Respectfully,

Michelle DuGuay Landers, MBA, BSN, RN

Breakaway Media, LLC

Publisher

Journal of Special Operations Medicine (JSOM)

Lt Col, USAF/NC (Ret)

publisher@jsomonline.org

www.JSOMonline.org

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ABSTRACT

Background: Tube thoracostomy is the most effective treatment for pneumothorax, and on the battlefield, is lifesaving. In combat, far-forward adoption of open thoracostomy has not been successful. Therefore, the ability to safely and reliably perform chest tube insertion in the far-forward combat theatre would be of significant value. The Reactor is a hand-held device for tube thoracostomy that has been validated for tension pneumothorax compared to needle decompression. Here we investigate whether the Reactor has potential for simple pneumothorax compared to open thoracostomy. Treatment of pneumothorax before tension physiology ensues is critical. Methods: Simple pneumothoraces were created in 5 in-vivo swine models and confirmed with x-ray. Interventions were randomized to open technique (OT, n = 25) and Reactor (RT, n = 25). Post-procedure radiography was used to confirm tube placement and pneumothorax resolution. Video Assisted Thoracoscopic Surgery (VATS) was used to evaluate for iatrogenic injuries. 50 chest tubes were placed, with 25 per group. Results: There were no statistical differences between the groups for insertion time, pneumothorax resolution, or estimated blood loss (p = .91 and .83). Injury rates between groups varied, with 28% (n = 7) in the Reactor group and 8% (n = 2) the control group (p = .06). The most common injury was violation of visceral pleura (10%, n = 5, both groups) and violation of the mediastinum (8%, n = 4, both groups). Conclusion: The Reactor device was equal compared to open thoracostomy for insertion time, pneumothorax resolution, and injury rates. The device required smaller incisions compared to tube thoracostomy and may be useful adjunct in simple pneumothorax management.

ABSTRACT



Background: Surgical cricothyrotomy (SC) is a difficult procedure with high failure rates in the battlefield environment. The difficulty of this procedure is compounded in a low-light tactical environment in which white light cannot be used. This study compared the use of red-green (RG) light and red (R) light in the performance of SC in a low-light environment. Materials and Methods: Tactical Combat Casualty Care-certified navy corpsmen (n = 33) were provided 15 minutes of standardized instruction followed by hands-on practice with the Tactical CricKit and the H&H bougie-assisted Emergency Cricothyrotomy Kit. Participants acclimated to a dark environment for 30 minutes before performing SC on a mannequin with both devices using both R and RG light in a randomized order. Application time, success, participant preference, and participant confidence were analyzed. Results: There were similarly high levels of successful placement (>87.5%) in all four cohorts. Light choice did not appear to affect placement time with either of the two kits. On Likert-scale surveys, participants reported that RG decreased difficulty (p < .0001) and increased confidence (p < .0001) in performing the procedure. Conclusion: RG light increased confidence and decreased perceived difficulty when performing SC, though no differences in placement time or success were observed.



ABSTRACT

Background: The purpose of this preliminary investigation was to determine the impact of a mental and visual skills training (MVST) program on a high-value target identification and marksmanship (HVTM) task among Special Operations Forces (SOF) Soldiers. Methods: Deidentified archival data for 52 male SOF Operators (age: 31.06 ± 4.10 years) were assessed to determine if differences in performance existed between MVST program users (n = 15) and nonusers (n = 37) on a HVTM task performed immediately after a Special Forces Advanced Urban Combat (SFAUC) stress shoot. Independent-samples t-tests were utilized to determine if significant mean score differences existed between groups on specific shooting elements within the HVTM task. Effect size calculations were also performed to assess the magnitude of differences between groups in each measure of performance. Results: Statistically significant differences in performance were not discovered between MVST users and nonusers on overall score (Score) or any individual elements of the HVTM task. However, small to medium effect sizes (d = 0.305-0.493) were observed between groups in Score, Positive Identification Accuracy, Shot Accuracy, and Kill Shot Score. Conclusion: While inconclusive, these findings suggest the use of a MVST program administered by a trained cognitive performance specialist may have the potential to positively influence HVTM performance. More research using larger sample sizes is required to confirm this supposition.

Keywords: shooting; sport psychology; Special Operations Forces; cognition; military

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.

Current Episode

The new Fall 2022 episode of the JSOM podcast is now available on our website and wherever you listen to podcasts.

This podcast episode is focused on research and contributions made by women in service to the military. We start with a review of "Women in US Military History" by Gretchen Garceau-Kragh.

Guest medic HM1(FMF/EXW) Eric Dodson reviews "Active Warfighter Resilience: A Descriptive Analysis" by Nikki Rarczak-Scarborov, et. al.

Finally, we give an objective review of "Operation Blood Rain Phase 2: Evaluating the Effect of Airdrop on Fresh and Stored Whole Blood." The review is complemented with an interview with lead author Dr. (LtCol.) Roselyn Fuentes.

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For over 20 years, the Journal of Special Operations Medicine (JSOM) has brought important, lifesaving information to the Special Operations Forces (SOF) community. And over the years, as our audience and readership has expanded into over 80 countries, physicians, military and tactical medics, and other medical professionals working in unconventional environments rely on the JSOM for breakthrough research at the intersection of operational medicine and tactical casualty care. Our peer-reviewed research and interactive clinical content make the JSOM a must-read for:

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GERMANY

01.10.2023

Photo by Kirk Frady 

Medical Readiness Command, Europe

USAF Major Bryan Dukes (left), commander of the 86th Munitions Squadron at Ramstein Air Base, Germany presents Sgt. 1st Class Michelle Paris (right), a U.S. Army combat medic assigned to U.S. Army Medical Readiness Command, Europe, with the Department of the Air Force Air and Space Commendation Medal on Jan 10.

Paris received the medal for her heroic and selfless actions following a horrific car crash that occurred on May 13, 2022, near her home just outside Kaiserslautern, Germany. Paris provided immediate lifesaving first aid to several U.S. airmen who were involved in the crash. All of the airmen have since recovered from their injuries and praise Paris for coming to their aid.

Read more at: https://www.dvidshub.net/news/421456/army-medic-puts-life-saving-skills-use-following-car-crash

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