Page 118 - JSOM Fall 2019

An Ongoing Series

Update

SORTs, GHOST-Ts, New Guidelines, and Advanced Resuscitative Care

Jamie Riesberg, MD

s prolonged field care (PFC) continues to capture the Working closely with the JTS has also ensured that Special
attention of all levels of US Department of Defense Operations medics and corpsmen have a voice at the policy
Aproblem-solvers, Special Operations medics and pro- level. As the JTS continues to integrate PFC and peer–peer
viders continue to innovate. In this edition of the JSOM, read- conflict in all levels of medical support planning, it is reassur-
ers will find an excellent example of medical innovation. The ing to know that there will continue to be SOF medics provid-
Special Operations Resuscitation Teams (SORTs) are a com- ing invaluable input.
bat-proven medical support element that can provide robust
resuscitation capability far forward. When combined with a Finally, we constantly emphasize that expert Tactical Combat
Golden Hour Offset Surgical Treatment Team (GHOST-T), Casualty Care (TCCC) is a prerequisite for any PFC training.
Special Operations Forces (SOFs) can be assured of an adapt- Recent developments from the Committee on TCCC have con-
able, mobile, yet highly capable forward surgical capability. tinued to push for a PFC core capability—resuscitation with
The US Air Force Special Operations Surgical Teams are also fresh whole blood (FWB). Advanced resuscitative care (ARC)
a potent, highly mobile surgical solution that has continued to is a new aspect of TCCC that includes far forward blood
adapt to changing Special Operations missions. As the Services capability. Many units have integrated FWB or cold chain
continue to adapt their forward surgical capabilities, it is good stored blood into their medical training. If your unit has not
to see that SOF peculiar mission sets are consistently being yet included this in your training, please consider doing so as
addressed with highly modular platforms. While the defense there are ample resources to support the evidence and train-
medical community wrestles over tough questions like appro- ing methods. One option might be to peruse PFCare.org and
priate size and composition for these light surgical teams, the search “whole blood” for a bounty of resources to start your
SOMA PFC Working Group (WG) will continue to focus on planning for your blood program.
supporting the medic or provider at the point of injury with
strategies to improve patient survival until they can reach sur- Our best innovations come from medics, corpsmen, and
gical care. providers who are faced with difficult problems and solve
them with passion and creativity. To the people behind the
Current efforts among the PFC WG include collaboration GHOST-Ts, SORTs, and other Special Operations surgical
with the Joint Trauma System (JTS) to create two new pre- teams that continue to push the envelope, the defense com-
hospital clinical practice guidelines (CPGs) for PFC airway munity writ large owes a debt of gratitude as you continue to
and PFC ventilator management. These CPGs will round out push the “art of the possible.” Thank you to all who continue
the current 12 prehospital CPGs that support critical care in to labor to make it better for those who practice medicine in
austere settings. The CPGs are available on an open-source the most austere, hostile environments.
basis at: https://jts.amedd.army.mil/index.cfm/PI_CPGs/cpgs.

Correspondence to jamie.c.riesberg.mil@mail.mil
LTC Riesberg is SOMA PFC Working Group Co-Chair.

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