Algorithms, which are sets of rules for solving a problem in a limited number of steps,
allow individuals to use advanced medical logic to deal with patient problems within the
limits of their training. This system allows you to rapidly determine the degree of
urgency each soldier's complaint demands, quickly identify the health care provider who
should evaluate that complaint, and speed the soldier's return to duty. Algorithms may
vary from facility to facility. The algorithms shown in this subcourse are taken from HSC
Pamphlet 40-7-21, Ambulatory Patient Care: Algorithm-Directed Troop Medical Care.
The manual is designed to allow personnel, such as the medical specialist, to conduct
initial patient screening and triage (sort or categorize) patients based upon specific
common medical conditions. The steps of the procedure are documented on a DA
Form 5181-R, Screening Note of Acute Medical Care (figure 3-2), as the screening
process takes place.
LEVELS OF CARE IN THE ALGORITHM-DIRECTED TROOP MEDICAL CARE
The decision trees in the Ambulatory Patient Care (APC) manual end in one of
five courses of action being selected for the patient.
Many algorithm endpoints contained within the triage (sorting) manual
recommend that the medical specialist prescribe self-care protocols. If
this type of screening is done, the patient must be allowed to see a
medical officer (physician, physician assistant, or nurse practitioner) if he
requests. Also, any patient who does not accept Level IV protocol
must be referred to the PA (Level III).
a. Level I: See Physician Immediately. Physician stat. (MD stat.) indicates
that a medical problem exists which may be life threatening (an emergency) and
requires the immediate attention of a physician. If a physician is not immediately
available, emergency care should be initiated and ambulance transportation called. The
facilities at a troop medical clinic or battalion aid station are usually not adequate to care
for these patients. These patients should be transferred to a facility capable of
providing advanced cardiac and trauma life support, usually an emergency room in a
hospital, as soon as possible.
b. Level II: See Physician Assistant Immediately. Physician assistant stat.
(PA stat.) indicates that a medical problem exists which may develop into a life-
threatening emergency if not evaluated and treated by a medical officer quickly.