Naval operational medicine institute

	1997 United States Naval Flight Surgeon Handbook (Back to Navy Index)
1.	Introduction
2.			The flight surgeon and medical planning
3.		Boards of flight surgeons
4.	The waiver process
5.			Aviator Evaluation Boards
6.		Competency for duty exams
7.	Aircraft mishap planning
8.			Laser exposure
9.		Toxicology
10.	Burn Management
11.			Management of decompression sickness
12.		Aeromedical evacuation
13.	Standard subject identification codes
14.			Important phone numbers
15.		Flight time requirements

Introduction

 

Advice for reporting aboard your new duty station.

When reporting to your new duty station, you will be given the usual check in sheet, directing you to appear at a number of different offices for administrative in-processing at your assigned squadron. Stop in to introduce yourself to the X.O. and the C.O. There may be rare instances in which you will need to talk privately with the C.O., but as a general rule the X.O. is the first point of contact for issues that need to be brought to the attention of the command. In the interview, ask what they expect of you and listen carefully to their advice and guidance. Brief them on the things you may be able to provide as the medical officer to help them meet their requirements. Remember, you are now the advisor on all things medical to the commanding officer, and he will need to know of your activities and progress in helping him meet his mission requirements. From time to time, junior flight surgeons may be caught in a very dangerous trap. As advisor to the aviation commander on medical issues which effect members of the squadron, the procedure is simply one of resolution of that medical problem, followed by recommendations to the commanding officer regarding disposition and/or flight status of that individual. But what if the medical problem exists with the commanding officer himself? In these situations there exists the likelihood that pressures may be brought to bear upon you to compromise your position of responsibility. Since medical issues are involved, you are obliged to address them through the medical chain of command, and will benefit from the advice and assistance of your senior flight surgeon. If you are the senior medical officer in the area, you may seek help and advice from your TYCOM. Under NO CIRCUMSTANCES should you bypass or go outside the squadron/group/wing chain of command, so your senior flight surgeon may be the best person to extract you from a potentially difficult situation.

Meet the department heads and plan to work closely with the NATOPS and safety officers in your aeromedical brief and safety activities. Tour the squadron spaces so that all personnel will get to know who you are and what you are doing so that there are no surprises when you begin to make your rounds unaccompanied. Ask to see the squadron mishap plan and become familiar with your particular duties and responsibilities. Make sure you know the other members of the Aircraft Mishap Board (AMB) and attend its meetings.

Make it a point to get acquainted with the senior enlisted man and the senior enlisted of each department. They will be an extremely important link in the interaction between the enlisted personnel and yourself. They all need to know that you are accessible to them at all times to help them with training and with their medical concerns. They need to know that you are not just the "Officers’ Doc", but rather are there and available to all members of the unit.

Obtain a copy of the "alpha roster" from the administrative department so that you can begin to put names, faces and responsibilities together. If you have computer access or capability, consider developing a tickler file for all squadron members immunizations, physical exam due dates, water survival re-qualifications and the like, if such does not already exist.

Over the course of the next few weeks you will have become acquainted with a number of individuals from other squadrons, group, wing, headquarters and various support units. Learn the organization, structure and individuals well, for a good relationship is essential and guarantees their full cooperation when you need it, as you most certainly will.

After completion of your administrative check-in, you will need to repeat the process by reporting to the senior flight surgeon or senior medical officer, who will arrange for a briefing on your duties and responsibilities while at the clinical facility where you will spend about 50% of your time, and introduce you to other members of the staff.

Other key personnel you should meet as soon as possible include the leading petty officer (LPO) or leading chief petty officer (LCPO) who will be directing all of the clinic's corpsmen and can give you a brief on all enlisted personnel, with their special qualifications and assignments. Never allow yourself to come between your senior enlisted man and his staff. These men are his responsibility and he must be able to exercise his authority without interference. Need something done? Let him delegate those tasks to his people and see to their completion.

Meet with your AVT in the Aviation Examination Room. This individual is a critical member of your team. He needs to know your schedule and your thinking about each aeromedical issue that arises. He is a technician who is obligated to abide by strict rules. You have some discretionary powers as granted by the Manual of the Medical Department, and he needs to know your reasoning when there appears to be deviations from those rules. Let your AVT do the scheduling and control of your appointments which you will refer from your squadron. Let him help keep you out of trouble. Since he is in a fixed facility, he is more readily accessible for information regarding policy and physical qualification changes from NOMI and BUMED.

Another key member is the training officer who can put you on the schedule for training of corpsmen and otherwise take advantage of your specialized skills as well as adding you to local training events such as BLS and ACLS to keep your requirements updated. Additionally, he can schedule you for C-4, Medical Management of Chemical Casualties, Medical Effects of Nuclear Weapons and other training opportunities to improve your skills and maintain continuing medical education requirements.

Learn the organization, structure and rules of the medical facility in which you will be working and the chain of command. Then, follow that chain of command very carefully. Avoid going around the chain of command at all costs. Brief your boss fully on your activities and any potential problems you become aware of. Make it a point to prevent having him caught unaware of a situation of which you had prior knowledge and failed to provide him a brief. He will be much more content with his lot in life, and your success will be much more secure.

This is a good time to acquire the habit of maintaining a daily log of your activities, contacts and conversations, whether by phone or in person. It is not uncommon that issues which seem insignificant at the time, re-surface in unexpected and sometimes unpleasant ways. A carefully maintained daily log can be a powerful defense against such an eventuality.

In all you do, remember that you are a naval officer, working with other naval officers and enlisted personnel to achieve a common goal in service to your country. Your part is small in the grand scheme of things, but very important to the common success. How you present yourself as a Naval officer is every bit as critical to your credibility as are your medical skills. In fact, a careless appearance or attitude will almost certainly be perceived as clear evidence of overall poor performance in all you do, both militarily as well as medically. There are few other indicators by which they can judge.

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  Host Facility in CONUS
  
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  Navy Environmental and Preventive Medicine Units (See EPMU Chap.)
  
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  Unit Supply Officer
  
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  Unit Intelligence Officer
  
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  Armed Forces Medical Intelligence Center (AFMIC)
  

 

General:

Whether planning for a CONUS training evolution or an overseas deployment, the line Commander must have at his disposal all information which will potentially impact upon completion of the mission. The medical department is often overlooked in the myriad of details surrounding pre-deployment planning, but its role is not to be taken lightly. Consider for a moment that U.S non-combat losses have historically been greater than combat losses in every conflict in which we have been involved. During WWII, 95% of hospital admissions were non-combat related. This alone would seem to be adequate justification for you to get involved as early as possible in deployment planning.

 

Deployment:

Deployments in CONUS will usually be to a fixed and established facility which can serve as a base of operations. A few phone calls to establish contact with the medical department there may be all that is required to find out what their capabilities are, and determine what additional arrangements you need to make.

Deployments to remote locations or out of CONUS will require considerable planning and preparation.  Among the many questions to consider are:

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  Climate/Temperatures/Precipitation
  
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  Altitude and type of terrain
  
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  Edible and poisonous plants
  
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  Dangerous animals and snakes
  
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  Availability and safety of water supplies
  
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  Endemic diseases
  
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  Vector control
  
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  Current epidemics
  
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  Host medical capabilities and availability
  
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  Host scientific and technical capabilities, including NBC warfare
  
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  Aeromedical evacuation routes and receiving facilities
  
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  Initial medical supply and re-supply
  
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  Status of Forces agreements
  
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  Decedent affairs
  

 

Further Responsibilities:

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  Work with your PMU on rations/water/sanitation issues
  
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  Country hazard briefs for all hands
  
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  Immunization and dental completion for all hands
  
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  Corpsman Training
  
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  Buddy Aid Training all hands
  
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  Work with Chaplain and legal for personal affairs all hands
  
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  Aeromedical briefs as required for all aircrew