Page 121 - JSOM Summer 2019

FIGURE 1 Advanced technology offers unique capabilities to SOCM of a critical patient was required, and the consumption of
forward. resources from other departments was reduced. Ultrasound
machines were compact and so could easily fit in the emer-
gency department rooms. Enhanced focused assessment with
sonography for trauma, (eFAST) examinations allowed doc-
tors to immediately exclude abdominal free fluid (e.g., blood
in peritoneal and retroperitoneal space), cardiac tamponade
and hemothorax or pneumothorax, because of the extra abil-
ity to examine the pleural cavity. These capabilities are highly
3
beneficial. However, for the SOCM, they are impractical, and
the casualty must wait until evacuation to a higher-level facil-
ity. Previous work has quantified the technological evolution
of ultrasound machines and the possibility to use them at a
Special Operator level (i.e., Special Operator–level ultrasound
[SOLCUS]). Monti et al. described how these capabilities
4,5
5
could fit and integrate within the Special Operations medical
system by training the SOCM, because ultrasound specialists
are not common at the SOF level. A few years later, point-of-
care ultrasound became a reality, with evolved technology and
training programs such as SOLCUS. Ultrasound probes have
6
become smaller and adapted to fit smartphones and tablets,
and the necessary education for the Special Operations medi-
cal personnel became a part of the SOCM programs. This kind
of training is provided in programs for SOCMs, such as Inter-
national Special Training Center’s NATO SOCM (NSOCM)
course that prepares SOCMs to help the immediate and fu-
ture higher-level providers perform actions in their scope of
practice.

preparing the whole health support system to receive the pa- Alongside training programs, organizations like SOFSONO.
tient and create a robust treatment plan that will be ready org created websites promoting the use of ultrasound at the
7
on arrival of the casualty. All this can be conducted even if Operator level. Via these organizations, Special Operations
a dedicated MEDEVAC asset is not available at that time. A medical personnel can attain extra information and methods
standard armored troop carrier with the relevant team medical to apply in their missions. A SOCM now can detect internal
kit that includes all aforementioned equipment will transform abdominal bleeding by performing an eFAST examination us-
any standard armored carrier into a MEDEVAC transport, ing an ultrasound machine consisting of a probe and a smart-
with the the advanced diagnostics of the aforementioned kit phone or tablet. This can be conducted in a moving vehicle
and communications available, and will improve continuity during CASEVAC to a higher-level medical facility, transmit-
of care. ting the data to prepare the facility to treat the incoming casu-
alty appropriately (Figure 2).
Portable Ultrasound Devices in PFC:
Advanced Skills at SOF Level Telemedicine: The Voice of the “Guardian Angel”
With the ability of ultrasound devices to offer diagnostic imag- Another advanced capability offered at the SOCM’s level in
ing capabilities to emergency doctors, no additional movement PFC, thanks to modern technology, is telemedicine, which

FIGURE 2 SOF medics using ultrasound capabilities remotely.

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