01 March 2021 - Issue 192 |
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Greetings JSOM Newsletter Subscribers,
We are looking for medics or corpsman interested in prehospital critical care. We are seeking interested authors to volunteer to help publish a JSOM prehospital-focused Critical Care Supplement to come out this fall. If you are interested or have questions, please contact Andrew D. Fisher, MD, PA-C, LP at adfisher20@gmail.com.
The JSOM podcast is growing and we want your feedback. It's important to us. Please find us on Apple Podcasts by searching Journal of Special Operations Medicine, rate and review! |
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.
New on the JSOM Online Store
Celebrate the 20th Anniversary of the JSOM with this special collectors set of last years’ editions for $128 (20% off cover price). Order today at http://jsom.us/2ZWeA0M.
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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ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has demonstrated that new and devastating respiratory pathogens can emerge without warning. It is therefore imperative that Special Operations medical personnel be aware of the presence of emerging pathogens within their area of operation. Human bocavirus (HBoV) is a newly described member of a family of viruses known as the Parvovirinae that are often associated with acute respiratory illness. The presence of HBoV in the country of Georgia has not been previously reported. Nasal and throat swabs were collected from 95 symptomatic members of the Georgian military. HBoV was detected in 11 of them (12%). To our knowledge, this is the first report of HBoV infection in the country of Georgia. This finding may have a significant impact on members of the Special Operations community who train in Georgia as more data concerning the transmission, pathogenesis, and treatment of HBoV are accumulated and the role of HBoV in human disease is more clearly defined.
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ABSTRACT
Frontline military personnel are at high risk of acute acoustic trauma (AAT) caused by impulse noise, such as weapon firing or blast. This can result in anatomic disruption of the tympanic membrane and damage to the middle and inner ear, leading to conductive, sensorineural, or mixed hearing loss that may be temporary or permanent. AAT reduces warfighters' operational effectiveness and has implications for future quality of life. Hearing protection devices can mitigate AAT but are not completely protective. Novel therapeutic options now exist; therefore, identification of AAT as soon as possible from point of injury is vital to ensure optimal treatment and fulfillment of the duty of care. Early recognition and treatment of frontline AAT can maintain the deployed team's capabilities, avoid unnecessary case evacuation (CASEVAC), and raise awareness of military occupational AAT. This will help prioritize hearing preservation, maintain the fighting force, and ultimately retain personnel in service. The UK Defence hearWELL research collaboration has developed a frontline protocol for the assessment of AAT utilizing future-facing technology developed by the US Department of Defense: the Downrange Acoustic Toolbox (DAT). The DAT has been operationally deployed since 2019 and has successfully identified AAT requiring treatment, thereby improving casualties' hearing and reducing unnecessary repatriation.
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March 2021 JSOM Feature Article |
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An Analysis and Comparison of Prehospital Trauma Care Provided by Medical Officers and Medics on the Battlefield
Fisher AD, Naylor JF, April MD, Thompson D, Kotwal RS, Schauer SG. 20(4). 53 - 59. (Journal Article)
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ABSTRACT
Background: Role 1 care represents all aspects of prehospital care on the battlefield. Recent conflicts and military operations conducted on behalf of the Global War on Terrorism have resulted in medical officers (MOs) being used nondoctrinally on combat missions. We are seeking to describe Role 1 trauma care provided by MOs and compare this care to that provided by medics. Methods: This is a secondary analysis of previously described data from the Prehospital Trauma Registry and the Department of Defense Trauma Registry from April 2003 through May 2019. Encounters were categorized by type of care provider (MO or medic). If both were documented, they were categorized as MO; those without either were excluded. Descriptive statistics were used. Results: A total of 826 casualty encounters met inclusion criteria. There were 418 encounters categorized as MO (57 with MO, 361 with MO and medic), and 408 encounters categorized as medic only. The composite injury severity score (median, interquartile range) was higher for casualties treated by the medic cohort (9, 3.5-17) than for the MO cohort (5, 2-9.5; P = .006). There was no difference in survival to discharge between the MO and medic groups (98.6% vs. 95.6%; P = .226). More life-saving interventions were performed by MOs compared to medics. MOs demonstrated a higher rate of vital sign documentation than medics. Conclusion: More than half of casualty encounters in this study listed an MO in the chain of care. The difference in proportion of interventions highlights differences in provider skills, training and equipment, or that interventions were dictated by differences in mechanisms of injury.
Keywords: prehospital; medic; healthcare provider; military medicine; war-related injuries
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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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Feb-March 2021
The new JSOM podcast episode is up on our website and on Apple podcasts. For this episode, our podcast hosts Alex and Josh take a deep dive into civilian practice with the world-renowned rotor wing tactical detail from Los Angeles. Their interview with Deputy Steve Doucette of the Los Angeles County Sheriff's Dept will give you a better understanding of the original transfer of tactical skills from military to law enforcement setting after the Korean war. We then find out about the absorption of tactical medicine into special weapons and tactics (SWAT) teams and its recent drastic evolution, thanks to the hard-won lessons from the battlefield. Our interview ends with an outstanding overview of the difference between a tactical medic, tactical medicine, and TEMS. Please let us know what you think about our foray into civilian medicine.
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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 53 active institutional subscriptions, reaching a potential 59,000+ readers!
US Army John F. Kennedy Special Warfare Center and School, Ft. Bragg, NC
Medical Support Unit, Hereford Garrison, Hereford, UK
USAF Pararescue, Langley AFB, Va
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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FORT GORDON, GA, UNITED STATES
Sgt. Maj. John Wright of Regional Health Command- Pacific, applies a pressure dressing to a simulated casualty during the 2021 CSM Jack L Clark Jr. U.S. Army Best Medic Competition (ABMC) lane validation at Fort Gordon, Ga.
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Journal of Special Operations Medicine
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