Chapter 16: Medical Support
Medical Support Principles
1603. MC 319 states that "General logistics policies apply
in most measures to the medical support function.
However, medical support guidance must be governed in addition
by specific medical factors". Consequently, the Committee of
the Chiefs of Military Medical Services in NATO
(COMEDS) developed a series of Medical Support Precepts and
Guidance for NATO were approved by the Military Committee (MC)
and issued as MC 326.
1604. The following are the principles that will govern
the planning of medical care during operations. These are related
to the code of medical ethics that govern the actions of
medical personnel and to the rules of conduct that express the
humanitarian conscience of the Alliance's member nations.
- Compliance with Humanitarian
Conventions. The conduct of medical activities will comply with the
rules laid down under the Hague and the Geneva
Conventions. In circumstances where the provision of the
Conventions may not be directly applicable, these principles will
define the minimum acceptable standard. Without
discrimination, all entitled sick and injured shall be treated on the basis
of their clinical needs and medical resources availability.
- Standards of Medical
Care. Operational medical support to NATO
forces should meet standards acceptable to all participating nations. Even in crisis
or war, the aim is to provide a standard of medical care
as close as possible to prevailing peacetime
medical standards, given the difficulties of doing so in a
- Maintenance of Health and Prevention of
Disease. Medical support plans must include detailed
measures for the prevention of disease and injury to
deployed forces as a key factor of personnel sustainability.
- Spectrum of Medical
Responsibilities. Medical care is provided on
a progressive basis ranging from preventive medicine, first aid, emergency resuscitation
and stabilization of vital functions to evacuation
and definitive specialized care.
- Time-Related Constraints of Medical
Care. Resuscitation and stabilization of patients must be performed in a timely manner and be of as high quality as is
possible. Planning for medical support must take into account
that resuscitation and stabilization may require
immediate life saving surgical interventions as well as intensive
care procedures. Hence such support should be provided
as far forward as possible. Additional emergency
surgery and surgery to prevent potentially disabling
complications must be available as soon as possible after the
- Triage. Patients are sorted into categories for
treatment and evacuation according to the urgency of their
clinical needs to ensure medical care of the greatest benefit
to the largest number. This is essential when
casualties occur simultaneously and in numbers beyond
the capacity of the medical facility. It is a process
repeated at every opportunity.
- Fitness for Evacuation. The clinical condition of the
patient will govern the priority, timing, means and destination
of evacuation. Coordination by medical regulating staff
- Continuity of Care. Patients passing through the medical system must be given care which is continuous, relevant and progressive. In-transit care must be available during evacuation.
- Medical Confidentiality. Patient medical information is
not to be communicated to any individual or organization
who does not have a medical need to know except as
required by national policy for that nation's patients.