Page 78 - JSOM Winter 2023

The purpose of this study was to compare the traditional FIGURE 2 Types of communication devices tested. Standard radio
methods of communication used in tactical medical evacua- PTT (gray arrow) is shown in A with a single TM-ICS device (white
tion by Special Operations Forces (SOF) medical personnel arrow) in positions where they are commonly worn on body armor.
The radio used during testing is not shown. A multi-point internal
(radio PTT and internal communications system) to Bluetooth communications system is shown in B, which allows up to six
communication. The authors hypothesized that the use of the individuals to connect. Finally, the Bluetooth Peltors are shown in
Bluetooth headsets would result in a faster patient handoff to C (front of headset) and D (back of headset). The leads that can
the entire medical team and that it would be just as accurate as be connected to the radio PTT and TM-ICS devices are shown
the current standard of care. in C, white arrow. The button shown in D, white arrow, allows
communication with Bluetooth PTT.
Methods
Using a standard patient casualty form utilized by an SOF
medic, six patient scenarios resembling typical combat-related
injuries and initial point-of-injury (POI) care were created.
Each scenario included 8–10 pieces of key clinical information
(Figure 1).
FIGURE 1 Example of an SOF medic’s casualty card. Three
simulated casualties are shown (A, B, and C), which were three of the
six scenarios used in this study.

Radio PTT = radio push-to-talk; TM-ICS = tactical medic intercom
system.
MOI = mechanism of injury; EXP/KIA = expired/killed in action; guidance, all connected Bluetooth headsets within a 10-meter
GSW = gunshot wound; CBRN = chemical, biological, radiological, radius should be able to receive transmissions. All medical
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and nuclear; TNQT = tourniquet; Needle-D = needle-decompression;
IV/IO = intravenous/intraosseous; TXA = tranexamic acid; Ca = cal- personnel involved in the study had extensive tactical medical
cium; BLD = Blood, KET = ketamine, FEN = fentanyl; VER = Versed; experience that included training, real-world use, and gener-
ABX = antibiotics; amp = ampules; IM = intramuscular. alized familiarity with all methods of communication tested.
Typical communication for the SOF medical team is using ra- Medical personnel were given a blank casualty form and were
dio PTT (Figure 2A). An alternate method of communication allowed to familiarize themselves with it prior to the study.
is the use of a TM-ICS, which allows for one-on-one commu- During the study, team members were positioned at three lo-
nication via direct plug into the other’s headset (Figure 2A). cations: 1) immediately outside of the aircraft at the base of
In addition, a multi-point internal communications system, the ramp, 2) 8.13 meters inside the aircraft to the port or left
allowing for the connection of up to six individuals, is also side of the aircraft, and 3) 8.99 meters inside toward the nose
commonly used by this medical team to provide clear commu- of the aircraft at the center of the aircraft (Figure 3). This is a
nication between all team members that plug into an intercom typical setup for casualty evacuation used by this medical team
house (Figure 2B). This is ideal when multiple team members on a rotary-wing aircraft. All team members were positioned
are working on a single casualty but requires unplugging when facing away from the medic who started each handoff at the
moving between multiple casualties. ramp, eliminating any external influence.

Recently, Bluetooth Peltors (3M PELTOR ComTac VI NIB FIGURE 3 Typical positioning of medical personnel for casualty
Tactical Headsets, https://www.3m.com/3M/en_US/p/d/b5005 evacuation used by a SOF medical team on a rotary-wing aircraft.
083000/) have been fielded in SOF environments (Figures 2C,
2D). These headsets allow communication using standard ra-
dio PTT and TC-ICS but have the added features of Bluetooth
PTT and voice-operated transmission (VOX) settings. The
Bluetooth PTT allows the user to transmit by pressing a button
on the headset. The Bluetooth VOX setting allows voice-acti-
vated, wireless transmission. According to the manufacturer’s

76 | JSOM Volume 23, Edition 4 / Winter 2023