Drill Sergeant Self-care Brief

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Important Points

• Up to five OTC drugs can be issued at one time.
  All must relate to the chief complaint or
  identified symptom.
• Soldiers cannot use the same complaint for two
  consecutive self-care visits.
• OTCs cannot be shared with buddies.
• Soldiers can use the Self-care Program or Sick
  call at different times and in different
  situations.
• If soldiers are very sick or badly hurt, they
  must get medical help right away and tell their
  Drill Sergeant.

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TROOP MEDICAL CLINIC (TMC) SELF-CARE
PROGRAMTREATMENT OPTIONS FOR SYMPTOMS/CONDITIONS
Sample
Green Sheet

• I am aware that I am participating in a
  self-care program. I understand that to properly
  perform self-care and safely treat any symptom(s)
  of conditions(s) that I may have during training
  I must follow the symptom evaluation charts. I
  also understand that I am responsible for
  carefully following the directions for use of any
  medication received through this program. I
  verify that I have read the self-care decision
  guide and the recommendations provided therein.
  I also verify that I am requesting treatment
  options(s) voluntarily. I also agree that I will
  not share medication with anyone and that I will
  be the sole user.
• What allergies, to include medications, do you
  have?_________________________________________
• What medicines are you presently taking?
  ______________________________________________
• Print Name Print SSN Date
• Signature ? Unit Sex M F
• INSTRUCTIONS After reading the Soldier Health
  Maintenance Manual and identifying the proper
  treatment option(s), find the symptom(s)/condition
  (s) that you have on the list below. Circle it.
  Then follow the line across to find the treatment
  option(s) for your symptom(s)/condition(s).
  Circle the treatment you would like to receive.
  Request the identified treatment option(s) from
  the Consolidated Troop Medical Clinic Pharmacy.
• Treatment requests will be limited to five
  items.
• ?NOTE You can select Daytime OR Robo DM
  liquid but NOT BOTH.
• You can select Daytime OR SudaGest, but
  NOT BOTH.

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• SYMPTOM/CONDITION TREATMENT OPTION
• Acne . . . . . . . . . . . . . . . . . . . . . .
  . . Medication (Benzoyl Peroxide)
• Allergies Hay Fever . . . . . . . . . . . . . .
  . .SudaGest Decongestant (Pseudoephedrine)
• Athletes Foot . . . . . . . . . . . . Miconazole
  Nitrate Antifungal Cream
• Blisters . . . . . . . . . . . . . . . . . . . .
  . . . . . . . . . . . . . . . . . . . Mole Skin
• . . . . . . . . . . . . . . . . . .
  . . . . . . . . . . . . . . . . . . . . .
  Band-Aid
• . . . . . . . . . . . . . . . . . .
  . . . . Bacitracin Antibiotic Ointment
• . . . . . . . . . . . . . . . . . .
  . . . . . . . . . . . . . Baby Powder (Talc)
• Constipation . . . . . . . . . . . . . . . . . .
  . . . . . . . . Genasoft (Ducosate)
• Cough with congestion . . . . . . . . . . . . . .
  . . . . . . . . . . . . . Daytime
• Cough (dry) . . . . . . . . . . . . . . . . . .
  . . . . . . . . . . . . Robo DM liquid
• Cut or Scrape . . . . . . . . . . . . . . . . .
  Bacitracin Antibiotic Ointment
• . . . . . . . . . . . .
  . . . . . . . . . . . . . . . . . . . . . .
  Band-Aid
• Diarrhea . . . . . . . . . . . . . . . . . . . .
  . . . . Anti-Diarrheal (Loperamide)
• Earache . . . . . . . . . . . . . . . . . . . . .
  . . . . . . . . . . . Ibuprofen Tablets
• Headache . . . . . . . . . . . . . . . . . . . .
  . . . . . . . . . . . Ibuprofen Tablets
• Heat Rash . . . . . . . . . . . . . . . . . . . .
  . . . . . . . . . Baby Powder (Talc)
• Insect Bite . . . . . . . . . . . . . . . . . . .
  . . . . . . . . . . . . Calamine Lotion

SAMPLE
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YELLOW SHEETSelf-care Program Evaluation(Program
ParticipantSoldier)

• Instructions
• Please complete Part 1 and Part 2.
• Your responses are very important to the
  Self-care Program. This information is completely
  confidential and will only be used to improve the
  program. Please write any additional comments at
  the bottom of the page. Return the completed form
  to the proper pick-up location. Thank you.
• Part 1
• Date ___/___/___
• Installation ______________________
• Unit ______________________________
• MOS ______________
• Please circle one response for each of the
  following
• Age 18 19 20 21 22 23 24 25
  Over 25
• Sex M F
• Highest education level completed
• GED High school Some college College
  graduate

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• Yellow Sheet Part 2
•  Please circle one response for each of the
  following questions. If not sure, leave that
  question blank.
• 1.  I used the Self-care manual at least once to
  take care of myself. Yes No 
• 2.  I made at least one clinic visit for
  Self-care using the Green Sheet. Yes No
• 3.   I made at least one clinic visit for regular
  Sick call. Yes No
• 4.   The Self-care Program helped me to avoid
  missing training time at least once. Yes No
• 5.  I would feel comfortable following the
  Self-care steps in the manual if I needed
  to. Yes No 
• 6.  The Self-care Program is a valuable benefit
  for my own health. Yes No
• 7. The Self-care training and manual taught me
  how to take better care of myself. Yes No
• 8.  When I can, I prefer to use the Self-care
  Program instead of regular Sick call. Yes No
• 9. The training and manual helped me decide
  whether to use Self-care or regular Sick call.
  Yes No

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Drill Sergeants Role

• Ensure soldiers attend the self-care class.
• Remind the soldier to follow the Self-care
  Program procedures.
• Distribute the green sheet as requested by
  soldier.
• Green sheets are only to be used by soldiers who
  have completed the self-care class.
• Distribute and collect the yellow sheets at the
  end of the training cycle for each unit.

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Questions?