Page 151 - Journal of Special Operations Medicine - Fall 2017

What do you view as the greatest achievement in Tactical of our community have made military medicine better and
Combat Casualty Care (TCCC) during the past 15 years of have played a large part in the medical success achieved by
combat operations? the deployed military health system. Eventually, the wars in
The reduction in mortality from extremity hemorrhage Afghanistan and Iraq will come to an end, and we cannot
through the use of a tourniquet has had the largest effect afford to lose the lessons we have learned. When I first went
of any of the recommendations of TCCC. All the updates to back to Iraq for Operation Inherent Resolve, I was appalled at
TCCC guidelines combined during the past 15 years don’t the state of conventional medical support. Many lessons had
hold a candle to the impact of emphasizing tourniquet use been cast aside and forgotten. I was proud to see SOF take
to control extremity hemorrhage. the lead in providing recommendations for better conven-
tional medical support of the operation, and over the next
Please tell us what you think the three most important few years the support evolved to meet our expectations. We
issues for SOF medicine will be in the next 5 to 10 years. must continue to maintain the knowledge, as the conven-
We must continue to evaluate our training and appropriately tional medical force has demonstrated that it cannot.
adjust our tactics, techniques, and procedures (TTPs) in re-
sponse to lessons learned and developing requirements. To
do this, we need a system that is responsive to the needs of COL Lutz retired this summer after a 30-year career in the
the force and not bogged down by bureaucratic processes. Army. A 1993 graduate of the Uniformed Services University,
he is a board-certified emergency physician who served mul-
We must ensure that the training of SOF Medics does not tiple assignments with USASOC and JSOC, which included
revert to the training and execution of strict protocol-driven multiple deployments to CENTCOM, SOUTHCOM, and
medicine as is done in the civilian paramedic world. Our AFRICOM AOR’s. He is currently a Sports Medicine Fellow
guys and gals are smarter than that. We need to teach them at the Duke Sports Sciences Institute and a Duke University
anatomy and physiology to understand not only the “why” Hospital Emergency Department Attending Physician in Dur-
of a protocol but also the “why not.” They need to have the ham, NC.
agility to assess each injury and illness individually and imple-
ment a treatment plan. There is always pressure to shorten Keywords: interviews; Tactical Combat Casualty Care
the training pipeline, and we need to guard against diluting
the training to increase the throughput.
The opinions or assertions contained herein are the private
We must ensure that medical R&D is generated from the views of the author and are not to be construed as official or
“bottom up.” The requirements for new devices or TTP come as reflecting the views of the Department of the Army or the
from the Soldiers on the ground, not researchers in the lab. Department of Defense.

Do you have anything else you would like to share with us?
It has been a humbling experience to serve in SOF medicine
during the past 20 years. The innovations that have come out

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