18 Deltas: Special Forces Medical Sergeant (SFMS) CMF 18

Scope of Practice

Duties and Responsibilities:  The SFMS 18D provides U.S. forces, allied and indigenous personnel preventive medical, dental and medical care within the limits of his training and subject to the remote or proximate supervision of a physician authorized by the U.S. Army Special Operations Command (USASOC) Surgeon to precept the SFMS.       

He may also provide mission-related veterinary support.  The SFMS provides routine and emergency care for:  

1. Uncomplicated illnesses, injuries or problems which have low risk for the patient
2. Major illnesses, injuries, conditions or procedures without significant risk to life but warranting evacuation to a higher echelon of medical care as soon as practical
3. Major illnesses, injuries, conditions or procedures that carry substantial threat to life and which warrant urgent evacuation to a higher echelon of care as soon as possible. 

The SFMS scope of practice includes:

1. Patient assessment.

2. Triage of patients.

3. Disposition of patients.

4. Airway management including intubation and emergency cricothyroidotomy.

5. Bag-valve-mask or bag-valve-tube ventilatory support.

6. Intravenous vascular access.

7. Patient immobilization and transport.

8. Urinary tract catheterization and placement of a nasogastric or orogastric tube for lavage or gavage.

9. Minor surgical procedures for the purpose of wound debridement, hemorrhage control, completion of an amputation, and incision and drainage of hematomas and abscesses.

10. Wound suturing.

11. Bandaging, splinting and casting.

12. Emergency needle and tube thoracostomy.

13. Basic interpretation of plain radiographs of the extremities, chest, spine and pelvis in the evaluation of a trauma patient, presence of a foreign body, or gross abnormalities of bone structure.

14. Preparation of specimens, performance and interpretationof results of the following:  urinalysis, blood count, gram’s staining, stool O&P, thick/thin blood smears, KOH and saline slide preparations, rapid diagnostic test results from kits such as card, vial or blister-packs, and bacterial and fungal culture results.

15. Collection, preparation, preservation and shipment of specimens for pathology evaluation.

16. Care for gingivitis, apthous ulcer, herpes simplex, pulpitis, uncomplicated dental caries and emergency management of maxillogacial and dental trauma.

17. Administration of topical, inhalational, oral, subcutaneous, intravenous and intramuscular medications approved by the Surgeon, USASOC.  Group and battalion surgeons may augment the list of approved agents when specifically required for the mission and after having accomplished training to competence in the use of the agent(s) to be added.

18. Initial management of patients with blunt, burn, concussion, crushing, fragmentation, laceration, penetrating and perforating wounds and traumatic amputations.

19. Initial management of fractures and soft-tissue injuries.

20. Management of uncomplicated infectious diseases.

21. Initial management of hemorrhage and all forms of shock.

22. Emergency management of altitude/decompression sickness, hypothermia and hyperthermia.

23. Initial management of alimentary tract, cardiac, immunologic, metabolic, neurological, opthalmologic, respiratory and toxicologic emergencies.

24. Management of uncomplicated conditions affecting the alimentary tract, the integument, ears, eyes, nose, throat, lungs, urinary tract, reproductive system and musculoskeletal system.

25. Management of uncomplicated emotional psychological conditions.

26. Administration of local, regional and intravenous general anesthesia for the primary purpose of providing sufficient analgesia/amnesia/relaxation to allow completion of the required surgical or manipulative procedure.

27. Management of uncomplicated pregnancy, labor, delivery and care of the newborn, and emergency child birth with normal presentation.

28. Assessment and management of acute, uncomplicated pediatric illness.

The SFMS participates in medical sustainment training prescribed by the Surgeon, USASOC.  The SFMS is required to maintain current certification with the National Registry for Emergency Medical Technicians at the Paramedic level.

The SFMS ensures detachment medical preparedness, establishes field and unconventional warfare medical facilities to support military operations.  He collects medical intelligence.  He recruits, organizes, trains, advises and supervises personnel to the battalion level.

1. MOSC 18D30.  Assembles and maintains detachment medical equipment and supplies.  Conducts medical cross training for detachment members.  Maintains medical and dental records.  Ensures provision of field sanitation for the detachment.

2. MOSC 18D40.  Supervises all medical and medical service support activities in the field or during deployment.  Prepares Medical Area Study and conducts ongoing Medical Area Assessment.  Plans and supervises medical training for allied and indigenous personnel.  Plans medical aspects of civic action programs.  In a deployed special operations environment may establish a medical facility with patient holding and treatment capabilities

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*This web version is provided by The Brookside Associates, LLC.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. The medical information presented was reviewed and felt to be accurate in 2001. Medical knowledge and practice methods may have changed since that time. Some links may no longer be active. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

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