Respectfully,

Michelle DuGuay Landers, MBA, BSN, RN

Breakaway Media, LLC

Publisher

Journal of Special Operations Medicine (JSOM)

Lt Col, USAF/NC (Ret)

[email protected]

www.JSOMonline.org

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ABSTRACT

Background: Airway obstruction is the second leading cause of preventable death on the battlefield. Most airway obstruction occurs secondary to traumatic disruptions of the airway anatomical structures. Facial trauma is frequently cited as rationale for maintaining cricothyrotomy in the medics' skill set over the supraglottic airways more commonly used in the civilian setting. Methods: We used a series of emergency department procedure codes to identify patients within the Department of Defense Trauma Registry (DoDTR) from January 2007 to August 2016. This is a sub-group analysis of casualties with documented serious facial trauma based on an abbreviated injury scale of 3 or greater for the facial body region. Results: Our predefined search codes captured 28,222 DoDTR casualties, of which we identified 136 (0.5%) casualties with serious facial trauma, of which 19 of the 136 had documentation of an airway intervention (13.9%). No casualties with serious facial trauma underwent nasopharyngeal airway (NPA) placement, 0.04% underwent cricothyrotomy (n = 10), 0.03% underwent intubation (n = 9), and a single subject underwent supraglottic airway (SGA) placement (<0.01%). We only identified four casualties (0.01% of total dataset) with an isolated injury to the face. Conclusions: Serious injury to the face rarely occurred among trauma casualties within the DoDTR. In this subgroup analysis of casualties with serious facial trauma, the incidence of airway interventions to include cricothyrotomy was exceedingly low. However, within this small subset the mortality rate is high and thus better methods for airway management need to be developed.

ABSTRACT

The role of US Special Operations Forces (SOF) globally has expanded greatly in the past 20 years, leaving SOF serving multiple deployments with little time or ability to recover in between. Currently, assessments of the health and human performance capabilities of these individuals are episodic, precluding an accurate assessment of physical and mental load over time, and leading to high rates of acute and chronic injury to the mind and body. The collection of personal health-related continuous datasets has recently been made feasible with the advancement of digital technologies. These comprehensive data allow for improved assessment, and consequently better results, partly due to the warfighters' real-time access to their data. Such information allows Soldiers to engage in their own health optimization. This article describes a research platform that allows for collection of data via a custom-made secure mobile application that extends the type, scope, and frequency of data collection beyond what is feasible during an in-person encounter. By digitizing existing assessments and by incorporating additional physical, neurocognitive, psychological, and lifestyle assessments, the platform provides individuals with the ability to better understand their mental and physical load, as well as reserve. The results of this interactive exchange may help to preserve the health of users as well as the stability and readiness of units.



ABSTRACT

Military medicine has made significant advancements in decreasing mortality by addressing the lethal triad - metabolic acidosis, coagulopathy, and hypothermia. However, casualties are still succumbing to injury. Recent conflict zones have led to the development of remarkable life-saving innovations, including the management of compressible hemorrhage and whole blood transfusions. Nevertheless, hypothermia prevention and treatment techniques remain relatively unchanged. Hypothermia prevention is anticipated to become more critical in future operations due to a predicted increase in evacuation times and reliance on Prolonged Casualty Care (PCC). This is likely secondary to increasingly distanced battlespaces and the mobility challenges of operating in semi-/non-permissive environments. Innovation is essential to combat this threat via active airway rewarming in the vulnerable patient. Thus, we propose the development, fabrication, and efficacy testing of a device in which we estimate being able to control temperature and humidity at physiologic levels in the PCC setting and beyond.

Keywords: Advanced Trauma Life Support care; airway management; critical care; emergency medicine; intellectual property; military medicine; patent; prehospital emergency care; prolonged casualty care; prolonged field care; resuscitation; technological innovations; war-related trauma; wilderness medicine hypothermia

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.

Current Episode

The new Winter 2022 episode of the JSOM podcast is now available on our website and wherever you listen to podcasts.

Our guest medic editor this quarter is Devin DeFeo, a former SOF medic. 2LT DeFeo enlisted in the Army in 2004 and served as an 18D with 1SFG(A) and USASOC. As a medic, he authored the concept for MARCHE2 for TCCC in the chemical, biological, radiological, and nuclear (CBRN) environment published in JSOM, which later formed the framework for the Joint Trauma System Clinical Practice Guidelines on CBRN medicine and the CBRN chapter in the Ranger Medical Handbook. He then participated in the Enlisted to Medical Degree Preparatory Program (EMDP2) at George Mason University, earning a master of science in biology. He is currently a third-year medical student at the Uniformed Services University of the Health Sciences (USUHS). 2LT DeFeo is considering a residency in emergency medicine. He will be reviewing Does Mental and Visual Skills Training Improve High-Value Target Identification and Marksmanship Among Elite Soldiers? by J. Jay Dawes, et al. (p. 22). Our author interview is with Michael J. Egnoto, PhD (An Exploratory Comparison of Water-Tamped and -Untamped Explosive Breaches: Practical Applications for the Tactical Community via Pilot Study). Dr Egnoto is affiliated with the Walter Reed Army Institute of Research, Forest Glen Annex, Silver Spring, MD.

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. This section also features peridoic promtional information for events and conferences, including the 2023 SOMA Scientific Assembly. 

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Visit https://jsom.us/Library for a full list of institutions 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 in the United States and abroad.

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Institutions receive 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 professionals 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 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:

• Physicians
• Medics
• Educators
• Law Enforcement
• The military and civilian global medical community

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.

BOISE, ID.

Photo by Master Sgt. Becky Vanshur 

124th Fighter Wing

DVIDS

Idaho National Guard Soldiers and Airmen, as well as active-duty counterparts joined forces with a one-team, one-fight mentality for joint training during a mass casualty exercise on Feb. 4, 2023, near Gowen Field, Boise, Idaho. Medical personnel from Gowen Field’s 124th Medical Group and active-duty medical personnel with the 366th Medical Group from Mountain Home Air Force Base teamed up for several mass casualty events, which also included the use of medevac Soldiers and UH-60 Black Hawk helicopters from the Idaho Army National Guard’s 1st of the 168th Aviation Regiment to participate in the medical evacuation scenarios. Combat medics performed treatment and stabilized casualties at a field medical tent in a simulated deployed location. The focus for the combat medics during the mass casualty scenarios was an emphasis on Tactical Combat Casualty Care. The TCCC is the military guideline for trauma life support in pre-hospital combat medicine, designed to reduce preventable deaths while continuing to maintain operation success. The ground combat medics and the Black Hawk flight medics worked together to stabilize the casualty during flight until they reached the simulated higher echelon of medical care. 

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