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Practice Individual Preventive Medicine Countermeasures

Conditions: You are a Soldier deployed to a unit in the field. The items you will need will vary depending on the physical environment and climate. They may include
water, food, replacement clothing, lip balm, personal insect repellent, hand sanitizing gel, sunscreen, foot powder, soap, washcloth, baby wipes, own supply of toilet
paper, toothbrush and toothpaste, shampoo, iodine tablets, and razor.

Standards: Apply preventive medicine countermeasures to protect, as appropriate, against cold, heat, biting insects, poisonous plants, animals, diseases from
contaminated food and water, diseases from human waste, diseases from soil and common objects, sexually transmitted diseases (STD), and acquired immune
deficiency syndrome (AIDS). Maintain personal hygiene and proper level of nutrition, take measures to resist stress, and avoid adverse effects of tobacco products.

Performance Steps
Note: Every Soldier should be issued and should maintain a supply of personal protection items. These items include lip balm, personal insect repellent, hand
sanitizing gel, sunscreen, and foot powder.
1.        Apply proper preventive medicine measures (PMMs) for protection against cold injuries.
a.        Wear layers of loose clothing.
Note: Minimize sweating. When clothing becomes wet or dirty, it loses its ability to provide warmth.
b.        Exercise to increase blood circulation.
(1)        Tighten and relax arm and leg muscles, fingers, and toes.
(2)        Use hands to massage and warm the face.
(3)        Refrain from smoking because it restricts blood flow to the skin.
c.        Change socks.
(1)        Put on dry socks during rest breaks to reduce the risk of frostbite and trench foot.
WARNING: Severe frostbite and trench foot can result in the loss of hands or feet.

Note: Inactive feet in damp or wet socks and boots or tightly laced boots, which impair circulation, are even more susceptible to injury.
(2)        Put damp socks inside the shirt to dry.
d.        Prevent dehydration.
(1)        Drink sufficient fluids (potable water, juices, and warm nonalcoholic beverages).
Note: Drinking a sufficient amount of potable water in cold weather is as important as it is in hot weather. In cold weather, you may not realize that your body is losing
fluids and salt. Sweat evaporates rapidly or is absorbed so completely by the layers of clothing that it is seldom visible on the skin.
(2)        Rest when possible.
2.        Apply proper PMMs for protection against heat injuries.
a.        Drink sufficient amounts of water.
Note: Your body needs a minimum amount of water for cooling, waste elimination, and metabolism. Any attempt to train the body to use less water can be harmful
and may lead to heat injuries.
(1)        Fluid intake should not exceed 1½ quarts of water every hour. Daily fluid intake should not exceed 12 quarts. If your urine is dark yellow, you are not drinking
enough water.
(2)        Fluid intake needs will vary depending on the type of work and the temperature (see figure 081-831-1053-1 and table 081-831-1053-1).

Figure 081-831-1053-1
Categories of Work

Table 081-831-1053-1
Fluid Replacement Policy

(3)        Drink extra water before combat operations.
(4)        Maintain excess water in your system for strength and alertness.
(5)        Protect yourself from dehydration and heat injuries associated with wearing full chemical protective gear.
b.        Rest whenever possible.
(1)        Take rest breaks in accordance with the heat condition table, as the tactical situation permits.
(2)        Use rest breaks to drink water and to cool off. Take a cool shower, if possible.
c.        Eat meals.
(1)        Eat regular meals daily to replace salt lost through heavy sweating.
(2)        Eat something at each meal, even if you are not hungry.
Note: Usually, eating field rations or liberal salting of the garrison diet will provide enough salt. Excess intake of salt should be avoided.
(3)        Do NOT take herbal-type medications, diet supplements, or performance-enhancing drugs.
d.        Protect yourself from exposure.
(1)        Wear your uniform properly.
(2)        Use shade whenever possible.
(3)        Use barrier creams and lotions.
3.        Apply proper PMMs for protection against arthropod (insect) bites and arthropod-borne diseases.
a.        Apply extended-duration arthropod repellent lotion to exposed skin, ankles, and waistline.
b.        Apply insect repellent to your uniform (if not treated with permethrin).
c.        Keep sleeves down and trouser legs tucked into boots to protect from biting insects.
d.        Check yourself and your buddy for ticks twice a day.
4.        Apply proper PMMs for protection against poisonous plants and animals.
a.        Look inside sleeping bag before getting in.
b.        Look inside boots before putting them on.
c.        Keep sleeves down and trouser legs tucked into boots to protect from poisonous plants.
d.        Do not play with snakes.
5.        Apply proper PMMs for protection against diseases from contaminated food and water.
a.        Drink water from approved sources only.
b.        Eat from approved sources only.
Note: Street vendors are never approved food sources as they are not inspected by U.S. military preventive medicine or veterinary personnel. Foods consumed from
street vendors can cause severe illness in U.S. troops.
6.        Apply proper PMMs for protection against diseases from human waste.
a.        A cat-hole is dug to use for excreting waste if your unit is on the move. Cover it sufficiently to prevent flies from spreading germs from the waste to your food
and to keep unwanted animals out of your bivouac area.
b.        The straddle trench latrine is used on short bivouacs and field training exercises--1 to 3 days duration.
c.        Deep pit latrines are constructed for temporary camps that are more than 3 days.
d.        Individual waste collection bags may be used on the march, on convoys, or for small groups in isolated areas. It is important to seal and transport the waste
with you until it can be burned or buried safely.
e.        The pail latrine and the burn-out latrine are constructed when chemical toilets are not available, the ground is too hard, or the soil is very wet. The latrine is
burned out daily by adding sufficient fuel to incinerate the excrement. The contents are burned until they are dry and odorless. Any remaining ash should be buried.
7.        Apply proper PMMs to protect against diseases from soil and common objects.
a.        Wash your hands regularly to defend against germs from the soil and from objects handled by other people. Wash your hands--
(1)        After using the latrine.
(2)        Before touching eating utensils or food.
(3)        After eating.
(4)        After handling any item that can potentially transfer germs.
(5)        Frequently during the work day to keep your hands free of germs.
b.        Cleaning your hands with hand-sanitizing gel is an effective way to disinfect them from nearly all germs that cause illnesses. You should use soap and water
to wash your face and to bathe the rest of your body.
8.        Maintain personal hygiene on the move.
a.        While in the field or deployed, you will not always have ready access to your rucksack. Always carry these items with you:
(1)        A bar of soap and a washcloth or baby wipes.
(2)        Your own supply of toilet paper or baby wipes.
(3)        Your toothbrush and toothpaste.
(4)        Shampoo.
b.        If shower or laundry facilities are not available, use plastic wash bins or other containers to bathe or wash clothing, if you have an adequate water supply.
c.        Sprinkle foot powder in your socks to help absorb the moisture.
d.        Remove the inserts from your boots at night to prevent fungus from growing.
e.        If you get athlete's foot, you will need an antifungal solution or cream to treat it.
f.        Wear one pair of boots one day and change to your other pair the next day.
g.        Use boot/sock liners for road marches greater than 5 km (3.1 mi) to prevent blisters.
Note: Boot/sock liners are your military issued black dress socks worn underneath your military black boot socks.
9.        Maintain your level of nutrition.
Note: Soldiers typically do not eat enough when they are in the field or deployed; they lose weight, and they lose their edge on physical and mental performance.
a.        Your meal, ready to eat (MRE) is the standard individual ration for operations.
Note: There are 24 different menus. The MRE contains cooked entrees and other food items that require no preparation. It will sustain the Soldier engaged in heavy
activity, such as field training and deployed missions, when normal food service facilities are not available. One MRE provides an average of 1,300 calories,
consisting of 13% protein, 36% fat, and 51% carbohydrates.
b.        It is important to eat at least some of each item in the MRE, even if you are not hungry.
10.        Take measures to resist stress.
a.        Fear and physical signs or symptoms of stress are normal reactions before and during combat or other dangerous/life-threatening situations. You should not
let fear or stress keep you from doing your job.
b.        Talk about what is happening with your buddies, especially during after-action debriefings.
c.        Learn ways to relax quickly.
d.        Integrate new replacements into your unit and get to know them quickly.
e.        If you must join a new unit, be active in establishing friendships.
11.        Protect against sexually transmitted diseases (STDs).
a.        Use a condom (rubber).
Note: Individuals should use a condom during vaginal, anal, or oral sex when there is a possibility of acquiring an infection.
b.        Avoid high-risk sexual behaviors. Such behaviors include--
(1)        Having more than one sexual partner.
(2)        Changing sex partners frequently.
(3)        Having sex with casual partners, prostitutes, or their clients.
(4)        Having anal sex.
c.        Control alcohol intake (it affects your ability to use safe sex practices).
12.        Protect against human immunodeficiency virus (HIV), the virus that causes AIDS.
Note: HIV is contagious in the same way STDs are contagious. Infection can result from a sexual relationship with an infected person. Sexual contact is not the only
way to contract HIV, but it is a major contributor.
a.        Prevent sexual transmission--know your partner. Avoid having sex with persons who might be infected with HIV. At highest risk are those who have more than
one sex partner or who have unprotected sex with casual partners, prostitutes, or their clients; partners who are HIV infected or who share needles with others.
b.        Prevent transmission through shared needles or syringes--do not use injected, nonprescribed drugs.
Note: Although progress has been made in research and medications, it is important to remember that there is presently no cure for AIDS and no vaccine to prevent
HIV infection.
13.        Avoid adverse effects of tobacco products.
a.        Using tobacco affects your ability to function when you are in the field or deployed.
b.        Smoking has tactical hazards:
(1)        Cigarette smoke can be detected up to 300 meters down wind by the enemy.
(2)        The flame can be detected by enemy snipers.
(3)        There are possibilities of starting a fire.
c.        Smoking can be hazardous to a Soldier's health, even if it is a buddy who is smoking. The long-term adverse effects of using tobacco include chronic
diseases of the heart and lungs, cancer, stroke, and high blood pressure.
d.        Short-term effects can cut into your effectiveness in performing your mission. Such effects include--
(1)        Watering eyes.
(2)        Runny nose.
(3)        Coughing.
(4)        Loss of smell and taste.
(5)        Increased heart rate (up to 30%).
(6)        More easily fatigued.
(7)        Elevation in blood pressure (up to 15%).
(8)        Decreased appetite.
(9)        Diarrhea, constipation, or both.
(10)        Reduced stamina.
(11)        Decreased ability to recover from illness and injury.
(12)        Decreased blood circulation to the brain.
(13)        Decreased night vision (20 to 25%).

Evaluation Preparation:
Setup: Evaluate this task during a field training exercise (FTX) or during a normal training session. If the evaluation is conducted during an FTX, use the
environmental and physical conditions at the FTX as the scenario to implement preventive medicine countermeasures. If the evaluation is done during a normal
training session, create the scenario to include environmental and physical conditions.  Develop a series of questions to guide the Soldier through the appropriate
performance measures.

Brief Soldier: Tell the Soldier he/she will be evaluated on his/her ability to apply the appropriate preventive medicine countermeasures.

Performance Measures        GO        NO-GO
1.        Applied proper PMMs to protect against the cold.        ——        ——
2.        Applied proper PMMs to protect against the heat.        ——        ——
3.        Applied proper PMMs to protect against arthropod bites and arthropod-borne diseases.        ——        ——
4.        Applied proper PMMs to protect against poisonous plants and animals.        ——        ——
5.        Applied proper PMMs to protect against diseases from contaminated food and water.        ——        ——
6.        Applied proper PMMs to protect against diseases from human waste.        ——        ——
7.        Applied proper PMMs to protect against diseases from soil and common objects.        ——        ——
8.        Maintained personal hygiene on the move.        ——        ——
9.        Maintained the proper level of nutrition.        ——        ——
10.        Took measures to resist stress.        ——        ——
11.        Knew how to protect against sexually transmitted diseases.        ——        ——
12.        Knew how to protect against AIDS.        ——        ——
13.        Avoided adverse effects of tobacco products.        ——        ——

Evaluation Guidance: Score the Soldier GO if all performance measures are passed. Score the Soldier NO GO if any performance measure is failed. If the Soldier
scores NO GO on any performance measure, show or tell the Soldier what was done wrong and how to do it correctly.

Required        Related
AR 600-63
FM 21-10
FM 4-25.11
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