Thursday, June 7, 2012
Virginia Commonwealth University Medical Center is one of only three civilian institutions in the country to participate in the U.S. military’s Special Operations Combat Medic (SOCM) training program. With the completion of its current class, VCU will have trained its 1,000th SOCM.
The training takes approximately nine months, starting with eight months at Fort Bragg, N.C., at the Joint Special Operations Medical Training Center for intense classroom and field medic training. SOCMs receive training in pharmaceutical calculations, medication administration, anatomy and physiology (including cadaver lab), physical examination, basic lab and radiology, clinical pathology, dentistry, preventative medicine, routine and emergency medical care, tactical combat casualty care and trauma management.
SOCMs are certified in Basic Life Support, Advanced Cardiac Life Support, Pediatric Education for Prehospital Providers and the National Registry Emergency Medical Technician. Some of the skills trained are hemorrhage control, endotracheal intubation, circothyrotomy, intravenous and intraosseous access, venous cutdown, needle decompression, tube thoracostomy, splinting, wound care, nasogastric intubation, urinary catheterization and ultrasound/eFAST. A variety of simulators, including METIman, are used throughout the training. Upon completion of the first eight months, there is a four-night culmination field training exercise.
After the initial training at Fort Bragg, students then are attached to one of three sites in the country where they receive a one-month period of highly supervised hands-on training in high acuity areas of the hospital.
At the VCU Medical Center, this includes its very busy emergency department, trauma and burn center, intensive care units, operating rooms and labor and delivery area. In addition, the students spend time with the Henrico Fire and EMS system responding to 911 emergency calls.
Following this hands-on training, the SOCM students return to Fort Bragg for graduation. They will then be assigned to a unit for deployment or additional training.
“These are not the traditional Army medics or Navy Corpsman,” said Kevin Ward, M.D., professor and associate chair in the Department of Emergency Medicine and director of VCU Reanimation Engineering Science Center (VCURES). “These are highly trained individuals from the various services who go on to become the medical care providers for the special operations detachments such as the Army Rangers and Green Berets and the Navy SEALs.”
The overall goal for these SOCMs is to provide care for the wounded for up to 72 hours since many missions are in areas with limited access or ability to evacuate to more definitive care. An example is the Afghanistan mountains.
While not nearly the challenge of the combat environment, exposure and training of these students in busy urban medical centers like the VCU Medical Center’s emergency department and Level I Trauma Center are the next best thing.
“During hands-on training at the VCU Medical Center, these medic students work with teams of nurses, residents and attending physicians to learn and perform life-saving procedures that will help stabilize the wounded on the battle field until they reach a higher level of care,” said Dr. Rao Ivatury, professor and eminent scholar of surgery and chair of the Division of Trauma, Critical Care and Emergency Surgery. “It is our privilege to be a small part of what they accomplish.”
The students are also exposed and trained to diagnose and treat common ailments since they are also responsible for the general medical health of their small units and are often called upon to provide care to the indigenous populations in the areas in which they are deployed.
“The SOCMs not only provide in-theater first-line trauma care for our nation’s warriors, but they act as ambassadors,” said Bruce Spiess, M.D., professor in the VCU Department of Anesthesiology. “Often times, they are the only medical personnel in a remote or underserved part of the world. As such, they have to have the skills for routine medical care, providing an indigenous population with treatment of a wide range of local diseases.
“We in anesthesiology are so very proud to contribute to the SOCMs learning through airway management and tracheal intubation teaching,” continued Spiess. “The establishment of an open airway is a foundation upon which survival for any critical situation depends.”
“The clinical training SOCM students receive at VCU is a crucial element in ensuring our graduates have the requisite skills and confidence to perform the grave responsibility bestowed on them in combat,” said Lt. Col. LoryKay Wheeler, D.O., director of the SOCM course for the U.S. Army John F. Kennedy Special Warfare Center and School. “We are truly grateful for the amazing efforts made by the VCU staff in support of the SOCM training program.”
Ward said that he is proud to have such an important and integral role in SOCM training at VCU.
“It is rewarding to know that a piece of knowledge or skill that these young heroes may have learned here at VCU may save a life thousands of miles away,” said Ward. “Even on my most stressful day in our busy emergency department, I have to remind myself that I am working in a safe, dry and air conditioned environment and can go home to see my family 10 hours later.
“These SOCMs, on the other hand, operate in the most extreme and austere environments, many times under fire, and far away from home. It’s just one of the many ways VCU supports our military personnel. VCURES has, and is, working on various research projects to improve survival and the quality of life of critical illness and injury victims, including critically wounded soldiers in combat,” Ward said.
For more information about VCURES and these research projects, visit www.vcures.org