BY ORDER OF THE SECRETARY AIR FORCE …

1 BY ORDER OF THE SECRETARY AIR FORCE INSTRUCTION 44-102 17 NOVEMBER 1999. OF THE AIR FORCE . medical COMMUNITY HEALTH MANAGEMENT. COMPLIANCE WITH THIS PUBLICATION IS. MANDATORY NOTICE: This publication is available digitally on the AFDPO. WWW site at: OPR: AFMOA/SGOC Certified by: AFMOA/SGO. (Lt Col Arnyce R. Pock) (Lt Gen Charles H. Roadman, II). Supersedes AFI 44-102, 1 July 1998. Pages: 65. Distribution: F. This instruction implements AFPD 44-1, medical Operations, and provides guidance for the organization and delivery of community based, prevention focused, healthcare. It implements various publications of Department of Defense (DoD) recognized professional medical organizations, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), and appropriate health and safety agencies. This instruction applies to all personnel assigned to or working in Air FORCE medical Treatment Facilities (MTF) and Aeromedical Evacuation units, including Reserve and Guard personnel during their active duty periods, civilian, contract, volunteer personnel and trainees.

2 Submit all supplements to this Air FORCE Instruction (AFI) to AFMOA/SGOC for approval. Send comments and suggested improvements on AF. Form 847, Recommendation for Change of Publication, through channels, to AFMOA/SGOC, 110. Luke Avenue, Suite 400, Bolling AFB DC 20332-7050. SUMMARY OF REVISIONS. This revision incorporates IC 99-1 and clarifies the procedure(s) to be used when storing, dispensing, or disposing of controlled substances. A bar (|) indicates a revision from the previous edition. The entire text of IC 99-1 is at Attachment 2. Chapter 1 MANAGING PATIENT TREATMENT AND CLINICAL SERVICES 9. Section 1A Areas of Responsibility 9. 9. Responsibilities .. 9. Section 1B Organization and Functions 9. 9. 2 AFI44-102 17 NOVEMBER 1999. Section 1C Managed Healthcare 10. Managed Care .. 10. 10. Section 1D Population Health Management 10. Epidemiologic Assessments.

3 10. Clinical Practice Guidelines (CPGs): .. 11. Critical 11. Case 11. Discharge 11. Health Promotion/Disease Prevention .. 12. Patient/Staff 12. Section 1E Emergency Services 13. Emergency Services .. 13. Emergency Resuscitation Training .. 13. Requirements for Advanced Life Support 13. Table CURRENT ACLS CERTIFICATION + REQUIRED .. 14. Table ACLS TRAINING + REQUIRED: (to be accomplished on a biennial basis) .. 14. Table CURRENT PALS CERTIFICATION + 14. Table PALS TRAINING + REQUIRED: (biennial training) .. 15. Table CURRENT NRC CERTIFICATION + REQUIRED .. 15. Table NRC TRAINING + REQUIRED: (biennial training) .. 16. Pediatric Advanced Life Support (PALS).. 16. Neonatal Resuscitation Course (NRC) .. 17. Coordination of Nonmedical Basic Life Support (BLS) 17. Automated External Defibrillation (AED).. 17. Section 1F Primary Care and Aerospace Medicine 17.

4 Provisions for 17. Ambulance Services .. 18. Local MTF Policies and Procedures .. 18. Section 1G Medicine and Surgery 18. AFI44-102 17 NOVEMBER 1999 3. Organization .. 18. Section 1H Performing Surgical Procedures 18. Qualified 18. Cosmetic Surgery .. 18. Ambulatory Procedure 19. Refractive Surgery .. 19. Section 1I Organs or Tissue Donation for Transplantation or Research 19. Organ and Tissue Procurement Planning .. 19. Requesting Permission .. 20. Section 1J Anesthesia Policy, Practice, and Services 20. Responsibilities .. 20. Certified Registered Nurse Anesthetists (CRNA).. 20. Managing Controlled Substances on the Anesthesia 21. Using AF Form 579, Controlled Substances Register, and SF 517, Clinical Record - Anesthesia .. 21. Processing and Completing Records .. 22. Conscious 23. Section 1K Central Supply Service (CSS) 23. The Operating Room (OR) Supervisor.

5 23. Functions of CSS Personnel: .. 24. Requesting, Issuing, and Returning Central Supply Items .. 24. Section 1L Clinical Laboratory and Anatomic Pathology Services 24. General Guidance .. 24. Laboratory Services .. 25. Blood Donor Centers (BDC) .. 25. Anatomic Pathology Services .. 25. Section 1M Radiology and Radiologic Services 26. 26. Technicians .. 26. When Early Interpretation is 26. Completion of 26. 4 AFI44-102 17 NOVEMBER 1999. Film Loaning and Transfer .. 26. Contract Employees' X-Ray Films .. 27. Radiation Safety 27. Records of 27. Section 1N Pharmacy Services 27. Organization .. 27. Policies and 27. The Pharmacy and Therapeutics 29. The 29. Drug Inventory .. 30. Inventorying Controlled Drugs .. 30. Accountability of Controlled Substances .. 30. Securing Drugs .. 31. Writing Prescriptions .. 31. Packaging 32. Labeling Prescriptions.

6 32. Refilling Prescriptions .. 32. Mailing Medications .. 32. Inpatient Pharmacy Services .. 33. Sterile Product Preparation .. 33. Bulk 33. Section 1O Optometry Service 33. Policies and 33. Using Therapeutic Agents .. 34. Contact Lens 34. Documentation of Optometry 34. Section 1P Occupational Medicine 34. Work Related Illness and Injuries .. 34. Care of DoD Civilians Injured or Ill in the Line of Duty .. 35. Section 1Q Occupational and Physical Therapy Services 35. Chief of Occupational and/or Physical Therapy .. 35. AFI44-102 17 NOVEMBER 1999 5. Requests for Occupational and/or Physical 35. Documentation .. 36. Section 1R Continuity of Care for Mental Health Patients 36. Initial 36. Evacuation and Hospitalization .. 36. Nonmilitary Patients Returning to the United 36. Section 1S Administrative Procedures Pertaining to Diagnostic Test Results 37.

7 MTF Requirements for Tracking Test 37. Section 1T Electrocardiography 37. Responsibilities .. 37. Section 1U Patient Transfers 37. Required Attendants .. 37. Section 1V Departmental Staff Procedures 37. Title of Doctor .. 37. Name Tags .. 38. Section 1W Commercial Insurance Company Physical Examinations 38. Completion of Forms .. 38. Section 1X Using Chaperones 38. Actions Necessary to Implement Air FORCE Policy in AFPD 44-1, medical Operations 38. Section 1Y medical Personnel Rest Standards 38. Policy on Rest Standards: .. 39. Section 1Z Reportable Diseases and Conditions 39. What and How To 39. Section 1AA Off-Duty Employment 39. To Whom This 39. The MDG/CC Responsibilities .. 39. Requirements .. 39. Types of Services Which Can be Provided as Off-Duty 40. Requirements and Restrictions for Off Duty Employment .. 40. 6 AFI44-102 17 NOVEMBER 1999.

8 Request Processing .. 41. Chapter 2 HEALTHCARE FOR SPECIAL AND HIGH RISK POPULATIONS 43. Section 2A Pseudofolliculitis Barbae 43. MTF Written Guidance for the 43. Section 2B Acquired Immune Deficiency Syndrome (AIDS) 43. Infected Healthcare Workers .. 43. HIV-Infected Patient Referral .. 43. Section 2C Hepatitis B Infected Healthcare Workers 43. Hepatitis B Infected Healthcare Workers .. 43. Section 2D Allergy Treatment 44. Responsibilities .. 44. Training for AIT 44. Section 2E Family Planning 44. Family Planning Services Provided .. 44. Sterilization .. 45. Contraceptive Services .. 45. Induced 45. Section 2F medical Care Related To Pregnancy 46. Standards .. 46. High Risk Pregnancy Care .. 46. Epidural Anesthesia for Delivery .. 46. Use of Oxytocic Drugs in 46. Restrictions for USAF Military Personnel During Pregnancy .. 47. Chemical Warfare Defense Ensemble (CWDE).

9 47. Assignment Curtailment In Isolated or Remote 48. Weight and Fitness Compliance .. 48. Illness During the Prenatal 48. Evaluation of Pregnant Civilian Employees .. 48. Section 2G Other Women's Health Issues 49. Annual Health Maintenance 49. AFI44-102 17 NOVEMBER 1999 7. 49. Gynecological 50. Section 2H Newborn Care 50. Inborn Diseases in Newborn Infants .. 50. Newborn and Intensive Care 50. Section 2I medical Nutrition Therapy 50. medical Nutrition 50. Section 2J The Weight Management Program (See also AFPD 40-5, Fitness and Weight Management) 51. medical Evaluation of USAF Personnel Entering the Weight Management Program (WMP).. 51. Use of Anorectic Drugs .. 51. Section 2K medical Conditions Existing Prior to Service (EPTS) 51. Correction of 51. Section 2L Using Clinical Hypnosis 52. Provider Privileges .. 52. 52. Section 2M Formal Sex Therapy 52.

10 Clinician 52. Section 2N Medicolegal Matters 52. medical Law Consultants (MLC) .. 52. Healthcare Provider and Patient Privileged 52. Biological Specimens in Administrative or Judicial Proceedings .. 53. Reporting Serious Incidents .. 54. Section 2O Informed Consent 54. MDG/CC Responsibilities .. 54. Resolving Questionable Issues .. 54. Informed Consent 54. Informed Consent for Certain 55. Section 2P Treating Minors 55. 8 AFI44-102 17 NOVEMBER 1999. General Guidelines .. 55. Treating Minors in 55. Treating Minors 55. Section 2Q Hearing Aids 55. Diagnostic Hearing Centers (DHC) .. 55. Accessories, Spare Parts, 56. Repair of Defective Hearing 57. Return of Unserviceable Hearing Aids .. 57. Replacement Hearing 57. Accountability of Hearing 57. Section 2R Forms Prescribed 58. Forms 58. Attachment 1 GLOSSARY OF REFERENCES AND SUPPORTING INFORMATION 59.