A Word From Our Publisher |
|
Greetings JSOM Newsletter Subscribers,
We hope you're enjoying the Summer edition.
The Ranger Medic Handbook is currently out of stock. We are in the process of printing more copies and the JSOM Online Store and our Amazon store will be restocked over the next couple of weeks. Thank you for your patience.
The JSOM podcast is growing in popularity! We want to thank everyone who is listening. Please remember to subscribe, rate, and review wherever you listen to podcasts.
Mark your calendar for Defense Strategies Institute’s 3rd Annual Operational Medicine Symposium occurring this September 28-29 in San Antonio, TX! Join 250+ attendees from across the services, medical units, industry partners and practitioners to discuss current DoD priorities to advance the practice of medicine in expeditionary environments and streamline medical care within DHA. Look for their ad below and follow the link to their website for more information about this event.
|
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
01 August 2021 - Newsletter Issue 202
|
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, we suggest opening the newsletter in a browser. |
|
Journal of Special Operations Medicine Featured Abstracts |
|
ABSTRACT
Background: After-action reviews (AARs) in the Prehospital Trauma Registry (PHTR) enable performance improvements and provide commanders feedback on care delivered at Role 1. No published data exist exploring overall trends of end-user performance-improvement feedback. Methods: We performed an expert panel review of AARs within the PHTR in Afghanistan from January 2013 to September 2014. When possible, we categorized our findings and selected relevant medical provider comments. Results: Of 737 registered patient encounters found, 592 (80%) had AAR documentation. Most AAR patients were male (98%, n = 578), injured by explosion (48%, n = 283), and categorized for urgent evacuation (64%, n = 377). Nearly two thirds of AARs stated areas needing improvement (64%, n = 376), while the remainder left the improvement section blank (23%, n = 139) or specified no improvements (13%, n = 76). The most frequently cited areas for improvement were medical knowledge (23%, n = 136), evacuation coordination (19%, n = 115), and first responder training (16%, n = 95). Conclusions: Our expert panel reviewed AARs within the PHTR and found substantial numbers of AARs without improvements recommended, which limits quality improvement capabilities. Our analysis supports previous calls for better documentation of medical care in the prehospital combat setting.
|
|
ABSTRACT
Background: While the US military has relied on the "Golden Hour" for casualty evacuation in Iraq and Afghanistan during most of the last two decades, Special Operations Forces (SOF) personnel have found themselves operating further outside of this established medical infrastructure. This has required prolonged casualty care beyond doctrinal timelines. Telemedicine is increasingly used by medical personnel to bridge this gap, augmenting the local staff with the expertise of a distant consultant. This pilot study was launched to establish a baseline of current SOF telemedical capabilities. Methods: This is a cross-sectional study of a 292 Department of Defense (DoD) SOF medical personnel via an online questionnaire during the period of October 2018-May 2019. Results: Approximately 16.1% of the 292 respondents stated they received telemedicine equipment, 51.1% of respondents who received telemedicine equipment reported also receiving training on their equipment. Overall, 40.6% of respondents were "actively looking to add telemedicine to their practice," with prolonged field care as the primary intended use.
|
|
August 2021 Featured Article |
|
23.4% Hypertonic Saline: A Tactical Option for the Management of Severe Traumatic Brain Injury With Impending or Ongoing Herniation
DeSoucy ES, Cacic K, Staak BP, Petersen CD, van Wyck D, Rajajee V, Dorsch J, Rush SC. 21(2). 25 - 28.
(Journal Article)
|
|
ABSTRACT
There are limited options available to the combat medic for management of traumatic brain injury (TBI) with impending or ongoing herniation. Current pararescue and Tactical Combat Casualty Care (TCCC) guidelines prescribe a bolus of 3% or 5% hypertonic saline. However, this fluid bears a tactical burden of weight (~570g) and pack volume (~500cm3). Thus, 23.4% hypertonic saline is an attractive option, because it has a lighter weight (80g) and pack volume (55cm3), and it provides a similar osmotic load per dose. Current literature supports the use of 23.4% hypertonic saline in the management of acute TBI, and evidence indicates that it is safe to administer via peripheral and intraosseous cannulas. Current combat medic TBI treatment algorithms should be updated to include the use of 23.4% hypertonic saline as an alternative to 3% and 5% solutions, given its effectiveness and tactical advantages.
Keywords: traumatic brain injury; TBI; military medicine; hypertonic saline; Tactical Combat Casualty Care; TCCC
|
|
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. |
|
SUMMER 2021
The new JSOM podcast episode is up on our website. Join our podcast hosts, Alex and Josh, as they review 3 articles from the Summer 21 edition:
Infectious Myositis in the Austere Setting by Simon Sarkisian
Autopy-Determined Atherosclerosis in SOF Forces by Russ Kotwal
23.4% Hypertonic Saline by Eric DeSousy
|
|
Highlights from the JSOM Special Talk Series |
|
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.
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.
|
|
Please Support Our Sponsors |
|
Institutional 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.
This edition, we welcome back University College Cork! UCC is instrumental in developing SOF medical training for NATO forces, and we are happy to have them aboard.
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.
|
|
Support the Journal of Special Operations Medicine |
|
NT, AUSTRALIA
DVIDS
U.S. Army and Australian Defence Force military personnel perform High Altitude Low Opening jumps during Exercise Talisman Sabre 21, over Northern Territory, Australia, July 16, 2021. TS21 is a month-long multi-domain exercise consisting of training events that reinforce the strong U.S./Australian alliance and demonstrate the U.S. Military’s unwavering commitment to a free and open Indo-Pacific.
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.
|
|
|
|
|
|
|
