CAMP GRAYLING, Mich. -- Over more than two decades of combat, the military has refined its ability to save lives on the battlefield.
Rapid handoff of wounded patients to qualified, equipped surgical teams within one hour of injury -- the “Golden Hour” -- dramatically increased the survival rates of those wounded in combat.
Now, the Army must prepare for a different kind of combat where the volume of wounded outnumbers front-line resources and rapid medical evacuations are near impossible.
That is why U.S. Army Futures Command is designing a new capability for Prolonged Care Augmentation Detachments, or PCADs.
PCADs will provide prolonged care and critical care enroute on evacuation platforms during periods of delayed evacuation. Each PCAD will be comprised of a physician’s assistant, a nurse practitioner or ICU nurse and two medics. The goal is to treat patients as far forward as possible and maximize survival and return to duty rates.
During Large-Scale Combat Operations, or LSCO, lives will depend on this concept not only delivering immediate help -- but also sustaining it.
That is where U.S. Army Medical Logistics Command plays a role.
To help test the concept and plan for sustainment requirements, AMLC participated in a recent capabilities experiment of the PCAD concept Aug. 12-15 during Operation Northern Strike, one of the DOD’s largest reserve component readiness exercises held annually in Michigan.
“Our job is to ensure medical readiness of the warfighter through sound logistics and sustainment solutions,” AMLC Readiness and Sustainment Director Pam Wetzel said. “As the sustainment planning experts, we participate as members of integrated product teams, determining maintenance support requirements and assisting the product managers with product support strategies. Participating in this event allowed us to identify potential sustainment issues before they become an issue for the warfighter.”
The goal of the Readiness and Sustainment, or R&S, Directorate, which is a part of the AMLC’s Integrated Logistics Support Center, is to support Army acquisition stakeholders, materiel developers and warfighters with medical materiel sustainment expertise, sourcing solutions and end-item management for the Army’s medical materiel.
PCADs, which will include active duty and reserve components, will operate alongside Role 1 (e.g., battalion aid station), Role 2 (e.g., medical company), forward resuscitation and surgical detachments, and evacuation platforms in brigade combat teams.
Keith Griffith, an equipment specialist with R&S, attended the test event at Camp Grayling.
While the new PCAD capabilities will require some level of additional sustainment needs, Griffith said they won’t require new equipment sets to be built out. Instead, the current plan is to issue additional types of sets already in the Army inventory.
“Even though this concept does not plan to introduce new medical devices into the inventory, we are changing quantity, and that can have impacts on the transportation burden, maintenance requirements, power support and cold chain management,” Griffith said.
During the experiment, the U.S. Army Medical Center of Excellence’s Capability Development Integration Directorate, or CDID, conducted unit-level trials with the 1171st Medical Company Area Support, which established a Role 2 patient hold to simulate prolonged casualty care for seriously ill patients.
“Our role as the sustainment experts is to observe and recommend considerations, such as how units will get repair parts if they are in a location where we can’t easily reach them,” Griffith said. “We also highlight other factors, such as how long the battery will last on a refrigerator, because the PCAD might not have access to something like a generator or other power source.”
AMLC activated in 2019 to serve as the Life Cycle Management Command, or LCMC, for medical materiel. The ILSC, a developing capability within the AMLC enterprise, synchronizes acquisition and sustainment activities throughout the life cycle. The AMLC ILSC is the Army’s premier organization for medical materiel life cycle logistics, enabling readiness solutions at the point of need.
“We greatly appreciate our partnership with the capability developers, materiel developers and end users,” Wetzel said. “Together, we ensure medical materiel is safe, suitable and supportable. Ultimately, we’re all on the same team, focused on the same goal: warfighter readiness.”