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

Introduction: Timely vascular access is critical, as hemorrhage is the number one cause of death on the battlefield. Anecdotal evidence in the Military Health System identified an operationally relevant procedural skills gap in vascular access, and data exist in civilian literature showing high rates of iatrogenic injuries when lack of robust procedural opportunity exists. Multiple pre-deployment training courses are available for surgical providers, but no comprehensive pre-deployment vascular access training exists for non-surgical providers. Methods: This mixed-method review aimed to find relevant, operationally focused, vascular access training publications. A literature review was done to identify both relevant military clinical practice guidelines (CPGs) and full text articles. Reviewers also investigated available pre-deployment trainings for both surgeons and non-surgeons in which course administrators were contacted and details regarding the courses were described. Results: We identified seven full-text articles and four CPGs. Two existing surgical training programs and Army, Navy, and Air Force pre-deployment training standards for non-surgeons were evaluated. Conclusion: A cost-effective and accessible pre-deployment curriculum utilizing reviewed literature in a "learn, do, perfect" structure is suggested, building on pre-existing structures while incorporating remotely accessible didactics, hands-on practice with portable simulation models, and live-feedback training.

Ultrasound Localization of Resuscitative Endovascular Balloon Occlusion of the Aorta in a Human Cadaver Model

Lopachin T, Treager CD, Sulava EF, Stuart SM, Bohan ML, Boboc M, Fernandez P, Bianchi WD, McGowan AJ, Friedrich EE. 23(2). 73 - 77. (Journal Article)

ABSTRACT

Objective: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a method of gaining proximal control of noncompressible torso hemorrhage (NCTH). Catheter placement is traditionally confirmed with fluoroscopy, but few studies have evaluated whether ultrasound (US) can be used. Methods: Using a pressurized human cadaver model, a certified REBOA placer was shown one of four randomized cards that instructed them to place the REBOA either correctly or incorrectly in Zone 1 (the distal thoracic aorta extending from the celiac artery to the left subclavian artery) or Zone 3 (in the distal abdominal aorta, from the aortic bifurcation to the lowest renal artery). Once the REBOA was placed, 10 US-trained locators were asked to confirm balloon placement via US. The participants were given 3 minutes to determine whether the catheter had been correctly placed, repeating this 20 times on two cadavers. Results: Overall, US exhibited an average sensitivity of 83%, specificity of 76%, and accuracy of 80%. For Zone 1, US showed a sensitivity of 78% and specificity of 83%, and for Zone 3, a sensitivity of 88% and specificity of 76%. In addition, US exhibited a likelihood positive ratio (LR+) of 3.73 and a likelihood negative ratio (LR-) of 0.22 for either position, with similar numbers for Zone 1 (+4.57, -0.26) and Zone 3 (+3.16, -0.16). Conclusion: Ultrasound could prove to be a useful tool for confirming placement of a REBOA catheter, especially in austere environments.

ABSTRACT

Operation Gunpowder is a high-fidelity military medical field practicum conducted by the Uniformed Services University of Health Sciences, Bethesda, MD. During this multi-day combat simulation, Special Operations Medics and Corpsmen teach military medical students how to treat patients in an austere, resource-limited environment. To investigate the effectiveness of this teaching model, our research team used a qualitative phenomenological design to explore medical students' experiences being taught by Special Operations Medics and Corpsmen during Operation Gunpowder. We found two themes regarding the medical students' personal and professional development: an increased understanding of medics' skills and capabilities and the realization of their future roles as educators and leaders. Our study suggests that the use of Special Operations Corpsmen and Medics in medical student training is a valuable model for both military and civilian medical education and training.

Keywords: medical student; educators; professional development; training; simulation; qualitative study; military medical officer; teaching model; medical student experiences; medic capabilities; corpsman capabilities



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. THE SUMMER 23 EPISODE IS HERE!

Current Episode

The Summer 2023 episode of the JSOM podcast is our most recent recording and is now available on our website and wherever you listen to podcasts.

Our Guest Medic Editor is SO1 Brentyn Jone, a Navy SEAL/SOCM, currently, working in the Tactical Medical Training Department. He will be reviewing Prevalence of Trauma-Induced Hypocalcemia in the Prehospital Setting.

JSOM Guest Author Interview

Patrick Thompson is affiliated with the Trauma, Hemostasis & Oxygenation Research Network, Bergen, Norway. He will be reviewing Risk of Harm in Needle Decompression for Tension Pneumothorax.



CPT Josh Randles will review The Impact of Special Operations Medics and Corpsmen on Military Medical Student Training: A Qualitative Study.

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If your institution is not on the list and you want more information about our institutional access, contact our subscriptions manager, Dr. Scott Graverson.

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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For these reasons, many of the world’s top medical technology companies and medical device distributors make the JSOM a cornerstone of their advertising programs. And with a strong multichannel and social media presence, the JSOM offers the most dynamic print and digital media options at cost-effective prices. For medical marketers worldwide looking to reach our niche audience, the JSOM is the gold standard. For more information, please see our attached media kit.

FORT HUACHUCA, AZ,

08.28.2023

Photo by Sgt. Bryon Mutherspaw 

U.S. Army Training and Doctrine Command 

DVIDS

Spc. Raymond Gonzalez with the Combined Arms Command squad provides medical care during the TRADOC Best Squad Competition on Ft. Huachuca Arizona, August 28, 2023. The squad is using tactics learned from their training in Tactical Combat Casualty Care (TCCC) to provide medical support to wounded service members in the E3B event that encompasses tasks from all expert warrior tasks.

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