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A Word From Our Publisher

Greetings JSOM Newsletter Subscribers,


The JSOM team is back from the SOMA conference and hard at work on the summer issue. It was nice to catch up with old friends and meet new ones at our booth. We hope everyone had a successful and productive experience and traveled safely. 


The updates are in and the 2022 Ranger Medic Handbook is out and available on the Online Store. In addition, we have also updated the protocols in the Standard Medical Operations Guide (SMOG) and you can purchase the new book here


The Spring 22 podcast is out. A little late, but well worth the wait. In this episode, our experts Josh and Alex review articles from Dr. Alexander Iteen and Dr. Hossam Abdou. Guest Medic PJ Pelaez reviews the article from PA Brett TerBeek. Josh and Alex are joined by Dr. Jonathan Morrison, coauthor of the Swine Polytrauma article. Their discussion delves into the particulars of the research and adds an element of fidelity to the manuscript. Find the podcast on our website or wherever you listen to podcasts.

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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Journal of Special Operations Medicine Featured Abstracts

Expeditionary Mechanical Ventilation in Conjunction With Extracorporeal Life Support During Ground Transport

Beely BMHarea GTWendorff DSChoi JHSieck KKaraliou VCannon JWLantry JHCancio LCSams VGBatchinsky AI. 22(1). 64 - 69. (Journal Article)

ABSTRACT


Background: We assessed the use of an FDA-cleared transport ventilator with limited functions and settings during ground transport in a swine model of ground evacuation. We hypothesized that when used as an adjunct to extracorporeal life support (ECLS), the device would enable safe mobile ventilatory support during ground evacuation. Methods: Female Yorkshire swine (n = 11; mean, 52.4 ± 1.3 kg) were sedated and anesthetized and received mechanical ventilation (MV) with a standard intensive care unit (ICU) ventilator and were transitioned to the Simplified Automated Ventilator II (SAVe II; AutoMedx) during ground transport. MV served as an adjunct to ECLS in all animals. Ventilator performance was assessed in the uninjured state on day 1 and after bilateral pulmonary contusion on day 2. Data were collected pre- and post-transport on both days. Results: During 33 transports, the SAVe II provided similar ventilation support as the ICU ventilator. Mean total transport time was 38.8 ± 2.1 minutes. The peak inspiratory pressure (PIP) limit was the only variable to show consistent differences pre- and post-transport and between ventilators. No adverse events occurred. Conclusion: As an adjunctive supportive device during ground transport, the SAVe II performed adequately without failure or degradation in subject status. Further testing is warranted to elucidate the clinical limits of this device during standalone use.

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Linear Regression as a Method to Prioritize Humanitarian Efforts in Stability Operations

Nicholson JPerry MJ. 22(1). 92 - 96. (Journal Article)

ABSTRACT


With a mandate to work by, with, and through host nation partners, Special Operations Forces (SOF) often face the challenge of pursuing humanitarian endeavors in the hopes of securing access to a specific population and mapping the human terrain. Likewise, should limitations in the rules of engagement (ROE) shift incentives from lethal to non-lethal effects, commanders must find unique ways to exert influence on the operational environment. However, with inevitable resource constraints such as money and time, it can be exceedingly difficult to determine which humanitarian project to undertake, especially in a population whose needs are multifaceted. Linear regression, a statistical tool available within the standard Microsoft Excel package on government computers, permits the modeling of predictive outcomes between a number of independent variables against a dependent variable. This allows the determination of significance and effect for each independent variable, which can facilitate a thoughtful recommendation to commanders for project selection. Using Iraq as an example, publicly available information (PAI) provides a wealth of records to make data-driven assessments for mutually beneficial shaping efforts in a stability operations framework. Additionally, this paper will highlight how data can be analyzed without a reliance on statistical software that is unlikely to be present in the tactical environment.


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May 2022 Featured Article
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)
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
Read More
The Journal of Special Operations Medicine Podcast

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.

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)

Listen on our Website
Listen, Rate, and Review on Apple Podcasts
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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

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.

Contact Dr. Graverson
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Photo of the Week
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EGLIN AIR FORCE BASE, FL

05.07.2022

Photo by Samuel King Jr.    

96th Test Wing Public Affairs

DVIDS


An Army Ranger takes down a rowdy fan during a combat demonstration at the 6th Ranger Training Battalion’s open house event May 7 at Eglin Air Force Base, Fla. The event was a chance for the public to learn how Rangers train and operate. The event displays showed equipment, weapons, a reptile zoo, face painting and weapon firing among others. The demonstrations showed off hand-to-hand combat, a parachute jump, snake show, and Rangers in action.


Do You Have a Photo to Share?  

Please send us your approved medical action images for future covers, our journal Photo Gallery, bi-weekly eNewsletters, and JSOM social media! All images must include captions in the emails in which they are sent. Images for print must be high resolution, at least 300 dpi. Images for the eNewsletter and social media must be at least 400px wide, 72 dpi.  


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Journal of Special Operations Medicine 

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