Page 117 - Journal of Special Operations Medicine - Spring 2015

Figure 1 MEDCAN–GRO model. and practice. Elements of engagement are modular to
allow for perpetually transitioning SOF to plan and ex­
ecute discrete engagements with defined goals and end
states. Each modular skill set is directly linked to more
sophisticated tasks that provide a continuum for future
engagements or synergism with efforts of conventional
military units, and government and nongovernment
agencies. This developmental continuity provides fol­
low­on opportunities to evaluate measures of effective­
ness as each skill set is incorporated into the higher level
of training or engagement. The proposed model provides
a framework for a national­level prehospital and health
protection system capable of information and skills ex­
change based on common operating procedures that can
optimize tactical and disaster healthcare delivery.

The MEDCAN–GRO model consists of two main de­
facilitates balance between the needs of the civilian ver­ velopment pathways with modular adjunct components
sus military healthcare sector, and promotes cross talk (Figure 2). The first foundational pathway consists
between the two with translational skill sets that allow of medical assessment and treatment skills that start
for interoperability at local, regional, national, and mul­ with individual first aid and advance through TCCC/
tinational levels. Advanced Trauma Life Support (ATLS), aid station/
clinical operations, and culminates in regional medical
The foundation of the model is individual skill develop­ operations and Role 2 care (Table 1).
ment, civilian or military, which is built upon to establish
unit or community baselines from which coordinated Beginning phases can be taught by SOF medics with the
networks can be developed with common knowledge addition of minimal provider support for higher­echelon

Table 1 Medical Training
Phase Medical Training Objectives Resources Contact Time
I BLS/first aid Basic medical concepts for wound care, injury 2 trainers per 20 students 6 hours
treatment, and health protection
Nominal Class VIII
II TCCC/ATLS Care under fire, tactical field care, tactical 3–4 trainers per 20–30 20–30 hours
evacuation, treatment of combat injuries or disaster­ students
related injuries/ATLS in civilian sector
(introduction of patient movement) IFAK or similar per student
III Train the trainer Refresher of TCCC/ATLS concepts and development 3–4 trainers for 8–10 30 hours
of teaching methods and course administration skills instructor candidates and pool
(introduction of medical logistics) of 20–30 students
IFAK or similar per student.
IV Aid station/clinic Principles of battalion­level aid station or remote 4 instructors (minimum, 30 hours
Operations clinic operations, including set up, logistics, triage, 1 provider) per 20–30 students
evacuation, tactical field care, MASCAL, and sick
call operations (introduce disaster planning) Tactical medical set and
evacuation assets
V Regional medical Introduction to higher echelons of care and Collaborative meeting Initially 20
operations coordinated public health, public safety, and medical of stakeholders with 2–4 hours, then
response to disasters facilitators quarterly
Framework of execution and sustainment of training
with integrated patient movement, logistics, and
communication plan (introduce international
cooperation)
Role 2 establishment Establish mobile surgical capability with coordinated Personnel and equipment for Variable
logistics, communications, and patient­evacuation Role 2
systems
Note: ATLS, Advanced Trauma Life Support; BLS, basic life support; IFAK, individual first aid kit; MASCAL, mass casualty; TCCC, Tactical
Combat Casualty Care

A Case Study in Special Operations Forces Capacity Building 107