15 February 2021 - Issue 191 |
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Greetings JSOM Newsletter Subscribers,
We have received several requests on social media regarding the availability of the new PJ Med Handbook. Rest assured, we are actively working on the book and should have it available to purchase very soon. As soon as it's available we will make an announcement on all of our social media networks @jsomonline. Thank you for your patience.
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Currently in production and available soon:
The 2020 updated and new versions to the following handbooks have been slightly delayed due to the authors' response to COVID19:
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Pararescue Medical Operations (PJ MED) Handbook 8th Ed. The 8th Ed will be available as a spiral-bound handbook. The updates are in. We are working to bring this title to you very soon.
- NEW 2020 Advanced Ranger First Responder Handbook
New handbooks will feature waterproof / tearproof paper.
Respectfully,
Michelle DuGuay Landers, MBA, BSN, RN
Breakaway Media, LLC
Publisher
Journal of Special Operations Medicine and Advanced Tactical Paramedic Protocols Handbook
Lt Col, USAFR/NC (Ret)
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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, including the sidebar items which can sometimes disappear depending on your email settings, we suggest opening the newsletter in a browser. |
ABSTRACT
Background: The COVID-19 pandemic has been a struggle for medical systems throughout the world. In austere locations in which testing, resupply, and evacuation have been limited or impossible, unique challenges exist. This case series demonstrates the importance of population isolation in preventing disease from overwhelming medical assets. Methods: This is a case series describing the outbreak of COVID-19 in an isolated population in Africa. The population consists of a main population with a Role 2 capability, with several supported satellite populations with a Role 1 capability. Outbreaks in five satellite population centers occurred over the course of the COVID-19 pandemic from its start on approximately 1 March 2020 until 28 April 2020, when a more robust medical asset became available at the central evacuation hub within the main population.
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ABSTRACT
The increase in global violence in recent years has changed the paradigm of emergency health care, requiring early medical response to victims in hostile settings where the usual work cannot be done safely. In Spain, this specific role is provided by the Tactical Environment Medical Support Teams (in Spanish, EMAETs). The Victoria I Consensus document defines and recognizes this role, whose main lines of work are the emergency medical response to the tactical team and to the victims in areas under indirect threat, provided that the tactical operators can guarantee their safety. To reinforce the suitability of this approach, we submitted the possible outcomes of this response model to a panel of national experts to assess this proposal in the different areas of Spain.
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February 2020 JSOM Feature Article |
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Case Series on 2g Tranexamic Acid Flush From the 75th Ranger Regiment Casualty Database
Androski CP, Bianchi W, Robinson DL, Zarow GJ, Moore CH, Deaton TG, Drew B, Gonzalez S, Knight RM. 20(4). 85 - 91. (Journal Article)
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ABSTRACT
Early tranexamic acid (TXA) administration for resuscitation of critically injured warfighters provides a mortality benefit. The 2019 Tactical Combat Casualty Care (TCCC) recommendations of a 1g drip over 10 minutes, followed by 1g drip over 8 hours, is intended to limit potential TXA side effects, including hypotension, seizures, and anaphylaxis. However, this slow and cumbersome TXA infusion protocol is difficult to execute in the tactical care environment. Additionally, the side effect cautions derive from studies of elderly or cardiothoracic surgery patients, not young healthy warfighters. Therefore, the 75th Ranger Regiment developed and implemented a 2g intravenous or intraosseous (IV/IO) TXA flush protocol. We report on the first six cases of this protocol in the history of the Regiment. After-action reports (AARs) revealed no incidences of post-TXA hypotension, seizures, or anaphylaxis. Combined, the results of this case series are encouraging and provide a foundation for larger studies to fully determine the safety of the novel 2g IV/IO TXA flush protocol toward preserving the lives of traumatically injured warfighters.
Keywords: tranexamic acid; TXA; TXA flush; TXA intraosseous; TXA protocol; Tactical Combat Casualty Care; TCCC
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The Journal of Special Operations Medicine Podcast |
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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. |
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Winter 2020
In this episode of the JSOM Podcast, Alex and Josh discuss the articles "Life and Limb In-Flight Surgical Intervention: Fifteen Years of Experience by Joint Medical Augmentation Unit Surgical Resuscitation Teams" and "Austere Surgical Team Management of an Unusual Tropical Disease: A Case Study in East Africa". Guest reviewer medic SGT Greg Spencer reviews "An Analysis and Comparison of Prehospital Trauma Care Provided by Medical Officers and Medics on the Battlefield". Finally, Alex and Josh review "Case Series on 2g Tranexamic Acid Flush From the 75th Ranger Regiment Casualty Database" with author MSG Simon Gonzalez.
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Highlights From the 20th Anniversary JSOM Interview Series: |
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Dr. Frank Butler discusses the evolution of TCCC and the COTCCC
THE Dr Frank Butler helps us review the state of combat care 20 years ago when the JSOM and TCCC both started. We learn about how he came to have an interest in improving the quality and delivery of combat care and the many different evolving roles he has had in combat casualty care. He also teaches us about how we arrived at recent changes in TCCC and future directions in care. Please join us for our great discussion with the plank holder of TCCC. Listen here.
MAJ Andrew Fisher, MS-4, PA-C, LP for a great review of pre-hospital whole blood in the military; where we are now and how we got there. He reminds us that, "everything old is new again." The first whole blood transfusion research was done by the military in 1940 (Armed Forces Blood Program) and was used extensively in WWII and the Korean War. But times change and lessons learned are lost to the sands of time as one generation of peacetime military surgeons hands off the reigns to the next. Listen here.
World-renowned tourniquet expert Dr. John Kragh. In this interview, Dr. Kragh takes us through his history in becoming a tourniquet expert as well as detailing the evolution of tourniquet use in combat situations as a battalion surgeon in Southwest Asia. Tourniquet use has evolved considerably even during the 20-years since the JSOM has been in publication. Be sure to read Dr. Kragh's contributions to this quarter's journal as a companion to this interview. Listen here.
CMSgt Michael Rubio, currently the commandant of the 351st Special Warfare Training Squadron of the PJ schoolhouse at Kirkland AFB. It's a great opportunity to hear from the best about how PJ training has changed during the past 20 years, and get a glimpse of where it is heading in the future. You can listen here. Look for another episode later this month.
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Institutional Subscribers and Re-subscribers |
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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. We currently have 56 active institutional subscriptions, reaching a potential 59,000+ readers!
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.
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2021 Army Best Medic Competition Obstacle Course Validation
U.S. Army Medical Command
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Journal of Special Operations Medicine
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