Echelon III Medical Treatment WW II
Evacuation Hospital, Italy, Fall 1944.
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Description of Echelon III Medical Treatment in WW II
The third echelon of medical support in World War II was the equivalent of what was later called corps-level medical support, but was provided during the war by the field army. This was because the corps, as employed in World War II, served only as a tactical headquarters, with little or no logistic or administrative capability. There was no overall medical command
and control headquarters at this echelon. All third-echelon medical units were under the direct command of the army commander and under the technical supervision of the army surgeon.
The third echelon of health-services support had three major missions:
- Provide first- and second-echelon health services support to those units in the army area that lacked organic medical assets
- Evacuate patients from second-echelon treatment facilities
- Provide hospitalization
To provide for the first mission, the field army had assigned to it separate, numbered clearing and collecting companies. The separate medical clearing company provided clearing support for up to 15,000 troops or support or reinforcement to divisional clearing elements. The basis of allocation for this unit was one company per supported division.
The mission of the separate medical collecting company was essentially the same as its divisional counterpart at second echelon: to collect patients by litter or ambulance from first-echelon treatment facilities, provide them with needed stabilizing treatment at the collecting station, and then transport them by ambulance to a supporting clearing company. In addition to collecting patients in the corps or army area, the company could also be used to support a divisional medical battalion with additional collecting assets. The normal basis of allocation was one company per supported division.
To accomplish the second third-echelon mission -- evacuation from second-echelon treatment facilities -- the army used separate, numbered motor-ambulance companies. The motor-ambulance company's mission was to evacuate patients from second-echelon medical facilities belonging to divisional medical battalions or nondivisional clearing or collecting companies to third-echelon hospitals belonging to the field army. The basis of allocation of this unit was one company per 12,000 supported troops.
These separate collecting, clearing, and motor-ambulance companies would be organized under separate medical battalions, which were in turn organized under a medical group headquarters, generally on the basis of one medical group per corps supported by the army.
The medical group and separate battalion headquarters were similar in organization and function. The group headquarters was composed of ten officers and twenty-four enlisted men. The commander (a colonel) and the executive officer (a lieutenant colonel) were both Medical Corps officers; the rest of the officers in the headquarters were Medical Administrative Corps officers. The headquarters provided command and control for six to eight subordinate battalions, companies, or separate units. The separate medical battalion headquarters was composed of six officers, one warrant officer, and twenty-two enlisted men. With the exception of the commander and executive officer (who were Medical Corps officers) and the personnel-services warrant officer, all officers of the headquarters were Medical Administrative Corps officers. The battalion provided command and control for three to six subordinate medical companies and provided maintenance and personnel-services support to its subordinate units through sections formed by attaching mechanics and clerks to the battalion from companies under its control.
The final service provided by third-echelon health-services support was hospitalization. To provide this service, the field army used three types of hospitals:
- 750-bed evacuation hospital
- 400-bed evacuation hospital (semimobile)
- Field hospital
The evacuation hospital had almost no mobility through its organic transportation assets, nor was its staff trained in unit movements. It was essentially a fixed medical installation designed to be moved infrequently. The evacuation hospital (semimobile) was a 400-bed facility with the same mission as the 750-bed evacuation hospital. One important difference between the two was that the semimobile evacuation hospital was equipped with more trucks than the evacuation hospital, making it about 25-percent mobile in organic transportation assets. Additionally, the staff was trained in moving the facility and could move in eight to ten hours (after all patients had been removed) and could reestablish the facility in four to six hours after arriving at a new location.
The Field Hospital
The field hospital was especially valuable, as it could be established as a single 400-bed facility or as three 100-bed facilities, which gave the army surgeon a great deal of flexibility in providing needed health-services support. The field hospital was considered a semimobile station hospital designed to provide "definitive surgical and medical treatment to troops in the theater of operations where fixed facilities [did] not exist, and where construction of fixed facilities [was] undesirable." In practice, the hospital units of the field hospital were often employed in close proximity to a division clearing station, where they could provide more definitive care than that available in the division -- much the same way in which Mobile Army Surgical Hospitals (MASH) would be employed in Korea a few years later. The lack of sufficient surgeons and nurses in the hospital units of the field hospital was, in fact, one of several factors leading to the development of the mobile army surgical hospital after WW II.
Surgical Augmentation Teams
Also found in the field army, and helping to partially counteract the lack of physicians in the field hospital, was an assortment of surgical augmentation teams. There were seven types of surgical teams in World War II, all organized under the blanket Table of Organization and Equipment 8-55, Professional Services. These included:
- Team EA: general surgery
- Team EB: orthopedic surgery
- Team ED: maxillofacial surgery
- Team EE: neurosurgery
- Team EF: thoracic surgery
Each of the above teams had three officers, one nurse, and three enlisted men. There were also Team EC: shock treatment, with one officer, one nurse, and three enlisted men, and Team EG: gas treatment, with one officer and three enlisted men. The EA through EF
teams provided, in effect, additional staffed operating tables for the facilities to which they were attached, while team EG provided oxygen therapy for lung-irritant casualties. The teams were organized under a headquarters to form an auxiliary surgical group.
Logistics and Other Support Units
A hodgepodge of additional units, serving directly under the army surgeon, provided medical logistics, laboratory, veterinary, and other ancillary services to the army. The most important of these units was probably the medical depot company. Commanded by a lieutenant colonel, the company -- with 13 officers, 1 warrant officer, and 136 enlisted men organized into a headquarters, a maintenance platoon, and 3 storage platoons -- was the equivalent of the modern medical-supply, optical, and maintenance (MEDSOM) battalion.
The three storage and issue platoons gave the company the ability to provide continuous
support while displacing over large lateral distances. The company's mission was to provide third- and fourth-level medical maintenance of medical equipment; to replace and repair spectacles and dental prosthetic appliances; and to receive, store, and issue medical supplies in support of 125,000 combat-zone troops.
Material on this page adapted from the U.S. Army Command and General Staff College (Ft. Leavenworth, KS) publication, "From the Roer to the Elbe with the 1st Medical Group: Medical Support of the Deliberate River Crossing", by Donald E. Hall.
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