Austere Prep / R2RA
Mission
Austere preparation is the phase between notification and arrival on the objective. Its purpose is to convert a notional team and its equipment into a deployable, mission-ready Role 2 capability — task-organized, equipped, briefed, and integrated into the larger operational and trauma-system picture. R2RA (Role 2 Resuscitative Augmentation) refers to Role 2 capability augmented beyond a baseline, generally with additional resuscitation or surgical capability.
A Role 2 that arrives unprepared is a Role 2 that fails its first casualty.
Personnel & Task Organization
The full ARSC team is identified, manifested, and briefed during this phase. Roles are confirmed against the operational task organization — STP, FRSS, Holding — and gaps (vacancies, unqualified billets, training shortfalls) are identified and resolved or risk-accepted.
Cross-training assignments are confirmed. Authority to act in the absence of a primary role-holder is documented.
Equipment & Logistics
- AMAL pull and 100% inventory against the current allowance list.
- Pre-mission shortfalls reported to higher; risk accepted by appropriate authority.
- Cold-chain capability for blood and temperature-sensitive pharmaceuticals confirmed end-to-end from origin through arrival.
- Equipment movement plan synchronized with operational movement plan.
- Power, water, and Class I sustainment estimate built for the planned mission duration plus the doctrinal contingency margin.
Doctrinal References
- MCWP 5-10, Marine Corps Planning Process
- MCRP 4-11.1G, Health Service Support TTPs
- MCO 6000.20, Health Services Concept of Operations
- JP 4-02, Joint Health Services
- ARSC Joint Training Standard
Clinical Practice Guidelines
This is a planning-phase node. Clinical CPG familiarization is a readiness expectation rather than a node-level activity. The team should have walked the relevant CPGs before this phase ends — at minimum, Damage Control Resuscitation, Damage Control Surgery, Walking Blood Bank, Triage of Casualties, and Prolonged Casualty Care Guidelines.
Decision Points
| Decision | Trigger | Outcome |
|---|---|---|
| Team assessed mission-ready | All readiness gates closed | Authority to deploy |
| Team assessed not mission-ready | Any closing gate fails | Escalate to higher; mitigate or risk-accept |
| Augmentation required | Identified capability gap | R2RA request; or accept reduced capability |
| Operational change of plan | New mission or significantly changed conditions | Re-run mission analysis |
Specific readiness gates depend on command policy and mission type.
Linked ELOs
| TLO | ELO | Primary or Secondary |
|---|---|---|
| Clinical Ops | CO-1 (CONOP, mission analysis, COA) | Primary |
| Clinical Ops | CO-6 (logistics plan) | Primary |
| Clinical Ops | CO-13 (communications plan) | Primary |
| Clinical Ops | CO-15 (military brief to Command) | Primary |
| Trauma Integration | TI-2 (continuum of care, unit location) | Primary |
| Trauma Integration | TI-3 (local medical asset integration) | Primary |
| Trauma Integration | TI-4 (partner nation system) | Primary |
| Prepare to Receive | PR-3 (mission analysis HSS) | Primary |
| Prepare to Receive | PR-4 (Commander SITREP) | Primary |
| Prepare to Receive | PR-10 (movement to/from team location) | Primary |
| Team Development | TD-6 (MDMP familiarization) | Primary |
Forms & Documentation
- Pre-mission readiness checklist.
- Mission analysis brief (JP 5-0 / MCPP format).
- Commander SITREP template.
- Logistics estimate.
Reference Imagery
Last reviewed: • OPSEC reviewed: