiants are materials that deprive the respiratory tissues of oxygen; they do not damage the lungs. Simple asphyxiants are gases, which when present in sufficient quantities, exclude an adequate oxygen supply. Examples are nitrogen, nitrous oxide, carbon dioxide, hydrogen, helium, methane, and ethane. Chemical asphyxiants are materials which have the ability to render the body incapable of using an adequate oxygen supply. Two classic examples are carbon monoxide and cyanide.

Toxic Industrial Materials: agents whose main toxic action is their depressant effect upon the central nervous system, particularly the brain. - Anesthetics are agents whose main toxic action is their depressant effect upon the central nervous system, particularly the brain. The degree of anesthetic effect depends upon the effective concentration in the brain as well as upon the specific makeup of the contaminant.

Toxic Industrial Materials: cause damage to internal organs such as the liver, kidney, central nervous system, or the cardiovascular system - Systemic poisons cause damage to internal organs such as the liver, kidney, central nervous system, or the cardiovascular system. For example, carbon tetrachloride produces necrosis of the liver.

Maintaining good hearing is critical during garrison as well as in a field environment. What are some of the benefits of good hearing during offensive or defensive operations?

(8 benefits) - Good hearing is critical to the success of the Army mission, both in offensive and defensive

operations and is essential for:

1. Aiding in small arms accuracy, weapons identification, and target acquisition.

2. Determining the position, number, and type of friendly or enemy vehicles.

3. Hearing enemy movement.

4. Hearing radio messages and verbal orders.

5. Hearing the activation of perimeter alarms.

6. Localizing snipers.

7. Locating patrol members.

8. Recognizing foreign language being spoken.

Hearing loss caused by loud noise becomes permanent and is not medically treatable. Impaired hearing can cause serious or fatal mistakes at work or during training and in combat.

Wastewater management plan is essential to ensure proper health of Soldiers in the field. Waste water is organized into two categories---gray and black water.

What percentage of all water used for purpose other than human consumption ends up as wastewater? - Roughly 80% of all water used for purposes other than human consumption ends up as wastewater which requires treatment and disposal

Depending on the source, some water may need disinfecting prior to consumption.

At unit level, what are some of the chemicals Soldiers rely on to disinfect drinking water?

(3 chemicals) - Members of unit field sanitation teams and Soldiers in the field rely on the following chemicals to disinfect drinking water:

1. Calcium hypochlorite (white powder)

2. Water purification tablets, chlorine

3. Water purification tablets, iodine

Prevention of waterborne diseases is accomplished by employing field water disinfectants provided in the field sanitation teams equipment sets; _______________________________; conducting inspections; and enforcing simple rules of water discipline which include: Drinking water from approved sources only, ______________________, and _________________________. - (Unit field sanitation teams are responsible for ensuring that unit bulk water supplies are thoroughly disinfected to eliminate the pathogens which are responsible for the spread of waterborne disease and maintaining appropriate chlorine residuals to ensure that the water remains pathogen-free.)

They accomplish this task by:

1. employing field water disinfectants provided in the field sanitation teams equipment sets

2. issuing individual water disinfectants

3. conducting inspections

4. and enforcing simple rules of water discipline.

The rules of water discipline are:

1. Drink water from approved sources only.

2. Prevent water waste.

3. Protect water sources with good sanitary practices.

21A. Arthropods: represents the most substantial and continuous noncombat threat to Soldiers during deployments. - Disease Transmission. Transmission of arthropod or vectorborne disease represents the most substantial and continuous noncombat threat to Soldiers during deployments. Historically, vectorborne diseases have produced far more morbidity and mortality (greater than 60 percent) among United States military forces during modern wars than battle injury and nonbattle injury combined. Others with their long convalescent period cause a manpower drain resulting in a major economic loss every year. Mosquitoes, flies, lice, fleas, mites, and ticks are among the most important vectors of arthropodborne diseases.

21B. Arthropods: injection of venom (toxins) into the body through bites and/or stings and is perhaps the most rapid and harmful response arthropods can inflict on humans. - Envenomation is

the injection of venom (toxins) into the body through bites and/or stings and is perhaps the most rapid and harmful response arthropods can inflict on humans. The response of such envenomation can range from swelling, irritation, pain, sometimes paralysis, mild irritation and limited necrosis of tissue to systemic failure and death. The venoms producing these conditions are broadly grouped as either neurotoxic or necrotic. Neurotoxic venoms are those that negatively affect the nervous system while necrotic venoms are those that destroy blood and tissue. Occasionally, the venom of some arthropods contains both neurotoxic and necrotic properties. In addition to injecting venom, some caterpillars and beetles produce toxins that cause dermatitis when contacted.

Arthropods: invasion of the tissue of man or animals with the larvae (maggots) of certain flies that consume flesh or body fluids for sustenance - Myiasis is the invasion of the tissue of man or animals with the larvae (maggots) of certain flies that consume flesh or body fluids for sustenance. Such invasions may be benign or even asymptomatic, or they may result in more destructive disturbances. Cutaneous myiasis is the traumatic invasion of tissue and the most significant form of myiasis. Myiasis has tremendous potential for psychological disturbance among afflicted Soldiers.

Arthropods: can be localized and the range of severity, including death, is broad. - Soldiers may experience allergic reactions (a hypersensitive reaction to insect protein) when they come in contact with the venom, saliva, or certain body parts of arthropods. Reactions can be localized (wheals, swelling) or systemic (anaphylactic shock), and the range of severity, including death, is broad. This condition may occur among people with repeated prolonged exposure to the same type insect, such as beekeepers or workers in insectaries. It may also result from a single exposure to insects with highly allergenic proteins, such as flies or gypsy moth caterpillars.

You were given the task to instruct your platoon on how to properly compute the wet bulb-globe temperature index.

What is a key note to reminder regarding the ambient temperature? - Measure the wet bulb-globe temperature index when the ambient temperature is over 75 degrees Fahrenheit.

There are 60 male Soldiers and 20 female Soldiers in your company.

How many toilets and urinals are required to accommodate the number of Soldiers assigned to your company? - (For planning purposes, the number of latrines should be based on 1 toilet and urinal per 25 male Soldiers (1/25 or 4%), or 1 toilet per 17 female Soldiers (1/17 or 6%).

(60 males)x(0.04 latrines/male)=2.4 --> 3 latrines

(60 males)x(0.04 urinals/male)=2.4 --> 3 urinals

(20 females)x(0.06 latrines/female)=1.2 -->

2 latrines

*Need 3 male latrines, 3 urinals, and 2 female latrines. Or need 3 urinals and 5 total latrines

Fill-in the missing letter.

The major diseases caused by the s__n__ f__y are l__i__h__a__i__s__s, s__n__ f__y f__v__r, and b__r__o__e__l__s__s - The major diseases caused by the sand fly are leishmaniasis, sand fly fever, and bartonellosis.

(Review ATP 4-25.12, Table 6-2. Arthropods of military importance and the major diseases they transmit.)

You have just deployed your unit to Afghanistan. It is now June and you have only been on ground for one week.

On an average, how much longer will it take for your Soldiers to get acclimatized to their new environment? - It willl take about 1 more week to acclimate, since Soldiers need about 2 weeks to heat acclimate.

Most Soldiers' physiological responses to heat stress improve in 10 to 14 days of exposure to heat and regular strenuous exercise. Factors to consider in acclimatizing Soldiers are the wet bulb-globe temperature index; work rates and duration; uniform and equipment; and Soldiers' physical and mental conditions.

When conducting Detainee Operations, it is a best practice to be familiar with all legal considerations that will affect the way Detainees are handled.

As a newly assigned team leader, how do you brief your team on the Law of Land Warfare prior to your upcoming deployment? - The conduct of armed hostilities on land is regulated by the Law of Land Warfare. This body of law is inspired by the desire to diminish the evils of war by:

1. Protecting both combatants and noncombatants from unnecessary suffering.

2. Safeguarding certain fundamental human rights of persons who fall into the hands of the enemy, particularly prisoner of war (POW), the wounded and sick, and civilians.

3. Facilitating the restoration of peace.

The Law of Land Warfare places limits on the exercise of a belligerent's power in the interest of furthering that desire (diminishing the evils of war) and it requires that belligerents:

1. Refrain from employing any kind or degree of violence that is not actually necessary for military purposes.

2. Conduct hostilities with regard for the principles of humanity.

The Law of Land Warfare is derived from two principal sources:

1. Lawmaking treaties or conventions (such as The Hague and Geneva Conventions).

2. Customary International Law (unwritten customary law binding on all States developed from a general and consistent practice of States followed by them out of a sense of legal obligation).

Under the U.S. Constitution, treaties constitute part of the Supreme Law of the Land and, thus, must be observed by both military and civilian personnel. The Customary International Law is also part of U.S. law. It is binding upon the U.S., citizens of the U.S., and other persons serving this country.

You are a medic/provider assigned to an Aid Station at FOB Orgun-E Afghanistan. Detainees are being kept in a holding facility located on your FOB. It has being brought to your attention that for the past four days two of the four detainees are refusing to eat the meals they have been provided.

Are you required to take any actions? If so, what actions should/must you take? - Any detainee refusing food for 72-hours is considered to be on a hunger strike and will be referred for medical evaluation and possible treatment. Health care personnel will isolate the detainee in a single occupancy observation room and deny him contact with other detainees, when medically advisable. If measuring food and liquid intake or output becomes necessary, health care personnel may place the detainee in a special management unit or in a locked MTF room. The detainee may remain in the special management unit, based on the detainee's medical condition, until health care personnel determine a move advisable. The medical officer will immediately report the hunger strike to the TIF commander.

Medical staff shall monitor the health of a detainee on a hunger strike. If the detainee is engaging in a hunger strike due to a mental condition, appropriate medical action will be taken. During the initial evaluation of a hunger-striking detainee, the medical staff will:

1. Measure and record the detainee's height and weight.

2. Measure and record vital signs.

3. Perform a urinalysis.

4. Conduct a psychological/psychiatric evaluation.

5. Examine the detainee's general physical condition and if clinically indicated, proceed with radiographs and or laboratory studies.

6. Take and record weight and vital signs at least once every 24-hours during the hunger strike.

7. Take other medical measures as required.

You are the commander for an Area Support Medical Company located in Afghanistan. A request for dental support was sent to you from the Aid Station at FOB Orgun-E. This support includes treatment of detainees at the Theater Internment Facility (TIF). You got in a heated discussion with your assigned Dental Provider whether or not dental treatment is a service rendered at the TIF.

As the commander, how do you advise your provider on TIF operations specific to dental care? ( medical services provided at TIF) - Medical services provided in the TIF to include:

1. Initial medical examinations.

2. Medical treatment (routine care, sick call, emergency services, hospitalization, and medical consultation and specialty care requirements).

3. Medical evacuation.

4. Preventive medicine (to include medical surveillance, occupational and environmental health surveillance, hygiene and sanitation standards and practices, pest management activities, water potability inspections, and dining facility/services hygiene and food preparation practices).

5. Dental services.

6. Veterinary service support (to include food safety, veterinary preventive medicine, animal health care, and oversight of animal welfare, as required).

7. Neuropsychiatric treatment and stress prevention (as required) and BH support.

8. Medical logistics (to include medical supplies, pharmaceuticals, medical equipment and medical equipment maintenance and repair, blood management, and optical lens fabrication).

9. Medical laboratory services for the clinical diagnosis of infectious diseases.

You are a team leader working the night shift at a BAS. You were just told that two detainees will be transported to your facility for treatment. You were also told that the detainees are very combative.

What are some of the precautions you and your team members should be aware of prior to the arrival and during treatment of the detainees? - Restraints in addition to the two-point standard (one arm and one leg) will be applied when detainees become combative or dangerous to themselves or others. Once the detainee becomes oriented or cooperative, the restraints in addition to the two-point standard will be removed. Restraint removal will be the result of a joint vetting process in close coordination with the commander of the security forces.

Any patient who becomes combative, or when otherwise medically indicated, may be restrained for his own safety and that of other patients and staff.

A gradually increasing level of appropriate restraint will be used. The first level will be physical restraints and typically will be either standard leather restraints of the wrist and/or ankles or a bed sheet specifically used to secure the patient to the gurney.

You have just provided treatment to a detainee at the TIF. The detainee will be transferred from your location to another holding facility.

How does the Geneva Conventions affect the treatment, management and documentation and release of information of the detainee's injury - The Health Insurance Portability and Accountability Act does not apply to the medical records of detainees and EPWs. Given that the Geneva Conventions require the military to provide the same standard of care to detainees and EPWs as U.S. Forces, detainee/EPW medical records should be initiated and maintained at the same standard. The procedures outlined in AR 40-66 regarding the release of medical information for official purposes should be followed for detainee/EPW medical records.

Due to responsibilities of the TIF chain of command regarding the care and treatment of

detainees/EPWs, they are entitled to some medical information. For example, detainees suspected of having infectious diseases, such as TB, should be separated from other detainees/EPWs. Releasable medical information on detainees and EPWs includes that which is necessary to supervise the general state of health, nutrition, and cleanliness of the security force, detainees, and EPWs, and to detect contagious diseases. The information released should be used to provide health care, to ensure the health and safety of detainees and EPWs, to ensure the health and safety of the personnel operating or working in the TIF, to ensure law enforcement on the premises, and to ensure the administration and maintenance of the safety, security, and good order of the TIF.

Detainees should be entitled to copies of their medical records upon release from the TIF. Copies of medical documentation provided to released detainees will have all U.S. military unit designation,

health care provider, and other medical support personnel information (for example, name or provider number) redacted (removed or obliterated).

Sick call is a daily operation at your BAS.

How do you incorporate sick call procedures and distribution of medication for detainees at your FOB? - SICK CALL PRACTICES. Timeframes are established for sick call and distribution of medication to avoid abuse of the medical system. Medication pass (distribution) should not extend past a 2-hour timeframe, unless there are extreme circumstances. Detainees must present for any sort of medical encounter with his identification band on hand. This aids in confirmation of that detainee's identity. In addition, the detainee must have water on hand for medication consumption. Absence of either the identification band or water can cause major delays in medication distribution as well as sick call. Allow a certain amount of time for sick call. Usually this should not exceed 3 hours, especially if there is no overhead cover for the personnel performing sick call. Setting limits permits the health care provider to command the situation, in contrast to allowing the detainee to dominate the encounter. Consider using a sign-up sheet, distributed at night, for the next day's sick call "appointments." Experience shows that an "open-access" system, now popular in clinics nationwide, can be cumbersome and overwhelming. Allow a standard number of sick call slots and plan for acute illness visits as well.

Any person who is detained for imperative reasons of security as specified in the mandate set forth in the United Nations Security Council Resolution 1546. - Security Internee

Security internee of significant intelligence or political value. - High Value Detainee

Any person previously held as a detainee - Former Detainee

During your medical screening of detainees, an eye exam revealed three detainees with 20/50; 20/30; 20/40 vision.

A recommendation to produce eyewear for all three detainees was suggested. How do you proceed with this recommendation? - Detainees with uncorrected visual acuity of worse than 20/40 (with both eyes together) at distance or near are eligible for clear prescription eyewear.

(So only the detainess with 20/40 and 20/50 vision may receive eyewear.)

You have just been informed of a possible abuse of a detainee. You plan to educate your staff on abuse prevention strategies.

How do you educate your staff members on principles of abuse prevention? - When dealing with detainees, Soldiers need to use their common sense and exercise good judgment. Remember that if:

1. It looks wrong, then it probably is.

2. It is something that would enrage you if you saw a Family member or another Soldier being

subjected to, then it is probably wrong.

3. You are confused and you do not know if it is right or wrong, seek help and guidance.

Fill in the blanks. International law requires that each__________________ be screened_____________ by_________________. This is to ensure continued health of detainees. When conducting _______ ____, health care personnel should also be alert to the signs and symptoms of communicable diseases, ____________________, hydration status, and _____________________. - International law requires that each detainee be screened monthly by health care personnel. This is to ensure continued health of detainees. When conducting monthly weigh-ins, health care personnel should also be alert to the signs and symptoms of communicable diseases, louse infestations, hydration status, and other indicators of health status.

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