Page 74 - Journal of Special Operations Medicine - Spring 2016

SOLCUS:
Update on Point-of-Care Ultrasound
in Special Operations Medicine

Katarzyna (Kasia) Hampton, MD; William N. Vasios III, APA-C, MPAS;
Paul E. Loos, 18D, ATP

ABSTRACT

Point-of-care ultrasonography has been recognized as a at the upcoming Special Operations Medical Associa-
relevant and versatile tool in Special Operations Forces tion Scientific Assembly (SOMSA) in Charlotte, North
(SOF) medicine. The Special Operator Level Clinical Carolina, 23–26 May 2016.
Ultrasound (SOLCUS) program has been developed
specifically for SOF Medics. A number of challenges, SOLCUS: Background
including skill sustainment, high-volume training, and Eight years ago, a small group of early ultrasound
quality assurance, have been identified. Potential solu- adopters in the SOF medical community coined the term
tions, including changes to content delivery methods SOLCUS. They fielded a POCUS program designed to
2
and application of tele-ultrasound, are described in this match the Special Forces Medical Sergeant (SFMS, 18D)
article. Given the shift in operational context toward scope of practice. Through trial and error, the SOLCUS
extended care in austere environments, a curriculum curriculum debuted in full during the 2010 SOMSA.
3
adjustment for the SOLCUS program is also proposed. By 2013, the SOLCUS Program of Instruction unoffi-
cially became the largest of its kind within the Depart-
Keywords: ultrasound, point-of-care; ultrasound, prehos- ment of Defense. It was formally adopted at the Joint
pital; tele-ultrasound; ultrasound, clinical, Special Operator Special Operations Medical Training Center for both
level the Special Operations Combat Medic and SFMS/18D
courses. Furthermore, ultrasound skills were added to
the SFMS/18D Critical Task List. SOLCUS training is
under consideration for limited inclusion in the SFMS
Introduction
Refresher Course that is being developed.
As the Special Operations Forces (SOF) medical commu-
nity revisits the concept of prolonged field care (PFC), SOLCUS: What’s Next
1
an excellent opportunity is presented to reengage the With PFC on the horizon, a renewed interest in SOLCUS
discussion on point-of-care ultrasonography (POCUS) is certainly notable in SOF medicine. Numerous PFC ex-
in SOF medicine. Numerous lessons have been learned ercises have repeatedly demonstrated that ultrasound is
since the introduction of the Special Operator Level the most versatile tool available to SOF Medics. It can
Clinical Ultrasound (SOLCUS) concept in 2008. With be successfully applied for diagnostics, procedural guid-
2
the operational context of PFC shifting toward extended ance, and patient monitoring, because it provides objec-
care in resource-constrained austere environments, the tive and reproducible findings. The operational mindset
1
SOLCUS program is due for a review. Certain aspects of PFC and the entire framework of its essential capa-
3
merely need an adjustment; however, the issues of skill bilities can be supported by POCUS.
5
sustainment, high-volume training, and quality assur-
ance (QA) still await resolution. 4 Curriculum
The original SOLCUS curriculum is primarily focused
3
This article is intended to stimulate a discussion about on trauma and regular “sick call” applications. A se-
POCUS in Special Operations medicine. Our goal is to ries of lectures covers an introduction to POCUS, ex-
focus on the SOLCUS curriculum, alternative learning tended focused assessment with sonography for trauma
environments, and the value of tele-ultrasound. We aim (eFAST) examination, and limited renal, aorta, pelvic,
to engage the ultrasound experts and enthusiasts among scrotal, deep venous thrombosis, musculoskeletal, soft
the SOF Medics, their leadership, military physicians, tissue, and ocular scans. It also encompasses a number
and civilian faculty. Let us start this conversation via the of bread-and-butter procedures, such as ultrasound-
digital venues of the PFCare.org website and continue guided vascular access or regional anesthesia.

58