DA Form 7595-6-2 Initiate Treatment for Altitude Illness

DA Form 7595-6-2 - also known as the "Initiate Treatment For Altitude Illness" - is a United States Military form issued by the Department of the Army.

The form - often mistakenly referred to as the DD form 7595-6-2 - was last revised on May 1, 2014. Download an up-to-date fillable PDF version of the DA 7595-6-2 down below or look it up on the Army Publishing Directorate website.

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INITIATE TREATMENT FOR ALTITUDE ILLNESS
For use of this form see TC 8-800; the proponent agency is TRADOC.
VI
TABLE:
REFERENCE:
STP 8-68W13-SM-TG, Task: 081-833-0035, Initiate Treatment for Altitude Illness.
PRIVACY ACT STATEMENT
AUTHORITY:
10 U.S.C. S 3013 Secretary of the Army; AR 350-1, Army Training Leadership and Development.
S
PRINCIPAL PURPOSE:
To ensure that accomplishment of training is properly credited to the correct individual for NREMT certification IAW AR
40-68, AR 220-1 and AR 350-1.
Used by Unit personnel to monitor training. The DOD "Blanket Routine uses" set forth at the beginning of the Army's
ROUTINE USES:
compilation of system of records notices may apply to this system.
DISCLOSURE:
Voluntary. Failure to provide your name may result in a loss of credit for accomplishing the training or error in processing
applicable favorable personnel actions. For Official Use Only.
1. Soldier (Last Name, First Name, MI)
2. Date (YYYYMMDD)
SCENARIO:
On a patrol in Afghanistan you have a Soldier complaining of weakness, dizziness and headache. You have completed a combat casualty assessment.
Initiate treatment for altitude illness.
GRADING SHEET
TASK
COMPLETED
1ST
2ND
3RD
3. Performance Measures
P
F
P
F
P
F
a. Recognized the signs and symptoms of altitude illness.
b. Initiated prophylactic measures to prevent high altitude illness.
c. Manage high altitude illness.
d. Recorded the altitude illness treatment on the patient's DD Form 1380 [Tactical Combat Casualty Care
(TCCC) card].
e. Sought advice and assistance of a medical officer if possible.
4. Demonstrated Proficiency
Yes
No
5. Start Time
6. Stop Time
7. Initial Evaluator
8. Start Time
9. Stop Time
10. Retest Evaluator
12. Stop Time
13. Final Evaluator
11. Start Time
14. Evaluator's Comments
This form was prepared by U.S. Government employees for use in the 68W MOS. Although it contains, in part, copyrighted material from National
Registry of Emergency Medical Technicians, Inc. (NREMT), skill sheets ©2011, this form has neither been prepared nor approved by NREMT.
Use is restricted to guidelines contained in the Preface to TC 8-800.
DA FORM 7595-6-2, MAY 2014
APD LC v1.00
INITIATE TREATMENT FOR ALTITUDE ILLNESS
For use of this form see TC 8-800; the proponent agency is TRADOC.
VI
TABLE:
REFERENCE:
STP 8-68W13-SM-TG, Task: 081-833-0035, Initiate Treatment for Altitude Illness.
PRIVACY ACT STATEMENT
AUTHORITY:
10 U.S.C. S 3013 Secretary of the Army; AR 350-1, Army Training Leadership and Development.
S
PRINCIPAL PURPOSE:
To ensure that accomplishment of training is properly credited to the correct individual for NREMT certification IAW AR
40-68, AR 220-1 and AR 350-1.
Used by Unit personnel to monitor training. The DOD "Blanket Routine uses" set forth at the beginning of the Army's
ROUTINE USES:
compilation of system of records notices may apply to this system.
DISCLOSURE:
Voluntary. Failure to provide your name may result in a loss of credit for accomplishing the training or error in processing
applicable favorable personnel actions. For Official Use Only.
1. Soldier (Last Name, First Name, MI)
2. Date (YYYYMMDD)
SCENARIO:
On a patrol in Afghanistan you have a Soldier complaining of weakness, dizziness and headache. You have completed a combat casualty assessment.
Initiate treatment for altitude illness.
GRADING SHEET
TASK
COMPLETED
1ST
2ND
3RD
3. Performance Measures
P
F
P
F
P
F
a. Recognized the signs and symptoms of altitude illness.
b. Initiated prophylactic measures to prevent high altitude illness.
c. Manage high altitude illness.
d. Recorded the altitude illness treatment on the patient's DD Form 1380 [Tactical Combat Casualty Care
(TCCC) card].
e. Sought advice and assistance of a medical officer if possible.
4. Demonstrated Proficiency
Yes
No
5. Start Time
6. Stop Time
7. Initial Evaluator
8. Start Time
9. Stop Time
10. Retest Evaluator
12. Stop Time
13. Final Evaluator
11. Start Time
14. Evaluator's Comments
This form was prepared by U.S. Government employees for use in the 68W MOS. Although it contains, in part, copyrighted material from National
Registry of Emergency Medical Technicians, Inc. (NREMT), skill sheets ©2011, this form has neither been prepared nor approved by NREMT.
Use is restricted to guidelines contained in the Preface to TC 8-800.
DA FORM 7595-6-2, MAY 2014
APD LC v1.00

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