Green Beret Medics Train at Duke

(Photo: Courtesy of Flickr user Ildar Sagdejev  under the Creative Commons license.)
(Photo: Courtesy of Flickr user Ildar Sagdejev under the Creative Commons license.)

DURHAM -- Soldiers from the 3rd Special Forces Group received hands-on instruction at Duke University Medical Center as they prepare for a new mission in Africa.

About a dozen Green Berets, all medics with the Fort Bragg-based group, spent Monday honing their skills with ultrasound machines.

Special Forces medics use the machines in lieu of X-rays when they are deployed in austere environments.

They're used to help diagnose everything from internal bleeding to kidney stones to bone fractures. They can help medics observe potentially life-threatening problems well before they could travel to a hospital.

Dr. Brianne Steele, an assistant professor of surgery and Duke's ultrasound director within its Division of Emergency Medicine, led the workshop.

She said advancements in technology have pushed ultrasound to the front lines of medical care.

"Originally, ultrasound machines were as big as your SUV, and they weren't that great," Steele said.

Today's machines can fit in a box the size of a suitcase and can produce images that in some cases can be more reliable than an X-ray, faster and for less cost.

The system is versatile.

In addition to being a tool for diagnoses, ultrasound can help guide medics in administering anesthesia or removing foreign objects from the body that would otherwise be invisible on X-ray.

But Steele warned the soldiers not to rely too much on the machine.

"The ultrasound is an extension of an examination," she said, explaining that the machine can help "rule in" diagnoses, but should necessarily be used to "rule out" possible causes for complaints.

Special Forces medics have deployed with the machines for roughly five years, said Master Sgt. Rick Hines, the 3rd Group senior medic. Their introduction to the battlefield have helped improve front-line care, he said.

Monday's workshop was meant to build on existing experience and introduce the medics to new techniques and uses for the machines just in time for 3rd Group to turn its attention from Afghanistan to Africa.

The group is returning to its historical mission on that continent after spending most of the past decade as the main effort for Special Forces in Afghanistan.

All the medics involved will be deploying as part of the group's first or second efforts into the country in the new year.

Their new lessons, Hines said, were focused on more general medical care rather than the wounds of war to compliment that new mission.

"Our guys over the past 14-plus years have gotten really good at trauma," Hines said. "They've seen a lot of it."

But that's not what they're likely to see in Africa, he said.

Once the soldiers deploy, they'll work with partner forces in a 12-nation area of operations stretching across north and west Africa, including Libya, Chad, Cameroon, Nigeria, Niger, Algeria, Tunisia, Morocco, Mauritania, Senegal, Mali and Burkina Faso.

While the region has its own dangers and challenges, Hines said the medics expect to see fewer medical complaints from bullets and bombs and more from car wrecks and illnesses.

And many of their patients, he said, will come from outside the team.

"When you want to get to know folks and earn their trust, one of the best ways is to do some tailgate medicine," Hines said. "You build that rapport and that trust by going out and helping folks."

He said more sustained care would be an issue for Special Forces in Africa.

In Afghanistan, the soldiers were always less than an hour away from a medical evacuation flight.

In Africa, it could be a day or more before medical help can arrive, Hines said.

Medics will have to leverage everything they can in those instances, he said, that includes the ultrasound machines.

One of the new techniques the soldiers learned involved using the machines to measure the inferior vena cava, a large vein carrying blood into the heart.

Steele explained that the medics can look at the vein in an ultrasound to assess whether or not a patient is loosing blood, even without other signs of internal bleeding.

Hines said with that information, a medic could save a life using team members as blood donors -- so-called walking blood banks -- while working to stop the bleeding before additional medical help can arrive.

Soldiers have learned that technique in class before, Hines said, but Monday was the first time they could put the learning to action.

The workshop was the latest partnership between Duke and Green Berets. Hines said more like it would be in the works.

"The medics are always hungry for training," he said.

In addition to the workshop, Duke helps train Special Forces medics by hosting them for one-month residencies.

Dr. Mark Shapiro, chief of acute care surgery at Duke, said up to four Green Berets are working in the hospital at any given time.

Their work is often tailored to upcoming deployments, he said, but generally cover plenty of medical ground.

Nearly 50 medics have trained at Duke since that partnership began in 2014, Shapiro said. That includes soldiers from the 1st, 3rd, 5th and 7th Special Forces Groups.

"It's really a big source of pride for Duke," Shapiro said.

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