d. Treat in Unit. Given rest and replenishment treatment in the unit, soldiers
with severe reactions to the stress of combat are often able to return to full duty in a
matter of days. Mild cases can be treated in this manner in their immediate units or in
the combat service support units of the next higher headquarters located in a more
stable rear area, treated without being under the direct care of medical personnel. It is
generally preferable to rest the soldier with his comrades rather than evacuate him to a
medical unit. The common physical complaints can be attended to during routine sick
call. Medical personnel must, however, exercise supervision over such rest areas to
assure that soldiers with serious illnesses are not being overlooked.
e. Military Environment. Treat the soldier in a military not a hospital
environment. Keep the soldier in uniform not in pajamas. Maintain rank distinctions
and military courtesy. Assign the soldier to do tasks between periods of rest, if possible.
f. Medication. Medicate the soldier only as a last resort. Sedatives such as
Valium can be given. Only sedate him if he is disruptive and requires evacuation.
g. Return to duty. Return the soldier to duty as soon as possible. Past
experience indicates that failure to return the soldier to duty leads to a permanent
disability for him.
h. Evacuation. Evacuate the soldier only if absolutely necessary. Soldiers with
disruptive (severe) reactions to the stress of combat may require evacuation. As the
medical NCO, you recommend to the commanding officer or his representative that the
soldier be evacuated. When evacuating the soldier, use physical restraints only if
necessary to control the soldier or to comply with regulations.
PROGNOSIS FOR SUCCESSFUL RETURN TO DUTY
a. Soldier's Performance After Treatment. Soldiers who have been treated
for severe reactions to the stress of combat are least likely to relapse if they return or
are still in their original units and are accepted there by their old comrades. A rough
"rule of thumb" is: "After treatment for strong reactions to the stress of combat, a good
soldier will be good again. A new soldier deserves a second chance. A poor soldier
may need reclassification and reassignment." Experience indicates that 70 percent of
soldiers so treated will return to full duty within the first two days. Another 20 percent
will return to full duty within 96 hours.
b. Soldier's Possibility of Relapse After Treatment. Good soldiers who are
temporarily overloaded by the combination of stressors in combat will be no more likely
to overload again than other good soldiers in the same situation. These soldiers need
to be welcomed back, treated appropriately, and given jobs of increasing responsibility.
They will be less likely to break than an unknown new replacement. If sent to a strange
unit, they will be at some increased risk, temporarily, as are all new replacements.