Page 78 - Journal of Special Operations Medicine - Spring 2016

for the additional ultrasound machines shortly after the
SOLCUS After-Action Report second SOLCUS article was published in 2010, which
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validated the proof of concept and outlined guidance for
From Good Idea to the Largest Ultrasound training objectives.
Training Program in the Department of Defense
Prior to the SOLCUS concept, each Special Forces Bat-
by William N. Vasios III, APA-C, MPAS talion (BN) was authorized one ultrasound machine. It
was rarely used and only if the BN surgeon had experi-
ence with bedside clinical ultrasound. Limited access to
he Special Operator Level Clinical Ultrasound equipment was a significant issue. With a single ultra-
(SOLCUS) program started as a good idea and sound machine in the BN, the 18Ds had minimal oppor-
Tdeveloped into the largest ultrasound program in tunities for adequate training experience. The additional
the Department of Defense (DoD). It is also the only ul- ultrasound machines allowed each BN to have up to five
trasound program dedicated to training enlisted medics devices to use—not a monumental increase but enough
within the DoD. This success did not happen by acci- to spark the interest of the medics who were early
dent or without the efforts of many motivated people in adopters of this technology. Simon Sinek discussed early
a variety of situations and locations. What worked well, adopters during his TEDx talk on 28 September 2009.
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what needed to be improved, and what was the missing Simon referenced 13.5% as the typical percentage of
ingredient to keep it going? The answers to these and a early adopters. The concept of training every available
few other questions are discussed in this long-overdue 18D in the BNs and then selecting the most motivated
SOLCUS After-Action Review. and capable medics to deploy with their own ultrasound
device aligned nicely with the number of new machines
The SOLCUS program is at a transitional point in its available to the 18Ds in each BN. Medics were selected
existence. Reflecting on the past is the best way to un- based on their comfort level and ability to understand
derstand its current status and the changes taking place. the training to that point combined with their mission
This article examines what we did correctly, what im- during the next deployment. This plan worked well
provements were implemented, and what was the miss- inside the 3rd SFG and provided the format for other
ing element that renewed interest in the program. It also SFGs to adapt to their environments.
highlights the major events of the last 5 years of the
SOLCUS program. Developing the SOLCUS program of instruction re-
quired many expert opinions, with the singular goal of
Acceptance and Development educating the 18D on the use of ultrasound. The initial
In response to the first Journal of Special Operations ultrasound training focused on the Focused Assessment
Medicine SOLCUS article in 2008, a small group of in- with Sonography in Trauma (FAST) and expanded from
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novators and leaders began to popularize the concept of there. The idea was to use trauma management, some-
training the Special Forces Medical Sergeant (SFMS/18D) thing the 18D was already very skilled at, and introduce
in the use of ultrasound technology. Medical leadership the skill of ultrasound. This allowed them to quickly
from the 3rd Special Forces Group (Airborne) (3rd SFG), advance to the other core applications of emergency ul-
the US Army Special Forces Command (USASFC), and trasound, such as limited vascular (abdominal aorta,
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the US Army Special Operations Command (USASOC), lower-extremity deep vein thrombosis), biliary, thoracic,
conveniently located at Fort Bragg, North Carolina, soft tissue, musculoskeletal, ocular, and procedural
supported the concept. However, this consensus within guidance.
the Special Operations Forces (SOF) medical community
meant little without funding. Convincing the command From 2009 to early 2010, as part of the ultrasound pur-
leadership to spend money on ultrasound machines to chase agreement, Sonosite (https://www.sonosite.com)
improve the skillset of the 18D seemed simple compared sponsored the initial ultrasound training instruction.
with securing the funds to purchase more ultrasound They hired Dr Rob Blankenship of EMsono (https://
machines. The USASFC and USASOC medical offices www.emsono.com) to travel with the USASFC train-
were co-located, streamlining the early interactions and ing team to each of the SFGs. This level of individual
conversations when issues arose. Funding came through instruction for the medics eventually led to the core

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