Page 122 - JSOM Summer 2019

provides, in most locations around world, the SOF medic with FIGURE 3 Tigr-M MKTK REI PP electronic warfare (EW) system
consultation from subject matter experts (SMEs) to treat crit- Leer-2 on wheeled armored vehicle. More countries can acquire
ical patients who need treatment out of the SOF medic’s med- advanced EW technology, affecting telemedicine capabilities.
ical scope of practice.

Telemedicine is a part of NATO doctrine for medical support.
According to NATO, “Telemedicine uses advanced medical
and communication technology to enable those responsible
for provision of health care in a deployed or isolated location
to access appropriate clinical advice and specialist guidance
when needed. For example, enabling a healthcare provider
(potentially patients themselves) to obtain advice from special-
ists such as dermatologists, radiologists, infectious disease spe-
cialists etc. Though it cannot replace traditional direct referrals
and consultations, it does complement them. It also increases
the capabilities available to a deployed force and can make
best use of the full range of skills within a multinational the-
atre of operations. The increased communications bandwidth
needed to support the use of telemedicine needs to be consid-
ered during the planning of medical support to operations.” 8 preserve the tactical advantage over the enemy, regardless of
their technological advances.
The idea of telemedicine is not a new concept. It is almost as
old as telephone and applied in many parts of the world in re-
mote medical centers where the presence of a specialist doctor Conclusion
is not feasible, but communication means are available. Technology has become a necessity in modern society, provid-
ing capabilities that have never been experienced before. The
The PFC Working Group began testing teleconsultation in Oc- integration of such capabilities in Special Operations medicine
tober 2015, in the form of Virtual Critical Care Consultation, and PFC arms today’s Special Operations medic with abilities
to improve the survivability of the critically ill or injured when that can make a vast difference to the survivability rate of an
the transportation to a definitive care treatment facility in the ill or injured patient, compared with past standards. Taking
golden hour is not feasible. This service provides SOCMs the advantage of new technological capabilities in PFC will also
9
ability to consult SMEs anytime using mobile phones, sat- play a key role in the improvement of the quality of the life
ellite communications, and other electronic devices that the of a patient who has survived a serious injury or illness in the
SOF medic or team members can easily carry as a part of their field. The advanced monitoring and diagnostics and porta-
mission equipment. These devices can also be used in almost ble ultrasound offer imaging capabilities in places where they
every part of the world because their mobile and satellite net- were impossible a few years ago; together with the evolution
works have worldwide coverage. A perfect example of the in modern communication that brings the SME expertise in
application of telemedicine is the research conducted by Na- the field, these are some of the weapons of the Special Opera-
tional Aeronautics and Space Agency in the use of ultrasound tions provider against time and higher morbidity and mortal-
by the crew of the International Space Station. That crew had ity rates. Time is one of the biggest enemies of SOF medical
received 3 hours of ultrasound training at the Johnson Space personnel and their patients. As long as new means and ca-
Center and was able to perform a FAST examination using pabilities are available for the SOF medic, they will be the
telemedicine for the interpretation of the images by a specialist hand of the “Guardian Angel” in the field for the SOF of the
located at the ground. The results were encouraging and pave future.
the way for the use of such applications in rural and military
environments. 10 Acknowledgments
The authors give special thanks to Mike Hetzler for his sup-
The theatres in which SOF work are ever changing and the port and help in writing this article.
opposing forces are becoming more technologically advanced
(Figure 3), SOF medics should have available in their arsenal Funding
far more secure means of communication to conduct telemed- No funding was received for this article.
icine. Such devices will help the whole PFC set up, providing
the extra time needed for the critically ill or injured patient Disclosure
to be transported to a definitive care treatment facility. They The authors have indicated they have no financial relation-
can be transported securely without providing intelligence ships relevant to this article to disclose.
to the enemy about our forces’ situation, using their techno-
logical assets (e.g., signals intelligence operations, electronic Author Contributions
countermeasures). Both authors wrote the article and reviewed and approved the
final manuscript.
Telemedicine has proved to be a beneficial use of advanced
technology in SOF medicine. We should continue taking ad- References
vantage of technology and the opportunities it provides to 1. North Atlantic Treaty Organization. NSHQ 75-001 Medical Stan-
help achieve the survivability and sustainability of our patients dards and Training Directive. North Atlantic Treaty Alliance. May
working at range while at the same time enabling our forces to 2017.

120 | JSOM Volume 19, Edition 2 / Summer 2019