2017 TCCC Quick Reference Guide

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Download your copy of the Tactical Combat Casualty Care (TCCC) Quick Reference Guide:

TCCC Quick Reference Guide 2017

What you get: Abbreviated TCCC Guidelines, TCCC in Algorithm Format, Pharmacology Reference specific to TCCC, Planning Considerations, and more…

How to Get Up-To-Date on DVD if You are Deploying

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If you want to get a copy of Up-To-Date on DVD because you are deploying, you just have to send your mailing address to:

Robin.Vello <at>

Personnel Chiefs Worry Over Deployment Pace, New Blended Retirement

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Here is a link to an article that discusses two genuine concerns, the current operational tempo and the new Blended Retirement System (BRS):

Personnel Chiefs Worry Over Deployment Pace, New Blended Retirement

Deployments and Dwell Time

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According to the policy that controls these things, dwell time is “the period of time a unit or individual is not on an operational deployment.”  This policy also states that the target deployment-to-dwell ratio is 1:2 or greater.  Here is an example to illustrate how this works:

  • You deploy for 7 months.
  • You minimum dwell time (or time at home until you get deployed again) is 14 months.

The policy spells out all sorts of ways you can request a waiver of this policy and certain other circumstances you may want to check out, but if you are in a specialty that deploys alot (like me) it is good to know that a 1:2 deployment-to-dwell ratio is the current target.

How to Get Specialty Consults/Assistance While Deployed

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It is always good to know how to get help when you are deployed.  During one of my deployments, I had a patient develop Mollaret’s meningitis, which I had never heard of, and using resources like those below I was able to get advice and provide the best care I could in a resource-limited environment.  If you are going to deploy, make sure you are aware of these services that will allow you to get some help:


This system will allow you to get specialty consults and turn the consult into a patient movement request.

(HELP PDF Information Sheet)

Background: Health Experts onLine Portal (HELP) is a web-based, HIPAA-compliant, secure, asynchronous, teleconsultation system started up by Naval Medical Center Portsmouth (NMCP) in June 2014. Naval Medical Center Portsmouth serves as the DoD’s tertiary medical care facility for Navy Medicine East Military Treatment Facilities (MTFs) in the eastern United States, Europe, Middle East, and their regionally associated Fleet and Marine assets. Many of these MTFs have limited or no access to local specialty consultation services. This vast region spans 11 time zones, making real-time synchronous teleconsultation impractical. This unique medical and geographic situation created the need for asynchronous teleconsultation capabilities. Health Experts onLine Portal was built upon the existing, tested, and proven Pacific Asynchronous TeleHealth (PATH) System in use at Tripler Army Medical Center since 2000.

System Description: HELP is a web-based, asynchronous (store-&-forward), HIPAA-compliant platform used for provider-to-provider teleconsultation, patient movement, and case management. The HELP website allows remote providers to submit patient demographics, clinical data, and supplementary multimedia as dictated by the clinical scenario. Consultations are screened by consult managers and forwarded to the appropriate subspecialist or Fleet Liaison for input. All case discussion is done on the web- based platform, with notification of new case activity via HIPAA-compliant e-mail.

Effectiveness/System Impact: HELP is based on the Pacific Asynchronous TeleHealth (PATH) system which first demonstrated improved healthcare access and quality with significant cost savings (Arch Ped Adol Med 2005 & Telemedicine and e-Health 2011). In February 2016, HELP demonstrated improved access and quality of care, while saving over $580,000 within its first year (SAGE Open Medicine 2016). Other associated benefits include HIPAA-compliance, proper documentation in the patient’s electronic health record, workload credit for specialty consultants, reduced testing, improved patient movement request coordination, and provision of continuing education to remote healthcare providers. In mid-2016, HELP brought providers and liason assets from Landstuhl Regional Medical Center and Walter Reed National Military Medical Center on board.

Patient Movement Functionality: Patient movement function was activated in February 2015 to allow outside MTFs and the Fleet improved visibility on their patients transferred to NMCP. It allows requests for information in a secure and HIPAA-compliant format, continuous situational awareness for consults, appointments, and patient arrival at NMCP. For more information on the patient movement functionality, please contact the NMCP Fleet Liaison office.


This system is purely e-mail based, not HIPAA compliant, and cannot be turned into a patient movement request.  That said, it is still available and will allow you to get a specialty consult so I wanted to make sure the information/service was available.  The e-mail addresses and procedures to get a consult are all in this Powerpoint:

Teleconsultation Quick Reference Guide

Deployment Gear Lists

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The gear you need for a deployment will obviously depend on the type of deployment, but every time I deploy I take a look at the gear lists I have to see what I might need to bring that I’m forgetting.  Some of the gear lists and deployment checklists I have are old and I don’t even know who created them, but I wanted to post them so people could use them if they so desired.  Here they are:

CDR Temerlin’s Gear Organization

Deployment Checklist 1

Deployment Checklist 2

Deployment Checklist 3

Recommended Blackhawk Stomp II Load

Thanks to Steve Temerlin and whoever else created these, and if you have any gear/deployment lists you’d like to share just use the Contact Me tab and you’ll then be able to send them to me over e-mail once I reply.

Types of Deployments

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This post will help you learn all that you can about deployments.  Personally, I’ve done three deployments, one as a GMO during the initial invasion of Iraq, and two after residency.  In 2010 I deployed with the 15th Marine Expeditionary Unit or MEU and earlier this year I deployed to GTMO.  In addition, as both a Detailer and Emergency Medicine Specialty Leader I’ve deployed a number of physicians, so I’m pretty familiar with all the details of the current deployment situation.

In the current operational environment, there are a few types of deployments.  They include platform-based deployments, individual augmentee or IA deployments, global support agreement or GSA deployments, and what I’ll call parent unit deployments.

Let’s deal with the last one first because it is the easiest to explain.  For what I’ll call a parent unit deployment, you deploy when your parent unit deploys.  For example, if you are assigned to the Marine Corps with a MEU, when that MEU deploys so do you.  You go with the unit you are primarily assigned to.  The same could be said for a medical battalion, a Preventive Medicine Unit, and many other units.

A platform-based deployment happens to people who are stationed at military treatment facilities or MTFs.  Some people who are primarily stationed at MTFs are assigned to what is called a “platform.”  A platform is an operational unit of some kind.  It could be the Mercy or Comfort, a Marine Corps unit, an Expeditionary Medical Facility, a fleet hospital, etc.  In essence, it is an operational unit who “owns” you if they get activated or deployed.  In other words, if your platform is a medical battalion and that medical battalion gets deployed, you would go with them because it is your platform.  If they don’t get deployed, you may never have to do anything for or with your platform.  On the other hand, if your platform regularly drills or does exercises, since it is your platform you may have to participate in these drills and get pulled away from your primary duties at your hospital or MTF.

How is it decided whether you get placed on a platform, and if so which one?  The main determinant is most likely which billet you get orders into.  Some billets at MTFs have secondary assignments to platforms.  For example, the billet I am in at NMC Portsmouth is “mobilized to” or “MOB’ed to” an Expeditionary Medical Facility.  That is my platform.  To be honest, sometimes commands will rearrange platforms, so it is not always determined by the billet you are in.  If you want to know if you are on a platform, you will have to go to your command’s Plans, Operations, Medical Intelligence or POMI officer.  They are the ones who manage platforms and can tell you if you are on one.

Platform based deployments are the wave of the future in Navy Medicine, and you can expect an increased focus on platforms, platforms training, and deployments as a platform.

An individual augmentee or IA deployment is when a request in placed by an operational unit somewhere for an individual person, you are selected to fill that requirement, and you individually augment that unit.  When they deploy, you deploy with them as an IA but stay attached administratively to your parent command.  In other words, if you are at NMC Portsmouth but deploy as an IA, you stay attached to NMC Portsmouth the entire time you are deployed.  This is the type of deployment most of us have experienced for the majority of our career, but the Navy is trying to get out of the “IA business” and is shifting, as already mentioned, to platforms.

The final type of deployment is a global support assignment or GSA.  With this type, you detach from your current command, move or execute a permanent change of station or PCS to a processing center that becomes your new military command, and then you are given orders to deploy.  For example, my last deployment was a GSA.  I detached from BUPERS, my old command, PCS’ed to my new command, the processing center in Norfolk, and then was given deployment orders to go to my unit in GTMO.  During this time my parent command was Expeditionary Combat Readiness Center or ECRC, the processing center, and they were primarily responsible for my fitreps and pay issues.

The unique part of a GSA deployment is that pretty much as soon as you report to the processing center you have to contact your Detailer and Specialty Leader to get orders to your next command.  The GSA orders usually only last up to a year, and you’ll need orders so you can PCS to your next command when you get back from the deployment.  This is the major downside that people complain about with a GSA…the fact that you get PCS orders and have to leave your old command, which people may not want to do.  On the other hand, it can be a major benefit.  If you are stationed somewhere you don’t want to be, volunteering for a GSA can get you out of there because you’ll PCS away.  In addition, because you are volunteering or accepting a deployment, it may give you some leverage with the Detailer or Specialty Leader.  For example, you could say, “I’ll deploy on this GSA, but only if you are willing to write me orders to Hawaii as follow-on orders.”  That may not always work, but it is worth a try.

Those are the major types of deployments that currently exist, and here are some additional resources:

IA and GSA Frequently Asked Questions

NAVADMIN 332-10 – IA Manpower Management Business Rules

NAVADMIN 333-10 – IA-GSA Officer Business Rules

2007 Pay Entitlement Policy Interpretation and Clarification Pertaining to Members Serving in GWOT GSAs