R 142210Z JAN 10 ALCOAST 021/10 COMDTNOTE 6120 SUBJ: FORCE HEALTH PROTECTION - OPERATION SAFE RETURN / HAITI RELIEF OPERATIONS A. COAST GUARD MEDICAL MANUAL, COMDTINST 6000.1 (SERIES) B. COAST GUARD SAFETY AND ENVIRONMENTAL HEALTH MANUAL, COMDINST 5100.47 1. PER REFERENCE A, COAST GUARD PERSONNEL MUST ENSURE THEY FOLLOW APPROPRIATE FORCE HEALTH PROTECTION MEASURES FOR ALL CONTINGENCY DEPLOYMENTS. 2. COAST GUARD ACTIVE DUTY AND SELECTED RESERVE PERSONNEL SUPPORTING OPERATION SAFE RETURN / HAITI RELIEF OPERATIONS MUST ENSURE THEY ARE GREEN IN COAST GUARD BUSINESS INTELLIGENCE (CGBI) FOR THEIR INDIVIDUAL MEDICAL READINESS, WHICH INCLUDES COMPLETED: A. PERIODIC HEALTH ASSESSMENT (NOTE - ROUTINE PHYSICAL EXAMINATIONS ARE NO LONGER A READINESS REQUIREMENT) B. MEDICAL TESTS (HUMAN IMMUNODEFICIENCY VIRUS, DEOXYRIBONUCLEIC ACID,BLOOD TYPE, BASELINE TUBERCULIN SKIN TEST, GLUCOSE-6-PHOSPHATE DEHYDROGENASE) C. DENTAL EXAMINATION (CLASS 1 OR 2) D. IMMUNIZATIONS (TETANUS/DIPTHERIA OR TETANUS/DIPTHERIA/ACELLULAR PERTUSSIS, HEPATITIS A, HEPATITIS B, INFLUENZA (SEASONAL AND H1N1), MEASLES, MUMPS AND RUBELLA, AND POLIO) E. NO DEPLOYMENT LIMITING MEDICAL CONDITIONS F. INDIVIDUAL MEDICAL EQUIPMENT (IME) - DEPLOYING MEMBERS THAT REQUIRE VISION CORRECTION MUST DEPLOY WITH A MINIMUM OF TWO PAIRS OF CORRECTIVE SPECTACLES (EYE GLASSES). CONTACT LENSES ARE NOT RECOMMENDED AS FIELD CONDITIONS MAY NOT ALLOW FOR PROPER CONTACT LENS HYGIENE. 3. ADDITIONAL FORCE HEALTH PROTECTION MEASURES FOR PERSONNEL DEPLOYING ON THE GROUND IN HAITI ARE: A. TYPHOID IMMUNIZATION B. MALARIA PROPHYLAXIS - FOR COAST GUARD MEMBERS THAT MAY GO ASHORE, APPROPRIATE MEDICATION INCLUDES CHLOROQUINE OR DOXYCYCLINE AS PRESCRIBED BY THE COGNIZANT MEDICAL OFFICER (USE OF THESE MEDICATIONS IS AUTHORIZED FOR AVIATION PERSONNEL). C. DENGUE FEVER AND INSECT BITE PROTECTION - THERE IS NO MEDICAL PROPHYLAXIS FOR DENGUE FEVER. INSECT BITES CAN BE PREVENTED THROUGH COMBINED USE OF INSECT REPELLENT AND BARRIER METHODS SUCH AS WEARING LONG SLEEVED SHIRTS AND LONG PANTS WHEN OUTDOORS. SKIN REPELLENT SHOULD CONTAIN DEET. UNIFORMS SHOULD BE TREATED WITH PERMETHRIN. D. FOODBORNE AND WATERBORNE DISEASES - DO NOT DRINK WATER FROM WELLS, FAUCETS OR LOCAL BOTTLED WATER VENDORS AND DO NOT EAT FOOD FROM ANY LOCAL VENDORS. THERE IS A HIGH RISK OF CONTRACTING DIARRHEAL DISEASES. CONSULT WITH MEDICAL FOR GUIDANCE REGARDING TREATMENT OF DIARRHEA. E. PRESCRIPTION MEDICATIONS - ENSURE 90 DAYS OF PRESCRIPTION MEDICATIONS ARE SUPPLIED. F. DD-FORM 2766 - FOR NON-CUTTER BASED FORCES, ENSURE THE MOST CURRENT VERSION OF THE DD-2766 (PRINTED OUT FROM THE MEDICAL READINESS REPORTING SYSTEM) IS USED AS THE MEMBER'S BATTLE RECORD. 4. ENVIRONMENTAL HEALTH GUIDANCE - FOLLOW SAFETY GUIDANCE SPECIFIC TO THE LOCAL OR CURRENT OPERATIONS BY REVIEWING THE INCIDENT COMMAND SITE SAFETY PLAN (SSP). VARIOUS SCENARIOS MAY REQUIRE PROPER USE OF OPERATIONAL RISK ANALYSIS PRIOR TO COMMENCING MISSIONS IN-COUNTRY. THIS INCLUDES UNSTABLE OR FALLING STRUCTURES, SHARP MATERIALS FROM FALLEN DEBRIS, ELECTRICAL HAZARDS FROM EXPOSED WIRES, BLOODBORNE PATHOGEN HAZARDS WHILE HANDLING OR TREATING INJURED VICTIMS OR HUMAN REMAINS, CONTAMINATED FOOD AND WATER SOURCES, AND CRIMINAL ACTIVITY CAUSED BY LOOTERS OR OTHER PERSONNEL SEEKING TO TAKE ADVANTAGE OF THE SOCIAL DISORDER. A. TO PROTECT AGAINST CERTAIN DISEASES (SUCH AS SOIL TRANSMITTED HELMINTHS, LEPTOSPIROSIS), AVOID BARE SKIN CONTACT WITH MOIST SOIL AND FRESH SURFACE WATER (RIVERS, LAKES, IRRIGATED FIELDS). ENSURE ADEQUATE PERSONAL HYGIENE MEASURES INCLUDING HAND WASHING AND USE OF HAND SANITIZERS. PERFORM DAILY SKIN CHECKS. B. HEAT STRESS - KNOW THE SIGNS AND SYMPTOMS AND PRECAUTIONS TO PROTECT YOURSELF AND SHIPMATES TO REDUCE YOUR CHANCE OF HEAT INJURY. STAY HYDRATED AND USE SUNSCREEN TO PREVENT SUNBURNS. C. ANIMAL BITES - AVOID CONTACT WITH ANIMALS. IF YOU ARE BITTEN OR SCRATCHED, WASH THE WOUND WELL WITH SOAP AND WATER AND CONTACT MEDICAL ASAP. THERE IS A RISK OF CONTRACTING RABIES IF YOU HAVE DIRECT CONTACT WITH BATS, CARNIVORES, AND OTHER MAMMALS. 5. SAFETY GUIDANCE - A. HAVE MAPS AND DESIGNATED ROUTES TO LOCATIONS IN COUNTRY PRIOR TO COMMENCING OPERATIONS. B. HAVE AND MAINTAIN COMMUNICATIONS WITH YOUR UNIT AT ALL TIMES WITH APPROPRIATE REPORTING TIMES AND PROCEDURES TO TAKE IF THE UNIT DOES NOT RECEIVE THE REQUIRED REPORT STATUS. C. TRAVEL IN GROUPS OF TWO OR MORE PERSONNEL AT ALL TIMES. D. AVOID DIRECT SKIN CONTACT WITH BLOOD, OTHER BODILY FLUIDS, AND HUMAN REMAINS. E. MAINTAIN COGNIZANT AWARENESS OF ONE'S SURROUNDINGS AT ALL TIMES PAYING ATTENTION TO FALLING, TRIP, ELECTRICAL AND CHEMICAL HAZARDS. F. REPORT BACK AT THE APPOINTED TIME TO THE ASSIGNED AND SECURE LOCATION WHEN DIRECTED. G. MANAGE CREW REST DESPITE THE LONG, ARDUOUS HOURS BY ATTEMPTING TO ATTAIN A SEVEN HOUR UNINTERRUPTED SLEEP CYCLE OR BREAKING THE DAY WITH 10-15 MINUTE NAPS IN A SAFE AND SECURE LOCATION, H. DO NOT ENTER ANY CONFINED SPACES WHERE TOXIC GASES, FALLING DEBRIS, OR OTHER HAZARDS MAY EXIST. EVALUATE ALL CONFINED SPACES PRIOR TO ENTRY. 6. PERSONAL PROTECTIVE EQUIPMENT - WITH THE CONTINUED DEGRADATION IN SANITARY CONDITIONS, EXPOSURE TO COMMUNICABLE DISEASE THREATS ARE SIGNIFICANT PARTICULARLY WITH THE LACK OF TOILETS, LACK OF POTABLE WATER, EXPOSURE TO BLOOD FROM OPEN WOUNDS OR SEVERE LACERATIONS, AND PRESENCE OF HUMAN REMAINS IN PUBLIC AREAS. A. THE H1N1 PERSONAL PROTECTIVE EQUIPMENT (PPE) PUSH PACKS CONTAIN THE N-95 RESPIRATORS, DISPOSABLE NON-LATEX GLOVES, SAFETY GOGGLES, AND HAND SANITIZING SOLUTION TO PROTECT AGAINST THESE COMMUNICABLE DISEASE THREATS. DEPLOYING COAST GUARD PERSONNEL MAY USE THESE PUSH PACKS AS PART OF FORCE HEALTH PROTECTION WHILE IN-COUNTRY. THIS EQUIPMENT WILL WORK AS UNIVERSAL PRECAUTIONS WHEN TREATING OR ASSISTING INJURED VICTIMS. RESUPPLY MAY BE REQUESTED THROUGH COMDT (CG-1133) BY CONTACTING MS. CAROLYN ONYE AT (202) 475-5214. MEMBERS SHOULD BE FIT-TESTED PRIOR TO WEARING N-95 RESPIRATORS. B. IF COAST GUARD PERSONNEL ARE DIRECTED TO PARTICIPATE IN URBAN SEARCH AND RESCUE OPERATIONS, MEDICAL TREATMENT AND EVACUATION OPERATIONS, OR ASSESSMENTS IN-COUNTRY, ADDITIONAL PPE IS HIGHLY RECOMMENDED TO INCLUDE THE FOLLOWING: HARD HATS, SAFETY SHOES (E.G. COAST GUARD OPERATIONAL DRESS UNIFORM BOOTS MEET THIS REQUIREMENT), LEATHER WORKING GLOVES,SUFFICIENT POTABLE WATER FOR THE OPERATION, SUFFICIENT APPROVED MEALS (SUCH AS MEALS-READY-TO- EAT (MRE)) FOR THE OPERATION UNLESS DIRECTED TO EAT AT A VERIFIED SAFE DINING FACILITY DURING THE OPERATION. 7. MEDICAL SURVEILLANCE - COAST GUARD PERSONNEL WHO FEEL THEY WERE EXPOSED TO HAZARDS REQUIRING FURTHER MEDICAL FOLLOW-UP, MUST FILL OUT THE ACUTE EXPOSURE FORM PER REFERENCE A, CHAPTER 12. 8. MISHAP REPORTING - COAST GUARD PERSONNEL, INJURY, ILLNESS AND PROPERTY DAMAGE SHALL BE REPORTED USING THE E-MISHAP SYSTEM OR THE ICS 237-CG INCIDENT MISHAP REPORTING RECORD. GO TO HTTP://APPS.MLCA.USCG.MIL/KDIV/KSEMISREP/ FOLLOW THE GUIDANCE IN REFERENCE B, CHAPTER 3. 9. SELRES PERSONNEL MUST ENSURE THEY FOLLOW THE DEPLOYMENT HEALTH GUIDANCE IN REFERENCE A, CHAPTER 6. 10. WORK LIFE - COAST GUARD MEMBERS NEED TO TAKE CARE OF THEMSELVES AND EACH OTHER. INFORMATION AND RESOURCES ARE RESOURCES ARE AVAILABLE FOR MEMBERS AND THEIR FAMILIES WHO MAY HAVE CONCERNS, CALL 1-800-872-4957 TO TALK TO A COAST GUARD WORK-LIFE STAFF MEMBERS OR 1-800-222-0364 TO ACCESS COUNSELING SERVICES. 11. ADDITIONAL GUIDANCE CAN BE FOUND AT WWW.CDC.GOV AND ON THE CG-11 WEBSITE AT HTTP://WWW.USCG.MIL/HQ/CG1/CG11 (UNDER HOT TOPICS). 12. FOR QUESTIONS PERTAINING TO THIS ALCOAST CONTACT CDR ERICA SCHWARTZ, COMDT (CG-1121) AT (202) 475-5172 OR ERICA.G.SCHWARTZ(AT) USCG.MIL. FOR OPERATIONAL MEDICINE QUESTIONS CONTACT CAPT MARIO FAJARDO (HSWL OPMED) AT (510) 637-1225 OR CDR JEFF SALVON-HARMAN (HSWL OPMED) AT (757) 628-4331. FOR SAFETY OR ENVIRONMENTAL HEALTH QUESTIONS, CONTACT LCDR KIM CHESTEEN (HSWL DETACHED D7) AT (757) 647-6399 OR CDR H. RHAMBAROSE (HSWL SUPACT) AT (757) 647-1007. 13. RADM M. TEDESCO, DIRECTOR OF HEALTH, SAFETY AND WORK-LIFE SENDS. 14. INTERNET RELEASE AUTHORIZED.