DOCTOR AND THE MEDICS: Responding to emerging requirements in battlefield medicine associated with increases in expeditionary deployments, special forces continue to evolve their practices to safely operate in areas lacking even the most basic support infrastructure.

Author:White, Andrew

Traditionally deployed in a variety of force components ranging from 60-strong Special Operations Task Groups (SOTGs) down to two-man teams, special forces are often required to organically support themselves. This is because larger, conventional medical support units can potentially be located across borders, or at forward operating bases, sometimes hundreds of kilometres away, defence sources associated with the North Atlantic Treaty Organisation Special Operations Forces Headquarters (NSHQ), based in Mons, southern Belgium, described to Armada. However, special forces continue to rely upon battlefield medicine to support not only themselves but local populations where a requirement to influence local civilians, via so-called 'hearts and minds' efforts remain critical 'support and influence' factors in contemporary counterinsurgency missions.

The latest trends in battlefield medicine range from next-generation pharmacology solutions, aimed at preventing the onset of symptoms, which can negate the effects or even cancel a mission, through to tactical systems deployed on the battlefield and improved training regimes, aimed a enhancing individual operator and small unit TTPs (Tactics, Techniques and Procedures). Many of these battlefield medicine solutions continue to be developed by multinational bodies including the NSHQ, as well as at the national level by the likes of the US Special Operations Command (USSOCOM) which must also rely upon significant support from industry and academe alike.


On 15th May NATO's International Special Training Centre (ISTC), based in Pfullendorf, southern Germany, announced the conclusion of its first 22-week NATO Special Operations Combat Medic (NSOCM) course. According to NATO officials, this course has been specifically designed to train NATO special forces commandos in being able to treat casualties deployed at reach for up to 36 hours at a time; a significant change from concepts of operations utilised during campaigns in Afghanistan and Iraq during the 2000s which focused on keeping casualties alive during the so-called 'Golden Hour'; the first hour after a traumatic injury, until Medical Evacuation (MEDEVAC) by specialist platforms strategically spread across the theatre of operation.

The NSOCM's officer commanding, Major Juliane Puhan of the Heer(German Army) described the course content, stating: "Filling a time gap between the first hour and 'hour X' can be, in the worst-case scenario, more than 24 hours ... We will go through all the clinical topics like eye conditions, cardiological conditions and abdominal conditions. If you're not trained like that as a medic, it overwhelms you and the patient will not survive that," she explained while highlighting the breadth of course content: "The fact that we can basically reach back to our worldwide network and bring in guest instructors from all over the world is quite unique for a training centre and results in truly high-quality instruction for our students," Maj. Puhan continued, while describing how the first course relied upon a total of 67 military and civilian instructors from 14 member nations.

According to ISTC officials, the new NSOCM course (which was launched in October 2016) has been designed in response to dynamic operational requirements in order to "... transform international SOF (Special Operations Forces) first responder medics...

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