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deployment. The proximity of the TCCC training to leaving by the CoTCCC. So far the feedback has been outstanding
for a combat environment will also enhance the impact of the and the training continues with several more SO units sched-
training and provide a second strong reason to focus the train- uled in the near future. SFC Greydanus and his team are only
ing on departing units. limited by scheduling conflicts. I encourage all the SOF units
to get in touch with him and schedule your team training. For
2004;4(3):27–34 further information, please contact him directly at USAISR
Special Forces Battalion Aid Station in Support of a Direct via e-mail at: Dominique.Greydanus@CEN.AMEDD.ARMY
Action Task Force Bryan Fisk, MD .MIL. Don’t miss out on this great training opportunity at NO
COST TO YOU except three days of your time. Your engineer
ABSTRACT: A Special Forces battalion aid station (BAS) ex- or communicator just may save your life!
ecutes a wide range of medically-related missions during de-
ployment. However, this does not typically include attachment 2005:5(1):1–2
to a small-unit direct action team. The BAS for Forward Oper-
ating Base (designation censored) had an uncommon opportu- FROM THE SURGEON Frank Butler, MD, CAPT, USN,
nity when it received such a mission during Operation IRAQI HQ USSOCOM Command Surgeon
FREEDOM (OIF). This article discusses the planning involved EXCERPT: A third option is to discuss the casualties in the
and the configuration used to accomplish this mission. Fur- SOF Med Truth surveys when you next attend Special Opera-
thermore, we discuss lessons learned during the execution of tions Combat Medic sustainment training. Current plans are
these missions, with their relevance to current tactical combat to share the lessons from these scenarios through the TCCC
casualty care guidelines. Transition Initiative and other appropriate SOF educational
venues.
2004;4(4):1–2
FROM THE SURGEON Frank Butler, MD, CAPT, USN, HQ 2005:5(1):3
USSOCOM Command Surgeon ENLISTED CORNER Senior Enlisted Medical Advisor (SEMA)
HMCM Gary Welt
EXCERPT: The Committee on Tactical Combat Casualty
Care (COTCCC): This committee was started by USSOCOM EXCERPT: The Tactical Combat Care (TCCC) Transition
in 2001 and is currently funded by the Navy Surgeon Gener- Initiative has gotten off to a great start. To date, SFC Dom
al’s office. The COTCCC has representatives from the Army, Greydanus and his crew have trained over seven deploying op-
Navy, Air Force, Marine Corps, and Coast Guard and includes erational units from Washington state to Germany. The feed-
shooters, surgeons, and scientists who all collaborate very ef- back during and following the courses has been outstanding,
fectively to update the TCCC guidelines. Proposed innova- but everyone said it could use some more hands-on and sce-
tions in battlefield trauma care such as new resuscitation fluids nario-based training. The suggestions, comments, and recom-
or hemostatic agents are evaluated by the committee and the mendations that have been submitted by the participants are
finalized recommendations published in each new edition of immediately reviewed and taken into consideration for place-
the Prehospital Trauma Life Support Manual. A good recent ment into the next course.
example of how to engage with the COTCCC is the paper that
was published on the use of fentanyl lozenges to provide rap- Just recently, several medical professionals of the SOF medical
id-onset analgesia for traumatic injuries that occur in a tactical community and the U.S. Army Institute of Surgical Research
setting without having to start an IV. This paper was published (USAISR) got together in Pensacola, Florida, for a meet-
in Annals of Emergency Medicine by LTC Russ Kotwal and ing sponsored by the Naval Operational Medicine Institute
his co-authors (and will soon be re-published in the JSOM). (NOMI) to revise the current course based on YOUR valu-
The concept was presented to and approved by the COTCCC able input. Seven personnel worked for three very long days
and should be included in the updated guidelines published in and consumed six dozen doughnuts and 12 pots of coffee to
the PHTLS Manual in 2005. ensure that the material presented during this program was
correct, concise, and completely up to date as of mid-Janu-
ary 2005. We developed several recent “real world” medical
2004;4(4):3 training scenarios of actual combat medical related treatment,
ENLISTED CORNER Senior Enlisted Medical Advisor (SEMA) designed to make the non-medical operator as well as the
HMCM Gary Welt team medic exercise his baseline knowledge and skills. We also
EXCERPT: As I enter my second article in the JSOM, I feel have split the presentations for the medics and operators into
compelled to let the force know what great strides we as a two separate lecture programs as not to bore either group,
Total Medical Force are making. The single most visible im- nor waste their time reviewing medical issues that don’t apply
pact that the office has made is to ensure that the individual to them. We are also investigating the production of a basic
operator has a warmer and fuzzier feeling of medical compe- pocket reference card to outline the three phases of TCCC, the
tence as the team departs for combat. This is currently being treatment guidelines, specific instructions for utilizing lifesav-
accomplished by an initiative sponsored by the Biomedical ing equipment issued prior to deployment, and the CASEVAC
Initiative Steering Committee (BISC) and being implemented “rules of thumb” to include the 9-Line CASEVAC format. All
by the US Army Institute of Surgical Research (USAISR) in of these new innovations are in direct response to the opera-
San Antonio, TX. SFC Dominique Greydanus has spent an tors’ requests from the ground level. Preliminary reports from
inordinate amount of time to ensure that ALL SF teams, SEAL the battlefield are indicating a dramatic DECREASE in pre-
platoons, and PJ squadrons have this very important “just-in- hospital deaths, which means the men and medics are doing
time” training prior to deployment. To date, there have been what it takes to keep their buddies and fellow soldiers alive
several Special Operations units who have received the official and that we are on the right track with this program. Keep up
training as well as the needed new equipment recommended the great work and keep saving lives!

14 | JSOM Volume 20, Edition 4 / Winter 2020