Combat & Casualty Care

Q1 2017

Military Magazines in the United States and Canada, Covering Combat and Casualty Care, first responders, rescue and medical products programs and news\Tactical Defense Media

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COMMANDER'S CORNER In 2010, the AFSOC SG identified that our SOSTs were not treating enough trauma cases at DoD medical facilities to maintain surgical proficiency. The decision was made to embed several surgical teams into civilian Level 1 trauma institutions. For the past seven years, three SOSTs have been detailed to the University of Alabama, which admits over 2300 trauma patients each year. Partnerships have also been established with the University Medical Center (UMC) Las Vegas and Miami Ryder. UMC and Miami admit over 2800 and 3500 trauma patients per year, respec- tively. These partnerships conform to the NDAA, which states that "the Secretary [of Defense] will enter into partnerships with civilian academic medical centers and large metropolitan teaching hospitals that have Level 1 trauma centers", and that "trauma teams will embed within these trauma centers." AFSOC is leading the way. The most advantageous approach to support our austere surgical team requirements and man- age the expanding battlefield is to supplement our surgical teams with expert civilian clinicians. Therefore, I am presently working with the Air Force Reserve Command to build the first SOST Individual Mobilization Augmentee (IMA) team to leverage the Total Force. OPERATIONAL PERFORMANCE: Special Operations Forces (SOF) invest heavily in recruiting, selecting, and training AFSOC's Special Tactics (ST) teams. This small cadre of high-performance athletes must be prepared for exposure to direct combat. Statistically, this physically-elite group has the greatest morbidity and mortality rate in the Air Force. Due to the high-risk nature of their occupation, repeti- tive injuries render the majority of them inoperable for strenuous duty, within six to eight years. Five years ago, SOCOM began to embed physical therapists, men- tal health professionals, physical trainers, and other medical providers into ST squadrons as part of the POTFF program. This multi-functional team develops a rapport with each patient and becomes thoroughly familiar with their medical, psychological, and social history. This approach shaves months off of post-deployment recovery time and has nearly doubled the functional years of members in the ST commu- nity. In light of this achievement, AFSOC is expanding the POTFF model to improve the health of even more Air Commandos, and the USAF is bringing additional psychological and physical health resources to the rest of the conventional force. It is interesting to note that about one-third of our deployed service members are treated for non-combat injuries. Approximately 50% of these injuries are musculoskeletal in nature, acquired while wearing a flak vest twelve hours a day, or exercising. Three-quarters of those seeking care will require multiple treatments. In a resource-constrained environment, we can get the most "bang-for-the-buck" focusing on the health issues that account for the highest medical utilization rates. Keeping deployment injuries in mind, we have added a sports medicine provider to our SG staff, and intend to add one to each of AFSOC's primary locations. The goal is to deliver care in synergy with physical therapists, strength and conditioning coaches, and athletic trainers in a "pit crew" approach. Other aspects of the operational performance program include commercial off-the-shelf (COTS) testing of human performance technology devices, and pharmacological and non-pharmacological enhancements. We have also developed partner- ships with the Air Force Research Lab (AFRL) and Wilford Hall to study ways to combat overtraining injuries, androgen use, and neck strain from night vision equipment. MEDICAL MODERNIZATION: All military leaders must rapidly respond to the warfighter's needs. Lessons learned are developed from afteraction reports and gap analyses, but a majority of the recommen- dations are not acted upon. However, AFSOC's Medical Modernization Division (SGR), which researches battlefield trauma care, austere support, force health protection, and human performance, has a close relationship with the Medical Readiness Division (SGX). As soon as SGX receives an after-action report, SGR investigates ways to fill the gaps, providing mission-enabling capability through rapid equipping, COTS-first procurement, and research and development. Initiatives for 2017 include the implementation of a freeze-dried plasma and fresh whole-blood program, expansion of 3D printing capa- bilities, development of IV fluid warmers, innovation of hemorrhage and resuscitation monitors, and deployment of portable diagnostic systems. Our modernization success is built on collaboration with SOCOM, the Air Force Medical Service (AFMS) advanced development unit, Army MEDCOM, Navy BUMED, DARPA, and the FDA. The modern- ization staff is also partnering with DARPA and the Global Good Orga- nization to design ultrasound devices that have intuitive evaluation techniques and diagnostic algorithms. This technology will be capable of providing 'on the battlefield' point-of-injury diagnoses. Ultimately, the mandate of the modernization team is to rapidly deploy the lightest, most up-to-date capabilities, with the smallest footprint, keeping patient safety as a priority. Since 2010, this medical footprint has been reduced by 87%, from more than 1000 pounds to less than 200 pounds, and with greater effectiveness. Reducing the medical package expands the types of transport aircraft that can be used, and increases the mobility of on-the-ground medics. Over a four- year timeframe, nearly 200 new items have been operationally tested, evaluated, and fielded for Air Commando medic utilization downrange. Over 60 Educational Workshops Over 30,000 Square Feet of Exhibit Space Virginia Beach Convention Center Join Us September 12-15, 2017 18 | Combat & Casualty Care | Spring 2017

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