A Word From Our Publisher

Greetings JSOM Newsletter Subscribers,

As many of you know, we temporarily pulled the Advanced Tactical Paramedic Protocols Handbook (ATP-P) 11th Edition from our Online Store. We have been in the process of making significant changes to the TCCC, Prolonged Casualty Care, and Canine TCCC guidelines. The updates span over 100 pages of new material. As a result, the book is larger than previous editions, requiring a larger binder. The cost of the book has increased due to paper costs and as a result of the increase in shipping. The book will be available to purchase on our Online Store and Amazon later this week. Two versions of the book will be available, one featuring standard paper and the other featuring

waterproof paper. 

The new podcast episode is available. You can stream the JSOM podcast directly on our website or wherever you listen to podcasts. For more information about this episode, please see the podcast section of the newsletter below.

As of October 1st, we've revamped and simplified the subscriptions to our publications.


Domestic Print - $146 – you receive the print journal only (for domestic subscribers)

International Print - $210 – same as above for non-US addresses

Digital Journal - $131 – Access to digital flipbook and PDF (on mobile devices) version of the journal and archives

Digital Handbooks - $134 – Access to digital flipbook and PDF (on mobile devices) of all handbooks

Domestic Print and Digital Journal - $250 – Print journal and digital access to the journal and archives

International Print and Digital Journal - $307 – same as above for international addresses

Domestic Print and All Digital - $370 – Print journal and digital access to the journal, archives, and all handbooks

International Print and All Digital - $428 – Same as above for international addresses

All Digital - $239 – Digital access to all journals and handbooks


All current subscriptions will remain in effect until they expire. If current subscribers on the automatic renewal plan want to upgrade to one of the new plans, please contact us at subscriptions@jsomonline.org, and we will work with you to upgrade your subscriptions.

Michelle DuGuay Landers, MBA, BSN, RN
Breakaway Media, LLC
Journal of Special Operations Medicine (JSOM)
Lt Col, USAF/NC (Ret)
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.
Journal of Special Operations Medicine Featured Abstracts

Hypertonic Saline for Severe Traumatic Brain Injury with Herniation: A Military Prehospital Case Report

Antonino NPayne RGaddy MDeSoucy ESRush SCMichael R. 22(3). 98 - 100. (Journal Article)


Severe traumatic brain injury (sTBI) is a devastating injury with limited prehospital therapies available. The Joint Trauma System (JTS) Clinical Practice Guidelines recommend hypertonic saline (HTS) for casualties with sTBI and signs of impending or ongoing herniation (IOH), but its use by combat medics has never been reported in the literature. This report details the management of a pregnant patient with sTBI and signs of IOH, including the use of HTS, by US Air Force pararescumen in an austere prehospital setting. Treatment with HTS was followed by improvement in the patient's neurologic exam and successful evacuation to definitive care where her child was delivered alive. Additionally, we review the pathophysiology and signs of herniation, the mechanism of action of hyperosmotic therapies, and the rationale behind the use of HTS in the combat setting.

Read More

Active Warfighter Mental Health Lower in Mid-Career

Barczak-Scarboro NECole WRDeFreese JDFredrickson BLKiefer AWBailar-Heath MBurke RJDeLellis SMKane SFLynch JHMeans GEDepenbrock PJMihalik JP. 22(3). 129 - 135. (Journal Article)


Purpose: The present study investigated Special Operations Forces (SOF) combat Servicemember mental health at different SOF career stages in association with resilience. Methods: Fifty-eight SOF combat Service Members either entering SOF (career start; n=38) or multiple years with their SOF organization (mid-career; n=20) self-reported mild traumatic brain injury (TBI) history, resilience, subjective well-being, depression, anxiety, and posttraumatic stress. Poisson regression analyses were employed to test SOF career stage differences in each mental health symptom using resilience, while accounting for other pertinent military factors. Results: There were significant interaction effects of SOF career stage and resilience on mental health symptoms. SOF career start combat Servicemembers endorsed lower depression and posttraumatic stress and higher subjective well-being with higher resilience, but these associations between resilience and mental health symptoms were not seen in SOF mid-career Servicemembers. Conclusions: Although preliminary, the adaptive association between resilience and mental health seemed to be blunted in combat Servicemembers having served multiple years in SOF. This information informs research to provide evaluation tools to support prophylactic performance and long-term health preservation in military populations.

Read More

November 2022 Featured Article

Active Warfighter Resilience: A Descriptive Analysis

Barczak-Scarboro NE, Cole WR, DeFreese JD, Fredrickson BL, Kiefer AW, Bailar-Heath M, Burke RJ, DeLellis SM, Kane SF, Lynch JH, Means GE, Depenbrock PJ, Mihalik JP. 22(3). 22 - 28. (Journal Article)


Purpose: Our aim in this study was to psychometrically test resilience assessments (Ego Resiliency Scale [ER89], Connor-Davidson Resilience Scale [CD-RISC 25], Responses to Stressful Experiences Scale [RSES short-form]) and describe resilience levels in a Special Operations Forces (SOF) combat sample. Methods: Fifty-eight SOF combat Servicemembers either entering SOF (career start; n = 38) or having served multiple years with their SOF organization (mid-career; n = 20) self-reported resilience, mild traumatic brain injury (mTBI) history, and total military service. Results: All resilience metrics demonstrated acceptable internal consistency, but ceiling effects were found for CD-RISC and RSES scores. ER89 scores were moderate on average. ER89 scores were higher in SOF career start than mid-career Servicemembers (ηρ2 = 0.07) when accounting for the interaction between SOF career stage and total military service (ηρ2 = 0.07). Discussion: SOF mid-career Servicemembers had similar ER89 resilience scores with more total military service. The SOF career start combat Servicemembers had higher ER89 measured resilience with less total military service only, potentially showing a protective effect of greater service before entering SOF. Conclusion: The ER89 may be a more optimal military resilience metric than the other metrics studied; longitudinal research on SOF combat Servicemember resilience is warranted.

Keywords: ego resiliency; US Army; US Air Force; psychometrics; readiness

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

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

This podcast episode is focused on research and contributions made by women in service to the military. We start with a review of "Women in US Military History" by Gretchen Garceau-Kragh.

Guest medic HM1(FMF/EXW) Eric Dodson reviews "Active Warfighter Resilience: A Descriptive Analysis" by Nikki Rarczak-Scarborov, et. al.

Finally, we give an objective review of "Operation Blood Rain Phase 2: Evaluating the Effect of Airdrop on Fresh and Stored Whole Blood." The review is complemented with an interview with lead author Dr. (LtCol.) Roselyn Fuentes.

Listen on our Website
Listen, Rate, and Review on Spotify

Please Support Our Sponsors and Media Partners

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. 

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.

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.

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 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.

Contact Dr. Graverson
Support the Journal of Special Operations Medicine
Photo of the Week


U.S. Air Force photo by Staff Sgt. Shannon Bowman 

378th Air Expeditionary Wing

Soliders assigned to the 1-182nd Infantry Regiment strap a training casualty to a medical litter during a Tactical Combat Casualty Care course at Prince Sultan Air Base, Kingdom of Saudi Arabia, Oct. 20, 2022. During the TCCC training, Soliders practiced combat life saving techniques during a simulated casualty scenario.

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.  

Staff Directory
Facebook  Twitter  Linkedin  Instagram  

Breakaway Media, LLC, is a woman service-disabled veteran-owned small business (WOSB and SDVOSB) registered with the Central Contracting Office of the Department of Defense

DUNS #070397122 / Cage #6F0Z6
Primary SIC Code - 2721
Journal of Special Operations Medicine 

This disclaimer pertains to any publication (aka, "publications") written or electronic set forth by Breakaway Media, LLC (BAM) and includes, but is not limited to: The Journal of Special Operations Medicine (JSOM), social media posts to Facebook, Twitter, Instagram, LinkedIn, the JSOM eNewsletter, the JSOM website, and any promotional materials published by BAM. The views and opinions expressed in these publications are those of the authors, contributors, and sponsors of the JSOM and BAM, and do not necessarily reflect those of the JSOM, the JSOM Editorial Board ("the editorial board"), BAM, or its affiliates. Neither the JSOM, the editorial board, BAM, nor its affiliates hold themselves responsible for statements or products discussed in any BAM publications. Unless so stated, material in BAM publications does not reflect endorsement, official attitude, or position of the JSOM, the editorial board, BAM, or affiliates. Products advertised have not been tested by the JSOM, the editorial board, BAM, or its affiliates, and, as such, cannot be held liable for any injury or death caused by the use or misuse of the products contained herein. Neither BAM, the editorial board, nor its affiliates, make any warranty, representation, endorsement, or guarantee of products advertised, discussed, tweeted, retweeted, or shared any publication, to include the assumption of any liability whatsoever arising out of the application, use, or misuse of any product. As a medical publication, we are committed to sharing new technology and products we feel may be of interest to our readers, and encourage all readers and users of said products to use with caution and under proper authorization and professional guidance.

Tagging the JSOM on Instagram / Disclaimer
We assume by tagging us on Instagram, you are authorized to disseminate the photograph you are sharing with us. If you are a photographer whose image has been used or shared without authorization, please notify us immediately so we may give you proper credit.