Page 14 - NATO Supplement

12 n Journal of Special Operations NATO Supplement: HFM-224 Technical Proceedings

This approach works well in a homogeneous sys- potential prehospital curriculums, PHTLS has
tem with defined levels of healthcare and scopes been taught in 20 European countries since 2008
of practice where protocols can be established with established PHTLS instructors in these
and implemented easily, such as within a national countries. Additionally, TCCC training is cur-
healthcare system. The PHTLS program focuses rently under development in many European
on principles emphasizing an underlying fund of Union (EU) nations. PHTLS was introduced
knowledge that learners can adjust and apply based in Latin America in 2010 and TCCC in 2011.
on the situation. The PHTLS and M-PHTLS pro- In considering the future global SOF partner-
grams also emphasize preferences defined as how ing initiatives, M-PHTLS has a potential role in
the individual, the local jurisdiction, or the coun- unifying the global military prehospital curricu-
try achieves that standard based on the situation lum. Other courses such as International Trauma
they encounter, the condition of the patient, and Life Support (ITLS) and Battlefield Advanced
the ability of the provider in terms of knowledge, Trauma Life Support (BATLS) do not have the
skills, experience, and available resources. same global distribution, but for nations that al-
ready use one of these systems, a determination
The principle/preference framework provides should be made of whether these provide suffi-
several benefits when considering M-PHTLS as a cient NATO interoperability.
potential unifying NATO SOF medical curricu-
lum. The establishment of principles sets desired The process of establishing a national M-PHTLS
outcomes, frequently evidence-based, that most training program requires a representative na-
nations can agree on when treating casualties. The tional agency to assume program responsibility
preferences allow nations to use differing mea sures and nominate between four and seven individuals
to reach these outcomes consistent with cultural as faculty members. The faculty members attend
and legal guidelines. However, within the collabo- a training program for providers, instructors, and
rative PHTLS organization, these differences can administrators held either in the United States or
be examined and perhaps drive curriculum and abroad. These trained personnel then return home
practice improvement with global input. to create their new training program. A U.S.-based
PHTLS instructor attends the inaugural course
Both RWS panels agreed that it is not sufficient and then the U.S. National Registry of Emergency
for an NSOCM to use strictly protocol-based Medical Technicians (NREMT) keeps a registry of
decision-making processes. The SOF environ- all courses, instructors, and qualified trainees.
ments’ austerity and unpredictability require that
NSOCMs have a strong fund of medical knowl- With the flexibility of principles vs. preferences and
edge and developed critical thinking skills. Both a proven curriculum that is continually updated
PHTLS and M-PHTLS teach and train to lev- by military and civilian experts and adaptable to
els of proficiency based on critical thinking and local settings (e.g., South American drug trades),
decision-making skills with practice (drill, drill, the PHTLS and M-PHTLS/TCCC combination
drill) of those skills on mannequins, live patients, offers a robust platform for propagating military
and live tissue. The RWS agreed that adopting SOF principles within initial, refresher, and sus-
an accepted international standard as a baseline tainment training.
curriculum for NATO SOF medicine would be
the most feasible option to rapidly improve in- TCCC endorsement by both the U.S. NREMT
teroperability across the Alliance SOF. Looking at and the American College of Surgeons provides a