It’s common for units at the National Training Center to split their Battalion Aid Station (BAS) into a Forward Aid Station (FAS) and a Main Aid Station (MAS). Unfortunately, many units find they don’t really know what to do with them once they’re split. Observers often find units asking the same questions; Is there a difference in capability? Is the MAS required to stay fixed, while the FAS bounds ahead? When does it make sense not to split the BAS? To answer these question, we must look at doctrine to clarify commonly misused terms, understand medical unit composition, and review tactics. These three steps will demonstrate that extended medical coverage and bounding medical coverage are useful techniques that units can use to increase survivability and treat wounded soldiers to get them back in the fight.
Terminology
An initial point of confusion stems from doctrine’s inconsistent use of the terms FAS and MAS. While the terms FAS and MAS were common across doctrine in the 1980s and 1990s, today’s doctrine is unclear. The terms FAS and MAS still appear in the current ATP 3-21.21 (SBCT Infantry Battalion), but neither term appears in the most recent ATP 3-90.5 (Combined Arms Battalion). Additionally, ATP 3-21.20 and ATP3-21.21 refer to “Treatment Team Alpha” and “Treatment Team Bravo”, which match ATP 4-02.3 (Army Health System Support to Maneuver Forces).
Composition
The terms have changed to reflect changes in the conduct of medical support. In 2009 leaders at the Medical Center of Excellence’s (MedCOE) Doctrine and Literature Division* became aware of issues stemming from the use of the terms FAS and MAS. They were concerned that maneuver units were drawing inaccurate conclusions about medical support based on recent counterinsurgency experience. Units believed they could only use the FAS forward while the MAS remained in the rear with more capability. In response, MedCOE transitioned from the terms “FAS” and “MAS” to “Treatment Teams A and B”. They intended to reinforce the idea that the “Treatment Section” was the core of each team. They also emphasized that each treatment section was interchangeable in role and function.
MAS v. FAS
Figure 1 – Common Maneuver BN Medical Platoon Structure and Dividing Line
For clarity, we’ll use the terms “Treatment Team A (FAS)” and “Treatment Team B (MAS)” throughout the rest of this article. Regardless of the terms, however, MedCOE’s point stands; as seen in Figure 1, treatment teams provide similar medical capabilities but can adjust based on their support requirements. Medical platoons split sections with three basic elements: command, treatment, and evacuation. There are two important points to draw from this. First, Treatment Team A (FAS) and Treatment Team B (MAS) each only possess half the capacity and capability of an entire BAS. Second, there is no reason the Forward Aid Station must remain forward while the Main Aid Station must remain safely in the rear.
If trained, splitting the BAS can increase a unit’s overall survivability. The chart below shows the survivability rates of three BAS’s using various amounts of split capability at the National Training Center (NTC). Units that fully integrate Health Service Support at home station training tend to use BAS split operations more effectively at NTC. Clearly, a split BAS can add value to operations.
Figure 2 – Three Battalion Aid Stations and the Effects of Training Split Operations
Effective Medical Coverage Options
So when should a unit split the BAS? During planning, the battalion Medical Operations Officer (MEDO) must consider the potential of a consolidated BAS before committing to a split. Battalions should consider the medical planning principles to achieve smooth and effective coverage. Most importantly, the medical support plan must conform to the tactical plan. Additionally, BAS placement should balance the principle of proximity with BAS security to leverage an economy of force with evacuation assets. Finally, the BAS location must account for the principles of mobility and flexibility when conditions inevitably change on the battlefield.
The BAS is often able to achieve effective coverage from a single location; however, sometimes split coverage fits the needs of the mission. The MEDO must analyze resources available and each team’s limits to make splitting a success and not a hazard. MEDOs have several options when considering how to maneuver medical treatment teams to support operations: extended medical coverage, bounding medical coverage, and consolidated jumps.
Figure 3- Medical Coverage Options
Option 1: Extended Medical Coverage
The extended medical coverage technique consists of splitting the BAS into two halves in order to provide coverage across a wider area. Extending coverage is useful when maneuver elements spread further than a BAS can support from a single location, or when terrain restricts effective evacuation to a single location. Splitting the BAS to cover greater distances comes with a price. Each treatment team will have half the resources of a consolidated BAS and can only provide extended coverage for a limited time before mechanical or logistical issues degrade capabilities. In addition to dividing resources, the platoon leader’s ability to command and control each team becomes more challenging. To be successful, each treatment team must understand the tactical operation, communicate their team’s status, and have the authority to make decisions when communications falters.
Medical planners must consider operational limits before extending coverage to get the maximum effects. Important planning factors when considering extended medical coverage include:
- How long is the split operation expected to last?
- Where are the most casualties expected along the extended coverage area?
- What additional evacuation platforms and/or treatment resources are available to support the area with the most expected casualties?
- Where are adjacent unit aid stations? Can they support diverted casualties if needed?
Option 2: Bounding Medical Coverage
Bounding medical coverage is one of the most valuable—and least practiced—means of employment. In this technique, Treatment Team A bounds forward to establish medical support ahead of the remaining BAS. Treatment Team B (MAS) stays behind to clear casualties and receive new casualties. Once established, Treatment Team A (FAS) informs the supported units of their location and begins accepting casualties. Treatment Team B (MAS) then clears any remaining casualties and maneuvers to rejoin Treatment Team A (FAS). Bounding the medical platoon allows a battalion to maintain constant medical coverage of an advancing force. This technique is ideal during rapid movement to contact operations, or when adjusting BAS locations in support of shifting battlefield geometry.
Units must accept the inherent risk in time using this technique. If the battalion take too long to bring Treatment Team B (MAS) forward, then they leave the Treatment Team A (FAS) vulnerable to mass casualties. The delayed movement is often caused by the decision to keep Treatment Team B (MAS) physically collocated with the Combat Trains Command Post (CTCP) and the Unit Maintenance Collection Point (UMCP). Moving the BAS independent of the CTCP requires the MEDO to exercise greater battlefield awareness. It also requires the medical platoon to rely on terrain and battlefield positioning for security.
Important planning factors when considering bounding medical coverage might include:
- Have the companies rehearsed bounding medical coverage to avoid confusion?
- How are the locations and statuses of each treatment team communicated while bounding?
- What is the contingency if either team has issues while bounding (e.g. loss of communication, or vehicle breakdown)? Does the unit send what we have and recover The rest at a later time?
- Do the evacuation crews know the jump locations if they return from an evacuation and the BAS is gone?
Option 3: Consolidated BAS Jumps
In most situations, it makes sense to jump the entire BAS as a single element. Moving a consolidated BAS is easier to coordinate. It also allows units to mass the effects of available medical resources with each jump. Moving a consolidated BAS is ideal when a battalion is on an approach march through an uncontested area, or expects low casualty loads. While this technique provides simplified movement, it comes at the cost of responsiveness.
Moving a consolidated BAS is not without risk. Medical planners must remember that The BAS runs the risk of receiving casualties on the move. This can quickly desynchronize the Health Service Support plan. A BAS receiving unexpected casualties on the move must stop at an unrehearsed location, pull out equipment, treat, evacuate, repack equipment, and set off again. This could place treatment teams hours behind. Unfortunately, there are also times when the medical platoon’s combat power is reduced such that split coverage is impractical. Under those conditions, the Health Service Support plan requires detailed adjacent unit coordination to cover gaps in support.
Important planning factors when jumping as a consolidated BAS include:
- What are the conditions and triggers to jump the BAS with the least risk to being caught mid-jump?
- Where are adjacent unit aid stations during this jump, and can they potentially receive our casualties?
- Do we have a load plan that can support rapid tailgate treatment if we get sent casualties while on the move?
- Does my route to the next point have potential air evacuation support to maximize my evacuation resources?
Conclusion
The ability to split the BAS into two halves provides significant capabilities to the supported maneuver battalion. The techniques discussed in this article stem from observations at the National Training Center and Army Health System doctrine; however, they are also lessons learned on unforgiving, fast-paced battlefields—the same battlefields where they’ll be most useful again. It is imperative that medical platoons train BAS split operations at every opportunity available. The doctrinal terms can be confusing, but the concepts are easy to understand. Most importantly, units must practice to achieve a BAS’s true potential using split operations. When trained, resourced, and planned appropriately, BAS split operations will maximize finite medical resources and save soldiers’ lives.
*Based on author’s discussion with Mr. Lawrence M. Johannik (Doctrine Developer) at the Medical Center of Excellence’s (MCoE) Doctrine & Literature Division, Directorate of Training and Doctrine.
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