Happy Veteran’s Day! Thank you for all you do to protect our freedoms and ensure our safety. We would not be America without you. You not only shape our daily lives but have also influenced our field. You have revolutionized our present to not only secure our tomorrows but also to improve them.

Our lives are made better because military medicine focuses on so much more than caring for and healing service members and their families. Healthcare providers in the Army, Air Force, and Navy contribute to the world’s leading medical research and development, harnessing the power to address humanity’s most pressing healthcare issues. Military physicians have played a substantial role in almost every significant medical advancement. For example, Major Walter Reed led the Yellow Fever Commission in Cuba in the 1900s. A notable outcome of his work was discovering that mosquitoes carried the disease; with this insight, thousands of lives were saved.

Point-of-care ultrasound (POCUS) also has military origins. Our blog, Honoring our Veterans and the Role of POCUS in the Military, highlights how emergency ultrasound (EUS) is a required training component for all military emergency practitioners. Developed to help diagnose and aid in the care of soldiers during Operation Desert Storm, POCUS found a home on the battlefield. The Defense Research Projects Agency (DARPA) sparked the inception of SonoSite™ in 1997. Their mission: To develop a pocket-sized ultrasound modality to treat men and women in combat.

POCUS made such an impression on the military that the POCUS Quality Enhancement Research Initiative announced in 2016 that its Partnered Evaluation Initiative was partnering with the VA Simulation Learning, Education and Research Network (SimLEARN) to train VA providers in the clinical applications of the modality. Practitioners from selected facilities participated in an immersive POCUS Training Course offered by the VA SimLEARN, which was held at its National Simulation Center. The POCUS national training program was conducted from 2016-2020. Over 300 VA providers from over 38 VA medical centers nationwide were POCUS trained. Those results equate to benefitting approximately 130,000 veterans annually.

Due to these tremendous outcomes, regional and virtual courses using tele-ultrasound software were developed. The goal is to continue the training as results made evident through the program included:

• VA healthcare workers experienced long-term improvements in their POCUS knowledge and skills. They also used the device more frequently when caring for patients after attending the POCUS training course.
• Participating VA facilities had a 15% increase in POCUS usage. Non-participating facilities experienced a 4% decrease in its use.
• VA providers trained in POCUS usage noted 73 fewer procedural complications.

What has been made apparent through a program like the VA SimLEARN immersive POCUS training is that the modality isn’t for combat alone. Veterans discuss in their own words their eyewitness account of how POCUS has benefited both patients on the battlefield and at the bedside. In the article, Best Point-of-Care Ultrasound Practices: A Veterans’ Eye View of POCUS, U.S. Army Critical Care Physician Dr. Cristin Mount notes that using POCUS in military medicine traverses the various disciplines. Applications for POCUS are seen daily “in the Emergency Department and ICU for quick clinical decision-making to aid clinical decision-making and patient movement decisions in more austere environments.”

Dr. Mount also shared that her continued proficiency in POCUS is motivated by her love for helping to shape the future generation of military physicians. She is passionate about serving her country by training and teaching her colleagues to care for service members and their beneficiaries.

Dr. Jon Monti remembers when he was first introduced to POCUS. He was deployed in a remote Afghan outpost in 2005. He led a team of four medics, supporting a small surgical team and special forces personnel. The Sonosite 180, developed under DARPA, was the first portable ultrasound machine, and they had it in their possession. This is how Dr. Monti became fascinated with POCUS and its capability to support medical professionals treating trauma victims.

“What most inspires me is how POCUS is such a versatile tool— research demonstrates that everyone from medics and nurses to PAs and physicians can be variably trained to safely and effectively utilize POCUS to enhance patient assessment and care,” Dr. Monti explains. He appreciates how POCUS doesn’t care about clinical ranks, titles, or disciplines. This pocket-sized device has one thing in mind, to deploy the best care for those who need it most. “That’s what medicine is all about.”

Indeed, Dr. Monti, it is!

Again, we say thank you for all that you do. We salute our troops for our freedom and for our lives!

Happy Veterans Day!

References

Military Medical Advancements 2022, Medicine and the military website, Military Medical Divisions, accessed October 2022, https://www.medicineandthemilitary.com/military-medicine-101/military-medical-advancements

Partner Evaluation Initiative: Implementing a National Point-of-Care Ultrasound Training Program,  Quality enhancement research initiative website, U.S. Department of Veterans Affairs, accessed October 2022, https://www.queri.research.va.gov/centers/POCUS.pdf

Best Point-of-Care Ultrasound Practices: A Veterans’ Eye View of POCUS, Vave website, accessed October 2022, https://vavehealth.com/best-point-of-care-ultrasound-practices-a-veterans-eye-view-of-pocus/