medical logistics management and medical laboratory assets. Support for contingency
operations is normally initialized at this echelon.
CONUS SUPPORT BASE (ECHELON V)
a. Echelon V care is generally characterized by definitive care given to all
categories of patients. It is provided by CONUS-based Department of Defense (DOD)
tri-service hospitals and Department of Veterans Administration (DVA) hospitals.
Patients evacuated from the theater of operations who are expected to return within 60
days are admitted to tri-service hospitals to the maximum extent possible. Patients
requiring long term care are admitted to Veterans Administration hospitals and civilian
hospitals participating in the National Disaster Medical System. During mobilization, the
National Disaster Medical System may be activated. Under this system, patients
overflowing DOD and DVA hospitals will be cared for in civilian hospitals. Strategic and
operational planning and deployment of combat health support system assets also
takes place at this level.
b. During peacetime, the bulk of CONUS hospital military personnel are
organized into Table of Organization and Equipment (TOE) units which, upon
mobilization, deploy to the theater of operations. Reserve Component organizations
would then maintain the CONUS hospitals at current operational capacities. The
capacities can be expanded through the use of individual mobilization augmentees,
draftees, enlistments, and retired recalls. The CONUS peacetime health care structure
is designed to provide for wartime readiness and to provide early-on medical assets to
the theater of operations.
a. Units that lack an organic medical capability are provided routine and
emergency medical treatment on an area support basis. Within corps and echelons
above corps (EAC), this service is provided by area support medical battalions, which
are organized similar to divisional medical battalions. The battalion consists of medical
companies that have a treatment platoon (area support squad, treatment squad, and
patient holding squad) and an ambulance platoon. In addition to a normal battalion
staff, the headquarters has optometry, preventive medicine, mental health, and medical
b. The ambulance exchange point (AXP) is an intermediate point of patient
transfer. Ambulance exchange points are established when threats to air resources
prevent evacuation by air from forward units. These points will be established to the
rear of the battlefield air support (BAS). During deep operations, these points may be
established to ensure that lines of communications of unit/ division/corps level
resources are not overextended. The AXP is manned by the maneuver battalion
medical platoon and medical company personnel.