Student Handbook |
FMST 0601
17
Dec 99
TERMINAL LEARNING OBJECTIVES:
1.
Given a
field environment (day and night), perform field food sanitation per the
references. (FMST.06.01)
ENABLING
LEARNING OBJECTIVES:
1.
Without
the aid of reference materials and given a random listing, identify the proper
procedures involved in field sanitation preparation, prior to movement to the
field, per the student handbook. (FMST.06.01a)
2.
Without
the aid of reference materials and given a random listing of procedures, select
the proper storage and handling procedures for food in the field, per the
student handbook. (FMST.06.01b)
3.
Without
the aid of reference materials and given a list of food borne illnesses and
symptoms, match the disease to the symptoms, per the student handbook.
(FMST.06.01c)
OUTLINE:
A. PROCEDURES FOR PREPARING PROPER FIELD FOOD SERVICE SANITATION
a.
Medical
intelligence reports (see FMST 0607)
b.
Naval
Environmental and Preventive Medicine Units (NEPMU)
1)
Provide
location and phone number for area Army Veterinarians
2)
Provide
sources of approved food vendor
3)
Provide
training for Food Service Instructors
c. Disease Vector Ecology and Control Centers (DVECC)
1)
Will
identify vectors collected on operations by submitting a DD 1222 form
d.
Local
Preventive Medicine Services
1) Provide
training for Food Service Workers
e.
Army
Veterinarians
1)
Inspect
prospective food vendors
2)
Provide
up-to-date list of approved food sources
3)
Extend
shelf life for tray rations (T-rats) and Meals Ready to Eat (MREs)
a.
Select
supplies and materials for setting up a field kitchen
b.
Designate
personnel to perform sanitary duties, provide current training and
food service physicals
c.
Ensure
current immunizations and any additional vaccines for specific operation
for the food service workers
a.
Information on food sources
1.
Meals
Ready to Eat (MRE), Field Mess, Tray Rations
2.
Identify
what is safe to eat from local population including street vendors
3.
Wild
animals (in cases of emergency)
b.
Disease prevention
1.
Food borne - Personal hygiene is paramount
a. Hand
washing station (with soap and water) for patrons and messman.
See Figure - 1
2.
Water borne - source must be approved by Preventive Medicine prior to
consumption
3.
Respiratory - all food service workers must have a current skin test
using
Purified Protein Derivative (PPD) to test for
tuberculosis infection/disease.
B.
FOOD
STORAGE
a.
Required
temperatures are as follows:
1.
Refrigerators
are maintained at 32-41 degrees F
2.
Freezers
are maintained at 0 degrees F, or below
b.
One
internal and one external thermometer required for refrigerators and freezers
c.
Temperature
readings must be taken and accurately logged at least once per meal period
(3X/day)
d.
Freezer
spaces should be emptied and cleaned once per week
e.
Frost or
glaze ice must not accumulate to more than 1/4 inch on the cooling coils or
interior surfaces
a.
Items
such as potatoes, onions, carrots, and other raw vegetables must be stored on
pallets to allow for air circulation and to protect them from decay, spoilage,
and vermin infestation
a.
Store off
ground using pallets
b.
Rotate
stock (First in, first out)
c.
Maintain
storage area clean and orderly to facilitate access
d.
Maintain
good air circulation to minimize deterioration from moisture
e.
Inspect
regularly for vermin infestation
f.
Canned
goods inspection
1. Condition: Severely Dented
a)
Appearance:
1) End seam forced out of position so that it very
noticable and that there was
enough pressure to break the hermetic seal
2) Very
sharp angular dent with acute crimping
b)
Cause: Puncture from forklift,
dropping of cans
c)
Action: Discard
2. Condition: Leakers / Pinholers
a) Appearance:
1) Can with incomplete closure of the seam
2) A puncture
3) Rust spots that have perforated the can and ruptured the
hermetic seal.
b)
Cause: Acid in the can
c) Action: Discard
3.
Condition: Springers
a)
Appearance:
1) One end of
the can is always distended
2) When this end
is pushed in, the opposite end may become distended or the same end may spring
back to the distended position when pressure is released. Exception is coffee
and molasses
b)
Cause: Natural gas build up
c)
Action: Discard
4. Condition: Swellers/Swells
a)
Appearance:
1)
This can
has both ends distended at the same time
2)
Swellers
are classified as critical defects except when they contain molasses or coffee.
b) Cause: Natural gas build up
c) Action: Discard
5. Condition:
Flippers
a)
Appearance:
1)
This can
has little or no vacuum
2)
It
appears normal but when one end is struck on a flat surface, the opposite end
will distend and remain distended until forced back into position.
(a)
Cause:
Loss of vacuum by bacterial action or chemical action of the contents of
the metal can
(b)
Action:
Discard
NOTE: Never consume canned goods under these conditions. Do not attempt to taste test.
C.
FOOD
HANDLING IN THE FIELD
a.
Cold
foods prepared for serving shall be rapidly stored at 41 degrees F or below
b.
Hot foods
must be held at 140 degrees F or higher
a.
Food held
at temperatures between 41 degrees and 140 degrees F for more than four hours
shall be destroyed. This
temperature range is optimum for bacteria reproduction.
a.
Saving leftovers is strictly
prohibited due to field conditions where holding temperatures and refrigeration
are not reliable
b.
All leftovers must be disposed of as garbage
a.
Potentially
hazardous food (salad type fillings such as egg, tuna, and poultry) are
prohibited due to lack of clean prep areas, inadequate space for refrigeration,
and unreliable electrical supplies.
b.
Chopping
and grinding of meat is prohibited
c.
Frozen
food should be thawed under refrigeration
d.
Ice
machines must be scrupulously maintained
e.
Condiments
will be provided in individual packets
f.
Fruits
and vegetables obtained from local economy must be soaked in chlorine solution
of 100 parts per million (PPM) and rinsed with potable water prior to serving
5. MEALS READY TO EAT (MRE)
a.
Purpose
1.
Replaced
the Combat rations (C rations), for troops on the march or when initially
setting up camp
b.
Description
1.
Lighter,
less bulky and easier for personnel to transport
2. 12
different varieties and Kosher meals
3. Shelf
life is 48 months but may be extended by Army Veterinarians
c.
Storage
1.
Store off
the deck on pallets, in shaded area, and stack no more than three pallets high
d.
Inspection
of MRE
1.
Take
random sample of oldest stock
2.
Inspect
contents on smooth white paper square (36”X36”)
a)
Invert
case contents on paper
b)
Rap case
sharply to knock out debris or insects
c)
Collect
insects for identification
3.
Inspect
MRE bag
a)
Check bag
for punctures or penetrations
b)
Check bag
folds and seams for insect debris or penetration
a.
Purpose:
Used to transport, store, and serve hot and cold foods
b.
Description:
1.
Container
made of plastic or metal
2.
Each
container has three aluminum inserts with tight fitting covers
c.
Preparation:
1. For hot foods preheat the containers by filling
with 2 quarts of water and let stand
for
30 minutes
2. For cold foods pre-chill the containers by filling
with 2 quarts of ice water or
crushed
ice and let stand for 30 minutes
3. For filling containers, inserts must always be
used. Fill to capacity (5 1/3
liters, 5
2/3
quarts).
4. Labeling – include food item, number of
servings, and date/time of preparation
7. TRAY RATIONS (T-RATS)
a.
Purpose:
1. Serves
as storage, heating and serving trays for hot and cold food
b.
Description:
1.
The
entire heating and serving equipment is transported in the back of a
High-Mobility Multipurpose Wheeled Vehicle (HMMWV or
HUMVEE) with a water bull and 5 ton truck accompanying to carry the tray rations
and water
2.
The
heating equipment is a large basin of extremely hot water that can heat up 10
hermetically sealed trays in about 30-40 minutes
3.
Each tray
has up to 36 servings, depending on product
4.
Included
in the equipment are basic food service items like serving utensils, knives,
work table for chow line, and a tool kit for the equipment
c. Storage:
1.
Can be
stored and transported without refrigeration
c.
Inspection:
1.
Take a
random sample of stock
2.
Open
contents and visually inspect
D.
ETIOLOGICAL
CATEGORIES OF FOOD BORNE ILLNESS
a.
Definition-
Syndromes acquired by the consumption of food contaminated by disease pathogens,
microbial toxins, or poisonous chemical substances
b.
Types:
1.
Food
borne intoxication:
a)
Chemical
poisonings
1)
Arsenic
– residue of spray on fruits and vegetables
2)
Cadmium
or zinc – a result of dissolved acid foods (tomates)
3)
Insecticides
– exposure to food or equipment after spraying operation
4)
Symptoms
- Usually occur shortly (1-2 hours) after ingestion
(a)
Violent nausea
(b)
Vomiting
(c)
Diarrhea
5)
Treatment:
(a)
Gastric lavage
(b)
Respiratory support
(c)
Hydration
b)
Food
borne poisoning
1)
Source - Toxins produced by infectious agents present in the ingested
food that have short incubation periods
2)
Types:
(a)
Staphylococcal intoxication (Enterotoxin)
(1)
Foods most commonly implicated are:
[a] Potato salad
[b] Custard
[c] Pies
[d] Meats, in particular poultry
(2)
Signs /
Symptoms:
[a] Abrupt onset in 2-4 hours
[b] Severe nausea
[c] Projectile vomiting
[d] Diarrhea
[e] Prostration with little or no fever
(b)
Clostridium botulinum (Botulism-exotoxin) – food most commonly
implicated are home canned low acid foods such as vegetables and fruits
improperly processed.
(1)
Symptoms/signs
[a] Onset usually12-48 hours
[b] Blurred vision
[c] Cranial nerve paralysis
[d] Weakness
[e] Headache
[f] Dizziness
[g] Death resulting from respiratory and/or cardiac
failure
c)
Natural poison or
intoxicants (Shellfish, fish, mushrooms) – natural poisons
are found within these foods
when harvested
(1)
Signs / Symptoms
(a)
Weakness
(b)
Paralysis
(c)
Numbness
and tingling of ears
(d)
Apprehension
(e)
Death
(2)
Treatment
(a)
If nausea and vomiting persist, give IV fluids containing salts and
dextrose for dehydration and acid/base imbalance
(b)
Remove poison by gastric lavage
NOTE:
Food borne intoxication usually involves the upper gastrointestinal tract
and as an intoxication it usually only affects the stomach.
Symptoms are generally local in nature with a rapid onset from 30 minutes
to 7 hours. Symptoms usually
subside within 24-36 hours.
2.
Food
borne infection
a)
Source -
The ingestion of food containing bacteria, viruses, parasites which must
multiply within the gastrointestinal tract before causing symptoms
b)
Types –
foods most common are meats like hamburger, hash, turkey and seafood mixtures
such as lobster and crab
(1)
Salmonella
(2)
Shigella
(3)
Escherechia coli 0157:H7
c)
Symptoms/signs:
(1)
Onset usually 6-24 hours after ingestion
(2)
Fever
(3)
Abdominal pain or distress
(4)
Prostration
(5)
Diarrhea
(6)
Vomiting
d)
Treatment:
(1)
Electrolyte or IV fluid replacement
(2)
Symptomatic therapy
(3)
Antibiotics for bacterial infections (oral or IV depending on severity of
symptoms)
NOTE:
Food borne infections usually involve the lower gastrointestinal tract
and as an infection, it incurs total body reaction.
Symptoms are systemic, having an onset time after incubation of
pathogenic organism.
REFERENCE
(S):
1.
Manual of Preventive Medicine (NAVMED P-5010-1 & 9)
2. Field Hygiene and Sanitation (FM 21-10)
Field Medical Service School
Camp Pendleton, California