text: Chapter 1
  attempt to maintain the role of care during movement at least equal to the care provided at the
  preceding facility. Each type of AHS unit contributes a measured, logical increment in care appropriate to
  its location and capabilities. In recent operations, lower casualty rates, availability of rotary-wing air
  ambulances, and other mission, enemy, terrain and weather, troops and support available, time available, and
  civil considerations factors often enable a patient to be evacuated from the POI directly to the supporting
  combat support hospital (CSH) or hospital center. In more traditional operations, higher casualty rates,
  extended distances, and patient condition may necessitate that patients receive care at each role of care to
  maintain their physiologic status and enhance their chances of survival. The medical commanders, with their
  depth of medical knowledge, their ability to anticipate follow-on medical treatment requirements, and their
  assessment of the availability of their specialized medical resources can adjust the patient flow to ensure each
  Soldiers receive the care required to optimize patient outcome. The medical commander can recommend
  changes in the theater evacuation policy to adjust patient flow within the deployed setting. A major
  consideration and an emerging concern in future conflicts is providing prolonged care at the point of need
  when evacuation is delayed. The Army’s future OE is likely to be complex and challenging and widely
  differs from previous conflicts. Operational factors will require the provision of medical care to a wide range
  of combat and noncombat casualties for prolonged periods that exceed current evacuation planning factors.
  CONTROL
  1-31. Control is required to ensure that scarce AHS resources are efficiently employed and support the
  operational and strategic plan. It also ensures that the scope and quality of medical treatment meets
  professional standards, policies, and U.S. and international law. As the Army Medicine is comprised of 10
  medical functions which are interdependent and interrelated, control of AHS support operations requires
  synchronization to ensure the complex interrelationships and interoperability of all medical assets remain in
  balance to optimize the effective functioning of the entire system. Within the operational area, the most
  qualified individuals to orchestrate this complex support are the medical commanders due to their training,
  professional knowledge, education, and experience. In a joint and multinational environment it is essential
  that coordination be accomplished across all Services and unified action partners to leverage all of the
  specialized skills within the operational area. Due to specialization and the low density of some medical
  skills within the MHS force structure, the providers may only exist in one Service (for example, the U.S.
  Army has the only Veterinary Corps officers in the MHS).
  ROLES OF MEDICAL CARE
  1-32. A basic characteristic of organizing modern AHS support is the distribution of medical resources and
  capabilities to facilities at various levels of command, diverse locations, and progressive capabilities, which
  are referred to as roles of care. Definitive care refers to care or treatment which returns an ill or injured
  Soldier achieving maximum medical improvement.
  1-33. Definitive care embraces all care, treatment, and medical interventions provided at any role of medical
  care. These interventions can range from self-aid when a Soldier applies a dressing to a grazing bullet wound
  that heals without further intervention; to two weeks bed-rest in theater for the treatment of Dengue fever; to
  multiple surgeries and extensive rehabilitation with a prosthesis at a CONUS-based medical center or
  Department of Veterans Affairs hospital after a traumatic amputation. Injured Soldiers' dispositions may
  range from return to full duty without limitations to medical discharge from the military secondary to
  persistent physical limitations resulting from illness or injury.
  1-34. Definitive treatment refers to the final role of comprehensive care provided to return the patient
  to the highest degree of mental and physical health possible. It is not associated with a specific role or
  location in the continuum of care; it may occur in different roles depending upon the nature of the
  injury or illness.
  1-35. As a general rule, no role of care will be bypassed except on grounds of medical urgency, efficiency,
  or expediency. The rationale for this rule is to ensure the stabilization/survivability of the patient through
  TCCC, and far forward resuscitative surgery is accomplished prior to movement between MTFs (Roles 1
  through 3).