FCC experiments with Prolonged Care Augmentation Detachment

JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas — During the 2022 Joint Emergency Medicine Exercise at Fort Hood, TX, the Medical Capability Development Integration Directorate and the Future Force Integration Directorate conducted a limited assessment of the Prolonged Care Augmentation Detachment with support from U.S. Army Medical Test and Evaluation Activity and Directorate of Training and Doctrine on June 8-9, 2022.

The JEMX is a yearly evaluation designed by the Carl R. Darnall Army Medical Center to assess the clinical skillsets of emergency medicine program graduates, presenting a prime opportunity to evaluate the operational capabilities of the PCAD. The projected casualty rates during Large-Scale Combat Operations may overwhelm medical capabilities. The PCAD is a way to provide prolonged forward care when evacuation is unavailable.

PCADs will operate alongside Role 1 (Battalion Aid Station), Role 2 (medical company), Forward Resuscitation and Surgical Detachments, and evacuation platforms in the Brigade Combat Team area of operations to manage critical care and non-critical care patients in the prolonged care setting for up to 72 hours during combat operations. Ideally, the PCAD will additionally provide prolonged care and critical en route care on evacuation platforms within the Division area during periods of delayed evacuation. The goal is to treat patients as far forward as possible, maximizing return to duty rates.

Col. James J. Jones, MED CDID director, highlighted the importance of the training. “Maximizing return to duty rates is the Army Health System’s number one priority during LSCO. The PCAD, prolonged care training, and the Holistic Health and Fitness (H2F) System can profoundly influence the care we can provide far forward and increase our ability to maximize return to duty rates.”

MED CDID was supported by Lt. Col. Ismael Flecha, CRDAMC Interservice Physician Assistant Program Coordinator, Maj. Jason Jones, 555th FRSD commander, and Cpt. Joonghoon Choi, 1st Cavalry Division. The team worked to resource two (4-man) PCAD teams from personnel assigned to the 555th FRSD. Each team consisted of a physician assistant, emergency medicine or critical care nurse, licensed practical nurse, and combat medic.

Jason stated, “This is a great capability to enhance our mission, and the 555th FRSD is honored to have the opportunity to help inform the future of Army medicine.”

The PCAD’s two-day limited assessment identified mission, equipment, supply, and training shortfalls to ensure the PCAD is operationally ready before fielding. The PCAD teams were each stressed with up to six critical care patients with stable but tenuous injuries ranging from burns, fractures, postoperative open abdominal, and/or chest wounds.

Capitalizing on the 555th’s expertise, the PCAD’s patient capacity was assessed as six critical and up to 20 minimal care patients.

“Today, we proved we can comfortably manage several stable, postoperative critical care patients for multiple hours until the evacuation,” said Maj. Stephen Wilcox, 555th FRSD critical care nurse.

U.S. Army Medical Center of Excellence and MED CDID will incorporate U.S. Army Reserve medical planners in future planning to include an upcoming Limited Objective Experiment or Table Top Exercise for a broader assessment of the PCAD capabilities. MED CDID, FFID, USAMTEAC, Office of The Surgeon General and U.S. Army Medical Research and Development will facilitate a more robust operational assessment of the PCAD detachment during future field training exercises.

The JMEX generated an excellent opportunity for the Futures and Concepts Center and MEDCoE to integrate with operational units on a common task of great interest to Army senior leaders.

Brig. Gen. Guy Jones, FCC Deputy Director and Chief of Staff, commented, “The CDID and FFID partnered together and focused on a single target—the PCAD Force Design Update. This demonstrates how working together towards a single target can solve many problems and produce a better solution for our future Army.”