text: Chapter 5
  MEDICAL SUPPORT IN DENSE URBAN ENVIRONMENTS
  5-125. Security and the limits of operational reach determine the medical support required in dense urban
  environments. Civil information obtained during competition and crisis is analyzed and evaluated into civil
  knowledge, which is integrated into the Army integrating processes. This action is accomplished by the civil
  affairs staff officers (G-9/S-9) at corps echelon and below, to include the J-9 at joint and theater levels.
  PLAN, RESOURCE, COORDINATE, AND SYNCHRONIZE LARGE-SCALE CASUALTY EVENTS
  5-126. Patient movement occurs at the tactical, operational, and theater strategic levels and requires the
  synchronization and integration of Service component resources as well as coordination with air evacuation
  liaison teams and HR casualty liaison elements for personnel accountability. Strategic medical regulating
  officers coordinate and synchronize multi-modal global patient movement options (USTRANSCOM, unified
  action partners, and the global patient evacuation enterprise) for projected and surging requirements.
  Operational medical regulating officers (TMC, MEDBDE [SPT], MMB) coordinate and synchronize medical
  evacuation operations with aviation and sustainment organizations. Tactical medical staff (brigade surgeon,
  BSB SPO-Medical, BSMC, battalion medical operations officer/ platoon leader) coordinate with the chain
  of command, organic sustainment assets (first sergeants, FSCs), and supporting assets for air and ground
  evacuation and medical evacuation operations. EAB casualty liaison elements and other HR squads leverage
  the liaison officer chain at Role 3 and Role 4 MTFs to maintain accountability and readiness status of
  personnel throughout the continuum of care.
  5-127. Casualty information is collected from all available sources on the battlefield and reported through
  official channels as quickly as possible. The ASCC human resources operations center plans, coordinates,
  integrates, and synchronizes theater-level casualty reporting, and provides additional planning capacity and
  oversight. It establishes the theater casualty information center and oversees casualty reporting and policies
  developed by the ASCC G-1/AG. The casualty reporting mission needs to take priority, and additional
  requirements for information from higher levels may increase the complexity of the reporting requirements.
  5-128. During large-scale combat operations, units will report all casualties to include American civilians,
  DOD, and DA Civilians, contractors authorized to accompany the force, and personnel of other Services. A
  casualty is any person who is lost to the organization by having been declared deceased, duty status-
  whereabouts unknown, excused absence-whereabouts unknown, missing, injured, or ill. Mortuary affairs
  collection teams may need to be collocated with the BSB due to large-scale combat operations casualty
  estimates. For additional information see, ATP 4-46.
  5-129. When a casualty occurs, the commander of the unit in which a casualty occurs has the responsibility
  for initiating the casualty report using the tactical casualty report, or the Defense Casualty Information
  Processing System – Personnel Casualty Report spreadsheet for single casualty or multiple casualties. All
  persons with knowledge of a casualty will report to their chain of command using the tactical casualty report.
  The tactical casualty report or applicable Defense Casualty Information Processing System – Personnel
  Casualty Report spreadsheet (single casualty or multiple casualties) may be used to submit an initial report
  when a casualty incident is observed. Casualty information is frequently incomplete on the battlefield. This
  should not delay the initial report submission. Updated casualty information is provided as it becomes
  available. The G-1/AG and S-1 at echelon have overall responsibility for casualty reporting on behalf of their
  formations with the brigade S-1 having responsibility to submit the initial casualty report using Defense
  Casualty Information Processing System in accordance with the ASCC human resources operations center
  casualty reporting guidance to ensure all echelons have visibility. Human resources squads and teams
  performing casualty reporting missions work with the ASCC human resources operations center operating
  the theater casualty information center to provide accurate and timely casualty reporting and tracking
  information at Role 3 MTFs, theater mortuary affairs company HQ, General Officer commands, and the
  theater casualty information center to supplement casualty reporting information from G-1/AGs and S-1s at
  echelon. (NOTE: Role 1 tracking is performed at the battalion aid station whereas Role 2 reporting is
  performed at the BSMC.) Due to the personal nature of information within casualty reports, the theater CIC
  reports casualty information to the Casualty and Mortuary Affairs Operations Division using Defense
  Casualty Information Processing System as the official means of casualty reporting. In the absence of the
  ASCC human resources operations center, the senior element G-1/AG must immediately assume the role of
  the theater CIC.