Medical Course of Action Tool

Basics of using M-COAT

2

Agenda

• Introduction

• Agenda

• Learning Objectives

• Problem Statement

• Casualty Estimation Methods

• Medical Course of Action Tool

• Conclusion

3

Learning Objectives

• To introduce the fundamental principles of casualty estimation and their effect on CHS planning.

• To teach the basics of using the Medical Course of Action Tool.

4

Problem Statement• There is no Army approved automated tool

for conducting casualty estimation and CHS course of action planning for division and below operations– Kuhn Study / JCS Guide 3161 - Corps level

casualty estimation, can drill down to Division– FM 101-10-1 vol 2 - Division and above– ARI’s Commander’s Battle Staff Handbook -

Battalion level casualty estimation– Medical Analysis Tool (MAT)

• Corps and above Course of Action tool • Does NOT do Casualty Estimation

5

Casualty Estimation for 1003V(US/Coalition Forces)

3981

1665

3605 8400

0

2000

4000

6000

8000

10000

12000

EstimatedNumber ofCasualties

Actual Number ofCasualties During"Shock and Awe"

TBC DNBI • Used numerous tools:– Medical Analysis Tool

– CJSC 3161, “Casualty Planner”

– US AMEDD DNBI Data

– FM 8-55

– Dupey Attrition Model -1% and 3%

– MCOAT (Medical Course of Action Tool)

– ACE (Army Casualty Estimate)

• 34 days (19 Mar – 20 April)

• “Shock and Awe” approx 1% for TBCs and 4% for DNBI

Source: BG Weightman AUSA Presentation 2004

6

Casualty Estimation Methods• FM 101-10-1 Volume 2• OPLOG Planner• G1/G4 Battle Book• Logistics Estimation Worksheet• JCS Guide 3161• Dice• Agree to what the Commander says

• Modified Dupuy Method

7

Background• M-COAT was originally developed in

Force Structure and Analysis at Fort Sam Houston, TX in 1998

• Confusion on whether it is a casualty estimation tool or medical workload tool – it is a medical workload tool

• Available on AKO 70B Toolkit (https://www.us.army.mil/suite/folder/540490).

• It is NOT AMEDD approved!!!!

8

AKO Folder – 70B Toolkit

https://www.us.army.mil/suite/folder/540490

9

M-COAT Overview• Based on COL Trevor

Dupuy’s casualty estimation method from Attrition (Nova Pub. 1995)

• Conventional casualty estimation method only

• Intended to serve as TACTICAL level Course of Action Tool

• Casualty Estimation is a critical Battle Staff Task– Medical Requirements– Personnel

Replacements

• Not intended to serve as a Force Structure or Programming tool!

A Low Cost, Low Risk, Near Term Solution

10

M-COAT• Five Modules

– Casualty Estimation– Patient Flow- RTD and Evac Losses– Workload

• Evacuation Requirement and Capability• Operating Room Req. and Cap. • Hospital Bed Req. and Cap.

– Medical Supply– Basis of Allocation Rules

• Excel Spreadsheet Based

11

M-COAT Casualty Estimation (con’t)

• Nine Factors that affect WIA rates:– Population at risk (PAR)

– Terrain (17 variables)

– Weather (12 variables)

– Posture (8 variables)*

– Strength (17 variables)

* Denotes areas that are modified from Dupuy’s original formula

– Opposition (31 variables)*

– Surprise (4 variables)

– Sophistication (15 variables)*

– Operational Form (5 variables)*

258,019,200 combinations x PAR

12

M-COAT Casualty Estimation(con’t)

• Three Factors that affect DNBI– Population At Risk– Battlefield Location (5 variables)– Geographic Location (36 variables)

• Based on Force Structure and Analysis’ DNBI rates

13

M-COAT Modules

• Patient Flow- Derived from TAA05 patient flow

• Workload - Uses FM 8-55 evacuation planning factors

• Class VIII consumption- Medical Resupply Sets, FST supplies, and Blood

• Basis of Allocation rules (MRI and MF2K)

14

A Graphic ComparisonOf Various Casualty Estimation Methods

Casualty Estimate (Standard Error of the Estimate)Based on 13 Battles (1940-1991)

+1566%-1566% G1/G4 Battle Book

+1416%-1416% FM 101-10-1

+30%-30% M-COAT (Modified Dupuy)

+42%-42% Dupuy

15

Medical Course of Action Tool

16

Conventional vs. Operations Other Than War

M-COAT Conventional OOTW

Posture Offensive Recon - Screen

Opposition Significant Advantage

Overwhelming Advantage

Surprise Minor Substantial

Pattern of Operation

Disrupted Front Recon

Examples of the different settings that COULD be used

17

Conventional vs. Operations Other Than War

M-COAT Conventional OOTW

Total Battle Casualties

189 65

WIA 161 55

KIA 28 10

Examples of the different settings that COULD be used

Example – Constant: 5k Soldiers, Urban, Dry Sunshine, No Sophistication AdvantageVary: Posture, Opposition, Surprise and Pattern of Operation

18

Medical Course of Action Tool

19

Airborne Operations

• Estimates the additional number of casualties that suffer injury from the jump

• Airborne casualties are in addition to conventional casualties

• Influences:– Day vs. Night (night has higher casualty rate)

– Equipment weight (greater weight increases casualties)

– Drop Zone Conditions (harder surface increase casualties)

20

Creditable Casualty Range

21

Conclusion

• One of several tools available for use by medical planners, it is NOT the only / best / preferred way

• Routinely updated and improved based on user feedback, tell me how to make it more useful

• Do not hesitate to call or email and ask questions

• Bruce.shahbaz@us.army.mil