c. Level III: See Physician Assistant Today. Physician assistant today (PA
today) indicates that a medical condition exists which requires a physician assistant's
evaluation. The PA or other medical officer will make the decision as to the disposition
of the patient.
d. Level IV: Self-Care Protocol. Self-care protocol (SCP) indicates that a
health condition exists for which the patient can administer adequate care to himself
(self-care). The instructions and medications to be offered the patient are contained
within the body of the protocol. Either the patient or the screener may overrule this
recommendation of self-care. If a patient refuses the SCP, refer him to the PA for
e. Level V: Hospital Clinic Referral. Hospital clinic referral indicates that a
medical condition exists which should be evaluated in a specialty or subspecialty clinic
of a hospital.
NOTE: These "clinics" are part of the MEDCEN or USACH hospital and are not to be
confused with the medical and dental clinics discussed in Lesson 2.
Consultation with either a PA or supervising physician is required. When an
appointment is not available within the time frame specified by the algorithm, the patient
will be referred to Level III (PA today).
USING THE ALGORITHM-DIRECTED TROOP MEDICAL CARE SYSTEM
(AMBULATORY PATIENT CARE MANUAL)
The following steps provide general guidance for using the APC manual in an
a. Initiate DA Form 5181-R. Enter the patient identification information and
heading information on a DA Form 5181-R, Screening Note of Acute Medical Care.
Continue to enter information, to include physical findings and results of the algorithm,
as the screening process takes place. Once the form is completed, it is filed with the
patient's SF 600.
b. Select Appropriate Section. Determine the reason the patient is visiting the
facility (chief complaint). Classify the patient's main (chief) complaint and turn to the
appropriate section of the APC manual.
Constitutional complaint (fatigue, fever, chills, heat injury)--TA section.
(2) Neuro-psychiatric complaint (drowsiness, depression, nervousness,
anxiety, weakness, numbness, dizziness, fainting, headache, and so forth)--TB section.
Eye complaint (pain, redness, vision problem, and so forth)--TC section.