A Word From Our Publisher |
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Greetings JSOM Newsletter Subscribers,
By the time you read this, the JSOM team will be getting ready for the annual SOMA conference. The conference is happening May 2-6 in Raleigh, NC. As the official journal of SOMA and the conference, the JSOM team will be available at booth 909 to answer any questions you may have about our publication. We will also have all of our handbooks available to purchase including the brand new 2022 Ranger Medic Handbook. If you are not attending SOMA and would like to order the new updates, the book will be available on our Online Store on May 9th. If you're attending, please stop by our booth. We want to meet you!
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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
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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 the banner/header is missing and/or 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, we suggest opening the newsletter in a browser. |
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Journal of Special Operations Medicine Featured Abstracts |
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ABSTRACT
Surgical airway approaches are, at times, last resort options in difficult airway management. In Special Operations these interventions confront distorted anatomy from combat trauma, extreme conditions, and may be performed by non-medically trained personnel. Under these circumstances, needle cricothyroidotomy using a large bore intravenous catheter can be considered. A small syringe connected to the needle can confirm transtracheal placement through air aspiration before passing the angiocatheter over the needle. Button activated retracting needles should be avoided for this when possible. We recommend a 3-mL Luer-lock syringe because a small syringe is better suited for generating pressure and once the catheter is in the trachea, this same syringe can be connected to bag valve ventilation by replacing its plunger with a connector from a 6.5-, 7-, or 7.5-mm endotracheal tube. Adding these small and light high-yield items to the Tactical Combat Casualty Care medic inventory should be considered in future revisions.
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ABSTRACT
Management of hemorrhagic shock and airway stabilization are two pillars of trauma resuscitation which have a dependent, yet incompletely understood relationship. Patients presenting with traumatic hemorrhage may manifest shock physiology prior to intubation, conferring a higher risk of postintubation hypotension, pulseless arrest, and mortality. This case series describes of a group of seven US military members with combat-related trauma who experienced pulseless arrest after rapid sequence intubation in a role 2 or role 3 setting. All except one of the patients had hemodynamics suggesting hemorrhagic shock prior to intubation. This case series highlights the need for further research to define which trauma patients are at risk of postintubation pulseless arrest. It also focuses on the knowledge gap related to the role that delayed airway management and judicious blood product resuscitation may play in preventable death after injury.
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May 2022 Featured Article |
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Efficacy of Vancomycin Powder in Mitigating Infection of Open Penetrating Trauma Wounds on the Battlefield: An Evidence-Based Review (Spring 2022)
TerBeek BR, Loos PE, Pekari TB, Tennent DJ. 22(1). 76 - 80. (Journal Article)
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ABSTRACT
Background: Open penetrating trauma wounds to the extremities remain the most common injuries encountered in combat and are frequently complicated by bacterial infections. These infections place a heavy burden on the Servicemember and the healthcare system as they often require multiple additional procedures and can frequently cause substantial debility. Previous studies have shown that vancomycin powder has demonstrated efficacy in decreasing infection risks in clean and contaminated orthopedic surgical wounds. Methods: This review evaluates the most prevalent organisms cultured post-trauma, the current Tactical Combat Casualty Care (TCCC) guidelines for antibiotic prophylaxis, and relevant research of vancomycin's prophylactic use. Results: Results from previous studies have shown a time-dependent reduction in bacterial load when vancomycin powder is introduced early post injury in traumatic orthopedic wounds. Furthermore, perioperative application affords a cost-effective method to prevent infection with minimal adverse effects. Discussion: The current TCCC guidelines advocate for the use of antibiotics at the point of injury. When vancomycin powder is used in synergy with these guidelines, it can contribute a timely and powerful antibiotic to prevent infection. Conclusion: The prophylactic use of vancomycin powder is a promising adjunctive agent to current Clinical Practice Guidelines (CPG), but it cannot be conclusively determined to be effective without further research into its application in traumatic combat wounds.
Keywords: vancomycin; trauma; combat; TCCC; prehospital; osteomyelitis; infection
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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.
Our Spring 2022 episode has not yet posted to our website or streaming platforms. It should be available very soon. We hope to have an author interview and/or guest medic feature. We will make an announcement on social media as soon as the episode is available. For now, the links below will connect you to the JSOM podcast archive.
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SPRING 2022
In this episode of the JSOM Podcast, Alex and Josh review:
Feasibility of Obtaining Intraosseous and Intravenous Access Using Night Vision Goggle Focusing Adaptors by Alexander Iteen, MD, and colleagues (p. 56)
The Efficacy of Vancomycin Powder in Mitigating Infection of Open Penetrating Trauma Wounds on the Battlefield: An Evidence-Based Review by Brett R. TerBeek, 18B, 18F, MPAS, and colleagues (p. 76)
Development of a Swine Polytrauma Model in the Absence of Fluid Resuscitation by Hassam Abdou, MD, and colleagues (p. 77, Winter 2021 Edition)
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Please Support Our Sponsors |
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The Journal of Special Operations Medicine is proud to have the support of many great sponsors. 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. |
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Institutional 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.
In this edition, we welcome back the Naval Health Research Center, Wilkins Biomedical Library, San Deigo, CA!
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 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 would like more information about our institutional access, contact our subscriptions manager, Dr. Scott Graverson.
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Support the Journal of Special Operations Medicine |
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INCIRLIK, TURKEY
DVIDS
Tactical Combat Casualty Care students assigned to various units across Incirlik Air Base scan for threats as a UH-60 Black Hawk helicopter takes off during the first combined Medic-X and TCCC course hosted by the 39th Medical Group at Incirlik Air Base, Turkey, April 24, 2022. The five-day course integrated multi-capable airman concepts into the existing TCCC curriculum to prepare all medics for prolonged field care. The Air Force Medical Service tasked the 39th MDG to beta test a combined curriculum making this the first training of its kind in the Air Force.
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Journal of Special Operations Medicine
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