ABSTRACT

The types of injuries seen in combat action on a naval surface ship may be similar in many respects to the injuries seen in ground combat, and the principles of care for those injuries remain in large part the same. However, some contradistinctions in the care of combat casualties on a ship at sea must be highlighted, since this care may entail a number of unique challenges and different wounding patterns. This paper presents a scenario in which a guided missile destroyer is struck by a missile fired from an unmanned aerial vehicle operated by an undetermined hostile entity. Despite the presence of casualties who require care, the primary focus of a naval vessel that has just been damaged by hostile action is to prevent the ship from sinking and to conserve the fighting force on board the ship to the greatest extent possible. The casualties in this scenario include sailors injured by both blast and burns, as well as a casualty with a non-fatal drowning episode. Several of the casualties have also suffered the effects of a nearby underwater explosion while immersed. Challenges in the care of these casualties include delays in evacuation, the logistics of obtaining whole blood for transfusion while at sea, and transporting the casualties to the next higher level of care aboard a Casualty Receiving and Treatment Ship.

ABSTRACT



Nutrition is an essential component of Human Performance Optimization in Special Operations Forces (SOF) to enhance physical and mental performance, unit readiness, and mission success. Body composition is frequently used to monitor individual nutrition progress; however, using body fat percentage is limited both by the accuracy of the assessment method and its association with SOF relevant performance outcomes. Lower body fat and/or body mass index have generally, but not universally, been correlated with higher levels of physical performance, yet they poorly predict performance in military relevant tasks. As a complement to body fat, many performance dietitians in the SOF Human Performance Programs utilize the International Society for Advanced Kinanthropometry (ISAK) profile to assess body composition, proportionality, ratio of muscle to bone, and somatotype in combat Operators. Kinanthropometry is the study of human size, shape, proportion, composition, maturation, and gross function, and it is a helpful tool for monitoring nutrition and training progress in athletes and active individuals. The ISAK profile has been well established as an international method for talent identification, distinguishing characteristics between athletes across and within elite sports, and identifying predictors of sport performance that can be applied in the military setting. While some SOF dietitians are utilizing the ISAK profile, the challenge lies in translating sport data to military relevant outcomes. We present a series of four case studies demonstrating the utility of this method as a portable comprehensive assessment for cross-sectional and longitudinal body composition tracking in a military setting.

ABSTRACT

Pain is one of the most common complaints of battlefield casualties, and unique considerations apply in the tactical environment when managing the pain of wounded service members. The resource constraints commonly experienced in an operational setting, plus the likelihood of prolonged casualty care by medics or corpsmen on future battlefields, necessitates a review of analgesia and sedation in the prehospital setting. Four clinical scenarios highlight the spectrum of analgesia and sedation that may be necessary in this prehospital and/or austere environment.

Keywords: traumatic brain injury; pathophysiology; prehospital management; critical care

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.

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In this episode of the JSOM Podcast, Alex and Josh review:

Feasibility of Obtaining Intraosseous and Intravenous Access Using Night Vision Goggle Focusing Adaptors by Alexander Iteen, MD, and colleagues (p. 56)

The Efficacy of Vancomycin Powder in Mitigating Infection of Open Penetrating Trauma Wounds on the Battlefield: An Evidence-Based Review by Brett R. TerBeek, 18B, 18F, MPAS, and colleagues (p. 76)

Development of a Swine Polytrauma Model in the Absence of Fluid Resuscitation by Hassam Abdou, MD, and colleagues (p. 77, Winter 2021 Edition)

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WESTHAMPTON BEACH , NY

Associated Story by Staff Sgt. Kevin Donaldson 

New York National Guard 

DVIDS 

WESTHAMPTON BEACH, New York– On April 24, 2017, seven Airmen from the New York Air National Guard’s 106th Rescue Wing jumped into the night sky over the Atlantic, 1,700 miles from Long Island.

Their mission was to provide emergency care for two sailors on the Slovenian bulk carrier Tamar who had been badly burned in an explosion.

On June 4, 2022, the two combat rescue officers and five pararescuemen from the wing’s 103rd Rescue Squadron, who jumped that night, were awarded the Air Force Commendation Medal for heroism for their actions during a ceremony at F.S. Gabreski Air National Guard Base in Westhampton Beach...

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