For the second week, our team interviewed another 10 people serving or served in 18Ds or 18As. From these interviews, we redefined our beneficiaries as 18D (clarified medics’ problems on overwhelming work and low motivation) and 18A (discovered new challenge on information sharing and procedure establishing). Furthermore, we got more insight on the requirement of deliverables including knowledge sharing, easy to use and modifiable by non-technicians.
Sergeant First Class Chandler
- The over comprehensive medical equipment set lead to redundancy of checking tasks
- Med logistics isn’t sufficient to deal with actual need
- Swick could be a path when medics retire or get injured instead of a regular program
- A checklist of baseline clinic for 18D SF Medic will be very useful
- Missions spending 4-7 days in an area, setting up clinics once a week.
- The challenge for 18D is finding an area where casualties get treated quickly
- Standard procedures would ease ways of doing things
- Struggle with the evac process and being sure of patient status/communication
- Need of mutual communication about patient status/outcomes between Medics and commanders
Alan S. Colvin
- Need for info. management of medical resources in X country, i.e. a data bank for diff. countries
- Can’t rely on internet because of poor connection in certain operational environments
- The one medic is in charge so non-medics need more medical knowledge (SOFACC)
- Existing checklist include very narrow things like putting on a drip
- More real Africa-specific training other than some stuff on infectious diseases
- Budget (better to be small and portable) is a limitation of adapting new training
- 24 hour hotline (expert physician who can aid in the field) need to be available online
- Set the course in the Army geared towards load planning for planes
- Need DoD to be involved/approve
- Video telemedicine is helpful in diagnosis and procedures, especially talking to doctor
- An app/database could contribute better to the medical evacuation process
- Need standardized logistics training in Ergonomics of a clinic
- A digital checklist could be not ideal for those who are used to paper version and most apps serve as the reference of diagnosis and procedure
- It’s important to stay up to date on new medical advances, and filter out relevance
Thomas Williams, Professor at Duke Law School & Initiative for Science and Society
- Positioning SF by GIS, finding a spot or several to set up a clinic nearby based on those surroundings, then layering the clinic design into that space.
This week, we spent much of our time in interviews getting a baseline understanding of the roles of medics in the military (both “regular” medics as well as SF medics), and the challenges they face. What we tended to hear from many of the people we spoke to focused on training and on defining the role of a medic. With training, it is challenging to define what is necessary across Special Forces because situations vary across deployments; however there exists a need to balance breadth and depth so that medics can be effective in providing baseline lifesaving treatment. There is currently a gap between realistic approximation of an austere environment and the challenges medics face when deployed- especially with changes in the operating environment and greater need for prolonged field care as missions take teams farther away from access to higher levels of care. These challenges in the field increase with reduced medic retention, leading to, increasingly, only having 1 medic per team to handle all medical responsibilities (because Special Forces do not deploy as medical units). Current understanding of the situation has been limited because of less focus on medics’ perspectives (so there continues to be an emphasis on tactical training and actions- even in determining necessary equipment).
- Estban Barkneft: Army Nurse for 22 years
- Work of SF Medics is to move care up the chain of command as quickly as possible, “make our problem someone else’s problem”
- Explained that resources are organized by the “Ruck, Truck, and House” method and that requires a lot of adaptability on the part of medics
- Getting supplies locally on-the-go and the required re-certifications year-to-year hinder efficiency and effective care provision (bureaucratic hurdles are immense)
- Email – Efbarf13@gmail.com
- Phone Number – 910-574-4118
- Captain Joey Gamba is a critical care nurse with 8.5 years of experience including 1 deployment with hospital capabilities.
- Often those in medical roles within the military have to serve in multiple roles so that their ability to perform their best medical care may be compromised, especially when their training must be kept relevant and up-to-date and when hey must do their best to document actions before moving to higher levels of care.
- Email – firstname.lastname@example.org
- Phone Number – 352-397-9998
- Sergeant Joe Castle has been deployed in austere environments on 5-6 man teams and served as a medic in areas without much medical equipment (such as X-rays, monitoring equipment) where PFC was a necessity.
- Training is not always realistic in depicting the challenges medics in austere environments face, especially when tactical training is emphasized over medical training; he also discussed the constant need for on0the-job innovation when supplies are either unavailable or available but not made to “fit together”.
- Darrell Owens has served for 17 years, and joined following 9/11 and went to Iraq as a part of the initial invasion; he deployed as a medic and served for 10 years in that role after which he became a PA. He sees the limitations of being a medic after he became a PA and became responsible for managing teams of medics, especially when real world experience is such a determinant of success as a medic (which becomes more challenging considering issues with medic retention and those who might follow Darrell’s path to become a PA).
Email – email@example.com
Phone Number – 910-978-3426
- Dan Taylor is a civilian EMT who has taught with SFC Eric Palomar on the SOFAC (Special operational Forces Austere Care) course that trains Green berets who are not 18D’s. The course begins with basic EMT certification to cover elementary training and progresses through pharmacology in PFC and training exercises designed to mimic real operating environments. However, in giving training there are so many limitations that cannot begin to approximate the real environments, especially because of the diversity of students in the course which creates challenges in breadth versus depth.
Email – firstname.lastname@example.org
Phone Number – 315-484-8087
- Paul Tate is a former army medic with 2 deployments, one of which was with SF in Africa; he is now a physician with residency in family medicine. In his perspective, much of the challenges SF medics face can be traced to the changes in missions, especially those in Africa that limit the availability of transport to higher levels of care for patients and strain the resources medics have available to them- even with advances in telemedicine. On the receiving end of such advisory calls, he has to make decisions on patients sometimes based on just texts and no access to vitals information that could really help him and the medic in the field make a stronger patient decision.
Email – paul.tate.@socom.mil
Phone Number – 931-237-5789
- Eric is a sergeant First Class and 18D in the Office of Special Welfare with 15 years of experience in the military, and numerous deployments primarily in Afghanistan. He now teaches the Special Forces Austere Care Course. In the care course, he emphasizes clinical care because that can often be more of an issue than injury treatment; those who are in non-medical roles in active duty groups also go through this training. He also emphasized the changes in the operational environment that have led to challenges in PFC, including determination of necessary equipment and training simply because medicine is never a problem or priority until it is needed.
- Chase joined the Special Forces following 9/11 (when he was in college) and trained to be a special operations medic; he has 15 years of experience with 12 deployments in the SF of which 11 he served in the role as a medic. Chase explained many of the challenges medics face, from understanding of the role from leadership and the rest of an SF team, to medic retention, to changes in operations that have led to the necessity of prolonged field care- and the lack of alignment on what this means that shows gaps in current SF medic training.
- Jason Myers is a Chief Warrant Officer and works as a Doctrine Developer and Analyst, particularly within Special Forces Doctrine. He is a former medic and has been going over potential SOP and medical treatment overseas. He spoke about the need to address the proper authorities, such as the DOD, and funding in regard to training and supporting indigenous medical elements and find out what could enable this training. He also spoke on immunization programs and the trouble with cold chain management. In the case of technology, he believes that there are some instances that would be beneficial to have technology and some where it would be more important to focus on the training side. He spoke to his medic experience when talking about his experience and how non-medics can be helpful when there are multiple patients such as in the case of a mass casualty.
Email – email@example.com
Phone Number – 910-432-5759
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