01 April 2021 - Issue 194 |
|
Greetings JSOM Newsletter Subscribers,
The Special Operations Medical Association Medic of the Year Award annually recognizes a special operations medic who, during the preceding calendar year, has demonstrated unwavering dedication to the art and science of special operations medicine via gallant actions and/or via advancement of research, education, and/or clinical practice.
Nomination deadline: Friday, May 14.
|
Currently in production and available soon:
The 2020 updated and new versions to the following handbooks have been slightly delayed due to the authors' response to COVID19:
-
Pararescue Medical Operations (PJ MED) Handbook 8th Ed. The 8th Ed will be available as a spiral-bound handbook. The updates are in. We are working to bring this title to you very soon.
New PJ Handbook will feature waterproof / tearproof paper.
New on the JSOM Online Store
Advanced Ranger First Responder Handbook: The Advanced Ranger First Responders are entrusted with an advanced skillset of procedures, medications, and training. They are trained on specific first responder medical skills to provide a higher level of trauma response during Ranger operations. The ARFR is expected to provide limited scope trauma and emergency care in a tactical or austere setting; they may work independently or in support of a medical provider. They are proficient at advanced medical procedures and basic medication administration. The skills in this handbook enhance the basics of Tactical Combat Casualty Care (TCCC).
Celebrate the 20th Anniversary of the JSOM with this Special Collectors Set of last years’ editions for $128 (20% off cover price). Order today at http://jsom.us/2ZWeA0M.
Respectfully,
Michelle DuGuay Landers, MBA, BSN, RN
Breakaway Media, LLC
Publisher
Journal of Special Operations Medicine and Advanced Tactical Paramedic Protocols Handbook
Lt Col, USAFR/NC (Ret)
|
A note about the newsletter design: This newsletter has been created using one cohesive font and a unified JSOM brand and color design. If multiple fonts or unusual colors are appearing in your copy, it is a result of your personal settings or the settings attached to your email. For optimal viewing of this newsletter, including the sidebar items which can sometimes disappear depending on your email settings, we suggest opening the newsletter in a browser. |
ABSTRACT
Background: Limb position changes are likely during transport from injury location to definitive care. This study investigated passive limb position change effects on tourniquet pressure and occlusion. Methods: Triplicate buddy-applied OMNA® Marine Tourniquet applications to Doppler-based occlusion were done to sitting and laying supine mid-thigh (n=5) and sitting mid-arm (n=3). Tourniqueted limb positions were bent/straight/bent and straight/bent/straight (randomized first position order, 5 seconds/position, pressure every 0.1 second, two-way repeated measures ANOVA). Results: Sitting thigh occlusion pressures leg bent were higher than straight (median, minimum-maximum; 328, 307-403mmHg versus 312, 295-387mmHg, p = .013). In each recipient, the pressure change for each position change for each limb had p < .003. In each recipient, when sitting, leg bent to straight increased pressure (326, 276-415mmHg to 371, 308-427mmHg bent first and 275, 233-354mmHg to 311, 241-353mmHg straight first), and straight to bent decreased pressure (371, 308-427mmHg to 301, 262-388mmHg bent first and 312, 265-395mmHg to 275, 233-354mmHg straight first).
|
|
ABSTRACT
Uncontrolled hemorrhage secondary to unstable pelvic fractures is a preventable cause of prehospital death in the military and civilian sectors. Because the mortality rate associated with unstable pelvic ring injuries exceeds 50%, the use of external compression devices for associated hemorrhage control is paramount. During mass casualty incidents and in austere settings, the need for multiple external compression devices may arise. In assessing the efficacy of these devices, the magnitude of applied force has been offered as a surrogate measure of pubic symphysis diastasis reduction and subsequent hemostasis. This study offers a sensor-circuit assessment of applied force for a convenience sample of pelvic compression devices. The SAM® (structural aluminum malleable) Pelvic Sling II (SAM Medical) and improvised compression devices, including a SAM Splint tightened by a Combat Application Tourniquet® (C-A-T; North American Rescue) and a SAM® Splint tightened by a cravat, as well as two joined cravats and a standard-issue military belt, were assessed in male and female subjects. As hypothesized, compressive forces applied to the pelvis did not vary significantly based on device operator, subject sex, and subject body fat percentage. The use of the military belt as an improvised method to obtain pelvic stabilization is not advised.
|
|
April 2021 JSOM Feature Article |
|
Performance Characteristics of Fluid Warming Technology in Austere Environments
Blakeman T, Fowler J, Branson R, Petro M, Rodriquez D. 21(1). 18 - 24. (Journal Article)
|
|
ABSTRACT
Resuscitation of the critically ill or injured is a significant and complex task in any setting, often complicated by environmental influences. Hypothermia is one of the components of the "Triad of Death" in trauma patients. Devices for warming IV fluids in the austere environment must be small and portable, able to operate on battery power, warm fluids to normal body temperature (37°C), and perform under various conditions, including at altitude. The authors evaluated four portable fluid warmers that are currently fielded or have potential for use in military environments.
Keywords: intravenous fluids; fluid warning; resuscitation; hypothermia
|
|
The Journal of Special Operations Medicine Podcast |
|
The JSOM podcast digs deeper into the articles and subjects that matter to our readers. Our podcast hosts, Captains Alex Merkle and Josh Randles, tackle articles from the journal based on merit, interest, and application for operators in the field. In addition, the podcast features a special, not to be missed Interview Series with leaders, doctors, and authors. |
|
Spring 2021
The new JSOM podcast episode is up on our website and on Apple podcasts. For this episode, our podcast hosts Alex and Josh take a deep dive into civilian practice with the world-renowned rotor wing tactical detail from Los Angeles. Their interview with Deputy Steve Doucette of the Los Angeles County Sheriff's Dept will give you a better understanding of the original transfer of tactical skills from military to law enforcement setting after the Korean war. We then find out about the absorption of tactical medicine into special weapons and tactics (SWAT) teams and its recent drastic evolution, thanks to the hard-won lessons from the battlefield. Our interview ends with an outstanding overview of the difference between a tactical medic, tactical medicine, and TEMS. Please let us know what you think about our foray into civilian medicine.
|
|
Highlights From the JSOM Special Talk Series:
|
|
MSG (Ret.) Rick Hines I
Rick Hines has a long history in Special Operations and is currently an instructor Special Warfare Training Group. He teaches at the SF Medical Sergeant Recertification Course and focuses on anesthesia and surgical care in the austere environment. Rick discusses the benefits of recycling at the 18D course, historical basis, and current practice of surgical care and anesthesia for the far forward Special Operations medic.
Dr. Kyle Stigall
Dr. Stigall attended the United States Air Force Academy for undergrad and the University of Kentucky for medical school. He is currently a fourth-year general surgery resident at Brooke Army Medical Center. He completed a research year at the Naval Medical Research Unit in San Antonio in 2020 with a focus on trauma resuscitation and plans to apply to the Air Force Special Operations Surgical Team next year.
COMING SOON
COL (Ret) Russ Kotwal, MD, MPH
Dr. Kotwal spent nearly 30 years in the military and more than 15 years in operational assignments with the 25th Infantry Division, 75th Ranger Regiment, and U.S Army Special Operations Command. He deployed to combat 12 times with the Rangers -- nine times to Afghanistan and three to Iraq. He conducted hundreds of combat ground and air missions as the senior medical provider and is highly decorated, including five Bronze Star medals, two Joint Service Commendation medals for Valor, and two combat jump stars, among many others. Dr. Kotwal is also a master parachutist, master flight surgeon, and Ranger qualified. He is credited with numerous novel training and technology initiatives, professional publications, and national and international presentations related primarily to prehospital medicine on the battlefield. Dr. Kotwal is an adjunct professor for both the Texas A&M Health Science Center and the Uniformed Services University of the Health Sciences. He has been an advisor for the Defense Health Agency’s Joint Trauma System and Committee on Tactical Combat Casualty Care, as well as the National Academy of Sciences, Engineering and Medicine. He is a Fellow of the American Academy of Family Physicians, a Hero of Military Medicine award recipient, a Distinguished Member of the 75th Ranger Regiment, an inductee into the US Army Ranger Hall of Fame, and the current president of the Special Operations Medical Association.
|
|
Institutional Subscribers and Re-subscribers |
|
The JSOM is incredibly grateful to have the support of many institutions around the world. We would like to thank our recent institutional subscribers and re-subscribers for their support by acknowledging them in our eNewsletter and, when applicable, sharing their social media information.
We are getting very close to a new milestone! We currently have 58 active institutional subscriptions, reaching a potential 54,000+ readers!
We have several new libraries to introduce you to this month:
528th Sustainment Brigade at Ft. Bragg, North Carolina
The Defence Science and Technology Laboratory in Salisbury, Wiltshire, UK
The United States Military Academy at West Point, New York
Returning subscribers this month:
Canadian Forces Health Services Library, Ottawa, Ontario, Canada
Central Queensland University, Rockhampton, Queensland, Australia
China Book Import Center, China
Deutsche Zentralbibliothek fur Mediz (German Central Medical Library), Koeln, Germany
Latrobe University, Bundoora, Victoria, Australia
Naval Medical Center Portsmouth, Portsmouth, Virginia
Stimson Medical Library at Joint Base San Antonio (Ft. Sam Houston), Texas
Swedish Armed Forces - Center for Defence Medicin. Vastra Frolunda, Sweden
Visit https://jsom.us/Library for a full list of institutions that are currently subscribing to the JSOM. We are beginning a campaign to expand our institutional subscriptions. If you think your company would benefit from an institutional subscription, let us know! We'll be happy to talk to you and get the ball rolling. You don't have to be a university or medical center to subscribe - we have many EMS units, government agencies, and military medical units both in the United States and abroad.
Are you on the list? Great! Need to know how to access our resources? You can either contact your head librarian, or shoot an email to subscriptions@JSOMonline.org.
Institutions receive either a print copy of our journal, digital access, or both. Digital subscribers have unlimited access to our full compendium of articles, journals, and the ATP-P. If you are a student, researcher, doctor, or other medical professional at one of these institutions, please contact your librarian for login details. Additionally, the digital resources are typically available 2-3 weeks ahead of print publication.
If your institution is not on the list and you would like more information about our institutional access, contact our subscriptions manager, Dr. Scott Graverson.
|
|
MOODY AIR FORCE BASE, GA
DVIDS
Pararescue Airmen assigned to the 38th Rescue Squadron prepare to transport a wounded Airman during a simulated rescue mission at Moody Air Force Base, Georgia. The 347th Rescue Group performed its first scramble launch with the Jolly Green II to effectively execute Combat Search and Rescue missions.
Do You Have a Photo to Share?
Please send us your approved medical action images for future covers, our journal Photo Gallery, bi-weekly eNewsletters, and JSOM social media! All images must include captions in the emails in which they are sent. Images for print must be high resolution, at least 300 dpi. Images for the eNewsletter and social media must be at least 400px wide, 72 dpi.
|
|
Breakaway Media, LLC, is woman service-disabled veteran-owned small business (WOSB and SDVOSB) registered with the Central Contracting Office of the Department of Defense
DUNS #070397122 / Cage #6F0Z6
Primary SIC Code - 2721
Journal of Special Operations Medicine
This disclaimer pertains to any publication (aka, "publications") written or electronic set forth by Breakaway Media, LLC (BAM) and includes, but is not limited to: The Journal of Special Operations Medicine (JSOM), social media posts to Facebook, Twitter, Instagram, LinkedIn, the JSOM eNewsletter, the JSOM website, and any promotional materials published by BAM. The views and opinions expressed in these publications are those of the authors, contributors, and sponsors of the JSOM and BAM, and do not necessarily reflect those of the JSOM, the JSOM Editorial Board ("the editorial board"), BAM, or its affiliates. Neither the JSOM, the editorial board, BAM, nor its affiliates hold themselves responsible for statements or products discussed in any BAM publications. Unless so stated, material in BAM publications does not reflect endorsement, official attitude, or position of the JSOM, the editorial board, BAM, or affiliates. Products advertised have not been tested by the JSOM, the editorial board, BAM, or its affiliates, and, as such, cannot be held liable for any injury or death caused by the use or misuse of the products contained herein. Neither BAM, the editorial board, nor its affiliates, make any warranty, representation, endorsement, or guarantee of products advertised, discussed, tweeted, retweeted, or shared any publication, to include the assumption of any liability whatsoever arising out of the application, use, or misuse of any product. As a medical publication, we are committed to sharing new technology and products we feel may be of interest to our readers, and encourage all readers and users of said products to use with caution and under proper authorization and professional guidance.
Tagging the JSOM on Instagram / Disclaimer
We assume by tagging us on Instagram, you are authorized to disseminate the photograph you are sharing with us. If you are a photographer whose image has been used or shared without authorization, please notify us immediately so we may give you proper credit.
|
|
|
|
|
|
|
