A Word From Our Publisher

Greetings JSOM Newsletter Subscribers,


The Summer 2022 edition of the JSOM is out! Digital subscribers can now access the issue. Print subscribers will have their copies soon. As always, we welcome your feedback. Please join the conversation on all social media networks @jsomonline.


Have you heard of the THOR Network? The THOR Network hosts an annual meeting every year in Norway with speakers and attendees from around the world that are leaders in the field of trauma, both military and civilian. 


THOR’s tenth meeting is starting on June 27th and for the first time ever they are opening it up to include Virtual attendance. Virtual attendees will be able to watch the three days of lectures live, interact with the discussion sessions and have access to the recordings. 


This LIVE virtual conference includes over 40 lectures, panel discussions and case presentations from over 50 international researchers and practitioners.


Registration is normally: $200

Special offer for JSOM readers, medics and students: US $100 with coupon code: MEDIC


For more information and to register, please visit: https://www.rdcr.org/virtual

Registration closes June 22.

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

The Myths of Uncontrolled Emergence Reactions and Consideration to Stop Mandatory, Protocolled Midazolam Coadministration With Ketamine

Hiller HMDrew BFisher ADCuthrell MSpradling JC. 22(1). 49 - 54. (Journal Article)

ABSTRACT


Ketamine continues to demonstrate its utility and safety in the austere and prehospital environment, but myths persist regarding the frequency of behavioral disturbances and unpleasant reactions. These myths have led to protocolled midazolam co-administration. Properties of midazolam and other benzodiazepines have the potential to cause significant morbidity and potential mortality. Because of this risk, benzodiazepines should only be administered when the treating provider determines that the patient's symptoms warrant it. We also present evidence that agitation and altered mental status (AMS) encountered with ketamine occurs during titration of lower pain control regimens and is much less likely to occur with higher doses. As such, in most prehospital situations, the treatment for this "incomplete dissociation" is more ketamine, not the addition of a potentially dangerous benzodiazepine.

READ MORE

Advancing the Practice of Contemporary Military Performance Psychology:A Full-Spectrum Approach to Psychological Health and Readiness

Park GHKnust SKHaselhuhn SWhalen SJDeuster PAGreene CHDretsch MNBonvie JLLippy RDLunasco TKMyatt CA. 22(1). 115 - 120.

ABSTRACT


The Department of Defense (DoD) continues to emphasize operational readiness, lethality, and optimal performance. Performance psychology is a critical aspect of and central dimension to human performance optimization in support of Preservation of the Force and Family (POTFF) and Total Force Fitness (TFF). The delivery of performance psychology services must continue to evolve to maximize its potential for enhancing combat performance and supporting psychological readiness in warfighters across all branches of service. The authors (1) provide a brief history of the evolution of military psychology; (2) explore how performance psychology complements and broadens approaches to support warfighter health and readiness; and (3) present a set of strategies to advance performance psychology services toward an aspirational model. Such strategies will more effectively promote best practices to better target operational performance, complement existing health and medical service delivery, and encompass a systems approach to sustainable training. Moreover, these strategies aim to increase return on investment of psychological readiness efforts for warfighters across all branches of service.


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June 2022 Featured Article

Development of a Swine Polytrauma Model in the Absence of Fluid Resuscitation (Winter 2021)

Abdou H, Patel N, Edwards J, Richmond MJ, Elansary N, Du J, Poliner D, Morrison JJ. 21(4). 77 - 82. (Journal Article)

ABSTRACT


Background: In locations in which access to resuscitative therapy may be limited, treating polytraumatized patients present a challenge. There is a pressing need for adjuncts that can be delivered in these settings. To assess these adjuncts, a model representative of this clinical scenario is necessary. We aimed to develop a hemorrhage and polytrauma model in the absence of fluid resuscitation. Materials and Methods: This study consisted of two parts: pulmonary contusion dose-finding (n = 6) and polytrauma with evaluation of varying hemorrhage volumes (n = 6). We applied three, six, or nine nonpenetrating captive bolt-gun discharges to the dose-finding group and obtained computed tomography (CT) images. We segmented images to assess contusion volumes. We subjected the second group to tibial fracture, pulmonary contusion, and controlled hemorrhage of 20%, 30%, or 40% and observed for 3 hours or until death. We used Kaplan-Meier analysis to assess survival. We also assessed hemodynamic and metabolic parameters. Results: Contusion volumes for three, six, and nine nonpenetrating captive bolt-gun discharges were 24 ± 28, 50 ± 31, and 63 ± 77 cm3, respectively (p = .679). Animals receiving at least six discharges suffered concomitant parenchymal laceration, whereas one of two swine subjected to three discharges had lacerations. Mortality was 100% at 12 and 115 minutes in the 40% and 30% hemorrhage groups, respectively, and 50% at 3 hours in the 20% group. Conclusion: This study characterizes a titratable hemorrhage and polytrauma model in the absence of fluid resuscitation. This model can be useful in evaluating resuscitative adjuncts that can be delivered in areas remote to healthcare access.


Keywords: Polytrauma model; pulmonary contusion; controlled hemorrhage; tibial fracture; delayed medical care; prolonged casualty care; prolonged field care


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.

Current Episode


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
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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 Medical Support Unit Hereford Garrison, United Kingdom, and the 528th Sustainment Brigade, Ft. Bragg, North Car!


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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