A Word From Our Publisher |
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Greetings JSOM Newsletter Subscribers,
By now, our Fall 2021 edition should have reached the majority of our print subscribers. As always, we welcome your feedback via email or on our social media networks @jsomonline.
We need high quality images for the JSOM. Approved field photographs, simulation training, and exercise imagery are all acceptable. Images should be SOF or TACMED related or otherwise relevant to the unconventional medicine genre.
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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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Journal of Special Operations Medicine Featured Abstracts |
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ABSTRACT
Background: Terrorist attacks are growing in frequency, increasing concerns about chemical warfare agents (CWAs). Asphyxiants (e.g., cyanide), opioids (e.g., carfentanyl), and nerve agents (e.g., ricin) represent some of the most lethal CWAs. Our aim was to define the epidemiology of CWA use in terrorism and detail specific agents used to allow for the development of training programs for responders. Methods: The open-source Global Terrorism Database (GTD) was searched for all chemical attacks from January 1, 1970, to December 31, 2018. Attacks were included when they fulfilled the terrorism-related criteria as set forth in the internal Codebook of the GTD. Events meeting only partial criteria were excluded. Results: A total of 347 terrorism-related chemical events occurred, with 921 fatalities and 13,361 nonfatal injuries (NFIs) recorded during the study period. South Asia accounted for nearly 30% (101 of 347) of CWA attacks, with 73 of 101 occurring in Afghanistan. The Taliban was implicated in 40 of 101 events utilizing a mixture of agents, including unknown chemical gases (likely representing trials of a number of different chemicals), contamination of water sources with pesticides, and the use of corrosive acid. The largest death toll from a single event (200 fatalities) was attributed to a cult-related mass murder in the Kasese District of Uganda in March 2000. East Asia sustained the highest NFI toll of 7,007 as a result of chemical attacks; 5,500 were attributed to the Tokyo subway sarin gas attack of 1995 by Aum Shinrikyo. Conclusion: The use of CWAs remains a concern given the rising rate of terrorist events. First responders and healthcare workers should be aware of potential chemical hazards that have been used regionally and globally and should train and prepare to respond appropriately.
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ABSTRACT
Objectives: Lab companies developed serology tests for antibody detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with United States Food and Drug Administration (FDA) emergency use authorization. Antibody detection uses purified proteins of SARS-CoV-2 to determine antibody binding via enzyme-linked immunosorbent assay, chemiluminescent immunoassay (CLIA), or colloidal gold-based immunochromatographic assay. With the advent of coronavirus disease 2019 (COVID-19), nucleic acid amplification technology (NAAT) SARS-CoV-2 testing for active infection was not widely available to healthy, active-duty Soldiers. The purpose of this surveillance survey was to determine the prevalence of prior SARS-CoV-2 infection and symptoms of COVID-19 within a mechanized infantry brigade. Materials and Methods: Active-duty military Servicemembers (= 18 years) from a mechanized infantry brigade provided serum samples for testing for the Elecsys® Anti-SARS-CoV-2 qualitative antibody test from June to September 2020 at Joint Base Lewis McChord (JBLM).
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November 2021 Featured Article |
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Blood Product Administration During Transport Throughout the US Africa Command Theater of Operation
Schauer SG, Naylor JF, Fisher AD, Hyams DG, Carius BM, Escandon MA, Linscomb CD, McDonald H, Cap AP, Bynum J. 21(3). 66 - 70. (Journal Article)
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ABSTRACT
Background: United States Africa Command (US AFRICOM) is one of six US Defense Department's geographic combatant commands and is responsible to the Secretary of Defense for military relations with African nations, the African Union, and African regional security organizations. A full-spectrum combatant command, US AFRICOM is responsible for all US Department of Defense operations, exercises, and security cooperation on the African continent, its island nations, and surrounding waters. We seek to characterize blood product administration within AFRICOM using the in-transit visibility tracking tool known as TRAC2ES (TRANSCOM Regulating and Command & Control Evacuation System). Methods: We performed a retrospective review of TRAC2ES medical evacuations from the AFRICOM theater of operations conducted between 1 January 2008 and 31 December 2018. Results: During this time, there were 963 cases recorded in TRAC2ES originating within AFRICOM, of which 10 (1%) cases received blood products. All patients were males. One was a Department of State employee, one was a military working dog, and the remainder were military personnel. Of the ten humans, seven were the result of trauma, most by way of gunshot wound, and three were due to medical causes. Among human subjects receiving blood products for traumatic injuries, a total of 5 units of type O negative whole blood, 29 units of packed red blood cells (pRBCs), and 9 units of fresh frozen plasma (FFP) were transfused. No subjects underwent massive transfusion of blood products, and only one subject received pRBCs and FFP in 1:1 fashion. All subjects survived until evacuation. Conclusions: Within the TRAC2ES database, blood product administration within AFRICOM was infrequent, with some cases highlighting lack of access to adequate blood products. Furthermore, the limitations within this database highlight the need for systems designed to capture medical care performance improvement, as this database is not designed to support such analyses. A mandate for performance improvement within AFRICOM that is similar to that of the US Central Command would be beneficial if major improvements are to occur.
Keywords: prehospital; blood; Africa; prolonged field care; AFRICOM
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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. In addition, the podcast features a special, not to be missed Interview Series with leaders, doctors, and authors. |
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FALL 2021
In this episode of the JSOM Podcast, Alex and Josh start by reviewing, "Timeline of Psychological and Physiological Effects Occurring During Military Deployment on a Medical Team" by Hall, et. al. Guest reviewer Rico Pesce and SSG Meredith Cole review "Blood Product Administration During Transport Throughout the US Africa Command Theater of Operation," by Schauer, et. al. Josh and Alex discuss, "Impact of a 10,000m Cold-Water Swim on Norwegian Naval Special Forces Recruits" with author Jorgen Melau.
Hall AB, Qureshi I, Wilson RL, Glasser JJ
Schauer SG, Naylor JF, Fisher AD, Hyams DG, Carius BM, Escandon MA, Linscomb CD, McDonald H, Cap AP, Bynum J
Melau J, Hisdal J, Solberg PA
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Highlights from the JSOM Special Talk Series |
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COL (Ret) Russ Kotwal, MD, MPH
Dr. Kotwal spent nearly 30 years in the military and more than 15 years in operational assignments with the 25th Infantry Division, 75th Ranger Regiment, and U.S Army Special Operations Command. He deployed to combat 12 times with the Rangers -- nine times to Afghanistan and three to Iraq. He conducted hundreds of combat ground and air missions as the senior medical provider and is highly decorated, including five Bronze Star medals, two Joint Service Commendation medals for Valor, and two combat jump stars, among many others. Dr. Kotwal is also a master parachutist, master flight surgeon, and Ranger qualified. He is credited with numerous novel training and technology initiatives, professional publications, and national and international presentations related primarily to prehospital medicine on the battlefield. Dr. Kotwal is an adjunct professor for both the Texas A&M Health Science Center and the Uniformed Services University of the Health Sciences. He has been an advisor for the Defense Health Agency’s Joint Trauma System and Committee on Tactical Combat Casualty Care, as well as the National Academy of Sciences, Engineering and Medicine. He is a Fellow of the American Academy of Family Physicians, a Hero of Military Medicine award recipient, a Distinguished Member of the 75th Ranger Regiment, an inductee into the US Army Ranger Hall of Fame, and the current president of the Special Operations Medical Association.
MSG (Ret.) Rick Hines I
Rick Hines has a long history in Special Operations and is currently an instructor Special Warfare Training Group. He teaches at the SF Medical Sergeant Recertification Course and focuses on anesthesia and surgical care in the austere environment. Rick discusses the benefits of recycling at the 18D course, historical basis, and current practice of surgical care and anesthesia for the far forward Special Operations medic.
Dr. Kyle Stigall
Dr. Stigall attended the United States Air Force Academy for undergrad and the University of Kentucky for medical school. He is currently a fourth-year general surgery resident at Brooke Army Medical Center. He completed a research year at the Naval Medical Research Unit in San Antonio in 2020 with a focus on trauma resuscitation and plans to apply to the Air Force Special Operations Surgical Team next year.
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Please Support Our Sponsors |
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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.
Today, we welcome back several renewals:
Service Sante des Armees, Paris, France
Hong Kong Police Force, Hong Kong
Jefferson State Community College, Birmingham, Al
Plano Fire Rescue, Plano, Texas
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 professional 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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FORT JACKSON, SC, UNITED STATES
DVIDS
Trainees assigned to 1st Battalion, 34th Infantry Regiment, Fort Jackson, S.C., load a mock injured Soldier into a Black Hawk helicopter Oct. 18, 2021, as part of Tactical Combat Casualty Care, also known as TCCC. The trainee’s skills to provide care and transport casualties in the field are tested during the Forge. Two helicopters and flight crews assigned to the 2nd Battalion, 3rd General Support Aviation Battalion “Dust-off,” from Hunter Army Airfield located in Savannah, Ga., flew to the installation to help teach the trainees to load and unload a patient from the aircraft. Each team of trainees practiced their skills as the helicopters took off and returned to the landing zone marked by white smoke and orange flags staked into the ground to provide real-world experience during the training event.
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Journal of Special Operations Medicine
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