ABSTRACT

Intra-articular metallic foreign bodies can cause both shortand long-term outcome complications, from range of motion limitations to plumbism. Locating retained metallic foreign bodies can be challenging on physical exam alone due to unexpected trajectory of the object, though ultrasound can significantly aid in identification, especially in resource-limited environments. During a deployment to AFRICOM, a Special Operations Forces Operator had an intra-articular round retained during marksmanship, requiring consultation with both medical directors and specialists and eventual removal of the foreign body; strong advocation for removal allowed for both preserved range of motion as well as return to duty in the deployed location.

Keywords: SOFtoSOM; shrapnel; ultrasound; resource-limited environment; foreign body

Unconventional Resilience: A Holistic, Humanistic Infrastructure of Integrated Performance

Jeschke EA, Patton J, Wyma-Bradley J, Baker JB, Dorsch J, Huffman SL 25(2). 84

Abstract:

Building off our findings discussed at the strategic, operational, and tactical levels of unconventional resilience, we conclude this series by developing a holistic, humanistic infrastructure of integrated performance in Special Operation Forces (SOF) medicine. This infrastructure will explicitly acknowledge the human motivational context of practical performance and provide credibility to the medical-martial profession by acknowledging cultural values, norms, skills, and standards entailed in an emerging professional code of the Warrior Medic.

Keywords: unconventional resilience; SOF medic; integrated

ABSTRACT

Background: Ultrasonography has seen increasing integration into the clinical practice of Special Operations Combat Medics (SOCMs). However, there is limited literature available that describes SOCM use of ultrasonography. This narrative review aims to provide an overview of how SOCMs use ultrasound in clinical practice and explore proposed future applications. Methods: A PubMed search was conducted for articles discussing ultrasonography in the context of Special Operations medicine. This search initially included a broad PubMed search followed by a targeted search limited to the Journal of Special Operations Medicine. Inclusion criteria for this targeted search encompassed articles describing ultrasound use or advocating for ultrasound use in SOCM clinical practice. Results: The search was conducted in October 2023 and yielded 120 publications, of which 20 met inclusion criteria and are summarized in this review. Among these articles, 50% focused on cardiovascular applications, 35% on musculoskeletal applications, 20% on abdominal assessments (E-FAST exam), 15% on respiratory applications, and 10% on neurologic applications. Only 40% of the articles described operational use, while 60% advocated for use. Finally, 56.5% of the articles described diagnostic applications, while 43.5% pertained to procedural applications. Conclusion: SOCM use of ultrasonography likely differs from in-hospital provider use of ultrasonography. To improve ultrasound education for SOCMs, educators should consider customization of the curriculum to align with the unique mission requirements of individual units and an increased emphasis on procedure-based training.

Keywords: ultrasound; military medicine; Special Operations Medicine; FoCUS; POCUS

The JSOM podcast digs deeper into the articles and subjects that matter to our readers. Please help us welcome our new podcast hosts, 2d Lt Jessica Rodriguez, USAF, 2LT Matthew Farinella, USA, and ENS Sydney Duke USNR, to our team.

Current Episode is Summer 2025

Our JSOM podcast team will be reviewing the following articles for our newest podcast: 

Jessica will review “Ultrasound Use by Special Operations Combat Medics: A Narrative Review Limited to the JSOM” by Dr. Jonathan Curley. (https://jsomonline.org/product/ultrasound-use-by-special-operations-combat-medics-a-narrative-review-limited-to-the-jsom/) The heart of this article provides an overview of how Special Operations Combat Medics (SOCMs) use ultrasound in clinical practice and proposes future applications. 

Sydney is reviewing “Injuries in Specialist Police Officers: A Scoping Review” by Dr. Kate Lyons et al (https://jsomonline.org/product/injuries-in-specialist-police-officers-a-scoping-review/). This article identifies, collects, and synthesizes evidence on injuries sustained by specialist police and compares those injuries with those of other law enforcement officers and wider Special Forces populations. 

Matthew is reviewing “Proof of Concept: Is Small-scale Production of Diethyl Ether for Anesthetic Use Possible?” by Dr. Sandeep Dhanjal et al. (https://jsomonline.org/product/proof-of-concept-is-small-scale-production-of-diethyl-ether-for-anesthetic-use-possible/) In this manuscript, the authors explore the use of diether ether as a stopgap solution to anesthetic supply limitations in humanitarian crises or armed conflicts.

The Journal of Special Operations Medicine is proud to have the support of many great sponsors and media partners. Our sponsors are leaders in the field of military medical technology. Please help support these companies by following the links below to learn more about their missions and the products they offer.

The Mission

SOFtoSOM is dedicated to empowering U.S. Special Operations Forces (SOF) veterans in their journey to becoming physicians. Through mentorship, financial support and a strong professional network, we guide and prepare SOF personnel for success in the medical field. Our mission is rooted in a commitment to service, with the aim of making a lasting impact on healthcare and the communities we serve.

The Vision

To harness the unique SOF culture of excellence to create a cohort of SOF service members physicians that contribute their experience, talents, and traits in service to one another and the field of military and civilian medicine as it takes on future healthcare challenges.

Learn More

Visit the organization's website at https://www.softosom.org/

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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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