The PFC Truths
The Original SOF Truths were created to inform those both in, as well as out of, Special Operations not entirely familiar with the operating conditions faced in uncertain environments. This has helped commanders and guys on the ground
explain the realities of certain situations, limitations and capabilities needed. Our take on the SOF Truths, The PFC Truths, should also be used to help explain and translate what medics require to be successful in providing world class care in the worst environments possible.
Original SOF Truths
- Humans are more important than Hardware.
- Quality is better than Quantity.
- Special Operations Forces cannot be mass produced.
- Competent Special Operations Forces cannot be created after emergencies occur.
- Most Special Operations require non-SOF assistance
The PFC Truths
- If you think you need a surgeon or intensivist in the field, put one there.
Telemedicine, training and equipment will only get you so far. If the patient needs a thoracotomy or laparotomy, he needs the surgeon present to perform it. At a minimum, commanders should understand the risk of the decision not to include one of the many types of deployable surgical teams.
- No piece of kit will give you the capability.
If you take a Foley kit in order to monitor UOP but are unwilling to use it due to unfamiliarity, it will do you no good. Likewise using it improperly, such as not emptying the initial output and including it in your hourly measurements, may give you false results leading you to believe the patient is doing better than he is. We have seen that exact scenario multiple times now.
- PFC is not a qualification or skill set, it is an operational problem or situation that you find yourself in.
The skills required of a medic in a PFC situation are fundemental basic medic skills applied appropriately in a bad situation. These situations can be anticipated and planned for at all levels.
- Competent (PFC Medical) forces cannot be created after emergencies occur.
Training and refreshing on the skills required of these complex situations takes dedicated time and planning. Trying to fumble through a Fresh Whole Blood transfusion or sedation calculation while under the stress of your patient crashing while managing the other necessary treatments while tired and frustrated will likely lead to substandard care. This can be prevented by training on these complex tasks in a realistic environment prior to deploying.
- Most Special Operations require non-SOF assistance (especially if you have a smaller deployed force)
Medics will have to rely on non-SOF whether they be ISOS, a host nation facility, a big DOD surgical team or a non-standard StatEvac. All of these eventualities should be taken into account and planned for.