[Fixed Hospitals of the Medical Department (General and Station Hospitals)]
[From the U.S. Government Publishing Office, www.gpo.gov]

VH.SSt 0 TM 8-260
Document
Reserve
I WAR DEPARTMENT
TECHNICAL MANUAL
FIXED HOSPITALS OF THE
MEDICAL DEPARTMENT
(GENERAL AND STATION HOSPITALS)
July 16,1941
NON-CIRCULATING
NTSO LIBRARY

TECHNICAL MANUAL
TM 8-260
C 1
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT (GENERAL
AND STATION HOSPITALS)
Cha ng es 1 WAR DEPARTMENT,
No. 1 | Was hi ng to n , March 31, 1942.
TM 8-260, July 16,1941, is changed as follows:
6. Supply.—a. The initial supplies * * * may be directed.
In order to visualize the amount of supplies and equipment necessary
to equip a general hospital, reference is made to the following approximate
figures: Net weight, 408,488 pounds; shipping weight, 754
tons; volume, 30,000 cubic feet; freight cars required, 13.6; trucks
li/2-ton, 73.3. The number of separate packages required to pack
the initial supplies for a general hospital is 2,474, but if the individual
items are counted the total runs up to 100,000.
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
20. Function.—The functions are—
*******
d. Information given out.—Information concerning the condition
of sick and wounded, necessary to allay the anxiety of
friends, is given freely under the instructions of the commanding
officer, except that in no instance is the diagnosis
or information which might be used as a basis for a claim
against the Government furnished. Such requests are referred
to the adjutant or the executive officer.
****** *
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
42. Admission of patients.—a. General.— (1) All patients are
admitted through the receiving and disposition office, where the required
admission data are made of record and assignment to a proper
ward effected. In emergency the patient may be taken direct to the
ward and the necessary admission data obtained later.
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
55. Property.
*******
b. Exchange and replacement.
****** *
(2) All supplies classed as “supervised” by The Surgeon General
which have become unserviceable through fair wear and tear in the
public service are accompanied with a certificate in quadruplicate
449748—42
un.M-.vxbd

TM 8-260
TECHNICAL MANUAL C 1
signed by the responsible officer covering the unserviceability. This
certificate gives all information required by paragraph 36, Medical
Department Supply Catalog.
*******
[A. G. 062.11 (12-30-41).J (Cl, Mar. 31, 1942.)
59. Transfer of property.
*******
b. Upon receipt of orders for change of station or upon change of
duties which require transfer of accountability, the medical supply
officer will transfer the property to his successor in accordance
with the provisions of AR 35—6680. In the event that his authorized
relief has not reported prior to the departure of the medical
supply officer, an officer of the Medical Department is temporarily
appointed to assume medical accountability, receipt being taken as
required in AR 35-6680.
****** *
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
70. Procedure for other than separation from service or
transfer to another hospital.
*******
b. Patients on enlisted status.
*******
(2) Prior to the discharge of enlisted patients other than from
command, the commanding officer, detachment of patients, furnishes
the patient with a clearance form and instructs him to have it
initialed by the heads of the departments concerned and return the
form to the detachment of patients office, where it is filed in his 201
file.
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
71. Separation from service or transfer to another hospital.—
a. Officers.— (1) When the adjutant * * * and returns
it to the ward officer. He also approves the clinical record, has prepared
from it an abstract to accompany patient being transferred to
other hospital, and then transmits the clinical record to the registrar
to be forwarded to the other hospital.
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
96. Line of duty boards.—a. AR 345-415 directs that battle
casualties, injuries received while operating or riding in Government
vehicles or airplanes, and injuries received while on
maneuvers, during authorized athletic exercises, or other-
2

____m_u ------„------_ __'_ -_--_-_--_‘-_--_-_--_-_--_ nmvr «_o«n
TfcXAS STATE COLLEGE FOR WUMEK
I IRK? ADV TM 260
FIXED HOSPITALS (5f THE Mu SDTCAL DEPARTMENT C 1
wise while engaged in the execution of military duty, will be
considered to have been incurred in line of duty, provided misconduct
or gross negligence is not a contributory factor. In
such cases not involving misconduct or gross negligence, the
line of duty will be determined by the commanding officer or
the next superior officer and the surgeon. In every case of injury,
which in the opinion of the surgeon is likely to result in a partial
or complete disability and eventually be made the basis of a claim
against the Government, and which was incurred while on pass,
furlough, leave, or as a result of misconduct or gross negligence,
the commanding officer upon recommendation of the surgeon
will convene a board of officers to investigate and report upon the
circumstances attending the injury (AR 345-415).
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
98. Registrar.
*******
Z>. Supervision of clerical work.—The registrar coordinates all matters
relating to the discharge of enlisted patients on certificates of
disability. He is responsible that the entries on the certificate of
disability are correct and that upon completion of the discharge the
certificate of disability and allied papers are disposed of as directed
by section II, AR 615-360.
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appendix I
CHECK LIST FOR MEDICAL (HOSPITAL) INSPECTOR
2. Environmental sanitation.
*******
b. Public buildings.
* * * * * * *
(4) Bakeries.
*******
(z) Are towels or other cloths in use? (AR 40-205.)
*******
d. Disposal of garbage, manure, dead animals, and other refuse.
*******
(2) Is garbage collector permitted to transfer garbage from can to
can during collections at kitchens, thus creating a polluted condition
of the soil? (AR 40-205.)
*******
3

TM 8-260
TECHNICAL MANUAL C 1
e. Food supplies and their preparation.
* * * * * * *
(8) Is raw milk sold on the post ? (Ch. XI, Army Medical Bulletin
No. 23.)
*******
(11) Is milk used on the post from cows giving a positive agglutination
test? (Ch. XI, Army Medical Bulletin No. 23.)
*******
(33) Are dish cloths in use? (AR 40-205.)
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appendix II
CHECK LIST FOR COMMANDING OFFICER OR SURGEON
23/. Helpless patients are not kept above second floor of hospital
(AR 40-590).
[A. G. 062.11 (12-30-41).] (C 1, Mar. 31, 1942.)
37e. Are officers on duty at the hospital subsisted at the hospital
mess? (AR 40-590.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
47. Are civilian physicians in Army hospitals authorized to sign
official papers pertaining to military personnel? (Par. 8, circular
letter No. 1, S. G. O., 1940.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appe ndix III
CHECK LIST FOR REGISTRAR
51. Injuries are reported as required (par. 10 g and A, circular
letter No. 1, S. G. O., 1940).
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appendi x IV
CHECK LIST FOR MEDICAL SUPPLY OFFICER
4c. Are issues made at any hour of the day or night if a request is
made? (AR 40-590.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
7. Is an accumulation of nonstandard supplies on hand? (Circular
letter No. 1, S. G. O., 1940.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
4

mivr
TH 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT C 1
8. Is a record of surplus property kept? (AR 40-1705.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
12.
* * * * * * *
b. Is it customary to keep any of the narcotics or alcohol listed below
stored in unit equipment ?
* * * * * * *
d. Is a list of the above items kept in the equipment chests to
avoid danger of delay or shortage when a unit takes the field?
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
17(7. Do records show excessive exchange of biologicals? (Par. 64,
circular letter No. 1, S. G. O., 1940.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
20. Are separate meters installed to record the electric current used
for X-ray machines, centrifuges, and other such purposes?
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
39. Is hospital laundry put out to private laundries on contract or
informal agreement? (AR 40-590.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
446. Is there an accumulation of obsolete or damaged medical
books? (AR 40-1705.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
456. Was payment made from the hospital fund? (AR 40-590.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appendix V
CHECK LIST FOR DIRECTOR OF DIETETICS (MESS
OFFICER)
2h. Are containers for poisons such as rat poisons, roach powders,
etc., kept in the mess room? (AR 40-590.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
9(7. Mess officer has copies of TM 10-405 and 10—410.
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
5

TM 8-260
TECHNICAL MANUAL c 1
Appendix VI
CHECK LIST FOR COMMANDING OFFICER, MEDICAL
DETACHMENT
23. Are enlisted men permitted to wear the white uniform when
not actually engaged in an appropriate duty in the hospital? (AR
600-40.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appendi x VII
CHECK LIST FOR PRINCIPAL CHIEF NURSE
19. Is it possible to grant annual leave to the nurses without crippling
the service ?
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
21. Are expenditures from the hospital fund made for furnishings
for nurses’ recreation rooms or for other purposes? (AR 210-50, and
par. 15, circular letter No. 1, S. G. O., 1940.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
24. Does the principal chief nurse maintain a council book to
account for moneys received from miscellaneous sources in violation
of existing regulations? (Par. 15, circular letter No. 1, S. G. O., 1940.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appendi x VIII
CHECK LIST FOR CHIEF OF SURGICAL SERVICE
2. Genito-urinary section.
*******
/(2)(Z>) Are patients with gonorrhoea retained in hospital until
satisfactorily cured ?
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
4. Surgical wards.
*******
A (3) Is soiled clothing of patients laundered at Government
expense as a part of the hospital laundry? (AR 40-590.)
*******
s(l) Dietitian and head nurse are responsible for the service of
meals.
*******
6

TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT C 1
(9) Are attendants permitted to eat in the wards or diet kitchens?
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appen dix XI
CHECK LIST FOR CHIEF OF DENTAL SERVICE
5. Are enlisted men assigned to dental service regarded as being
on special duty and under special instruction, and not required to
attend any other form of instruction? (AR 40-15.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appen dix XII
CHECK LIST FOR CHIEF OF ROENTGENOLOGICAL
SERVICE
61. Are films stored in rooms which are shared with other activities ?
*******
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
Appen dix XIV
CHECK LIST FOR OFFICER IN CHARGE OF PHARMACY
12. Have unduly large amounts of alcoholic liquors been prescribed
at one time for any one person? (AR 40-590.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
22. Are prescriptions refilled without a written order calling for a
refill by number? (TM 8-233.)
[A. G. 062.11 (12-30-41).] (Cl, Mar. 31, 1942.)
By order of the Secretary of War :
G. C. MARSHALL,
Chief of Staff.
Off icial :
J. A. ULIO,
Major General,
The Adjutant General.
U. S. GOVERNMENT PRINTING OFFICE! 1942
TEXAS STATE COLLEGE FOR WOMEN
library
TM 8-260
C 2
tour:
TECHNICAL MANUAL
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT
(GENERAL AND STATION HOSPITALS)
War Depart ment .
Washington , February 9, 1943.
Changes
No. 2
TM 8-260, July 16, 1941, is changed as follows:
12. Administrative service.
/. Principal chief nurse.—The principal chief nurse has general
supervision over all Army nurses on duty at the hospital, arranges
the hours of duty, their assignment, and is responsible
discipline both on and off duty. (She brings to * * *
VII).
*
for their
and app.
* * * * * *
[A. G. 062.11 (2-1-43).] (C 2, Feb. 9, 1943.)
36. Messes for patient officers.—The director of dietetics causes
a separate mess to be maintained for all patients on an officer status.
Ambulant patients on an officer status on regular diets should be
furnished table service.
[A. G. 062.11 (2-1-43).] (C 2, Feb. 9, 1943.)
37. Nurses’ funds.—Rescinded.
[A. G. 062.11 (2-1-43).] (C 2, Feb. 9, 1943.)
By order of the Secr eta ry of War :
G. C. MARSHALL,
Chief of Staff.
Off icial :
J. A. ULIO,
Major General,
The Adjutant General.
512105°—43
U. S. GOVERNMENT PRINTING OFFICE: 1943

TM 8-260
C 3
TECHNICAL MANUAL
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT
(GENERAL AND STATION HOSPITALS)
Cha ng es 1 WAR DEPARTMENT,
No- 3 J Wash in gt on 25, D. C., 8 January 1944.
TM 8—260, 16 July 1941, is changed as follows:
179, Examinations,
* * * 3* $ $ $
1). Procedure.
*******
(2) Wassermann test.—Blood specimens for * * * laboratory
before 9:00 AM. Requests for Wassermann tests are prepared on
W. D., M. D. Form No. 55L-3.
* * *
* * * * * * *
[A. G. 300.7 (4 Dec 43).] (C 3, 8 Jan 44.)
254. Miscellaneous urological procedures.
* * * * * tj.
k. Venereal disease.—Rescinded.
[A. G. 300.7 (4 Dec 43).] (C 3, 8 Jan 44.)
Appen dix VIII
CHECK LIST FOR CHIEF OF SURGICAL SERVICE
* * * * , * * *
2. Genito-urinary section.—Rescinded.
[A. G. 300.7 (4 Dec 43).] (C 3, 8 Jan 44.)
By or de r of the Secr etar y of War :
G. C. MARSHALL,
Chief of Staff.
Offi ci al :
J. A. ULIO,
Major General,
The Adjutant General.
568627°—44 U. S. GOVERNMENT PRINTING OFFICE: 1944

TM 8-260
TECHNICAL MANUAL
No. 8-260
WAR DEPARTAIENT,
Washin gton , July 16,1941.
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT
(GENERAL AND STATION HOSPITALS)
Prepared under direction of
The Surgeon General
Chapter 1. Fundamental considerations. Paragraphs
Section I. General orientation____________________ 1-7
II. Organization of general hospital________ 8-14
III. Establishment of general hospital________ 15-17
Chap ter 2. Administrative procedure.
Section I. General____._________________________ 18
II. Information office_____________________ 19-21
III. Dietetic department___________________ 22-39
IV. Receiving and disposition officer1________ 40-50
V. Medical supply department_____________ 51-60
VI. Admission of patients_________________ 61-68
VII. Discharge of patients_________________ 69-76
VIII. Seriously ill patients__________________ 77-82
IX. Patients’ funds and valuables___________ 83-90
X. Disease or injury______________________ 91-96
XI. Action on discharge for disability________ 97-100
XII. Deaths ----------------------------------------------101-107
XIII. Clothing and baggage of patients_________108-115
XIV. Medical detachment____________________ 116-122
XV. Administrative officer of the day__________ 123-132
XVI. General supply and utilities______________ 133-138
Chapte r 3. Professional services.
Section I. General_______________________________ 139-144
II. Ward officer___________________________145-157
III. Detention ward________________________ 158-164
IV. Neuropsychiatric section_________________ 165-176
V. Laboratory service_____________________ 177-183
VI. Roentgenological service_________________184-188
VII. Dental service_________________________ 189-198
VIII. Army Nurse Corps and nursing service___ 199-204
IX. Dispensary --------------------------------------- 205-209
X. Pharmacy ------------------------------------------210-216
XL Professional officers of the day__________ 217-223
820358 s—41------1 i
TM 8-260
Chapte r 4. Professional standing orders. paragraphs
Section I. General______________________________ 224
II. Medical service---------- 225-232
III. General surgery______________________ 233-243
IV. Orthopedic surgery..--------------------------- 244-248
V. Genito-urinary surgery------------------------- 249-254
VI. Eye, ear, nose, and throat surgery------------- 255-256
VII. Dental and oral surgery------------------------ 257-262
VIII. Roentgenology________________________ 263-267
IX. Physical therapy (fever therapy) section--- 268-271
X. Acute poisonings, their antidotes and
treatment-------------------------------- 272
Chapt er 5. Station hospital_________________________ 273-276
Appendixes . Check lists.
I. Medical (hospital) inspector----------------- 1-6
II. Commanding officer or surgeon--------------- 1-47
III. Registrar___________________________ 1-52
IV. Medical supply officer--------------------------- 1-51
V. Director of dietetics (mess officer)------------ 1-13
VI. Commanding officer, medical detachment— 1-36
VII. Principal chief nurse--------------------------- 1-24
VIII. Chief of surgical service----------------------- 1-4
IX. Chief of medical service------------------------ 1-2
X. Officer in charge of laboratory----------------- 1-21
XI. Chief of dental service--------------------------- 1-24
XII. Chief of Roentgenological service------------ 1-7
XIII. Officer in charge of dispensary__________ 1-11
XIV. Officer in charge of pharmacy___________ 1-41
Page
Index _____________________________________________ 257
2
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 1
Chapter 1
FUNDAMENTAL CONSIDERATIONS
Paragraphs
Secti on I. General orientation_________________________ 1-7
IL Organization of general hospital______________ 8-14
III. Establishment of general hospital______________15-17
Section I
GENERAL ORIENTATION
Paragraph
General provisions______________________________________ j
Designation and identification_______________________________________ 2
Functions and control_____________________________________________ 3
Purpose________________________________ 4
Distribution and time of establishment________________________________ 5
Supply------------------------------------------------------------------------------------------- 6
Groupings of general hospital________________________________________ 7
1. General provisions.—a. Main classes— Hospitals provided by
and for the Army in peace or war are divided into two main
classes:
(1) Stationary or fixed (the “fixed establishments” of the Geneva
Convention).
(2) Field or mobile (the “mobile sanitary formations” of the
Geneva Convention).
b. Types.—(1) Fixed hospitals.—In time of peace or war at home
or abroad, only two types of fixed hospitals are maintained for permanent
or definitive hospitalization:
(a) Station hospitals (at times called post or camp hospitals).
(&) General hospitals (including those formerly called department
or base hospitals).
(2) Mobile hospitals.—In time of actual or threatened hostilities
or whenever in peace troops are in the field where fixed hospitals
are not available, readily accessible, or sufficient to meet the needs,
the following types of mobile units (see FM 8-5) provided for in
Tables of Organization are established for temporary or emergency
hospitalization:
(a) Clearing stations (formerly called field hospitals and hospital
stations).
(5) Surgical hospitals (formerly called mobile hospitals).
(c) Evacuation hospitals.
() Fixed hospitals located in a theater of operations are designated
and identified only by their number, type, and title. Their
location is not given. For example, 6th Station Hospital; 110th
General Hospital; 7th Veterinary General Hospital.
(c) Fixed hospitals bearing a numerical designation are given a
number in a consecutive series from one upward for each type.
(3) Names for general hospitals.—As required from time to time
appropriate names recommended by The Surgeon General for such
new general hospitals as may be established in the zone of the interior
are, upon approval of the Secretary of War, announced in
War Department orders.
b. Mobile hospitals.—Mobile hospitals are designated by giving
their number, type and title, without location. The number is assigned
by the War Department and is consecutive for each type. For
example, 2d Surgical Hospital; 5th Evacuation Hospital (see FM
8-5); 11th Veterinary Evacuation Hospital.
3. Functions and control.—a. Fixed hospitals.—The normal field
of usefulness for fixed hospitals is in the communications zone and
in the zone of the interior and not in the combat zone.
(1) Station hospitals.—A station hospital normally receives patients
only from the station to which it pertains. In exceptional instances
it may serve the needs of a circumscribed area, or may be
designated to receive special cases from any place without a corps area
or other military command under the control of whose commander it
functions. A station hospital in peace or war functions under such
local, district, section, or corps area control as may be prescribed by
the superior commander under whose jurisdiction it is being
administered.
4
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 3-4
(2) General hospitals.—(a) A general hospital is designed to
serve general and special rather than local and ordinary needs. Those
in the zone of the interior are located at such places as may be recommended
by The Surgeon General and approved by the War
Department.
(&) The control of general hospitals by higher authority is so arranged
that it is subjected to a minimum of administrative interference
in its work. Since the work of a general hospital is largely of
a professional nature it has been found that the service can best be
carried on untrammeled by direct military control. Within the continental
limits of the United States the general hospitals function
under the control of The Surgeon General, subject to the exemptions
prescribed in AR 170-10. The senior medical officer on duty with a
general hospital commands it and, within the continental limits of
the United States, is not subject to the orders of a local commander
other than the commanding general of the corps area in which the
hospital is located, to whom specific authority may be delegated by
AR 170-10. General hospitals in the insular possessions and those
in a theater of operations function under the control of the department
or tactical commanders within whose jurisdiction they may be
located.
5. Mobile hospitals.—Mobile hospitals are provided to meet the
needs of troops in the field or in campaign where it is impracticable
to establish fixed hospitals. They also serve as relay points in the
evacuation of patients to fixed hospitals where definite treatment can
be given most advantageously. Their normal field of usefulness is
in the combat zone. They function under the control of the tactical
or territorial commander under whom they may be assigned by proper
authority (see FM 8-5).
4. Purpose.—General hospitals are designed to—
a. Afford better facilities than can be provided at the ordinary station
or other hospitals for the study, observation, and treatment of
serious, complicated, or obscure cases. For this reason, general hospitals
are equipped with the most modern apparatus and assigned
especially qualified personnel.
b. Afford opportunities for the performance of the more difficult
or formidable surgical operations, facilities for which may be lacking
at station or mobile hospitals.
c. Study and finally dispose of cases that may have long resisted
treatment elsewhere, and to determine questions of the existence, cause,
extent, and permanence of mental and physical disabilities of long
standing or unusual obscurity.
5
TM 8-260
4—5 MEDICAL DEPARTMENT
d. Instruct and train junior Medical Department officers in general
professional and administrative duties.
e. Form the nucleus for the initial hospitalization needs of the zone
of the interior in time of war.
/. Receive and give definitive treatment to patients from other hospitals
in the theater of operations, particularly mobile units in the
combat area.
5. Distribution and time of establishment.—a. General hospitals
of the theater of operations are priority units in a general mobilization
plan and will be established whenever the armed
forces proceed to the theater of operations. The number employed
in the theater of operations depends upon the proximity of the zone
of the interior thereto. If these adjoin—no sea paths separating
them—general hospitals are usually established in the communication
zone only at the rate of one per division. Within hospitalization
allowances in terms of beds, the balance needed and not allocated to
the theater of operations is established in territory pertaining to the
zone of the interior. (See MR 4-2 and FM 100-10.)
b. Each general hospital in the theater of operations has a normal
capacity of 1,000 beds and is provided with personnel who, in emergencies
and by crisis expansion under tentage, may care for 2,000 patients
if the period of stress is not too prolonged. General hospitals
receive cases by hospital trains, airplanes, or ambulances direct from
the evacuation hospitals at the front and from other general hospitals
making retrograde secondary evacuation, as well as cases originating
in the communications zone. Being completely equipped from a medical
and surgical standpoint they give treatment to all types of cases
sent to them, forwarding to the zone of the interior only such cases
as require special treatment or are not likely to be fit for service for
a considerable period of time, or will probably be permanently incapacitated
for further duty. However, where their capacity is being
taxed or an extension of active fighting is m immediate prospect, they
must either be evacuated of suitable cases or reinforced by expansion
of accommodations already existing. No individual capable of further
duty in the immediate future should ever be sent farther to the
rear than a general hospital in the communications zone since experience
has shown that the services of a great proportion of cases coming
into the zone of the interior will probably be Jost for the campaign
if not for the war.
c. No standard capacity or equipment is prescribed for fixed hospitals
in time of peace, nor ordinarily in the case of those pertaining to
the zone of the interior in time of war. Their capacity and equip-
6
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 5-7
ment vary according to and are governed by local as well as general
requirements.
6. Supply.—a. The initial supplies required for the establishment
of a general hospital are assembled in the supply depots in the zone of
the interior or the communications zone as the case may be. They
may be requisitioned by the commanding officer in the form of a
request for “one general hospital” when the unit is ordered to duty
at the site finally selected. Tentative training equipment tables have
been prepared for the use of general hospitals while undergoing training
and this equipment will be left at training station sites or returned
to depots as may be directed. In order to visualize the amount of
supplies and equipment necessary to equip a general hospital reference
is made to the following approximate figures: Net weight, 220,083
pounds; shipping weight, 324 tons; volume, 13,000 cubic feet; freight
cars required, 7.3; trucks, 1%-ton, 73.3. The number of separate
packages required to pack the initial supplies for a general hospital
is 2,474, but if the individual items are counted the total runs up to
100,000.
&. Supplies required for the maintenance of a general hospital are
obtained periodically on requisition by the supply officer from the
Medical Department sections of the supply depots of the communications
zone or zone of the interior. Certain supplies such as food
stuffs may be obtained by local procurement. Special articles such
as nonstandard surgical or laboratory instruments may be furnished
by the American Red Cross.
7. Groupings of general hospital.—When possible two or more
general hospitals with a convalescent camp (capacity of 1,000) are
grouped together under an overhead known as the hospital center.
This arrangement has the advantage of economy of administration,
and offers the opportunity for specialization and pooling of transportation
facilities. From an administration point of view, it is
highly desirable to pool or otherwise centralize such features as quartermaster
and medical supplies, laundries, bakeries, water transport,
power, heat, military police, and fire prevention. Professionally, the
hospital center is advantageous in that it permits the special assignment
of one general hospital to any desired specialty or group of cases.
7
TM 8-260
8-10 MEDICAL DEPARTMENT
Section II
ORGANIZATION OF GENERAL HOSPITAL
Paragraph
Basis and divisions_______________________________________________ 8
Headquarters______________________________________________________ 9
Commanding officer_________________________________________________ 10
Unit staff__________________________________________________________ 11
Administrative service--------------------------------------------------------------------- 12
Professional service_________________________________________________ 13
Training___________________________________________________________ 14
8. Basis and divisions.—The general organization of numbered
general hospitals is in conformity with T/O 8-507 and with provisions
of AR 40-590. The organization falls naturally into three divisions,
the headquarters, the administrative, and the professional services.
The two services are not subordinate command elements but rather
a grouping of elements possessing related functions. The chain of
command is from the hospital commander directly to the commander
of the separate functional elements of the two major services.
9. Headquarters.—The headquarters consists of the unit commander,
the senior officer of the Medical Corps assigned and present
for duty (see par. 10), his staff (see par. 11), and the personnel necessary
to assist in the general administration of the unit and its
installation.
10. Commanding officer.—a. The commanding officer of a general
hospital is responsible for its proper discipline and administration,
including the care and preparation of the necessary reports, registers,
and records, as well as for the care and safeguarding of all Government
property that may come into his possession, for the proper expenditure
of supplies and funds, and for the preparation of requisitions,
returns, and pay rolls of the hospital. While the commanding
officer is not charged with the execution of duties properly delegated
by him to an assistant, yet he is responsible for exercising such supervision
over duties thus delegated as to insure their prompt and efficient
performance by the designated subordinate. The responsibility of the
commanding officer for the action of his assistants is something that
must always be borne in mind. At the same time, the commanding
officer must not exercise this supervision to the extent of operating a
functional element that has been assigned to a subordinate.
b. The commanding officer is responsible for the military and technical
training of all elements of his command. He must—
(1) Insure the attainment of proper training objectives prior to the
time his unit goes to the theater of operations.
8
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 10-11
(2) Establish policies regarding the various procedures involved
in the establishment and operation of the hospital, and assign
appropriate personnel to the various divisions (see app. II).
11. Unit staff.—a. Executive officer.—The executive officer is
charged under the direction of the commanding officer with the co -
co mman di ng OFFICER.
OR STATION SURGEON
I
I
________________________ I_______________
ADMINISTRATIVE _________ VETERINARY
OFFICER OF THE DAY I SERVICE
MEDICAL I _ A P _ PROFESSIONAL GENERALSURGERY I
INSPECTOR | OFFICER OF THE DAY *“------------------------------------
ZZZZZZZZZZ D R I—| ORTHOPEDICSREGISTRAR
CO. DET.. PATIENTS 4A O .-------------- , _J-----SEPT|C-------1 ----------------------------------------- ----- 1 SURGICAL SERVICE ~----------SEPTIC------------- 1
MED! CAL "Ul F HZ UROLOGY |
SUPPLY OFFICER N E I I EYE-EAR-NOSE
----------------------------------------- AND THROAMTESS ___ OFFICER._______ | £ _l ROENTGENOLOGICAL I
--------- SERVICE---------- | GENERALMEDICINE
COMMANDING OFFICER _JS S I .... DET..MED. DEPT _ COMMUNICABLE-> J | I DISEASE
PRINCIPAL I I--------------------------------------1
CHIEF NURSE JIW lOl r-—-7^—n H NEUROPSYCHIATRY |
w —[med ic al se rv ic e |—
OFFICER IN CHG ___ A N -(GASTRO-INTESTINAL |
OF UTILITIES ________________ T A "I CARPIO-VASCULAR."]
| LABSOERRVAITCOE RY *—I< ----------O, FFICERS |
V + ,________ , ----- 1 DENTAL SERVICE | E A PHARMACY [
DISPENSARY AND ______ ________________
_ OUT-PATI ENT SER- -4 PROPHYLAXIS
VICE. FORMERLY “ --------------------------------------1
ATT E N DI NG SU RG ---------------------------------------,
__ ----------------------------------- L-fGEN.EXAM.frTREAT.
Figu ke 1.—Organization of a hospital (to be used as a guide only).
ordination of all activities of the hospital and such additional duties
as may be prescribed by the commanding officer. All questions arising
in the hospital on which a decision must be rendered, unless they
are of a major character or are ones of policy, are decided by the
9
TM 8-260
11-12 MEDICAL DEPARTMENT
executive officer in the name of the commanding officer. Until the
executive officer is thoroughly conversant with the policies of the
commanding officer, all questions should be submitted to the commanding
officer if there is any possibility of doubt as to what his desires
in the matter may be. The decision of the commanding officer
is final and the executive officer must carry it out. Loyalty must
always be the keyword of this position.
b. Adjutant.—The adjutant performs the duties of his office as prescribed
in AR 90-50 (see also FM 101-5). He has charge of civilian
employees and is responsible for the proper operation of an
office for information. He has charge of all incoming and outgoing
correspondence, orders, circulars, and has general control of all hospital
records. He verifies and issues all orders and details, including
administrative assignments both special and by roster of officers
and civilian employees. He should keep a check on the audit of all
public funds and submit a report of audit, together with a statement
of all funds to the commanding officer as soon as possible after the
end of each month.
c. Medical supply officer.—The medical supply officer is charged
with the procurement, storage, and issue of all medical supplies at the
hospital, and is accountable for all medical property, except where
other accountability is specifically designated by proper authority.
He submits the required requisitions, etc., and maintains the necessary
property and other records pertaining to his office which may be
required by existing regulations. (See AR 40-1705. See also pars.
51-60 and app. IV.)
d. Chaplain.—See TM 10-205.
e. Personnel officer.—The personnel officer is the assistant adjutant
and is charged with the administration of all personnel matters except
those retained by the medical detachment and the detachment of
patients (see AR 345-5). It is suggested that the lieutenant, Medical
Administrative Corps, in the registrar and detachment of patients
section be charged with this office. Collectively, his clerical assistants
are designated the unit personnel section and are furnished from the
detachment Medical Department, supplemented if necessary by personnel
of the unit headquarters.
12. Administrative service.—a. Registrar.—The registrar performs
the duties outlined in AR 40-590 and such additional duties
as may be prescribed by the commanding officer. He has charge
of sick and 'wounded records and reports. He exercises administrative
jurisdiction over all matters pertaining to deaths, casualty
reports, and disposition of remains, and makes such reports in con-
10
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 12
nection therewith as may be required by existing regulations (AR
40-1025). He prepares the necessary notification to the nearest relative
or friend of casualties within the hospital.
b. Director of dietetics.—The director of dietetics has charge of and
is responsible for the administration of all that pertains to the hospital
messes. He is the custodian of the hospital fund and as such
is responsible that it is administered in accordance with existing
regulations (see pars. 22-41, and app. V).
c. Commanding officer, detachment of patients.—The commanding
officer, detachment of patients, exercises immediate command over all
patients and has charge of all records, reports, and correspondence
pertaining thereto. He also has charge of all money and valuables
belonging to patients. He is, in addition, in charge of the patients’
baggage room (see pars. 83-90 and 108-115).
d. Commanding officer, medical detachment.—The commanding
officer, medical detachment, exercises immediate command over all
enlisted personnel in the Medical Department on duty at the hospital,
supplying such details, temporary or permanent, to different
wards or departments of the hospital as may be required. He is
responsible for the discipline, training, equipment, uniform, and
quartering of all men of his detachment (see pars. 116-122 and
app. VI).
e. Receiving and disposition officer.—The receiving and disposition
officer is responsible for the admission and disposition of all patients
to and from the hospital. He receives, examines, classifies, and sends
to the proper wards all incoming patients, exercising due care and
precaution in the prompt isolation of all communicable diseases. He
keeps informed at all times concerning the number of beds available
in the various wards and foresees and provides for expected arrivals.
He supervises the transportation of sick or wounded to and from the
hospital. He temporarily receives and safeguards the money and
valuables of incoming patients and receives and receipts for the baggage
of patients prior to release to commanding officer, detachment
of patients. He prepares all required forms, records, and notifications
in connection with the admission of patients. He makes all
arrangements for patients leaving the hospital. When a convoy of
patients is being evacuated from the hospital, he should check the
convoy by name and see that necessary records and papers are
complete and go with the shipment (see pars. 40-50).
/. Principal chief nurse.—The principal chief nurse has general
supervision over all Army nurses on duty at the hospital, arranges
the hours of duty, their assignment, has supervision over their messes,
11
TH 8-260
12-13 MEDICAL DEPARTMENT
and is responsible for their discipline both on and off duty. She
brings to the attention of the commanding officer any serious breach
of discipline on the part of a nurse or other occupant of the nurses’
quarters. The principal chief nurse is in charge of the nurses’ quarters,
the property contained therein, is responsible for the comfort
and well-being of the nurses under her, and for the proper keeping
of the necessary records pertaining to Army nurses (see pars. 199-204
and app. VII).
g. Hospital inspector.—The hospital inspector acts as medical
inspector of the hospital (AR 40-270), and makes such routine and
special inspections and investigations as may be prescribed by the
commanding officer. He makes a monthly check of all alcoholics,
narcotics, and habit-forming drugs in the pharmacy and in the hands
of the medical supply officer, reporting the fact of inspection and
existing irregularities to the commanding officer. He inspects and
checks, once each month, the narcotic books in all wards and departments,
noting facts and dates of inspection immediately after the last
entries in the books. In conformity with the provisions of paragraph
10(7, AR 210-10, he makes an inventory at least once a month of such
articles in the hands of accountable and responsible officers as may
be designated by the commanding officer, and upon completion
thereof reports the fact of inventory and irregularities so discovered
to the commanding officer. He makes frequent inspections of all
offices and departments of the hospital to insure that the regulations
governing their operations are on file and are being complied with
(see app. I).
13. Professional service (see ch. 3).—a. General.—(1) The professional
service represents a grouping of certain functional elements
of the hospital and is not an organic element of the unit.
Normally, each service, medical, etc., is an independent element of
the hospital and the chief thereof directly responsible to the unit
commander. The commander may subordinate certain auxiliary
service (s) to one of the major services. For example, the physical
therapy section may be placed under the command of the chief of
the medical or surgical service. These are decisions for the unit
commander and do not change the various functions of the services
involved.
(2) The professional service is responsible for the care and
treatment of all patients admitted to the hospital from the
time they are relinquished by the receiving and disposition officer
until they are returned to duty or turned over for transfer to a convalescent
or another general hospital. The professional service is
12
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 13-14
the basic functional element of the unit, and the headquarters and
the administrative service merely furnish those aids necessary to
permit the execution of appropriate procedures by that service.
b. Services.—The professional service is normally made up of five
principal services as follows:
(1) Medical service.—The medical service is made up of six sections
as follows:
(a) Gastroenterology.
(b) Neuropsychiatry.
(c) General medical.
( — — . .— . —
ENLISTED MENS ~ MESS 1 KITCHEN M-IQ 700-447 P P l P I F l O HEATING £ ~ "o' o' o' o' o' "O' ‘O' I O'
WARD - STANDARD_____________________ W- I 7QQ-462 V------ x x=-— J 4 POWER g O -S A £ A
.WARD_~-COMBINATION__________________ W-2 700-463 1 ] 1 i ] 1 O l P l PLANT > * N J • ’ ■ ’ ’ M - L Fn K 4 » ? ? . ? ? ? ? ? |?
-BaPBACkS____________________________ Hfi-SQ ZQ0-I2O4 5 5 $ " 35 & P k I F S M * ± i ? I ? x ? ? x
-STOREHOUSE_______________ ___________ SH-6 700 -461 r .... I I I ■ . II 1 J---- U ||p | " | ________________________
-STOREHOUSE--------------------------------------------SH~JZ_ 700-461 '- O P E N C O V E R E D W A L K-H I lH --------O P E N C O V E R E 0---------If'w A L K-J__ f -LAUNDRY-------------------------------------------------.LDY-1 7DQ-.441 . _ _ _ k -----------> J lJ ______ H
GARAGE_______________________________ G -l • 700-465 y W WIRE JENCE^ LIRE ROAD. _ <_______ If H RQAp_ "FIRE ROAD-
—■^E—pATLON.------------------------------------------ £rl------ ZQQ -439 [ f ~y | ] AT r PATIENTS
GUARD HOUSE------------------------------------------ GH-3 70Q-440 ] — । .— f . __ j... ,1 'A J I, RECREATION _
.MORGUE ------------------------------------------------- MO-2. 700-4 40 » I — ~ ~ ~ ~ F l «O L / O \ J I BUILDING ~A — FA FA FA P
PHYSIOTHERAPY-----.---------------------------------P_Y-1, 700-438 L 3 , ' L & , S ] 2 ] 31 3,1 A M a \ F FT S 1 S' 1 2 1 * Stl £ 1 “ 1
i ? ? i - s 7 t t ■<; t • ? ‘ \ P - 7 7 7 * T ? ?
..CLINIC 6. LABORATORY________________ C - JB_ | * * I * 1 £ * s l c r J £ 5 ° Il “ 5 5 $ 5
CLINIC - SPECIAL C-7A xasicnco |_ 3'11 ‘ = = it . A- 1 „... ■ L L - :L 1 ■ m=.I F — 1 1 - I— I - J pA — 11 H - l . .I 1 , 1 1 I I - -JLQ J LJ
1 ’ l l A_-------------------- E N C L O S E D lw| C O R R I D O R* ^E N C L O S E D ‘w. C O R R I D O P l / ,a l ~ 10:1 • a ' o I“J ° Q ° r q r z i c z | ? c z j c = | r q ■ UJ - □ □ r- I ° m t=q F 3 a a °
a -2i] §• ] S-j ° 3.j 3 j 3-j 3-j S j 3 j 3 j 3 j 3 j 3 j 3 j §.] 3.)
7 7 7 ^ 7 7 7 7 7 ” J j “ 7 , 7 7 7 7 7 5 J * J J ? 4 6 Q J J I J 5 ° 5 5 j
X ............. ........ — -?-E N C L O S E D C O R R I D O R— \_ ~ N c" L O S E D C O R ^ l D O R—
»o eo ©o t» wo 300 lr\ s ' L—*
OPEN COVERED s ' OPEN COVERED-^ /OPEN COVERED OPEN COVERED
SCALE (N FEET J L ' WALK _____________ J ________ __________ ’ WALK ____________ ^-WALK
[_] I | W-2 (26) J HQ-18 (tejF | HQ-24 (24) |= HQ -24 (24) | | A-3 j | HQ-18 (e)~|= =Jm-27 (25C| EE | W-2 (26) J | C-7A ]
APPROX AREA - 42 ACRES I'J ^NURSES ^NURSES QUARTERS,^ ( o P V ^—e—\ OFFICERS |° | QUARTERS / / \ QUARTERS —n
| | W-2 gsj" | HQ-120^ | HQ-24 (2T"|=1L^ HQ-18 (18) | [. * (=J1=(hQ-IB Q8) | W-2 >€)""(] I ~ 2 1
'—* *HQ-6 1 '
----------- x----------------------------------------------------------------------------------------------------- --------------- > k ______________/ S T R E E __T____ (6)_________________________________________________________— _ __________________________________________________________________
F ig u k e 2.— Building lay-out, typical 1,000-bed general hospital.
18
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 18-19
Chap ter 2
ADMINISTRATIVE PROCEDURE
Paragraphs
Secti on I. General________________________________ 18
II. Information office________________________ 19-21
III. Dietetic department______________________ 22-39
IV. Receiving and disposition officer____________ 40-50
V. Medical supply department________________ 51-60
VI. Admission of patients____________________ 61-68
VII. Discharge of patients_____________________ 69-76
VIII. Seriously ill patients_____________________ 77-82
IX. Patients’ funds and valuables______________ 83-90
X. Disease or injury________________________ 91-96
XI. Action on discharge for disability__________ 97-100
XII. Deaths__________________________________ 101-107
XIII. Clothing and baggage of patients_____________108-115
XIV. Medical detachment_______________________ 116-122
XV. Administrative officer of the day_____________ 123-132
XVI. General supply and utilities_________________ 133-138
Secti on I
GENERAL
Paragraph
General___________________________________________________________ 18
18. General.—The administrative procedures outlined herein are
basic and somewhat in detail. The procedures should serve as a
guide for unit administration and be modified to meet the varying
conditions with which the unit may be confronted.
Section II
INFORMATION OFFICE
Paragraph
Organization----------------------------------------------------------------------------------- 19
Function----------------------------------------------------------------------------------------- 20
Report of administrative officer of the day___________________________ 21
19. Organization.—The information office for the purpose of
administration is under the adjutant. A noncommissioned officer is
detailed in charge with such enlisted assistants as may be necessary.
This office is kept open 24 hours each day.
19
TM 8-260
20-21 MEDICAL DEPARTMENT
20. Function.—The functions are—•
a. Index of patients.—In order that a ready reference may be
available, a Kardex card is prepared for each and every patient admitted.
Care is exercised that all the data recorded are correct.
These cards are filed alphabetically according to last name in dictionary
index order. Any change in wards or other data are noted
immediately on this card. These cards remain in the “live file” until
the patient is returned to duty, discharged, dies, or is otherwise disposed
of, when the card is filed in a “dead file” in the same manner
as prescribed for the live file where it is kept for 3 months for
reference.
&. Rosters of duty personnel.—A roster of duty personnel, military
and civilian, is kept up to date for reference.
c. Roster of seriously ill patients.—A roster of patients who have
been reported as seriously ill is kept and no name will be removed
until a death notice has been received, or on the request of the commanding
officer, detatchment of patients, who is responsible that no
patient who has been reported as seriously ill remains on the roster
after recovering sufficiently to warrant the removal of the name from
the list.
d. Information given out.—All information requested is given
freely, except that in no instance is diagnosis furnished. Requests
for diagnosis are referred to the adjutant or the executive officer.
e. Packages, telegrams, special delivery letters, etc.; received.—All
packages, telegrams, special delivery letters, flowers, etc., received
for a patient who is in the hospital, are receipted for, entered in a
book provided for this purpose, and delivered to the patient with
the least practical delay. Receipt from the patient or the nurse in
charge of the ward is obtained in this book.
f. Function under administrative officer of the day.—During the
hours that the administrative offices of the hospital are closed, the
personnel perform such duties in and about the hospital as may be
directed by the administrative officer of the day as well as any
clerical work that may be required.
g. Telegrams.—A book is maintained in the information office
with a copy of the standard forms for routine telegrams which must
necessarily be transmitted during hours that administrative offices
of the hospital are closed. All telegrams sent out during these hours
conform to the appropriate form indicated in each case. Replies
to all telegrams, except official business, are sent collect.
21. Report of administrative officer of the day.—The report
of the administrative officer of the day is prepared in the infor-
20
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 21-23
mation office. All changes in duty personnel are recorded under the
appropriate heading.
Secti on III
DIETETIC DEPARTMENT
Paragraph
Organization______________________________________________________ 22
Director of dietetics_______________________________________________ 23
Chief dietitian_____________________________________________________ 24
Records___________________________________________________________ 25
Subsistence, medicine, and miscellaneous charges______________________ 26
Purchase of food supplies___________________________________________ 27
Night cook________________________________________________________ 28
Payment for supplies______________________________________________ 29
Bank deposits_____________________________________________________ 30
Meals--------------------------------------------------------------------------------------------- 31
Food handlers_____________________________________________________ 32
Inventory of supplies_______________________________________________ 33
Property responsibility______________________________________________ 34
Cafeteria system___________________________________________________ 35
Messes__________________________________ 36
Nurses’ funds_____________________________________________________ 37
Responsibility of ward officer_______________________________________ 38
Hospital council___________________________________________________ 39
22. Organization.—All messes at the hospital are under the immediate
supervision of an officer designated by the commanding officer,
who is known as the “director of dietetics” (mess officer). He may
delegate the direct supervision of the nurses’ mess to the principal chief
nurse who is responsible for all activities pertaining to it. He has
such commissioned assistants, dietitians, and civilian employees as
the commanding officer may designate (par. 175 and d, AR 40-590).
Ward diet kitchens to which a dietitian is assigned to duty function
under the direct control of the director of dietetics who is responsible
for their police, sanitation, and efficient operation. He is also responsible
for the property pertaining thereto. Ward diet kitchens
in which a dietitian is not assigned to duty function under the direct
control of the ward officer.
23. Director of dietetics.—The director of dietetics has charge of
and is responsible for the general administration of all messes in the
hospital. He will comply with paragraph 17, AR 40-590. He is the
custodian of the hospital fund, and as such is responsible that it is
expended in accordance with existing regulations (par. 17, AR 40-590
and AR 210-50). He is charged with the responsibility for the selection,
purchase, care, storage, issue, preparation, and serving of all
food supplies. He sees that the equipment for the handling and serv-
21
TM 8-260
23-25 MEDICAL DEPARTMENT
ing of food is sufficient, clean, and properly cared for. He has charge
of the police and sanitation of the department. He assumes property
responsibility'unless the commanding officer directs otherwise. He
may delegate any of his duties to a commissioned assistant who is
responsible to him for the proper execution of such delegated duties.
24. Chief dietitian.—The chief dietitian, under the director of
dietetics, is responsible for the entire food service to all patients and
others authorized to mess at the hospital. She must submit bills
of fare for all patients to the director of dietetics for approval. She
maintains supervision over the dietitians under her charge and is
directly responsible for their conduct and efficiency. She assigns
them to specific duties and holds them responsible for the proper
performance thereof. She makes recommendations to the director in
regard to purchases of food supplies and mess equipment.
25. Records.—The following records are maintained by the
director of dietetics:
a. Stock cards.—For all articles in stock, cards are prepared and
purchases and issues are noted thereon.
b. Inventory list.—The inventory list is completely itemized to show
all articles of food remaining on hand in the storeroom at the end
of each month, together with the money value and total cost.
c. Monthly statement of cost.—In this book are recorded the cosc
of operating each mess, the total number fed during the month, and
the cost per capita.
d. Bills of fare.—Bills of fare are prepared daily. Signed copies
are furnished the commanding officer, wards, kitchen, and dining
rooms.
e. Mess accoumt.—Daily transactions of the mess are accounted for
on the Mess Account (W. D., M. D. Form No. 74) for each mess,
and a consolidated account is kept on this form for the entire dietetic
department.
f. Hospital fund statement.—The hospital fund statement is prepared
monthly in accordance with AR 210-50. Retained copies of the
hospital fund statement and mess account, with pertinent vouchers,
are filed with the records of the mess.
g. Cash book.—A cash book is kept of all cash receipts, and shows
the source and disposition.
h. File of patients'* receipts.—A duplicate of the receipts furnished
all pay patients upon payment of their accounts.
i. Record of pay patients.—A card is kept for each pay patient in the
hospital showing the name, status, date of admission, date of discharge,
rate of charges per day, date payment for subsistence and medicine
22.
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 25-27
charges was made, and the amounts for subsistence and for medicine
separately. This record is maintained in two files:
(1) A file consisting of patients in the hospital and unpaid accounts.
(2) A file consisting of those discharged from hospital and accounts
paid.
j. Records of durable property.—All durable property belonging
to the Hospital Fund is entered on Stock Record Cards (W. D.,
Q. M. C. Form No. 424), showing the date, voucher number, and quantity.
A memorandum receipt is prepared by the director of dietetics
and signed by the person holding the property and filed with the
stock record cards. An abstract of these receipts is kept on Account
of Property on Memorandum Receipt (W. D., Q. M. C. Form No.
488), showing the location of each article of durable property. Transfers
of responsibility are made whenever custody of property changes.
k. Bank account.—The bank account comprises deposit books, canceled
checks, retained stubs, and bank statements.
26. Subsistence, medicine, and miscellaneous charges.—The
director of dietetics makes collection of all subsistence indebtedness
due the hospital fund by pay patients, and is responsible for the
proper maintenance of all accounts and records pertaining thereto.
He also receives, accounts for, and disposes of all funds paid as medicine
and miscellaneous charges by patients in hospital who are not
entitled to care and treatment at the expense of Army appropriations.
He renders a statement to pav patients on the last day of each month
showing the patient’s indebtedness, and when paid he furnishes an
itemized, numbered, and signed receipt. All patients remaining in
hospital on the last day of the month are required to pay their indebtedness
in full before the fifth day of the following month. In
all cases where patients desire to make payment and are physically unable
to leave their ward, the ward officer arranges for the prompt payment
of their bills to the director of dietetics. All other patients are
required to make their payment at the office of director of dietetics.
Pay patients who are discharged from the hospital pay their indebtedness
on the day of their departure. The director of dietetics institutes
the necessary steps in accordance with Army Regulations for the collection
of moneys due the hospital fund by pay patients for which
settlement cannot be obtained.
27. Purchase of food supplies.—The director of dietetics, or his
commissioned assistant, personally makes all purchases of food supplies
required by the messes. He assures himself that the supplies
charged to the hospital fund are actually received, safely stored,
and issued for proper use. He maintains an accurate record of sup-
23
TM 8-260
27-34 MEDICAL DEPARTMENT
plies received and of those issued to the various messes. All components
of the ration of the organization mess are purchased from
the quartermaster when such components are available.
28. Night cook.—The director of dietetics details a night cook
from the personnel assigned to him. The night cook is on duty from
6:00 PM to 4:30 AM, at which time he is relieved by the day
cook. He remains awake and does not leave the mess during his
tour of duty. He prepares the night meal for the men on night
duty. He will not allow anyone in the kitchen except the personnel
actually on duty. The night personnel, including enlisted men,
nurses, and members of the guard, are served in the dining room
designated for that purpose between 11:00 PM to 12:30 AM. No
persons not actually on duty are served unless authorized by proper
authority. The night cook allows no property, supplies, or subsistence
stores to be taken from the mess during his tour of duty, and
reports any unusual occurrences to the administrative officer of the
day and to the director of dietetics.
29. Payment for supplies.—The director of dietetics makes
payment for all supplies purchased and obtains a receipt therefor.
30. Bank deposits.—The director of dietetics deposits in the authorized
bank to the credit of the hospital fund,--------General
Hospital, all moneys received. He is authorized to keep a small
amount of cash on hand with which to make change for pay patients
in the settlement of their indebtedness.
31. Meals.—a. Promptness.—Meals are served promptly at the
prescribed hours, exceptions to be made only upon proper authorization.
b. Hours.—The hours for serving meals in the various messes
of the hospital are prescribed from time to time in memorandum
orders.
32. Food handlers.—The director of dietetics is responsible for
the observance of AR 40-205 governing the examination of permanent
food handlers.
33. Inventory of supplies.—The director of dietetics, or his commissioned
assistant, makes a physical inventory of all supplies on
hand on the last day of each month, and enters the quantity of
each item, unit cost, value of each item, and the total value on the
inventory list.
34. Property responsibility—The director of dietetics is responsible
for all supplies. On the first day of each month the director
of dietetics, or his commissioned assistant, causes a physical
check to be made of all property for which he is responsible. On
24
TM 8-360
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 34-36
completion he reports the results to the accountable officer. Shortages
which cannot be adjusted will be surveyed without delay.
35. Cafeteria system.—All enlisted duty personnel and patients
on an enlisted status who are on a regular diet and whose condition
permits are served by the cafeteria system. Patients whose physical
condition is such as to preclude being served this way receive table
service. The director of dietetics provides a sufficient number of
tables and properly trained attendants for such patients.
36. Messes.—a. Patient officers.—The director of dietetics causes
a separate mess to be maintained for all patients on an officer status.
Ambulant patients on an officer status on regular diets should be
furnished table service.
b. Nurses.— (1) The nurses’ mess is a part of the dietetic department,
and functions normally under the delegated authority of the
principal chief nurse. She is responsible for the selection, purchase,
storage, issue, preparation, and serving of food for this mess. All
bills contracted by her must be sent promptly to the custodian of the
hospital fund for payment. She may receive reimbursement for cash
purchases made by her, or an authorized assistant, by forwarding the
receipt with a letter of transmittal to the custodian of the hospital
fund.
(2) A member of the Army Nurse Corps may be detailed in direct
charge of the mess. This nurse may personally make purchases of
supplies required or may request that they be made through the
director of dietetics. She is responsible for their economical use.
She checks the daily bills and keeps records of all her transactions.
She directs and is responsible for the work of the employees in the
kitchens and dining rooms.
(3) Army nurses, special nurses, dietitians, physical therapy aides,
and such other employees as may be authorized are subsisted in the
nurses’ mess. At the end of each month or upon departure from the
hospital by reason of transfer, leave extending over the end of the
month, etc., Army nurses, special nurses, physical therapy aides, and
all others subsisted at the nurses’ mess, pay into the hospital fund
for each day they have been furnished meals the amount prescribed in
Army Regulations. A statement showing clearly the amounts due
from the above groups, number of days, per diem rates, and amount
of credit allowed for mess attendants subsisted in the nurses’ mess
is submitted to the director of dietetics by the principal chief nurse at
the end of each month, together with the vouchers to be paid by him.
The total amount of the vouchers will not exceed the total amount of
credits.
25
TH 8-260
36-39 MEDICAL DEPARTMENT
(4) Hours for meals in the nurses’ mess are prescribed by the
principal chief nurse.
37. Nurses’ funds.—a. Funds accruing to the nurses’ mess from
commutation of rations, donations from guests, messing charges from
aides, technicians, and other civilian employees may be used to provide
means for contributing to the welfare, comfort, pleasure, contentment,
and physical and mental improvement of the members of the nurses’
mess.
b. The custodian of the hospital fund keeps a record of all funds
accruing from this source and keeps the principal chief nurse informed
of the amount available for recreational and other purposes
as indicated in a above.
c. The principal chief nurse may procure, within the limits prescribed
by AR 210-50, such articles as may be required for the purposes
mentioned above, submitting the bills therefor to the custodian,
hospital fund, or, if she prefers, may purchase the articles, secure
receipt therefor, submit them to the director of dietetics and secure
reimbursement for the amount so expended. When such action is
taken, request for payment or for reimbursement is made.
38. Responsibility of ward officer.—Nothing in this manual
will be interpreted as preventing the ward officer from making periodical
inspection of the food served to patients, the appearance of trays,
etc. Such inspections will be made at frequent intervals and irregularities
or defects which may be found to exist reported immediately
to the director of dietetics.
39. Hospital council.—a. The hospital council consists of the
three senior officers present and on duty with the unit to which the
fund pertains.
b. The hospital council is governed by the provisions of AR 210-50.
Secti on IV
RECEIVING AND DISPOSITION OFFICER
Paragraph
Function__________________________________________________________ 40
Receiving and disposition officer--------------------------------------------------------- 41
Admission of patients_____________________________t-------------------------- 42
Discharge of patients________________________________________________ 43
Evacuation of patients by boat or rail_________________________________ 44
Inspection of enlisted men returned to duty_____________________________ 45
Notification of patient’s arrival_____________________________,_________ 46
Ambulance service_________________________________________________ 47
Reports___________________________ _ ______________________________ 48
Out-patients_______________________________________________________ 49
Absence of receiving and disposition officer---------------------------------------------- 50
26
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 40-42
40. Function.—The receiving and disposition office is under the
immediate supervision of an officer of the Medical Corps who is designated
as the receiving and disposition officer. During his absence from
the office his duties are assumed by the medical officer of the day. The
admission and disposition of all patients are accomplished through
the receiving and disposition office. The ambulance service at the
hospital is regulated by the receiving and disposition officer.
41. Receiving and disposition officer.—The receiving and disposition
officer is responsible for—
a. Admission of all patients to hospital.
Z>. Final discharge of patients from hospital.
c. Regulation of the ambulance service provided by the hospital.
d. Preparation and rendition of prescribed reports and forms pertaining
to his office.
e. Strict observance of regulations governing funds, money, and
valuables of patients upon their admission to hospital.
f. Proper care and medical treatment of patients from the time of
their arrival in the receiving and disposition office until the professional
officer of the day or the ward officer has assumed charge of the
case.
g. Admission of only those patients to the hospital who are entitled
to treatment according to Army Regulations or whose treatment is
authorized by the Secretary of War. Only in extreme necessity will
persons not entitled to admission to Army hospital be admitted. (For
list of persons entitled to treatment see paragraph 6, AR 40-590.)
h. Deposit of sufficient funds in special cases to cover hospital
charges.
42. Admission of patients.—a. General.— (1) All patients are
admitted through the receiving and disposition office, where the required
admission data are made of record an assignment to a proper
ward effected. In emergency the patient may be taken direct to the
ward and the necessary admission data obtained later.
(2) Patients reporting for admission are examined and placed in
a ward without delay.
(3) Patients with communicable diseases arriving by ambulance
are not permitted to leave the ambulance or enter the receiving and
disposition office, but after being seen by the receiving and disposition
officer are sent direct to the communicable disease section. Ambulatory
patients with communicable disease reporting to the receiving
and disposition office are conducted by the shortest way to the communicable
disease section by an orderly who will prevent the patient from
coming in contact with other patients.
27
TM 8-260
42-44 MEDICAL DEPARTMENT
(4) The receiving and disposition officer in the case of each patient
admitted to hospital sees that he is admitted to the proper ward for
treatment.
(5) When insane cases or prisoners are admitted, their attendants
or guard escort them to the proper section or ward accompanied by
an orderly from the receiving and disposition office.
(6) Patients admitted to the hospital are conducted to the proper
ward by an orderly who, in all cases, carries any baggage the patient
may have.
b. Baggage.—Patients admitted from trains or boats are asked by
the receiving and disposition officer whether or not they have baggage
other than that which accompanied them at the time of admission.
If so, they are requested to deliver the checks to the receiving and disposition
officer. (See pars. 109 and 112.)
c. Arrival by boat or rail.—The receiving and disposition officer
provides the necessary ambulance service and attendants for patients
arriving by boat or rail. When he is advised that a number of patients
will arrive he makes preparations in advance for their reception and
admission to wards. When patients are scheduled to arrive at hours
other than those scheduled for the receiving and disposition officer, the
latter arranges for the necessary transportation and attendants, and
advises the medical officer of the day accordingly. The receiving and
disposition officer takes measures to assure that separate ambulances
are provided for communicable diseases.
43. Discharge of patients.—a. The final discharge of patients is
accomplished as directed in paragraph 70.
b. A record of all discharges from the hospital is entered by the
receiving and disposition officer on the admission and departure sheet,
the data therefor being obtained from the disposition slips of discharged
patients. After entry has been made the disposition slip
is transmitted to the registrar for permanent file.
44. Evacuation of patients by boat or rail.—The receiving and
disposition officer is responsible for the proper evacuation to train or
boat of all patients transferred to other hospitals, their homes, or
elsewhere. He familiarizes himself with the details of the evacuation
and is responsible for its conduct until the patients and attendants
are actually on the boat or train. Attendants detailed to accompany
patients report to the receiving and disposition officer in advance of
their departure for instructions regarding their specific duties. Patients
to be transferred without attendants report to him for instruction.
In either event he provides the necessary local transportation.
In the case of evacuations scheduled for hours when the receiving and
28
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTAIENT 44-48
disposition officer is off duty, he advises the medical officer of the day
and informs him of the details for the evacuation.
45. Inspection of enlisted men returned to duty.—The commanding
officer, detachment of patients, inspects all enlisted men returned
to duty from the hospital and sees that none are permitted
to leave in improper uniform. Particular care is taken that no
patients are permitted to leave for a colder climate without adequate
clothing.
46. Notification of patient’s arrival.—The noncommissioned
officer or clerk on duty at the time of arrival of a patient for admission
to hospital immediately notifies the receiving and disposition
officer or in his absence, the medical officer of the day.
47. Ambulance service.—Ambulance service at the hospital is
furnished under the direction of the receiving and disposition officer
or in his absence, the medical officer of the day. Ambulances will not
be ordered out by noncommissioned officers on duty in the receiving
and disposition office without authority of the receiving and disposition
officer or in his absence, the medical officer of the day, unless
the emergency is so great that the delay in obtaining such authority
is inadvisable. In such cases report is made to the proper officer
at the earliest opportunity.
48. Reports.—The receiving and disposition officer is responsible
for the preparation and disposition of the following records:
a. The forms prepared on the admission of all patients:
(1) Clinical Record, Brief (W. D., M. D. Form No. 55A), prepared
in triplicate and initialed by the admitting officer. The original is
sent to the ward with the patient, the duplicate to the registrar, and
the triplicate to the information office, thence to the chaplain and
director of the Red Cross. The duplicate and triplicate copies may
be on blank second sheets of approximately the same size as the
form.
(2) Ward roster card, prepared in triplicate and accompanying
patient to the ward, two copies to be used for ward rosters and one
for use with the clinical record jacket.
(3) Deposit slip, patient’s funds and valuables, prepared single
copy if no deposit is made; in triplicate if deposit is made. All copies
of the form are signed by the patient and the admitting officer.
In case deposit is made the triplicate copy is given the patient as
his receipt, the original and duplicate to the custodian patient’s fund
with the deposit. If no deposit is made the deposit slip single copy
signed by the patient and admitting officer is delivered to the custodian
patient’s funds and valuables.
29
TM 8-260
48-50 MEDICAL DEPARTMENT
b. The reports prepared daily or as otherwise directed:
(1) Admission and departure sheet. A record of patients who
have been admitted; who have departed; who have been transferred,
with number of the ward transferred from and transferred to, and a
record of patients whose status has been otherwise changed. This
report covers the period from midnight of one day to midnight of
the following day, and is disposed of in accordance with instructions
issued from time to time.
(2) Patient’s daily classification report.
(3) Daily report of hospital bed status.
49. Out-patients.—a. Reports of examination in cases referred
for consultation by medical officers, other than members of the hospital
staff, to chiefs of service are made to the receiving officer by
informal memorandum upon completion of the examination.
b. From the memorandum received, the receiving officer prepares
a report of the case in duplicate for the medical officer concerned for
signature of the executive officer.
c. When hospitalization is indicated the duplicate of the report
with the informal memorandum received from the examining officer
is placed in the suspended file, receiving office. Upon admission of
patient, report is forwarded to the sergeant major’s office for file in
patient’s 201 file. If hospitalization is not deemed necessary the duplicate
is noted immediately by the receiving officer and forwarded to
the sergeant major’s office for file.
50. Absence of receiving and disposition officer.—During the
hours other than those prescribed for the receiving and disposition
officer the medical officer of the day assumes and is responsible for the
duties of the receiving and disposition officer.
Section V
MEDICAL SUPPLY DEPARTMENT
Paragraph
Organization_______________________________________________________ 51
General duties_____________________________________________________ 52
Supplies, requisition, and issue----------------------------------------------------------- 53
Alcohol, narcotics, and habit-forming drugs------------ „----------------------------- 54
Property__________________________________________________________ 55
Inventories and reports--------------------------------------------------------------------- 56
Repair and renovation of Medical Department equipment------------------------- 57
Purchase of materials in open market--------------------------------------------------- 58
Transfer of property------------------------------------------------------------------------ 59
Requisition by medical supply officer---------------------------------------------------- 60
30
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 51-53
51. Organization.—The medical supply department is a part of
the administrative division of the hospital and is under the immediate
supervision of an officer designated by the commanding officer.
He is known as the medical supply officer and is directly responsible
for the efficient conduct of the department.
52. General duties.—a. Procurement, storage, issue, and accountability
for all medical supplies, equipment, and all Army blank forms
and such local blank forms as may be authorized by the commanding
officer.
b. Maintenance and operation of such utilities as may be authorized
for the repair and upkeep of Medical Department property.
e. Expenditure of all allotments for the purchase and upkeep of
medical supplies.
d. Preparation and maintenance of such memorandum receipts,
inventories, property reports, returns, and stock record system as
are prescribed by proper authority.
53. Supplies, requisition, and issue.—a. Requisition.— (1) Expendable.—
(a) Requisitions for expendable supplies are prepared
on the typewriter whenever practicable, using the nomenclature, item
number, and unit as listed in the Medical Department Supply Catalog.
Requisitions are signed by officers in charge of departments, wards, etc.,
and forwarded to the medical supply officer on days that may be
specified by the commanding officer.
(5) In an emergency in which the need could not have been
foreseen, requisitions may be submitted at any time. Such requisitions
are prepared as directed and marked “Emergency.”
(2) Nbnexpendable.—Requisitions for nonexpendable medical
property are made in the manner prescribed in (1) above, except
they will be prepared in duplicate on Issue Slip, Nonexpendable
Medical Property (W. D., M. D. Form No. 16b). The original copies
of the requisition are retained by the medical supply and the duplicate
returned to the responsible officer for file as a voucher to memorandum
receipt for nonexpendable property.
b. Issue.—(1) The medical supply officer inspects all requisitions
and reduces excessive amounts requisitioned to meet the allowances
prescribed by The Surgeon General.
(2) Regular issues are made at the medical supply department at
specified times. Supplies not called for within the specified hours
are returned to stock.
(8) Issues of drugs are made to the pharmacy and dispensed by that
department on prescriptions. Exceptions to this rule are made only
in the case of articles stored for the use of a specific service.
81
TM 8-260
53-55 MEDICAL DEPARTMENT
(4 ) Articles entering into the composition of surgical dressings are
issued in bulk to the surgical dressing room. All dressings are prepared
and sterilized in the preparation room pertaining to that section
and issued to wards, departments, etc., as required.
54. Alcohol, narcotics, and habit-forming drugs.—a. The
medical supply officer is directly charged with the safekeeping of all
stores of ethyl alcohol, absolute alcohol, alcoholic liquors, narcotics,
and habit-forming drugs until they are issued to the pharmacy or
other departments authorized to draw such supplies. He receives
and issues these supplies in person. All reserve supply of these articles
is kept locked in safes in the room especially provided for that purpose
in the medical storeroom. All keys and safe combinations are
kept at all times by the medical supply officer personally. He keeps
a detailed account of his issues on Return of Medical Property Slip
(W. D., M. D. Form No. 17a), keeping as vouchers requisition Issue
Slip, Expendable Medical Property (W. D., M. D. Form No. 16a)
upon which issues were made.
b. Issues of ethyl alcohol, alcoholic liquors, narcotics, and habit-forming
drugs are made only to the officer in charge of the pharmacy upon
requisition signed by him.
c. Alcohols, alcoholic liquors, narcotics, and habit-forming drugs in
the possession of the medical supply officer are checked once each
month by an officer designated by the commanding officer. Written
report of the findings is made to the commanding officer immediately
thereafter.
55. Property.—a. Responsibility.—The medical supply officer
maintains the account of property on memorandum receipt as prescribed
in paragraph 5) S. S. enema given the night before the test.
() Absolute bed rest; possibly a private attendant.
(c) Complete blood count at once and daily until further orders.
(<7) Test for serum sensitiveness as shown below if serum is to be
used.
(e) Sputum to laboratory in sterile petri dish with form marked
emergency for typing. For method of proper collection see paragraph
232e.
(/) Emergency bedside X-ray of chest.
(y) Give serum or sulfathiazole as indicated.
(A) Routine urinalysis, Kahn and other laboratory examinations
as indicated.
(Z) Have patient fed by attendant.
(;) Blood culture should be obtained on admission and then as
indicated.
(&) Enema (plain water or saline) should be used daily if necessary.
Prevent abdominal distention.
(Z) Seriously ill notice is initiated, if indicated.
(m) Temperature, pulse, and respiration recorded on graphic
chart every 4 hours. Blood pressure should also be recorded frequently,
especially if serum is given.
(n) Keep windows open but protect from direct drafts by use of
screens.
(o) Report to Board of Health.
(/>) See that patient obtains sufficient sleep.
(q) Use liquid diet for first few days, small amounts at short
intervals. No iced fluids as these tend to cause distention. Measure
fluid intake and output. Intake should be 2,500 cc. to 3,000 cc. daily,
depending on the urinary output. The urine output should be at
least 800 cc. to 1,000 cc. in adults.
119
TM 8-260
231 MEDICAL DEPARTMENT
(r) Do not use digitalis or cardiac stimulants unless specifically
indicated by falling blood pressure and increasing heart rate. Use
oxygen early if indicated by some cyanosis and hyperpnea. When
oxygen is used the procedure of its administration should be carefully
controlled and supervised.
(2) Serum therapy.—(a) Serum is available for use in all types
of pneumonia, but is most efficacious in types I, II, IV, V, VII,
VIII, and XIV. Both horse serum and rabbit serum are obtainable
for treatment. The technique of administering horse serum and
rabbit serum is the same.
(Z>) Have hypodermic syringe prepared, and in the patient’s room,
of 1 cc. of epinephrine 1:1,000 for use in treating allergic reactions.
() Saline.—8 grams (2 level teaspoonfuls) of ordinary salt to
1 quart of warm water (99° F.).
() For cleansing the entire bowel, 1 quart of the enema should
be used with the patient recumbent or better still in the knee-chest
position (if not too debilitated) and the solution given very slowly
to prevent cramping.
232. Miscellaneous.—a. Communicable diseases quarantine periods
(see FM 21-10 and FM 8-40).—(1) Measles, 10 days (minimum).
German measles, 10 days.
127
TM 8-260
232 MEDICAL DEPARTMENT
(2) Mumps, 21 days (minimum).
(3) Scarlet fever, 3 weeks (minimum).
(4) Chickenpox, all lesions must be healed. Minimum 10 days.
(5) Epidemic meningitis. Three consecutive negative cultures
from nose (both sides) and from throat for meningococci, 5 days
apart, taken before discharge.
(6) Typhoid group of diseases, 3 consecutive negative cultures from
stool and from urine at 5-day intervals. (Post surgeon should be
notified to prevent the assignment of the patient to duties involving
the handling of food.)
(7) Dysentery, amoebic or bacillary, same as for typhoid.
(8) Diphtheria, five consecutive negative cultures from nose and
throat at 3-day intervals.
(9) Smallpox, until lesions healed.
b. Communicable diseases reportable to Boards of Health.—(1)
Amoebic dysentery.
(2) Chickenpox.
(3) Diphtheria.
(4) Epidemic meningitis and meningococcemia.
(5) Erysipelas.
(6) Influenza.
(7) Measles.
(8) Pellagra.
(9) Pneumonia.
(10) Poliomyelitis.
(11) Rocky Mountain spotted fever.
(12) Scarlet fever.
(13) Smallpox.
(14) Tuberculosis.
(15) Tularemia.
(16) Typhoid fever.
(17) Typhus.
(18) Undulant fever.
(19) Venereal diseases.
(20) Whooping cough.
c. Table of normal values in blood examinations.—All amounts
for blood chemistries are in milligrams per 100 cc. of whole blood
unless otherwise stated, and these values are for bloods taken in the
morning after a fast of at least 10 hours.
128
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 232
Normal Remarks
Nonprotein nitrogen_____ 25-35 During digestion there is a rise of
Urea nitrogen___________ 12-17
about 4 mg. per 100 cc. Anything
below 30 mg. is to be considered
normal, but values up to 35 mg. are
to be found without any evidence
of kidney retention.
During digestion of a full meal con-
Creatinine______________ 1-2
taining meat, a rise of 2 or 3 or
more mg. occurs. In the usual run
of clinical cases, values as high as
20 mg. may be encountered.
In a selected series of normals the
Uric acid_______________ 2-4
upper limit may be as low as 1.7
mg.; 2 mg. is the more common
upper limit of normal.
The figures given are based on Bene-
Sugar__________________ 80-120
diet’s method which gives somewhat
higher figures than does that
of Folin and Wu. Values as high
as 4.5 mg. are frequently found in
bloods, all the other values of which
are well within normal range.
During the absorptive period after
Chlorides_______________ 450-500
food there is marked increase, dependent
on the carbohydrate content
of the food. The extent of
this rise after a standard carbohydrate
meal is the basis of the
“sugar tolerance test.”
Figures for plasma are somewhat
Cholesterol______________ 140-190
higher than those for whole blood;
575 to 625 mg. per 100 cc.
Bloor gives an average figure of 210
Calcium________________ 9-11
mg. per 100 cc. and others regard
the normal as lying even higher.
It is probable, however, that
150 mg. is a fairly representative
normal standard.
These values are for the serum alone
Phosphorus_____________ 3-4. 5
and represent the total calcium
present in the serum after clotting
and separation of the clot.
These values are for the inorganic
Alkali reserve (CO2 combining
power of the
blood plasma).
53-77
volumes
percent
phosphorus of the serum after separation
from the clot.
820358°—41----- 9 129
TM 8-260
232 MEDICAL DEPARTMENT
Normal Remarks
Alkali reserve (alveolar
CO2 tension).
van den Bergh___________
Icterus index____________
Total serum proteins _ ___
Serum albumin__________
Serum globulin__________
Albumin-globulin ratio pH
of blood.
Phosphatase__ __ __ __
5-5. 5
volumes
0. 4-0. 8
4-6
6. 5-7. 5
percent
4. 5-5. 5
percent
2. 2-2. 5
percent
2-2. 3
7. 51-7. 33
These figures are based on the Fridericia
method, which represents
arterial rather than venous carbon
dioxide tension.
A van den Bergh unit is equivalent
to 1 part of bilirubin in 200,000
parts of serum. The quantitive
estimation is made by the indirect
test only.
An icterus index below the normal
limit of 4 has so far been found only
in cases of secondary anemia. An
icterus index of 15 is necessary for
jaundice to be evident clinically.
Hence, an index between 6 and 15
is termed “latent jaundice.”
Low in nephritis with oedema.
Low in nephrosis.
In lipoid nephrosis the globulin is
usually normal and the reduction
is in serum albumin giving an inverse
ratio.
In extreme cases variation of 0.2 to
0.5 may occur.
For adults, 10 units is upper limit of
normal. For children, 15-20.
Howell method, 10-20 minutes. The
quotient of Herwitz and Lucas obtained
by dividing the unknown by
the prothrombin time of a normal
person, the normal being 1.0.
Begins in 3 to 6 hours; should be complete
in 24 hours.
1 to 3 minutes.
1 to 4 minutes.
0.5 to 2.0 percent.
150,000 to 300,000.
Cutler method with graph. At the
end of one hour normal equals men
0-8 mm., women 0-10 mm.
Segmented neutrophiles, 50 to 70 percent.
No myelocyte forms should
be present.
Prothrombin___ _ ____
Clot retraction time______
Bleeding time
—
Coagulation time________
Reticulocytes _ ______
—
Platelet count ____ _
Sedimentation__ __
Shilling count___
130
TEXAS STATE COLLEGE FOR WOMEN
library TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 232
d. Normal values for cerebrospinal fluid (Wechsler, 1939).— (1)
Fluid is clear, watery, colorless, alkaline.
(2) Pressure, patient recumbent, 100-150 mm. water; patient sitting,
200-250 mm. water. Queckenstedt, jugular pressure causes
sharp rise of pressure to 350-500 mm. water or to 25-5 mm. mercury,
followed by sharp fall on release of jugular pressure.
(3) Specific gravity 1,006 to 1,008.
(4) Cells, 0-5 per cubic millimeter over 5 abnormal.
(5) Sodium chloride, 720-750 mgm. per 100 cc.
(6) Globulin, none.
(7) Albumin, trace (2-5 mgm. per 100 cc.).
(8) Total protein, 25-40 mgm. per 100 cc.
(9) Nonprotein nitrogen, 12-18 mgm. per 100 cc.
(10) Glucose, 50-80 mgm. per 100 cc.
(11) Wassermann and Kahn, negative in all dilutions.
(12) Colloidal gold reaction, 0000000000.
e. Sputum collection in pneumonia cases for pneumococcus typing.—
(1) (a) The importance of proper collection of sputum for typing
and examination cannot be overemphasized. Encourage the patient
to cooperate and make sure the sputum is a “coughed up” specimen
from bronchi and lungs and not “hawked up” post nasal secretions.
This must be personally supervised by the nurse or doctor.
(Z>) In children one should not depend on coughed up secretions
but the specimen should be obtained by aspiration with catheter and
30-cc. syringe. The technique is as follows: One attendant should
hold the child’s hands and keep the head steady as the operator inserts
a tongue depressor toward throat to hold the tongue down and initiate
cough reflex. As the child coughs the catheter is gently inserted a
short distance in the open respiratory passages. At this moment
another assistant quickly manipulates the plunger of the syringe attached
to catheter. By pulling the plunger out quickly and returning
it somewhat more slowly several times, a specimen is usually ob-
(ained. The mucous will adhere to the catheter and it must be forcibly
ejected by the syringe into sputum container.
(2) Send the sputum to the laboratory in a sterile petri dish. The
sputum record should be marked emergency and the information requested
should include—
(a) Gross appearance (bloody, rusty, etc.).
(6) Gram stain for predominant type of organism.
() Shower or tub for patients as ordered by ward officer.
(3) Diets: The diet in each case is ordered by the ward officer.
The regular diets, liquid, light, and full, are prepared with careful
attention to the usual needs. When special diets are required the
articles desired will be designated.
(4) Medication is given only on the order of a medical officer.
This includes cathartics and enemas.
(5) Teeth of all surgical cases are examined often enough by
the ward officer to satisfy him that the proper mouth hygiene is being
carried out.
(G) Hot water bags and ice caps are not used without suitable
covers.
(7) Ice caps prohibited for post-operative abdominal cases, except
on written order of operating surgeon.
(8) All dressings on cases in open wards are done behind screens
with the attendants properly gowned, and wearing rubber gloves.
234. Preparation of patient for operation.—a. When a patient
is listed for operation he is sent to operating room the day before
operation for proper shaving (see par. 241).
b. The ward nurse sees that teeth are cleansed and assures herself
that urine and blood counts are reported back by the laboratory.
c. The ward officer prepares a preoperative examination report
which accompanies patient to operating room.
d. The night before operation the patient is given a light diet for
supper and cup of hot chocolate or ovaltine at 8:00 PM, or if preferred,
well-sweetened orange juice or cup of hot milk.
e. Preoperative medication, depending on type of anesthesia, is
ordered by ward officer (see par. 241).
134
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 234-235
/. Patient is instructed to void urine before going to operating
room, and ward nurse assures herself that false teeth, plates, gum,
and glasses are removed from patient.
g. Preoperative preparation of rectal and colon cases for resection
only:
(1) After the diagnosis of a colon lesion is established, the patient
is hospitalized 3 to 5 days prior to operation.
(2) Patient is given a high caloric, low residue diet.
(3) In most cases a saline cathartic, S. S. magnesium sulphate or a
double Seidlitz powder is given, followed by thorough cleansing of
the colon by warm compound or Nobel’s enema in morning and simple
enema in afternoon. These enemas are continued daily until operation.
If enemas are not expelled the day of operation they are
siphoned off.
(4) Intravenous or subdermal glucose solution in sufficient quantities
is given twice daily preceding operation.
(5) Three days (72 hours) prior to operation 1 cc. of Bargen’s
vaccine mixed with 10 cc. normal saline solution is given intraperitoneally,
using a 10-cc. Luer syringe, a blunt spinal needle, with strict
aseptic precautions, and given on the side opposite to that of
operation.
235. Post-operative care (after patient is returned to bed).—a.
Not left alone until sufficiently conscious to care for himself.
b. Have basin for vomiting, towel, gauze, tongue forceps, and mouth
gag on bedside table ready for emergency while patient is coming
out of anesthetic.
c. Patient is kept warm but not to be dehydrated by profuse sweating
upon return to the ward.
d. Patient when returned to bed is put in a semi-Fowler position,
except after a spinal anesthesia has been given, when the patient has
the head lowered.
e. Proctoclysis 25-50 drops per minute, on 2 hours and off 1 hour, of
normal saline solution with 1 percent sodium bicarbonate (except
after rectal operations) unless otherwise ordered.
/. Catheterization. It is always advisable to delay catheterization
and encourage patient to void, even to 18 hours.
g. Give hot water or hot tea freely by mouth as soon as nausea
ceases (except in stomach cases).
h. Morphine is ordered as indicated for each case by the operating
surgeon or by the ward officer.
i. Measure and record fluid intake by mouth, rectum, hypodermoclysis,
and proctoclysis until discontinued by order of ward officer.
135
TM 8-260
235 MEDICAL DEPARTMENT
j. After gastric or duodenal ulcer cases, drain stomach by stomach
tube first night and twice daily thereafter when indicated by dilatation
of stomach.
k. Measure and record urine.
Z. Measure and record amount of vOmitus.
m. Nausea or vomiting, if excessive insert duodenal tube attached
to vacuum bottle.
n. Patient during first 48 hours post-operative is turned from side
to side assisted by nurse (unless instructed to the contrary).
o. Gas pains and distention: Enemas are not given prior to 48
hours, unless ordered by the operating surgeon. A gas tube may be
inserted, except in rectal cases, to relieve distention, and the following
mixture to be sipped by patient may be given during first 48 hours
for gas pains:
Spirits peppermint, 4 cc.
Sodium bicarbonate, 0.60
Hot water, 60 cc.
Enema effective for gas after 48 hours, designated Nobel’s enema,
is prepared as follows:
Turpentine, 4cc. •
Glycerine, 30 cc.
Saturated solution magnesium sulphate, 90 cc.
Warm water, 90 cc.
p. No cathartic. 48 hours after operation {except gastric or rectal
cases'), give Nobel’s enema, and if results are not satisfactory follow
2 hours later with simple enema. In rectal cases, see paragraph 237.
q. Force fluids the first 3 days after operation, at least 2,000 cc.
to 3,000 cc. each 24 hours by mouth and rectum, supplemented by
intravenous of saline or 5 percent to 10 percent glucose or saline by
hypodermoclysis. This is an important part of post-operative treatment.
r. Diet: Hot water or hot tea may be given p. r. n. On second day
hot beef or chicken broth may be added. If the required fluids,
2,000 cc. to 3,000 cc. are given as indicated in e and g above, no
other nourishment is necessary until after the bowels have moved
as a result of the enema.
s. Post-operative toxic goitre cases are given 10 to 20 drops Lugols
solution in 45 cc. grape juice as soon as able to swallow after operation
and repeated every 4 hours for first 24 hours, then 10 drops
every 4 hours for second 24 hours, and then as surgeon directs.
Iced water, cold gingerale p. r. n.
136
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 235-236
t. Shock: Look for cause and treat as indicated: Raise foot of
bed and warm blankets. 1,000 to 2,000 cc. 5 percent glucose intravenously.
Blood transfusion when indicated. Adrenalin M 15 of
1 to 1,000 solution by hypo.
u. Removal of sutures: Ordinarily, unless soiled, dressings in clean
cases are not changed until sutures are to be removed. Muscle split
appendix incisions on the 8th day, and patient to sit up in bed leaning
against back rest, and the following day up in a chair and the
10th day to walk.
(1) Hernia cases.—Sutures out on the 9th day, but patient is not
allowed to sit up until 18th day in bed. 19th day in chair, and the
20th day may walk.
(2) Right rectus or paramedian incision.—Sutures out 10th day
and to sit up in bed. 11th day to sit in chair, and 12th day to
walk.
(3) Midline incision.—Sutures out 12th day, and sit up in bed
12th and 13th days, up in a chair 14th and 15th days, and to walk
the 16th day.
v. Drainage cases are dressed as ordered in each case.
w. A progress note in clinical record records any wound not healing
by primary union.
236. Special post-operative diets.—a. Routine.— (1) Hot tea
or hot water for the first 24 hours.
(2) Hot water, hot tea, hot beef or chicken broth for second 24
hours.
(3) Liquid for the third 24 hours.
(4) Soft for the fourth and fifth 24 hours.
(5) Light for the sixth 24 hours.
b. Gastric cases.— (1) First 24 hours:
(a) 5 percent glucose, intravenous, 1,000 cc. night and morning.
(&) Proctoclysis, on 2 hours, off 1 hour (normal saline).
(c) Hot water or tea, 6 to 10 cc. q. 20 minutes if desired.
(2) Second 24 hours:
(a) 5 percent glucose intravenous, 1,000 cc. night and morning.
(J) Proctoclysis, normal saline, on 2 hours, off 1 hour.
(c) Hot water or tea, 6 to 10 cc. q. 20 minutes if desired.
(3) Third 24 hours:
(a) 8:00 AM Strained broth of oatmeal, barley, or rice__ 60 cc.
(J) 10:00 AM Orange juice sweetened to taste--------------- 20 cc.
() 8:00 AM Strained broth of oatmeal, barley, rice, or
peas_______________ 60 cc.
(c) 9:00 AM Orange juice___________________________ 30 cc.
(g Z) 11:00 AM Orange albumin_______________________30 cc.
() 9:00 AM Strained gruel of oatmeal, barley, or rice----- 60 cc.
With strained stewed prunes, apple sauce,
or apricots____________________________30 cc.
(c) 12:00 M Strained puree of peas, string beans, carrots,
spinach, or cauliflower___________________60 cc.
Beef juice----------------------------------------------- 20 cc.
Fruit ice_____________________________16 gm.
Butter_______________________________ 2 gm.
(fZ) 2:00 PM Orange juice, sweetened-----------------------100 cc.
(e) 4:00 PM Strained gruel of oatmeal, barley, or rice______ 60 cc.
With strained stewed prunes, apple sauce,
or apricots________________________30 cc.
(/) 8: 00 PM Orange juice__________________________ 100 cc.
(6) Sixth and seventh days:
(a) 6:00 AM Orange juice, sweetened________________ 150 cc.
(b) 9 : 00 AM Gruel and puree_____________________ 100 cc.
(c) 12:00 M Puree_______________________________ 100 cc.
Beef juice_________________________ :__ 30 cc.
Fruit ice____________________________ 30 gm.
(gZ) 2:00 PM Orange juice__________________________ 100 cc.
(e) 4: 00 PM Gruel and fruit________________________100 cc.
(/) 6:00 PM Orange juice__________________________100 cc.
(y) 8:00 PM Orange juice__________________________ 100 cc.
138
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 236-237
(7) Eighth and ninth days:
(a) Breakfast: Wheatena, farina, cream of wheat, thoroughly
cooked and strained_______ 200 cc.
Strained stewed fruit_____________ 36-48 gm.
Hot tea_________________________ 200 cc.
(&) 9:00 AM Orange juice_____________________ 120 cc.
(c) Dinner: Baked potato, small and mealy, with
square of butter and a little salt.
Strained spinach, carrots, peas, string
beans, asparagus, or cauliflower-------150 cc.
Beef juice_______________________ 30 cc.
Vegetable may be decreased and an
equal amount of zweiback or arrow’-
root crackers soaked in beef juice
substituted.
Fruit juice_______________________ 60 cc.
(oQ 2:00 PM Orange juice____________________ 120 cc.
(e) Supper: Same as breakfast but add 100 cc. of
custard junket or gelatine.
(/) 8:00 PM Orange juice____________________ 120 cc.
(8) Tenth day, etc.:
(a) Same as ninth day but add soft-boiled or poached egg with a
small piece of double toast and butter for breakfast.
(Z>) Add lamb chop, chicken, first, 10 cc. jelly or marmalade with a
small piece of double toast for dinner or supper. Strain vegetables
and cereals until the fourteenth day.
c. Gastric resection cases.— (1) First seven days, same diet as all
gastric cases.
(2) Beginning eighth day:
(a) Breakfast: Same as all gastric cases, half portion.
(&) 7:30 AM Fruit juice______________________ 150 cc.
(c) 9:30 AM Eggnog (with zweiback)---------------- 150 cc.
(<7) Lunch: Same as gastric cases, half portion.
(e) 2:00 PM Fruit juice (with zweiback)------------- 150 cc.
(/) 4:30 PM Supper as for gastric cases, half portion.
(y) 6: 30 PAI Fruit juice______________________ 150 cc.
(A) 8:30 PM Cocoa (with toast) ---------------------- 150 cc.
237. Post-operative care of hemorrhoid and rectal cases.—a.
First 24 hours:
(1) Hot water and hot tea in moderate quantities allowed at once.
(2) No fluids by rectum.
(3) Hypo morphine sulphate, 0.016 gram (14 gr.) p. r. n. for pain.
139
TM 8-260
237-238 MEDICAL DEPARTMENT
b. Second 24 hours:
(1) Surgical liquids, orange juice, fruit juices, hot tea, hot beef tea,
or broth.
(2) For pain or tenesmus give 1 grain codeine, 5 gr. aspirin.
c. Third 24 hours:
(1) 6: 00 AM Mineral oil, 20 cc. Repeat at 8:00 PM.
(2) Oatmeal gruel, fruit juices, hot coffee, strained soup.
(3) Continue aspirin and codeine for pain.
d. Fourth 24 hours:
(1) 6:00 AM Mineral oil, 20 cc. Repeat oil at 8:00 PM and add
8 cc. cascara.
(2) Continue diet of third 24-hour period.
(3) Codeine and aspirin for pain.
e. Fifth 24 hours:
(1) 6:00 AM and 8: 00 PM. Mineral oil, 20 cc., with 10 cc. cascara.
(2) Add any cooked cereal, baked potato, boiled rice, stewed prunes,
and baked apple to diet.
(3) Continue codeine and aspirin for pain. (If given after bowels
have moved it will stop tenesmus.)
/. Sixth 24 hours: If bowels have moved, give light diet. Patient
may go to bathroom during sixth 24-hour period.
g. Seventh 24 hours: Officer and women patients may be discharged
with instruction to continue mineral oil, use damp cloth after bowel
movement; give patient three or four doses of codeine and aspirin to
take home to be taken if he has tenesmus after bowel movement. Enlisted
men and those on enlisted status should remain in hospital about
10 days.
238. Technique for intravenous infusion.—a Patient to be
screened.
b. Medical officer to wear clean gown and sterile gloves.
c. Glassware and tubing to be sterile and clean.
d. Read the label carefully on solution to be given and be sure it is
the correct solution, and that it is a fresh sterile solution.
e. Put folded bath towel under patient’s arm.
/. Apply light tourniquet to patient’s arm.
g. Paint patient’s arm with iodine.
h. Put about 100 cc. of the solution to be given (saline or glucose) in
the flask and rinse the flask out with this solution and allow to run out
through the tubing to cleanse the tube.
i. Fill flask half full with the solution to be given and get all the air
out by lowering the flask while the tube is elevated; repeat if necessary.
140
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 238-240
j. Have nurse hold the flask and tube while the medical officer punctures
the vein. Be sure the needle is open before the vein is punctured.
Be sure that the needle is well within the vein, then take off tourniquet.
A. Allow a few drops of solution to run out of the tube to get all air
out, then connect with needle.
I. The medical officer is not to leave the patient while intravenous is
being given.
m. Upon chilly sensations, weakness, or other evidence of reaction,
the infusion is stopped at once.
n. The blood pressure is taken before infusion is started, and the
blood pressure apparatus left on. The pressure is taken when the
infusion is half completed, and again upon completion. When the
pressure is taken during the infusion, if there is a marked rise or
fall in the pressure, the infusion is stopped.
o. The intravenous infusion must be given slowly. At least 15
minutes must be allowed for each 500 cc. of infusion.
p. Intravenous therapy is a serious procedure and should be so
considered. It must be given carefully and correctly.
239. Severe head injuries, concussion, severe contusion,
skull fractures, etc.—a. Patient to be put in warm bed on admission
to ward, clothing removed with as little disturbance as possible.
b. Blood pressure taken and recorded.
c. Ear and fundus examination made as soon as possible.
d. Ward officer will report case, with essential data to the office,
chief of surgical service.
e. All early treatment will be conservative.
/. A consultant from the neuropsychiatric section will be called.
g. Patient will not be sent to X-ray section until approved by an
operating surgeon and consultant.
240. Report of operation and request for pathological examination.—
a. The operating report in every instance is signed by
the operating surgeon. The diagnosis to be clear and concise and,
where multiple conditions, numbered 1, 2, 3, etc., and conform to
standard nomenclature. Operations also to be numbered 1, 2, 3, etc.,
stating simply name of operation. Qualifying remarks concerning
diagnosis and operative procedure will be extended on reverse side
of Operation Report (W. D., M. D. Form 55 O-2).
b. All operating surgeons personally prepare and sign requests
for pathological examination, or direct one of their assistant surgeons
to prepare it, with especial attention to a brief description of the
specimen and the clinical diagnosis. This information aids the
pathologist in reaching his conclusions.
141
TM 8-260
241 MEDICAL DEPARTMENT
241. Anesthesia and operating room.—a. Shaving, preoperative.—
Shaving by personnel from operating room day previous to
operation except in emergency. After shaving wash field thoroughly
with green soap and water. In emergency cases parts will be shaved
with dry lather and cleansed with alcohol or ether. No water will
be used on skin (reason is that it makes iodine less effective).
b. Anesthetists trained in taking blood pressure.—Anesthetists in
operating room will be trained in taking blood pressure. Special
blood pressure apparatus attached prior to anesthesia enables anesthetists
to take pressure at regular intervals during operation.
c. Preoperative preparation and premedication.—(1) Spiral anesthesia.—
(a) Light supper; nothing by mouth after midnight.
(5) S. S. enema at 9: 00 PM and 6: 00 AM.
(c) Sodium amytal 0.195 grams (3 gr.) at 9:00 PM and in the
morning 2 hours before the time set for operation.
(d) Hypodermic of morphine 0.016 gram (14 gr.) with scopolamin
0.0004 gram (%50 gr.) 1 hour before operation.
(2) Gas oxygen anesthesia.—Same as the above except for medication.
Give morphine 0.016 gram (14 gr.) with atropine 0.0004 gram
(%50 gr.) 1 hour prior to operation.
(3) Avertin anesthesia.— (a) Record weight, height, and age, give
B. M. R. if known. No laxative for 24 hours before day set for operation.
S. S. enema at bedtime. Twenty minutes after S. S. enema
give clear water enema. Allow patient to go to toilet to expell enema
if able to do so.
(5) Sodium amytal 0.195 gram (3 gr.) at bedtime.
(c) Hypo morphine 0.010 gram (% gr.) 1 hour before time set
for operation.
(d) Give no enema in AM.
(e) Light supper; nothing by mouth after midnight.
(4) Colonic ether.— («) No laxative for 24 hours before operation.
Nothing by mouth after midnight. Tea and toast for supper.
(5) Two hours after supper give S. S. enema followed at 20-minute
intervals by two clear water enemata. If unconscious or uncooperative
give colonic irrigation until return is clear.
() Rest in bed 24 hours.
(c) Hot application. Codeine, morphine, and atropine, as necessary
for pain.
() Cleanse external genitalia widely with solution of green soap
and water. Remove soap and dry with sterile towel or gauze.
(c) Apply bichloride solution 1 to 1,000 to external genitalia with
gauze.
() Elevate foot of bed 25 cm. during first 3 days.
(c) Keep patient in bed for 2 weeks.
(<7) Urogram, renal function, and blood chemistry 5 weeks postoperative.
(2) Prostatectomy and transurethral resection.—(a) Observe for
hemorrhage.
(&) No enema. No proctoclysis.
(c) Castor oil 45 cc. on morning of third (3d) day.
149
TM 8-260
251-252 MEDICAL DEPARTMENT
(cZ) Change dressings p. r. n. to keep patient dry.
(3) Durapwncture.— (a) Elevate foot of bed 25 cm. for 2 hours.
(6) Keep patient in bed for 24 hours.
() S. S. enema at 8: 00 PM day before.
(c) Sodium amytal 0.194 gram (3 gr.) 2 hours before operation.
Morphine sylphate 0.016 gram {y± gr.) and hyoscine hydrobromide
0.00065 gram (Vioo gr-) hypo 1 hour before operation. (Patients
under 18 years of age and those who are small or frail should receive
two-thirds of the adult hypo.)
(2) Children, general anesthesia.— {a) Light supper; no breakfast.
(6 ) S. S. enema at 8: 00 PM day before.
c. Nasal cases, local anesthesia.— (1) Light supper night before and
no breakfast day of operation.
(2) S. S. enema at 8: 00 PM day before.
(3) Sodium amytal 0.194-gram (3 gr.) 2 hours before operation.
Morphine sulphate 0.016 gram (14 gr-) and hyoscine hydrobromide
0.00065 gram (Vioo gr-) hypo 1 hour before operation. (Patients
under 18 years of age and those who are small or frail should receive
two-thirds of the adult hypo.)
d. Mastoidectomy, peroral endoscopy, and other operations.— (1)
Treatment is prescribed by ward officer prior to operating, depending
upon type of anesthesia, nature of operation, and condition of patient.
(2) An X-ray of chest is taken prior to mastoidectomy.
e. Eye cases, local anesthesia.—Same as Z>(1) above unless otherwise
directed.
256. Post-operative routine.—a. Tonsillectomy.—(1)
Adults.— («) Keep patient as quiet as possible in bed.
(&) Diet, liquids, water, after 2 hours. Milk, orange juice, or
ice cream after 5:00 PM. Soft diet next day. Thereafter the diet
may be increased, depending upon patient’s condition.
() Immediately after the evening meal dissolve the dye in a half
glass of grape juice and drink all. Tinctura opii camphorata may be
given to control diarrhea.
(c) Enema of clear water at 7:00 AM the morning of the examination.
Repeat once if necessary to secure clear return flow, but only
once.
158
TM 8-260
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 263-264
(c?) No breakfast, but may have water ad lib, clear tea or black
coffee with sugar, but no milk or cream. Report at X-ray section at
8: 00 AM and 11:00 AM.
(e) On return to ward after examination at 11:00 AM, have the
patient eat well-buttered toast, two soft-boiled eggs, and a glass of
top milk.
(/) Return to X-ray section 1 hour after eating the toast, eggs,
and milk.
(2) Double dose technique (give the second dose only when requested
by the X-ray section).— (a) The first dose is given according
to instructions in (1) above.
(Z>) After the X-ray examination at 8:00 AM ((1) () Heating system is adequate (AR 40-205).
() Any recommendations to improve sanitary conditions at the
guardhouse (AR 40-205).
(3) Mess halls and kitchens.— (a) General sanitary condition of
kitchens, mess halls, refrigerators, and store rooms (AR 40-205).
(Z>) Company kitchens and mess rooms are kept scrupulously clean
at all times (AR 40-205).
() Men on duty in the bakery bathe frequently, wear clean clothing,
and when practicable wear the white uniform (AR 40-205).
(c) These men are inspected frequently to see that before going
on duty they have clean hands, with nails short and free from dirt,
and that their clothing is clean (AR 40-205).
() Personnel on duty serving food, such as ice cream, milk, bottled
goods, and other food stuffs, have been examined and certified
by a medical officer as being free from communicable diseases
(AR 40-205).
(c) List of permanent food handlers and certificates from a medical
officer as to their being free from communicable diseases is posted
in the exchange (AR 40-205).
(d) Ice cream containers, soda fountains, and other food containers
are clean, free from corrosion or dirt, and kept tightly closed
when not in use (AR 40-205).
(e) Facilities are available for the proper cleansing of glasses,
spoons, and other utensils used in dispensing foods and drinks
(AR 40-205).
(/) Candies, fruits, and other foodstuffs are protected from dust
and insects (AR 40-205).
(p') Any recommendations to improve sanitary conditions at the
post exchange (AR 40-205).
(A) Post exchange sells the individual prophylactic kit (AR 40-235
and circular letter No. 4, S. G. O., 1940).
(z) Prophylactic equipment sold by the post exchange is inspected
and meets specifications (circular letter No. 4, S. G. O., 1940).
(6) Barber shop.— (a) All barbers on the post have read and
they are complying with the provisions of paragraph 9, AR 40-205.
(&) Each barber is required to undergo a monthly physical inspection
and such other tests as may be necessary to insure his
freedom from communicable disease (AR 40-205).
(c) Barbers are required to keep their persons and clothing clean,
and while attending patrons wear a clean, washable outercoat or
uniform (AR 40-205).
(d) Wash their hands thoroughly with soap and water before
attending each patron (AR 40-205).
(e) Barbers are prohibited from selling or giving away, without
the written approval of the surgeon, medicinal preparations for the
hair or skin, to be used outside the barber shop, or attempting,
under any circumstances to treat pimples, warts, moles, or similar
lesions of the skin or scalp (AR 40-205).
(/) Use of styptic pencils or lump or solid styptics is prohibited
(AR 40-205).
190
App. I
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 2
(g) Interior of the barber shop is in a clean and sanitary condition
(AR 40-205).
(A) Provisions have been made for an adequate supply of hot
water and for the disposal of waste water (AR 40-205).
(z) Cuspidors are used and they are cleaned and disinfected daily
(AR 40-205).
(j) A freshly laundered towel is used for each patron (AR 40-205).
(k) Head rest of barber chairs is provided with a sheet of paper
or clean towel for each patron (AR 40-205).
(7) All brushes, combs, razors, clippers, shears, scissors, tweezers,
buffers, massage and scalp appliances, etc., are cleaned, then sterilized
after each separate use in an antiseptic solution such as 5-percent
lysol for at least 3 minutes (AR 40-205).
(m) Use of powder puffs, sponges, and neck dusters is prohibited
(AR 40-205).
(n) Use of shaving cups in common is prohibited (AR 40-205).
(o) A copy of paragraph 9, AR 40-205, is posted in each barber
shop (AR 40-205).
(p) Any recommendations for sanitary improvement of barber
shops (AR 40-205).
(7) Commissary.— (a) Commissary is kept scrupulously clean at
all times (AR 40-205).
(5) See (4) (c) above.
(c) Permanent food handlers are examined by a medical officer,
certified as free from communicable disease, and a list of such persons
with the result of the examination posted (AR 40-205).
(d) Room used as a commissary is tightly screened, with doors
that close automatically (AR 40-205).
(e) Any evidence of flies, roaches, or ants in the commissary
(AR 40 205).
(/) All food is protected from dust (AR 40-205).
(y) Ice boxes and refrigerators are elevated to permit cleansing
and inspection underneath (AR 40-205).
(A) Ice boxes are clean (AR 40-205).
(z) Counters, blocks, and utensils are clean and free from dirt or
corrosion (AR 40-205).
(y) Any recommendations to improve the sanitary condition of the
commissary (AR 40-205).
(8) Meat market.—(a) Meat market is clean and maintained in a
sanitary condition (AR 40-205).
(5) See (4) (c) above.
(c) See (4) (d) above.
191
App. I
2 MEDICAL DEPARTMENT
(gZ) Room used as a market is tightly screened and equipped with
screen doors that close automatically (AR 40-205).
(e) Any evidence of the presence of flies, roaches, or ants (AR
40-205).
(/) All food is protected from dust (AR 40-205).
(g) Ice boxes and refrigerators are elevated at such height from
the floor as permits cleaning and inspection underneath (AR 40-205).
(A) Ice boxes are scrupulously clean (AR 40-205).
(z) Knives are clean and free from accumulations of dirt (AR
40-205).
(?) Meat block and the counter are scrubbed clean (AR 40-205).
(&) Towels or other cloths are in use (AR 40-205).
(9) Theater and service club.— (a) Post theater and service club
are well ventilated (AR 40-205).
(6) Both buildings are kept in a generally sanitary condition
(AR 40-205).
( to h, above.
c. A file is maintained of the nonexpendable medical supplies in
use in the ward on W. D., M. D. Form No. 16b (AR 40-1705).
d. Ward officer checks the surgical instruments monthly as required
(AR 40-1705).
e. Any inflammable material exposed to the danger of fire in any
of the wards or closets (AR 700-10 and AR 40-590).
/. (1) The head nurse, under the ward officer, is placed in charge
of the ward, of the nurses, of the enlisted personnel and others who
assist in the care of patients (AR 40-20 and AR 40-590).
(2) She records all instructions from the ward officer for the
guidance of both day and night nurses (AR 40-20 and AR 40-590).
(3) She is held responsible for the proper nursing of patients,
serving of all food, the administration of medicines, and the cleanliness
and order of the ward and of the public property therein
(AR 40-20 and AR 40-590).
g. (1) In the absence of members of the Army Nurse Corps, the
enlisted attendant (wardmaster) is in charge of the ward, and he
has responsibility in the same degree and manner as a head nurse
(AR 40-590).
(2) Enlisted attendants are required to comply with the instructions
of nurses in the execution of their offices (AR 40-590).
(3) Smoking by ward personnel while on duty in wards is prohibited
(AR 40-590).
(4) Enlisted attendants wrear the white uniform at all times when
on duty in wards (AR 40-590).
(5) Enlisted men on duty are forbidden to collect or hold money
or other valuables belonging to patients or to have financial transactions
with them (AR 40-590).
h. (1) Upon admission to the ward the patient is advised to deposit
his money and valuables for safekeeping in the safe provided for that
purpose, and that he keeps valuables in the ward at his own risk
(AR 40-590).
(2) In case a patient is unconscious or seriously ill, the ward
officer secures his valuables at once, in the presence of a witness, and
secures a receipt therefor from the custodian (AR 40-590).
235
App. VIII
4 MEDICAL DEPARTMENT
(3) Soiled clothing of patients is laundered at Government expense
as a part of the hospital laundry (AR 40-590).
(4) Patient’s clean clothing is listed in duplicate on W. D., M. D.
Form No. 75 in his presence (or in the presence of a witness in case the
patient is unconscious or insane), signed by the patient (if conscious),
bundled and tagged and properly and securely stored (AR 40-590).
i. (1) Patients are properly dressed in hospital clothing.
(2) Patient’s temperature, pulse, and respiration are taken and
recorded at once on W. D., M. D. Form No. 55 G-l, showing the time
the patient was admitted to the ward.
(3) Patient is bathed, clothed in hospital clothing, and put to bed
upon arrival unless otherwise instructed by a responsible medical
officer.
(4) If a patient shows any indication for prompt medical or
surgical attention the nurse informs the ward officer or responsible
medical officer.
(5) What the standing instructions are relative to nourishment
pending the prescribing of a diet by a medical officer.
(6) How long patients are in the ward before a complete detailed
history and a physical examination are made.
j. (1) Until what hour of the day patients are required to remain
in their wards.
(2) Use of profane language, loud talking, singing, or boisterous
actions are forbidden in the ward.
(3) Patients are permitted to smoke in the wards. If so, what
portion of the ward and at what hour.
(4) Gambling is forbidden.
(5) How often ambulatory patients are required to bathe and
change their hospital clothing.
(6) Patients are prohibited to use towels, basins, toilet articles,
or articles of clothing belonging to other patients.
(7) Patients are required to report to the ward officer any inattention
regarding care and treatment, or any dissatisfaction regarding
the character, quantity, or manner of serving of food.
(8) In what manner infractions of discipline by patients are
handled (AR 40-590).
(9) (a) When death is imminent the patient is properly segregated
from other patients.
(&) In case of death, the body is examined by a responsible medical
officer before being removed from the ward.
(c) Remains are promptly removed to the morgue.
236
App. VIII
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 4
(d) Body is properly tagged, washed, orifices properly cared for,
clothed in clean linen, and the remains wrapped in a clean sheet
(AR 40-590).
k. A ward morning report is prepared covering all cases admitted,
disposed of, or transferred to or from the ward in the previous 24
hours, ending at midnight (AR 40-590).
I. What hour daily diet request and mess storeroom request are
signed and sent to the mess officer (AR 40-590).
m. Complete clinical histories (W. D., M. D. Form No. 55-series) are
available for use (AR 40-1025).
n. Clinical records are forwarded to the registrar for a check 24
hours before the patient is discharged from hospital.
o. All orders for medicine or treatment are recorded in the ward
order book by the nurse receiving the orders and the book is signed
by the ward officer before he leaves the ward.
p. In checking narcotics and alcohols the ward officer’s order book
is checked against the record of administration of medicine to
patients.
q. At what hours of the day routine pulse rates, temperatures,
and respiration are taken.
r. Clinical records of patients are kept in places where patients
or visitors may have access to same.
s. (1) Dietitian head nurse is responsible for the service of meals.
(2) She is required to make full report when food is not satisfactory.
(3) She attempts to rectify immediately any mistakes observed.
(4) Proper tray service is provided for all bed patients.
(5) Tray service is attractive, food appetizing, and promptly
served upon reaching the ward.
(6) There is a sufficient variety and quantity in each meal.
(7) Food is properly cooked.
(8) Any waste.
(9) Attendants are permitted to eat in the wards or diet kitchens.
(10) Ward officer personally inspects the service of one meal daily
in his ward.
(11) Ward officer specifically states the patients who will go to
the dining room for meals.
(12) System used to transport food to the ward.
(13) Measures taken to insure that foods will be served hot to
the bed patients.
(14) Bills of fare for diets prescribed by the commanding officer
are made out and posted in the ward office (AR 40-590).
237
App. VIII
4 MEDICAL DEPARTMENT
t. (1) Ward officer makes a complete and detailed inspection
daily, including sanitation, neatness, upkeep, and repair of equipment,
outside police of ward areas, and the general administration
of his ward.
(2) What action he takes to correct defects and deficiencies noted
at the inspection (AR 40-590).
238
App. IX
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 1
Appendix IX
CHECK LIST FOR CHIEF OF MEDICAL SERVICE
1. General.—a. Organization of the medical service (AR 40-590).
b. (1) How often a complete inspection is made by chief of medical
service of the entire service.
(2) How frequently professional conferences are held.
c. Copies of hospital rules are posted in convenient places where
they may be seen by patients and duty personnel (AR 40-590).
d. (1) Patients with communicable diseases are isolated individually
or in groups (AR 40-245).
(2) A special section of the hospital is set aside for their management
(AR 40-245).
(3) Cubicle frames are provided (AR 40-245).
(4) Patients with communicable diseases are restricted to the
portion of the hospital set aside for their treatment during the communicable
stage (AR 40-245).
(5) Visiting is prohibited between patients with the various classes
of communicable diseases (AR 40-245).
(6) Beds, mattresses, and linen of such patients are properly disinfected
when the patient is released from the ward (AR 40-245).
(7) Cases with respiratory tract infection are required to use paper
napkins or pieces of gauze as handkerchiefs and these articles are
burned after use (AR 40-245).
(8) Their dishes, knives, forks, etc., are sterilized after use (AR
40-245).
(9) Patients with venereal diseases in a communicable stage are
isolated from all other patients (AR 40-245).
e. Ward attendants are fully instructed in methods of protection
from diseases for themselves and for others (AR 40-245).
/. A suitable, properly secured room is set aside for the care of
mental cases (AR 600-500).
g. Keys to mental wards and prison ward are so handled that these
wards can be entered quickly at any time in case of fire, disorder, or
for search (AR 40-590).
h. A Morning Report of Ward (W. D., M. D. Form No. 72) is accompanied
by diagnosis slips for the new admissions furnished the registrar
each morning (AR 40-590).
i. How transfers of patients from one ward to another ward are
handled (AR 40-590).
239
App. IX
1-2 MEDICAL DEPARTMENT
j. Prompt action is taken to dispose of patients actually determined
insane (AR 600-500).
k. Prison ward is suitable and properly secured by locks and keys
(AR 600-375).
2. Medical ward.—a. Organization of the medical ward section
(AR 40-590).
b. See paragraph 4, appendix VIII.
240
App. X
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 1-17
Appendix X
CHECK LIST FOR OFFICER IN CHARGE OF
LABORATORY
1. Room or building used as a laboratory is suitable. If not, state
requirements (AR 40-585 and AR 40-590).
2. Personnel assigned to duty in the laboratory are sufficient, well
trained, and satisfactory (AR 40-590).
3. Laboratory equipment and supplies are sufficient and satisfactory.
If not, state requirements (AR 40-1705, Medical Department
Supply Catalog, and circular letter No. 1, S. G. O., 1940).
4. Greatest care is used in handling electrical heating units in order
to avoid burning out of heating coils (AR 40-1705).
5. Potent poisons and alcohols are kept under lock and key (AR
40-590).
6. Ethyl alcohol is accounted for on W. D., M. D. Form No. 17a as
in a pharmacy (AR 40-590).
7. Any accumulation of supplies or equipment on hand in excess of
present requirements (AR 40-1705).
8. Any obsolete, damaged, or unserviceable supplies or equipment
on hand (AR 40-1705 and AR 700-10).
9. Officer in charge maintains a record on W. D., M. D. Form No.
16b of nonexpendable supplies (AR 40-1705).
10. Officer in charge checks his instruments monthly (AR 40-1705).
11. Medical property in the laboratory has been examined by a
commissioned officer of the Medical Department and verified by reference
to records within the last 6 months (AR 35-6520 and AR 40-1705).
12. All medical property is protected from the danger of fire, theft,
and damage (AR 40-590).
13. Rubber goods are protected by the use of talc.
14. Any inflammable material stored in the laboratory that is not
properly protected from the danger of fire (AR 700-10).
15. a. Laboratory animals are suitably housed and protected.
b. Laboratory animals are in good condition.
c. What funds are available for their upkeep.
16. How often the water in the swimming pool is examined.
17. a. What examinations are made at the laboratory.
b. What types of examinations are not made at the laboratory but
are sent to other Government agencies.
320358°— 41------1G 241
App. X
18-21 MEDICAL DEPARTMENT
18. a. A list of voluntary blood donors, by types, is kept on file at
the laboratory.
b. How often these donors are examined for syphilis (AR 40-1715).
19. Arrangements are made so that the laboratory officer or one of
his qualified assistants is available at all times for blood counts, etc.
20. a. All suspected venereal sores examined by dark field method
for spirochetae pallida.
b. If the first examination is negative, other examinations are made
later (circular letter No. 1, S. G. O., 1940).
21. a. All autopsies are performed by an officer assigned to the laboratory
service.
b. Chief of laboratory service is held responsible for all bodies from
the time they are delivered from the ward until they are turned over
to the undertaker.
c. A receipt is obtained from the undertaker for all bodies turned
over to him.
d. Bodies are inspected immediately after death and again after
they are properly clothed and ready to be placed in the casket (AR
30-1820).
e. A certificate of the inspection, signed by an officer of the labora^
tory service, stating whether or not the body is properly prepared and,
properly clothed for burial, is filed in the hospital records.
/. A copy of the records of each autopsy is forwarded direct,
Curator, Army Medical Museum (AR 40-590).
g. Tissue pathology is handled in accordance with The Sui'g&ffi
General’s instructions (par. 24, circular letter No. 1, S. G. O., 1W).
242
App. XI
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 1-8
Appendi x XI
CHECK LIST FOR CHIEF OF DENTAL SERVICE
1. Rooms set aside for the dental clinic are suitable, well lighted,
clean and neat in appearance (AR 40-15 and AR 40-590).
2. Opinion of the dental surgeon is secured in writing when the
construction, improvement, or upkeep of the dental clinic is under
consideration. In such cases the dental surgeon forwards a copy
of his recommendations through channels to The Surgeon General
(AR 40-15 and AR 40-585).
3. A suitable waiting room has been set aside for dental patients
(AR 40-15).
4. Dental personnel are sufficient. If not, detail the need for additional
personnel (AR 40-15).
5. Enlisted men assigned to dental service are regarded as being
on special duty and under special instruction, and not required to
attend any other form of instruction (AR 40-15).
6. Dental surgeon has prepared schedules for the technical training
of his enlisted assistants, including hours of duty with the dental
service, dental first-aid measures, care of public property, etc. (AR
40-15).
7. Regulations have been drawn up for the dental service, including
hours of duty, property regulations, sanitation, the keeping of records
etc. (AR 40-590).
8. a. Dental surgeon regularly makes such inspections and checks
of dental supplies and equipment as will insure that the property
is in serviceable condition at all times (AR 40-1705).
6. He inspects his instruments once a month (AR 40-1705).
c. He maintains a file showing the nonexpendable property for
which he is responsible (AR 40-1705).
d. Dental supplies are satisfactory as to kind, quantity, and quality
(AR 40-15, AR 40-1705, and Medical Department Supply Catalog).
e. Dental surgeon pays special attention to the safekeeping and
proper use of poisons, narcotics, alcohol, and substances containing
alcohol (AR 40-15 and AR 40-590).
/. Poisons, narcotics, and alcohols are kept under lock and key
(AR 40-15 and AR 40-590).
g. Who is intrusted with the key to the poison cabinet (AR 40-15
and AR 40-590).
243
App. XI
8-11 MEDICAL DEPARTMENT
h. Gold plate, gold for casting, gold solder, and gold lingual bars
are kept in a safe, except when small quantities for daily use are
kept in a safe place in the dental clinic (AR 40-15).
i. If a dental officer is relieved from duty he turns over his stock
of special dental material either to the medical supply officer or
to his successor, obtaining and distributing copies of the receipts
(AR 40-15).
j. When unserviceable gold accumulates, it is mailed in a registered
package to the distributing depot for the corps area, in weights
not to exceed 5 pennyweight (AR 40-1705).
k. Any unserviceable gold on hand (AR 40-1705).
I. Dental clinic is properly protected from theft, fire, and other
damage (AR 40-590).
m. Any accumulation of property or supplies on hand (AR 40-
1705).
n. Any obsolete, damaged, or unserviceable property on hand in
the dental clinic (AR 40-1705 and AR 700-10).
o. Medical property in the dental clinic has been examined and
verified by a commissioned officer of the Medical Department within
the last 6 months (AR 35-6520 and AR 40-1705).
p. It is understood by all concerned that the greatest care must
be used with heating units to avoid burning out of the heating coils
(AR 40-1705).
9. All inflammable material is protected from the danger of fire
(AR 700-10).
10. a. Dental surgeon makes an oral inspection at the time the
surgeon conducts the monthly physical inspection (AR 40-15 and
AR 615-250).
5. A dental survey is made of every patient who is hospitalized
(AR 40-15).
c. Date of the last complete dental survey of the command (AR
40-510).
d. Present dental classification of the command.
Class I Class II Class III Class IV
(AR 40-510).
e. Appointments are made in accordance with the result of the
classification (AR 40-510).
11. What administrative action is taken to insure that the following
persons report to the dental surgeon for examination and necessary
dental treatment:
a. Persons ordered to permanent detached service.
244
App. XI
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 11-19
b. Persons who may be performing detached service while attending
summer training camps and such other times as they may be
at the station (AR 40-510).
12. In examining or treating persons who may be performing detached
service while attending summer training camps the dental
surgeon forwards a statement of conditions found and defects corrected,
if any, and in case the treatment is not completed the reasons
therefor, to the corps area surgeon of the corps area in which the
individual is stationed (AR 40-510).
13. a. Dental surgeon keeps an appointment book.
b. Method used in making appointments with military personnel.
c. What percent of personnel fails to keep appointment.
d. Dental treatment is accorded to all who are entitled to receive it.
e. There is a daily emergency hour, and how it relates to sick call.
/. How many hours during the coming week are taken up with
appointments.
g. Regulations are in force requiring that the name, grade, etc., of
every militarized person in need of dental attention be placed on the
daily sick report (W. D., A. G. O. Form No. 5), and the individual
required to report at the hospital or dispensary (enlisted men on sick
call) before dental treatment is rendered by the dental service (AR
40-505, AR 40-510, AR 40-1025, and AR 345-415).
14. Dental surgeon has trained his enlisted assistants to keep the
records of the clinic (AR 40-15).
15. a. How many full dentures made during each month of the
past year.
b. How many partial dentures.
• c. Any unreasonable delay in furnishing dentures.
16. A record is kept of dental X-ray exposures (AR 40-15).
17. There is a current file and a permanent file of register cards of
dental patients (W. D., M. D. Form No. 79) (AR 40-1010).
18. In cases where patients were hospitalized for dental treatment
only, the chief of dental service furnishes the ward officer with a
copy of the patient’s case record to be attached to the patient’s
clinical record.
19. Patients in the hospital who require dental examination and
report or dental treatment are sent to the dental clinic with a report
from the ward officer showing name, etc., and whether referred for
dental examination or treatment, or both, the patient’s diagnosis, his
probable duration of hospitalization, together with any remarks pertinent
to the case, with special reference to the presence of syphilis
in the infectious stage.
245
App. XI
20-24 MEDICAL DEPARTMENT
20. At the close of each month the following reports are fastened
together and filed as “Dental history, Fort--------, for the month of
_____ »
a. W. D., M. D. Form No. 57.
b. W. D., M. D. Form No. 18b.
c. Report of dental opinions on clinic.
d. Schedules of instruction for enlisted assistants.
e. Memoranda recommended for incorporation in sanitary order.
/. Special reports and articles for publication.
g. Other pertinent data.
(AR 40-1010).
21. At the close of each calendar year an index has been made of
all subjects listed above and filed as “Index to the dental history,
Fort , year of-------- ” (AR 40-1010).
22. Dental surgeon keeps himself informed of existing or anticipated
conditions with reference to their influence on dento-oral health,
and he communicates such of this information as has a bearing upon
military administration to the surgeon and recommends to him measures
deemed advisable (AR 40-15).
23. Dental reports are checked as to accuracy (par. 12, circular letter
No. 1, S. G. O., 1940).
24. Instructions regarding central dental laboratories are being
complied with (par. 11, circular letter No. 1, S. G. O., 1940, and
references quoted therein).
246
App. XII
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 1-6
Appendi x XII
CHECK LIST FOR CHIEF OF ROENTGENOLOGICAL
SERVICE
1. a. Personnel assigned to duty in the department are adequate.
A Personnel are competent.
c. Conduct and appearance of the personnel are satisfactory (AR
40-590).
2. a. Hospital property used for other than Medical Department
purposes (AR 40-590).
b. Property is protected from theft, fire, and other damage (AR
40-590).
c. Any accumulation of property or supplies on hand above present
needs (AR 40-1705).
d. Any obsolete, damaged, or unserviceable property on hand (AR
40-1705 and AR 700-10).
e. A file is kept showing property held on Memorandum Receipt
(W. D., Q. M. C. Form No. 487) (AR 40-1705).
f. Supplies are adequate and satisfactory (AR 40-1705, Medical
Department Supply Catalog, and circular letter No. 1, S. G. O., 1940).
g. Medical property in use has been examined and verified by a commissioned
officer of the Medical Department every 6 months (AR
35-6520 and AR 40-1705).
h. Potent poisons are kept under lock and key and labeled as such
(AR 40-590).
i. Instruments of every description are checked monthly by a commissioned
officer (AR 40-1705).
j. Daily average number of X-ray pictures taken during past
month. Small size. Medium size. Large size. Fluoroscopic examinations.
X-ray treatments.
3. In view of fire hazards, accumulations of used X-ray films in
evidence.
4. Plans have been submitted to The Surgeon General for the
proper storage of X-ray films.
5. Standing instructions have been posted for the guidance of the
technician, especially in regard to fire hazards, the storage of films,
etc. (AR 40-590).
6. a. All electric wiring complies with the N. E. A. Code, especially
in regard to the use of insulators, conduits, stand-offs, fuse blocks,
switches, etc.
247
App. XII
6-7 MEDICAL DEPARTMENT
b. Only screened incandescent lamps are used.
c. Any portable lights on extension cords in evidence.
d. Diffusing glass in the illuminator ever becomes heated.
e. “no smoki ng ” signs are posted.
/. Any film kept within 2 feet of steam pipes, radiators, or other
sources of heat.
g. Fire extinguishing appliances are readily available.
A. Any of the fire extinguishers in the department contain carbon
tetrachloride, which will develop phosgene gas.
i. Films are in casettes or other containers in the operating room
at any time other than while operating.
j. Film negatives in storage or in the process of handling are kept
in heavy manila envelopes, or in cardboard boxes, not to exceed six
films to the envelope or 25 to a box.
k. Films in the laboratory in excess of 100 pounds to one vented
cabinet, or 200 pounds in two vented cabinets, are kept separated by
at least 15 feet.
I. Films are stored in rooms which are shared with other activities.
m. Any accumulation of combustible material in the X-ray laboratory.
n. How deteriorated X-ray films are disposed of.
7. Equipment and space allotted for X-ray department are satisfactory.
248
App. XIII
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 1-2
Appen dix XIII
CHECK LIST FOR OFFICER IN CHARGE OF
DISPENSARY
1. Out-patient service furnishes medical attendance to all persons
entitled thereto (AR 40-505).
2. a. At what hour sick call is held each day (AR 40-505).
b. It is a rule that every militarized person in need of medical attention
will be placed on daily sick report (AV. D., A. G. O. Form
No. 5) (AR 345-415).
c. As a rule the organization or detachment daily sick report
entries are completely filled out, including the line of duty (yes, no),
and signed by the organization or detachment commander before
being sent to the hospital or dispensary.
d. First entry for each occasion is made on the line immediately
following the signature of the organization or detachment commander
and medical officer to the preceding entry (AR 345-415).
e. Organization or detachment commander invariably places an
interrogation point (?) in the proper column when he cannot state
definitely at the time whether or not the disease or injury was incurred
in line of duty (AR 345-415).
f. Surgeon in every case of injury considers whether or not the
case may result in partial or complete permanent physical disability
and be made the basis of a claim against the Government (AR 345-
415).
g. If he believes that it may so result, he immediately takes steps
to request the action of a board of officers (AR 345-415).
h. A noncommissioned officer of the organization or detachment
brings the daily sick report to the place of holding sick call and
waits to return the daily sick report (AR 345-415).
i. Entries in the daily sick reports show name, grade, and Army
serial number (AR 345-415).
j. When the organization or detachment commander or the medical
officer determines that the injury to an enlisted man resulted from
his own misconduct, the notation “No; 107 AW” is made in the
line of duty column (AR 345-415).
k. Similarly, if an absence from duty of an enlisted man is caused
by venereal disease due to his own misconduct, the initial symptoms
249
App. XIII
2-6 MEDICAL DEPARTMENT
of which appeared more than a year prior to such absence, the notation
“No; 107 AW” appears (AR 345-415).
I. In case of an entry where the organization or detachment commander
or the medical officer is of the opinion that the sickness of
an officer or enlisted man was due to causes, as noted, “the effects of
a disease which is directly attributable to and immediately follows
his own intemperate use of alcoholic liquor or habit-forming drugs,”
this entry appears in the line of duty column, “No; AR 35-1440”
(AR 345-415).
m. When an entry of “No; AR 35-1440” or “No; 107 AW” is
made on the organization or detachment daily sick report, the individual
is given an opportunity to protest the findings to the commanding
officer (AR 345—415).
n. In case that the organization or detachment commander and the
surgeon do not agree upon the line of duty status, the daily sick report
is presented to the commanding officer for his decision to be placed in
the “disposition” column and signed with his official signature (AR
345-415).
o. In all cases of the entry “No; AR 35-1440” the initials of the
organization or detachment commander appear opposite both the
original entry and final entry of the current case (AR 345-415).
p. Erasures appear on the daily sick report in violation of orders
(AR 345-415).
q. When an incorrect entry has been made, a line is drawn through
the entry and the initials of the officer making the elimination placed
on the margin of the page (AR 345-415).
r. The signature, grade, and organization or arm or service of the
organization or detachment commander and medical officer are placed
on the line immediately below the last entry for each occasion, each
officer signing below the items of his report (AR 345-415).
3. The medical officer in charge of the out-patient service conducts
the prescribed physical examination of enlisted men (AR 615-250).
4. An out-patient index is kept in the out-patient service for all
patients treated but not admitted to the hospital.
5. How out-patient records are disposed of when no longer required
for current use (AR 40-1005).
6. A record is kept of the number of patients treated, number of
treatments, examinations, etc., for use with the report sheet (W. D.,
M. D. Form No. 51) at the end of the month, and under these headings:
a. Out-patients:
(1) Military.
(2) Training unit.
(3) Civilian.
250
App. XIII
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 6-11
(4) Others (specify).
b. Physical examinations:
(1) Appointment, promotion, and annual of officers, etc.
(2) Enlistment and reenlistment in Regular Army.
(3) Appointment to United States Military Academy.
(4) Appointment, promotion, or others, Officers’ Reserve Corps.
(5) Reserve Officers’ Training Corps.
(6) Citizens’ Military Training Camps.
(7) Enlisted Reserve Corps.
(8) Others (specify).
c. Vaccination, etc.:
(1) Typhoid immunizations.
(2) Smallpox vaccinations.
(3) Schick tests.
(4) Diphtheria toxin antitoxin.
(5) Others (specify).
(AR 40-1025).
7. How many patients were seen in the out-patient service during
the last completed month (AR 40-1025).
8. A summary of the work to include number of office visits, quarters
visits, number of persons carried in quarters (by classes) is
furnished the surgeon on the last day of each month (AR 40-1025).
9. The chief of each professional service is required to submit on
the first day of each month a report to the medical officer in charge
of the out-patient service showing the total number of treatments
given out-patients during the preceding month in the various
services and clinics under their jurisdiction.
10. a. Medical property for which the medical officer in charge is
responsible has been examined and verified by a commissioned
officer of the Medical Department during the last 6 months (AR
35-6520 and AR 40-1705).
b. Medical officer in charge checks the instruments for which he
is responsible monthly (AR 40-1705).
c. A record is kept on Form No. 16b of the supplies for which
the medical officer in charge is responsible (AR 40-1705).
d. Medical officer in charge safeguards the potent poisons, alcohol,
alcoholic liquors, narcotics, and habit-forming drugs which he may
carry in emergency cases by the use of lock and key (AR 40-590).
11. It is clearly understood by medical officers on duty that sulfanilamide
will be employed only when the patient is kept under
careful medical supervision in hospital and that it will not be administered
to out-patients (par. 4, S. G. O. circular letters No. 13,
1938, and No. 17, 1940).
251
MEDICAL DEPARTMENT
App. XIV
1-15
Appendix XIV
CHECK LIST FOR OFFICER IN CHARGE OF PHARMACY
1. Commanding officer of the hospital exercises personal supervision
over the pharmacy or he has detailed a subordinate Medical
Department officer for this duty (AR 40-590).
2. The pharmacy is generally clean, well lighted, and it presents a
neat appearance (AR 40-590)
3. Pharmacist on duty appears to be well qualified for his duties
(AR 40-590).
4. What members of the detachment are permitted to compound
prescriptions and under what circumstances (AR 40-590).
5. All prescriptions are written in the metric system (AR 40-590).
6. A separate prescription file is kept for prescriptions containing
alcohol, alcoholic liquors, and for medicines containing opium or any
of the salts, derivatives, or preparations of opium or coca leaves
(AR 40-590).
7. A separate prescription file is kept for prescriptions for civilians
(AR 40-590).
8. All other prescriptions are filed in a separate book (AR 40-590).
9. Labels placed on containers for medicines issued from the pharmacy
bear complete instructions to the patient and notations to
identify the prescriber and prescription (TM 8-233).
10. Initials of the pharmacist who filled the prescription are entered
on each prescription (TM 8-233).
11. a. Officer in charge of the pharmacy assumes responsibility for
safeguarding the use of the key.
b. Exactly to whom the keys of the poison cabinet are intrusted.
c. Who has the keys when the pharmacist is off duty (AR 40-590).
12. Unduly large amounts of alcoholic liquors have been prescribed
at one time for any one person (AR 40-590).
13. A permanent record is kept of the pharmacy receipts and expenditures
for each article such as alcohol, alcoholic liquors, and
all habit-forming drugs on W. D., M. D. Form No. 17a (AR 40-590).
14. The slips (W. D., M. D. Form No. 17a) have been checked once
a month by a Medical Department officer, balanced and verified, and
the facts with the balance he found noted over his signature (AR
40-590).
15. On each slip mentioned above, the date of receipt from the
storeroom is noted in the left-hand column, and the amount in the
252
App. XIV
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 15-20
proper metric unit entered in the debit column; the expenditures
noted by date, prescription number in the left hand column with
the amount expended in compounding the prescription in the credit
column (AR 40-590).
16. A separate slip is kept for each form in which the above-named
drugs are furnished. For instance, morphine is issued in four forms:
12940 Morphine sulfate, 1 oz. USP, powder.
12950 Morphine sulfate, %-grain hypo tablets, 20, USP.
12955 Morphine sulfate, ^4-grain hypo tablets, 20, USP.
12960 Morphine sulfate, 2-grain hypo tablets, 10, USP.
(AR 40-590 and AR 40-1705).
17. The entries on W. D., M. D. Form No. 17a are correct for each
of the drugs noted below, since date of the last medical inspection.
(Secure a list of the issues from the storeroom and check expenditures
from the prescription files.) (AR 40-590).
10480 Alcohol, ethyl, 1 qt. USP.
10490 Alcohol, ethyl, 5 gal. USP.
10500 Alcohol, dehydrated, 1 pt. USP.
11450 Cocaine, hydrochloride, y± oz. USP.
11480
11490
12940
12950
12955
12960
13220
14850
14860
14940
Codeine, sulfate, 1 oz.
Codeine, sulfate, y2-
Morphine, sulfate,
Morphine, sulfate^
Morphine, sulfate,
Morphine, sulfate,’
Opium, 1 oz. powdeF, USP.
gablet, 500, USP.
in hypo tablets, 20, USP.
ain hypo tablets, 20, USP.
ain hypo tablets, 10, USP.
Tincture, opium y± pt. USP.
Tincture, opium, camphorated, 1 pt. USP.
Whisky, 1 qt. USP.
Nonstandard items corresponding to the above.
18. The poison label is placed on every container when the contents
thereof may be dangerous to health or human life (TM 8-233).
19. Potent poisons, that is, “any substance (drug, chemical, or
reagent) which is likely to destroy human life or seriously endanger
health when applied externally to the body or when taken internally
in a dose of less than one teaspoonful (4 cc., or in the solid state, 4
gm.)”, alcohol, alcoholic liquors, and all habit-forming drugs are kept
under lock and key (AR 40-590).
20. The following-named drugs, etc., are kept under lock and key,
or are any of them exposed on the shelves or kept in drawers:
Acid, nitric. Acid, phosphoric.
Acid, oxalic. Acid, sulphuric.
253
MEDICAL DEPARTMENT
App. XIV
20-27
Alcohol, methyl. Physostigmine.
Amyl nitrite. Potass, hydroxide.
Antimony and Procaine.
potassium tartrate. Scopolomine.
Apomorphine. Silver nitrate.
Arsenic. Sod. hydroxide.
Atropine. Strophanthin.
Barbital or veronal. Strychnine.
Cantharides. Tinct. aconite.
Chloral hydrate. Tinct. belladonna.
Cresol. Tinct. digitalis.
Digitalis. Tinct. nux vomica.
Fl. ext. belladonna. Alcohol, ethyl.
Fl. ext. nux vomica. Cocaine.
Glyceryl trinitrate Codeine.
Homatropine. Morphine.
Iodine. Opium.
Mercury. Whisky.
Nux vomica. Other liquors.
Phenol.
21. A prescription is made out every time that medicine is issued,
as is customary in good practice.
22. Prescriptions are refilled without a written order calling for a
refill by number (TM 8-233).
23. A refill date and number are placed on the old prescription
(TM 8-233).,
24. In cases other than militarized personnel, a notation is placed
on each prescription immediately after the name of the individual so
as to enable the pharmacist to determine the status; for example,
“John Smith, civilian employee, Q. M. C.”
25. When prescribing for civilian employees of the United States
and civilians as out-patients (dependents of military personnel excepted),
medical officers are required to enter on each such prescription
the amount to be collected.
26. Medicine charges for patients in hospital who are not entitled
to medical relief at the expense of the War Department appropriations,
such as certain civilian employees and other civilians, are collected
promptly at the rate of 50 cents per diem, listed on War Department
Form No. 322, deposited at the end of each month with nearest disbursing
officer, and The Surgeon General notified of the fact by letter
(AR 40-590).
27. Is this station an isolated place within the meaning of paragraph
18c (3), AR 40-590.
254
App. XIV
FIXED HOSPITALS OF THE MEDICAL DEPARTMENT 28-36
28. If this station is considered an isolated place is it customary to
issue medicines to civilians, make charges and collect the same, notifying
The Surgeon General of the circumstances in each case (AR
40-590).
29. Medicine charges for civilian employees not in hospital are
collected at the rate of 50 cents per prescription in ordinary cases and
in the case of expensive medicines, dressings, appliances, etc., at such
increased rate as will reimburse the United States for their cost (AR
40-590).
30. When civilian employees are hospitalized because of injury incurred
in the performance of duty and their medical care has not
been assumed by the Army as a part of their compensation, bills for
medicine charges are mailed direct to the United States Employee’s
Compensation Commission and the receipt of the funds from the
Commission taken up on War Department Form No. 322, and deposited
(AR 40-590).
31. a. A chart or table is kept in a conspicuous place in the pharmacy
showing antidotes for such ordinary poisons as follows (TM 8-
233):
Acids: Antimony.
Carbolic. Arsenic.
Hydrocyanic. Corrosive sublimate.
Oxalic. Iodine
Aconite. Lead salts.
Alcohols. Opium and morphine.
Alkalies. Phosphorus.
Alkaloids. Snake venoms, etc.
6. Antidotes to specific poisons are properly labeled, kept in a convenient
place for emergency use (TM 8-233).
32. All medicine containers are clearly and properly labeled (TM
8-233).
33. A list of prescriptions (stock formulas) for pharmaceutical
preparations carried in stock is available at the pharmacy for the information
of medical officers.
34. The pharmacy is required to keep continually on hand as far
as practicable a complete supply of all medicines supplied for use of
the hospital.
35. Any accumulation of supplies or equipment on hand in excess
of present requirements (AR 40-1705).
36. Any obsolete, damaged, or unserviceable supplies or equipment
on hand (AR 40-1705 and AR 700-10).
255
App. XIV
37-41 MEDICAL DEPARTMENT
37. The officer in charge maintains a record of nonexpendable supplies
on W. D., M. D. Form No. 16b (AR 40-1705).
38. Medical property in the pharmacy has been examined by a commissioned
officer of the Medical Department and verified by reference
to records within the last 6 months (AR 35-6520 and AR 40-1705).
39. Any inflammable material stored in the pharmacy that is not
properly protected from the danger of fire (AR 700-10).
40. Proper precaution is taken in regard to smoking while handling
inflammable supplies (AR 40-590).
41. Proper precautions are observed to safeguard adequately sulfanilamide
to prevent unauthorized use (par. 6, circular letter No. 13,
S. G. O., 1938, and circular letter No. 17, S. G. O., 1940).
256
TH 8-260
INDEX
INDEX
Paragraphs Pages
Absence from duty on account of injury due to own misconduct. 95 52
Absence of receiving and disposition officer________________ 50 30
Absence without leave, discharge of patients_______________ 73 42
Acute poisonings, antidotes and treatment_________________ 272 163
Administration, ward___________________________________ 146 76
Administrative and clerical jurisdiction, deaths_____________ 101 55
Administrative officer of the day:
Confinement of persons_____________________________ 129 66
Detail____________________________________________ 123 64
Duty detachment__________________________________ 128 66
Escaped insane patient or prisoner, responsibilities______ 131 66
General duties_____________________________________ 125 65
Fire marshal_______________________________________ 127 66
Inspections by_____________________________________ 126 65
Meat inspection____________________________________ 130 66
Officers of the day, attention to and assistance of_______ 222 103
Reports___________________________________________ 132 67
Tour of duty______________________________________ 124 65
Administrative service, general hospitals___________________ 12 10
Admission of patients:
Arrival by boat or rail______________________________ 42, 65 27, 37
Channels____________________________________________ 64 36
Detention wards___________________________________ 160 82
Disposition of clothing and effects____________________ 109 57
Examination_________________________________________ 64 36
Neuropsychiatric section____________________________ 168 85
Personnel entitled to admission_________________________ 62 36
Procedure on certain types_____________________________ 68 37
Records_____________________________________________ 67 37
Reports rendered upon admission from other stations___ 66 37
Routine, general___________________________________ 233 132
Supervision__________________________________________ 61 36
Alcohol, narcotics, and habit-forming drugs________________ 54, 149 32, 79
Alternate officers of the day_____________________________ 223 103
Alveolar abscess________________________________________ 258 157
Ambulance service______________________________________ 47 29
Anesthesia____________________________________________ 241 142
Appointments, dental___________________________________ 195 94
Approved certificate of disability_________________________ 99 54
Arrival procedure, nurses________________________________ 200 95
Army Nurse Corps and nursing service:
Arrival procedure__________________________________ 200 95
Duties and reports_________________________________ 203 96
Hours of duty_____________________________________ 202 96
Principal chief nurse________________________________ 201 95
Relief procedure____________________________________ 204 97
Status____________________________________________ 199 95
320358°—41------17 257
TM 8-260
INDEX
Paragraphs Pages
Attendants, enlisted men, neuropsychiatric section__________ 167 84
Audit, patients’ funds and valuables______________________ 84 46
Autopsies_____________________________________________ 181 90
Baggage:
Check of baggage room records_______________________ 115 61
Disposition on admission____________________________ 109 57
Officers___________________________________________ 114 61
Patients admitted from train or boat__________________ 112 60
Room_____________________________________________ 108 57
Withdrawal_______________________________________ 113 60
Bank deposits_________________________________________ 30 24
Barium enema_________________ ._______________________ 265 160
Basis and divisions, general hospitals______________________ 8 8
Blood examinations, table of normal values in______________ 232 127
Blood transfusions______________________________________ 180 89
Bodies, disposition_____________________________________ 183 90
Buildings, general hospitals______________________________ 16 15
Buildings and equipment, maintenance and repair__________ 136 71
Bulletin boards________________________________________ 151 79
Cafeteria system_______________________________________ 35 25
Cerebro-spinal fluid, normal values for____________________ 232 127
Certificate of disability__________________________________ 99 54
Channels, admission of patients__________________________ 64 36
Check lists:
Chiefs of—-
Dental service_______________________________ App. XI 241
Medical service______________________________ App. IX 237
Roentgenological service_____________________ App. XII 245
Surgical service___________________________ App. VIII 228
Commanding officer, medical detachment__________ App. VI 221
Commanding officer or surgeon_____________________ App. II 197
Director of dietetics_______________________________ App. V 217
Medical (hospital) inspector_________________________App. I 185
Medical supply officer_____________________________App. IV 209
Officer in charge of—
Dispensary________________________________ App. XIII 247
Laboratory__________________________________ App. X 239
Pharmacy_________________________________ App. XIV 250
Principal chief nurse_____________________________ App. VII 225
Registrar_______________________________________ App. Ill 203
Chief dietitian_________________________________________ 24 22
Chiefs of sections_______________________________________ 141 75
Dental____________________________________________ 191 93
Chiefs of service________________________________________ 140 74
Dental____________________________________________ 190 92
Check list for________________________________ App. XI 241
Laboratory______________________________________ 106, 177 56, 87
Medical, check list for____________________________ App. IX 237
Roentgenological___________________________________ 184 91
Check list for_______________________________ App. XII >p 245
Surgical, check list for__________________________ App. VIII 228
258
TM 8-260
INDEX
Paragraphs Pages
Class of patients treated, fever therapy____________________ 268 160
Classes and types, hospitals______________________________ 1 3
Clearance, discharge of patients__________________________ 76 43
Clinical records________________________________________ 225 104
Clinical treatment, detention ward________________________ 164 83
Clothing, patients:
Baggage room______________________________________ 108 '" 57
Check of records_______________________________ 115 61
Disposition on admission____________________________ 109 57
Hospital, wear of___________________________________ 110 58
Officers___________________________________________ 114 61
Retention_________________________________________ 111 59
Withdrawal from baggage room______________________ 113 60
Collection and disposition of salvage and waste materials____ 135 70
Commanding officer, general hospital______________________ 10 8
Inspections, check list for__________________________ App. II 197
Communicable diseases__________________________________ 232 127
Concussion_________________________________________ *__ 239 141
Confinement of persons by administrative officer of the day___ 129 66
Consultations__________________________________________ 144 75
Contusion_____________________________________________ 239 141
Council, hospital_______________________________________ 39 26
Custodian, patients’ funds and valuables__________________ 83 45
Deaths:
Action by registrar___________________________________ 105 55
Administrative and clerical jurisdiction_________________ 101 55
Autopsies___________________________________________ 181 90
Disposition of bodies_________________________________ 183 90
Effects of deceased___________________________________ 107 56
Notification_________________________________________ 102 55
Procedure in________________________________________ 103 55
Report of___________________________________________ 104 55
Responsibility, chief of laboratory service_______________ 106 56
Dental and oral surgery:
Alveolar abscess____________________________________ 258 157
Diet______________________________________________ 262 158
Jaw fractures______________________________________ 257 157
Post-operative care_________________________________ 261 157
Pulpitis (toothache)________________________________ 260 157
Stomatitis_________________________________________ 259 157
Dental service:
Appointments______________________________________ 195 94
Chief_____________________________________________ 190 92
Chief of section____________________________________ 191 93
Emergency officer__________________________________ 194 94
Organization_______________________________________ 189 92
Property officer____________________________________ 192 93
Reports___________________________________________ 198 95
Responsibility for dental patients in hospital___________ 197 94
Special cases_______________________________________ 196 94
Treatment_________________________________________ 193 93
259
TM 8-260
INDEX
Paragraphs Pages
Deposit certificate, patients’ funds and valuables___________ 86 46
Designation, hospitals___________________________________ 2 4
Detention ward:
Admission procedure________________________________ 160 82
Clinical treatment__________________________________ 164 83
Daily inspection____________________________________ 161 83
Meals.,___________________________________________ 163 83
Medicine__________________________________________ 162 83
Wardmaster_______________________________________ 159 82
Ward officer_______________________________________ 158 82
Detail:
Administrative officer of the day_____________________ 123 64
Professional officers of the day_______________________ 217 102
Diagnosis:
Impression________________________________________ 228 108
Report______________________________ 154 80
Diagnostic procedure___________________________________ 230 108
Genito-urinary surgery______________________________ 249 147
Diet, special post-operative____________________________ 236, 262 137, 158
Dietetic department {See also Director of dietetics):
Bank deposits______________________________________ 30 24
Cafeteria system___________________________________ 35 25
Chief dietitian_____________________________________ 24 22
Director of dietetics________________________________ 23 21
Food handlers______________________________________ 32 24
Hospital council____________________________________ 39 26
Inventory of supplies_______________________________ 33 24
Meals_____________________________________________ 31 24
Messes____________________________________________ 36 25
Night cook________________________________________ 28 24
Nurses’ fund_______________________________________ 37 26
Organization_______________________________________ 22 21
Payment for supplies_______________________________ 29 24
Property responsibility. _____________________________ 34 24
Purchase of food supplies____________________________ 27 23
Records___________________________________________ 25 22
Responsibility of ward officer________________________ 38 26
Subsistence, medicine, and miscellaneous charges_______ 26 23
Director of dietetics:
Bank deposits.'_____________________________________ 30 24
Cafeteria system, duties in___________________________ 35 25
Food handlers, supervision by________________________ 32 24
Inspections, check list for_________________________ _ App. V 217
Inventory of supplies_______________________________ 33 24
Messes, duties in___________________________________ 36 25
Night cook, detailed by_____________________________ 28 24
Payment for supplies_________________________________ 29 24
Property responsibility______________________________ 34 24
Purchase of food supplies____________________________ 27 23
Records kept______________________________________ 25 22
Subsistance, medicine, and miscellaneous charges_______ 26 23
260
TM 8-260
INDEX
Paragraphs Pages
Directory board________________________________________ 155 80
Disabilities, two or more, determination of pay status_________ 92 50
Disability, action on discharge for:
Approved certificate of disability_______________________ 99 54
Enlisted members of permanent command_____________ 100 54
Registrar-___________________________________________ 98 53
Ward officer_________________________________________ 97 ' 53
Discharge of patients________________________________ 43, 69-76 28, 38
Absence without leave______________________________ 73 42
Clearance_________________________________________ 76 43
Disability, action on_______________________________ 97-100 53
Hospital to quarters status__________________________ 74 42
Leave or furlough__________________________________ 72 41
Recording_________________________________________ 69 38
Records___________________________________________ 75 42
Separation from service or transfer to another hospital____ 71 40
Other than____________________________________ 70 38
Dispensary:
Function__________________________________________ 205 98
Medical attendance_________________________________ 207 98
Officer in charge__________________________________ 207, 209 98, 99
Records___________________________________________ 208 98
Disposition:
Bodies____________________________________________ 183 90
Clothing and effects of patients upon admission________ 109 57
Distribution and time of establishment, general hospitals____ 5 6
Duties:
Administrative officer of the day_____________________ 125 65
Nurses____________________________________________ 203 96
Professional officers of the day_______________________ 219 102
Duty detachment, administrative officer of the day_________ 128 66
Emergency:
Detail:
Laboratory____________________________________ 178 88
Pharmacy_____________________________________ 213 100
Officer, dental service_______________________________ 194 94
Roster, medical detachment__________________________ 122 64
Treatment of severe injuries_________________________ 244 144
Enlisted members of permanent command, discharge for disability______________________________________________
100 54
Enlisted men returned to duty, inspection_________________ 45 29
Escaped insane patient or prisoner________________________ 131 66
Evacuation of patients by boat or rail_______________________ 44 28
Examinations:
Laboratory________________________________________ 179 88
Patients admitted to hospital________________________ 64 36
Physical_____ ___________________________________ 227 107
Roentgenological service______________________________ 185 91
Eye, ear, nose, and throat surgery______________________ 255, 256 155
261
TM 8-260
INDEX
Paragraphs Pages
Financial transactions with patients_________________________ 90 50
Fire marshal___________________________________________ 127 66
Food handlers____________________________________________ 32 24
Food supplies, purchase of--------------------------------------------------- 27 23
Functions:
Dispensary________________________________________ 205 98
Information office__________________________________ 20 20
Quartermaster Corps supply_______________________ 133 67
Receiving and disposition officer______________________ 40 27
Station hospitals___________________________________ 273 183
Functions and control, hospitals---------------------------------------- 3 4
Funds and valuables, patients’:
Audit_____________________________________________ 84 46
Custodian_________________________________________ 83 45
Deceased__________________________________________89, 107 49, 56
Deposit certificate__________________________________ 86 46
Financial transactions with patients___________________ 90 50
Subsequent deposits while in hospital_________________ 87 49
Withdrawal_______________________________________ 88 49
Gall bladder___________________________________________ 263 158
Gastro-intestinal_______________________________________ 264 159
General hospitals:
Distribution and time of establishment________________ 5 6
Establishment:
Buildings________________________________________ 16 15
Lay-out_________________________________________ 17 17
Selection of sites__________________________________ 15 14
Grouping of_______________________________________ 7 7
Organization:
Administrative service-------------------------------------------- 12 10
Basis and divisions_____________________________ 8 ' 8
Commanding officer____________________________ 10 8
Headquarters__________________________________ 9 8
Professional service_____________________________ 13 12
Training______________________________________ 14 13
Unit staff_____________________________________ 11 9
Purpose___________________________________________ 4 5
Supply____________________________________________ 6 7
Genito-urinary surgery:
Diagnostic procedures_______________________________ 249 147
Miscellaneous procedures____________________________ 254 153
Operation preparation_______________________________ 250 148
Post-operative care_________________________________ 251 149
Special care of prostate obstruction cases______________ 253 151
Urological instruments______________________________ 252 150
Grouping of general hospitals____________________________ 7 7
Habit-forming drugs____________________________________ 54 32
Hair cutting, patients in closed wards_____________________ 175 87
Head injuries__________________________________________ 23-9 141
Headquarters, general hospital___________________________ 9 8
262
TM 8-260
INDEX
Paragraphs Pages
Hemorrhoid cases, post-operating care____________________ 237 139
History-taking, outline__________________________________ 226 105
Hospital council________________________________________ 39 26
Hospital to quarters status, discharge of patients___________ 74 42
Hospitals:
Classes and types_________________:_________________ 1 A 3
Control___________________________________________ 3 4
Designation_______________________________________ 2 4
General. (Nee General hospitals.)
Functions_________________________________________ 3 4
Identification______________________________________ 2 4
Station. (Nee Station hospital.)
Hours of duty, nurses___________________________________ 202 96
Identification, hospitals_________________________________ 2 4
Information office:
Action, seriously ill cases____________________________ 78 44
Function__________________________________________ 20 20
Organization_______________________________________ 19 19
Report of administrative officer of the day_____________ 21 20
Information, release of__________________________________ 157 81
Insane. (Nee Neuropsychiatric section.)
Inspections:
Administrative officer of the day___________________ 126, 130 65, 66
Check lists. (Nee Check lists.)
Detention ward______________________________________ 161 83
Enlisted men returned to duty_______________________ 45 29
Neuropsychiatric section______________________________ 169 85
Intravenous infusions, technique------------------------------------------ 238 140
Inventory of supplies___________________________________ 33, 56 34, 24
Jaw fractures____________________________________________ 257 157
Jurisdiction, medical detachment_________________________ 116 62
Keys, neuropsychiatric section, check of___________________ 170 85
Label preparation, pharmacy______________________________ 215 101
Laboratory service:
Autopsies___________________________________________ 181 90
Blood transfusions____________________________________ 180 89
Chief. 1_____________________________________________ 177 87
Disposition of bodies_________________________________ 183 90
Emergency detail____________________________________ 178 88
Examinations________________________________________ 179 88
Preservation of specimens_____________________________ 182 90
Lay-out, general hospital________________________________ 17 17
Leave or furlough, discharge of patient____________________ 72 41
Line of duty boards_____________________________________ 96 52
List of seriously ill patients______________________________ 81 45
Maintenance:
Buildings and equipment______________________________ 136 71
Utilities_____________________________________________ 137 72
263
TM 8—260
INDEX
Paragraphs Pages
Meals:
Detention ward____________________________________ 163 83
Hour of serving____________________________________ 31 24
Inspection_________________________________________ 130 66
Medical attendance, dispensary__________________________ 207 98
Medical detachment:
Commanding officer, check list for__________________ App. VI 221
Emergency roster__________________________________ 122 64
Jurisdiction________________________________________ 116 62
Noncommissioned officer in charge of quarters__________ 121 64
Organization_______________________________________ 117 62
Salutes____________________________________________ 119 63
Sick call__________________________________________ 120 63
Wardmasters______________________________________ 118 63
Medical inspector, check list for____________ _____ .______ App. I 185
Medical service:
Clinical records____________________________________ 225 104
Communicable diseases_____________________________ 232 127
Diagnosis impression________________________________ 228 108
Diagnostic procedure_______________________________ 230 108
Normal values for cerebro-spinal fluid_________________ 232 127
Outline of history-taking____________________________ 226 105
Physical examinations______________________________ 227 107
Routine procedure on admission______________________ 229 108
Sputum collection in pneumonia cases_________________ 232 127
Table of normal values in blood examination___________ 232 127
Therapeutic procedure______________________________ 231 115
Medical supply department:
Alcohol, issue, requisition, and safeguarding____________ 54 32
Duties, general_________________________________ 52 31
Habit-forming drugs, issue, requisition, and safeguarding. _ 54 32
Inventories and reports_____________________________ 56 34
Narcotics, issue, requisition, and safeguarding__________ 54 32
Organization_____________ 51 31
Property____ _____________________________________ 55 32
Purchase of materials in open market_________________ 58 34
Repair and renovation of Medical Department equipment. 57 34
Requisition by medical supply officer__________________ 60 35
Supplies, requisition and issue________________________ 53 31
Transfer of property________________________________ 59 35
Medical supply officer:
Inspections, check list for_________________________ App. IV 209
Requisition of supplies by___________________________ 60 35
Medicine and medical treatment record___________________ 148 78
Medicines:
Detention ward____________________________________ 162 83
Dispensary, authority for____________________________ 216 101
Neuropsychiatric section____________________________ 171 86
Messes________________________________________________ 36 25
264
TM 8-260
INDEX
Paragraphs Pages
Misconduct, patients absence from duty on account of, injuries
due to-------------------------------------------------------------------- 95 52
Myelography----------------------------------------------------------------- 267 160
Narcotics-------------------------------------------------------------------- 54, 149 32, 79
Neuropsychiatric section:
Admission procedure________________________________ 168 85
Check of patients and keys__________________________ 170 85
Enlisted attendants_________________________________ 167 84
Inspection, daily___________________________________ 169 85
Medicines and poisons, safeguarding__________________ 171 86
Night nurse________________________________________ 174 87
Organization_______________________________________ 165 84
Prisoner status patients_____________________________ 176 87
Shaving and hair cutting of patients__________________ 175 87
Treatment of patients_______________________________ 172 86
Visitors in closed wards_____________________________ 173 87
Wards____________________________________________ 166 84
Night cook____________________________________________ 28 24
Night nurse___________________________________________ 174 87
Noncommissioned officer:
In charge of pharmacy____ __________________________ 212 100
In charge of quarters_______________________________ 121 64
Nonpay status, military patient placed on_________________ 93 51
Notification:
Deaths____________________________________________ 102 55
Patient’s arrival________________ .___________________ 46 29
Nurses (See also Army Nurse Corps and nursing service):
Fund_________________________________________ 37 26
Night, closed wards_________________________________ 174 87
Officer in charge:
Dispensary________________________________________ 206 98
Check list for_______________________________ App. XIII 247
Special duties__________________________________ 209 99
Laboratory, check list for___________________________ App. X 239
Pharmacy_________________________________________ 211 100
Check list for_______________________________ App. XIV 250
Officers clothing and baggage____________________________ 114 61
Operating room________________________________________ 241 142
Operation, pharmacy____________________________________ 210 100
Operation, preparation for_______________________________ 234 134
Genito-urinary surgery______________________________ 250 148
Organization:
Dental service_____________________________________ 189 92
Dietetic department________________________________ 22 21
General hospitals___________________________________ 8-14 8
Information office__________________________________ 19 19
Medical detachment________________________________ 117 62
Medical supply department__________________________ 51 31
Neuropsychiatric section____________________________ 165 84
Station hospital____________________________________ 275 183
265
TM 8-260
INDEX
Orthopedic surgery: Paragraphs Pages
Emergency treatment of severe injuries________________ 244 144
Plaster casts_______________________________________ 247 146
Post-operative care_________________________________ 246 146
Preoperative preparation____________________________ 245 145
Traction cases_____________________________________ 248 147
Outline of history-taking________________________________ 226 105
Out-patients___________________________________________ 49 30
Pathological examination, request for--------------------------------- 240 141
Patients:
Admission______________________________________ 42, 61-68 27, 36
Arrival, notification of_______________________________ 46 29
Clothing and baggage-------------------------------------------- 108-115 57
Deaths__________________________________________ 101-107 55
Dental:
Responsibility for_______________________________ 197 94
Treatment_____________________________________ 193 93
Discharge__________________________________________ 69-76 38
For disability_________________________________ 97-100 53
Disease or injury___________________________________ 91-96 50
Evacuation by boat or rail___________________________ 44 28
Funds and valuables________________________________ 83-90 45
Mentally ill:
Check of______________________________________ 170 85
Prisoner status_________________________________ 176 87
Shaving and hair cutting------------------------------------- 175 87
Treatment_____________________________________ 172 86
Post-operative care. (See Post-operative care.)
Preparation for operation__________________________ 234, 250 134, 148
Seriously ill________________________________________ 77-82 43
Ward officers, control, etc. of------------------------------------- 147 78
Payment for supplies___________________________________ 29 24
Personnel entitled to admission to hospitals-------------------------- 62 36
Pharmacy:
Authority for dispensing medicine____________________ 216 101
Emergency detail___________________________________ 213 100
Label preparation__________________________________ 215 101
Noncommissioned officer in charge____________________ 212 100
Officer in charge____________________________________ 211 100
Operation_________________________________________ 210 100
Prescriptions_______________________________________ 214 100
Physical examination___________________________________ 227 107
Physical therapy. (See Therapy.)
Plaster casts___________________________________________ 247 146
Poison, safeguarding in neuropsychiatric section------------------- 171 86
Poisonings, antidotes and treatment______________________ 272 163
Police and sanitation____________________________________ 143 75
266
TM 8-260
INDEX
Post-operative: Paragraphs Pages
Care_______________________________________________ 235 185
Enroute from operating room to bed________________ 243 144
Eye, ear, nose, and throat surgery__________________ 256 155
Dental surgery__________________________________ 261 157
Genito-urinary surgery____________________________ 251 149
Hemorrhoid and rectal cases_______________________ 237 139
Immediate______________________________________ 242 143
Orthopedic surgery_______________________________ 246 146
Diets------------------------------------------------------------------ 236, 262 137, 158
Preoperative preparation:
Eye, ear, nose, and throat surgery____________________ 255 155
Fever therapy_____________________________________ 270 161
Orthopedic surgery_________________________________ 245 145
Preparation of patient for operation_______________________ 234 134
Genito-urinary surgery_____________________________ 250 148
Prescriptions___________________________________________ 214 100
Principal chief nurse____________________________________ 201 95
Check list for___________________________________ App. VII 225
Prisoner status patients, neuropsychiatric section_____________ 176 87
Professional officers of the day:
Alternate___________________________________________ 223 103
Administrative (See also Administrative officers of the day) _ 222 103
Detail______________________________________________ 217 102
Duties______________________________________________ 219 102
Record of tour______________________________________ 220 103
Special instructions__________________________________ 221 103
Tour of duty________________________________________ 218 102
Property:
Director of dietetics________________________________ 34 24
Medical supply officer_______________________________ 55 32
Officer, dental service_________________________________ 192 93
Ward officers________________________________________ 153 79
Prostate obstruction cases, special care_____________________ 253 151
Pulpitis (toothache)______________________________________ 260 157
Purchase:
Food supplies______________________________________ 27 23
Materials on open market___________________________ 58 34
Purpose, general hospitals_______________________________ 4 5
Quartermaster Corps supply functions________________________ 133 67
Receiving and disposition officer:
Absence of________________________________________ 50 30
Admission of patients_______________________________ 42 27
Ambulance service__________________________________ 47 29
Discharge of patients_____________________ 43 28
Evacuation of patients by boat or rail_________________ 44 28
Function_____________________________________ :____ 40,41 27
Inspection of enlisted men returned to duty____________ 45 29
Notification of patient’s arrival_______________________ 46 29
Out-patients_______________________________________ 49 30
Reports___________________________________________ 48 29
267
TM 8-260
INDEX
Paragraphs
Recording discharge of patients__________________________ 69
Records (See also Reports):
Admission and disposition list------------------------------------- 75
Baggage room, check of_____________________________ 115
Director of dietetics________________________________ 25
Dispensary________________________________________ 208
Medicine and medical treatment--------------------------------- 148
Officers of the day__________________________________ 220
Roentgenological service____________________________ 186
Rectal cases, post-operative care_________________________ 237
Registrar’s action;
Deaths_____________________________________________ 105
Discharge for disability_____________________________ 98
Inspections, check list for_________________________ App. Ill
Seriously ill case___________________________________ 79
Release of information____________________________________ 157
Relief procedure, nurses__________________________________ 204
Repair and renovation of medical department equipment------- 57
Repair of buildings_______________________________________ 136
Reports:
Administrative officer of the day------------------------------- 21, 132
Chiefs of medical and surgical services------------------------- 141
Deaths____________________________________________ 104
Dental service_____________________________________ 198
Diagnosis_________________________________________ 154
Medical supply officer_______________________________ 56
Nurses____________________________________________ 203
Operations________________________________________ 240
Patients admitted from other stations_________________ 66
Receiving and disposition officer_____________________ 48
Seriously ill patients, by ward officer---------------------------- 77
Unusual occurrence_________________________________ 156
Request for pathological examination--------------------------------- 240
Requisition and issue, supplies___________________________ 53, 60
Retention of clothing and property_______________________ 111
Roentgen and radium therapy___________________________ 187
Roentgenograms_______________________________________ 186
Roentgenological service:
Chief_____________________________________________ 184
Examinations______________________________________ 185
Preparation of patients______________________________ 188
Records and roentgenograms_________________________ 186
Roentgen and radium therapy________________________ 187
Roentgenology:
Abdominal region, lumbar spine, sacroiliacs, KUB______ 266
Barium enema_____________________________________ 265
Gall bladder_____ _________________________________ 263
Gastro-intestinal___________________________________ 264
Myelography______________________________________ 267
Pages
38
42
61
22
98
78
J 103
91
139
55
53
203
44
81
97
34
71
20, 67
75
55
95
80
34
96
141
37
29
43
80
141
81, 35
59
91
91
91
91
92
91
91
160
160
158
159
160
268
TM 8-260
INDEX
Paragraphs Pages
Salutes, enlisted men of medical detachment_______________ 119 63
Salvage and waste materials, collection and disposition______ 135 70
Separation from service or transfer to another station, discharge
of patients___________________________________________ 71 40
Seriously ill patients:
Cessation of condition_______________________________ 80 44
Information office, action by_________________________ 78 44
List of------------------------------------------------------------------- 81 45
Registrar’s action___________________________________ 79 44
Report by ward officer______________________________ 77 43
Transfer to another ward____________________________ 82 45
Severe injuries, treatment_____________________________ 239, 244 141, 144
Shaving and hair cutting, patients in closed wards__________ 175 87
Sick call_______________________________________________ 120 63
Similarity between general and station hospitals____________ 276 184
Sites, general hospitals, selection of_______________________ 15 14
Skull fractures_________________________________________ 239 141
Special dental cases_____________________________________ 196 94
Specimens, preservation_________ 182 90
Sputum collection in pneumonia cases_____________________ 232 127
Staff, general hospitals__________________________________ 11 9
Station hospital:
Designation and identification________________________ 2, 274 4, 183
Function__________________________________________ 273 183
Organization_______________________________________ 275 183
Similarity to general hospitals_______________________ 276 184
Status, members of Army Nurse Corps____________________ 199 95
Stomatitis_____________________________________________ 259 157
Subsequent deposits of funds and valuables while in hospital. _ 87 49
Subsistence, medicine, and miscellaneous charges_____ _____ 26 23
Supervision, admission of patients________________________ 61 36
Supplies:
Food, purchase of__________________________________ 27 23
Inventory_________________________________________ 33 24
Payment for_______________________________________ 29 24
Requisition and issue______________________________ 53, 134 31, 68
Supply, general hospitals_______________________________ 6 7
Surgery:
Dental and oral__________________________________ 257-262 156
Eye, ear, nose, and throat_________________________ 255, 256 155
General:
Anesthesia and operating room___________________ 241 142
Diets, special post-operative_____________________ 236 137
En route from operating room to bed_____________ 243 144
Immediate post-operative routine...; _____________ 242 143
Intravenous infusion____________________________ 238 140
Post-operative care. (See Post-operative care.)
Preparation of patient for operation_______________ 234 134
Report of operation and request for pathological examination____________
24p 141
TM 8-260
INDEX
Surgery—Continued.
General—Continued. Paragraphs
Routine upon admission-------------------------------------- 233
Severe head injuries, concussion, contusion, skull fractures,
etc__________________________________ 239
Genito-urinary___________________________________ 249-254
Orthopedic______________________________________ 244-248
Table of normal values in blood examinations--------------------- 232
Therapeutic procedure__________________________________ 231
Therapy:
Fever:
Class of patients treated_________________________ 268
Preoperative preparation------------------------------------- 270
Procedure to obtain treatment___________________ 269
Treatment_____________________________________ 271
Radium___________________________________________ 187
Roentgen__________________________________________ 187
Time of establishment, general hospitals---------------------------- 5
Toothache_____________________________________________ 260
Tour of duty:
Administrative officer of the day--------------------------------- 124
Professional officer of the day------------------------------------- 218
Traction cases_________________________________________ 248
Training, general hospitals----------------------------------------------- 14
Transfer:
Property__________________________________________ 59
Seriously ill to another ward_________________________ 82
Transportation__________________________________________ 138
Treatment of patients:
Acute poisonings-------------------------------------------------------- 272
Dental______________________________________________ 193
Fever therapy_______________________________________ 271
Neuropsychiatric section______________________________ 172
Unit staff, general hospital----------------------------------------------- 11
Urological instruments__________________________________ 252
Urological procedures, miscellaneous______________________ 254
Utilities, maintenance and operation________________________ 137
Valuables, patients. (See Funds and valuables, patients.)
Visitors:
Closed wards________________________________________ 173
Ward officer responsibility_____________________________ 150
Ward attendants_________________________________________ 152
Wardmasters________________________________________ 118, 159
Ward officer___________________________________________ 45
Action on discharge for disability_____________________ 97
Administration______________________________________ 146
Alcohol and narcotics, responsibility for_______________ 149
Bulletin board_______________________________________ 151
Detention ward______________________________________ 158
Pages
132
141
147
144
127
115
160
161
161
161
91
91
6
157
65
102
147
13
85
45
72
163
93
162
86
9
150
153
72
87
79
79
63, 82
76
53
76
79
79
82
270
TM 8-260
INDEX
W ard officer—Continued. Paragraphs Pages
Diagnosis report____________________________________ 154 80
Directory board____________________________________ 155 80
Inspection of food, etc______________________________ 38 26
Medicine and medical treatment record_______________ 148 78
Patients, control etc. by_____________________________ 147 78
Property, responsibilities____________________________ 153 79
Release of information by___________________________ 157 81
Report of seriously ill patients_______________________ 77 43
Report of unusual occurrence________________________ 156 80
Visitors, responsibility for___________________________ 150 79
Wards, treatment of mental patients______________________ 166 84
Waste materials, collection and disposition_________________ 135 70
Wear of hospital clothing________________________________ 110 58
Withdrawal:
Clothing and baggage from baggage room_____________ 113 60
Funds and valuables________________________________ 88 49
[A. G. 062.11 (4-10-41).]
By order of the Secret ary of War :
G. C. MARSHALL,
Chief of Staff.
Off icial :
E. S. ADAMS,
Major General,
The Adjutant General.
Distribution:
(For explanation of symbols, see FM 21-6.)
UNITED STATES
government print ing offi ce
WASHINGTON : 1941
For sale by the Superintendent of Documents, Washington, D. O. Price 25 cents


1^4’ ■
UNT LIBRARIES DENTON TX 76203
1001895496