ABSTRACT

Introduction: Military medical research has affirmed that early administration of blood products and timely treatment save lives. The US Navy's Expeditionary Resuscitative Surgical System (ERSS) is a Role 2 Light Maneuver team that functions close to the point of injury, administering blood products and providing damage-control resuscitation and surgery. However, information is lacking on the logistical constraints regarding provisions for and the stability of blood products in austere environments. Methods: ERSS conducted a study on the United States Central Command (USCENTCOM) area of responsibility. Expired but properly stored units of stored whole blood (SWB) were subjected to five different storage conditions, including combinations of passive and active refrigeration. The SWB was monitored continuously, including for external ambient temperatures. The time for the SWB to rise above the threshold temperature was recorded. Results: The main outcome of the study was the time for the SWB to rise above the recommended storage temperature. Average ambient temperature during the experiment involving conditions 1 through 4 was 25.6°C (78.08°F). Average ambient temperature during the experiment involving condition 5 was 34.8°C (94.64°F). Blood temperature reached the 6°C (42.8°F) threshold within 90 minutes in conditions 1 and 2, which included control and chemically activated ice packs in the thermal insulated chamber (TIC). Condition 2 included prechilling the TIC in a standard refrigerator to 4°C (39.2°F), which kept the units of SWB below the threshold temperature for 490 minutes (approximately 8 hours). Condition 4 entailed prechilling the TIC in a standard freezer to 0.4°C (32.72°F), thus keeping the units of SWB below threshold for 2,160 minutes (i.e., 36 hours). Condition 5 consisted of prechilling the TIC to 3.9°C (39.02°F) in the combat blood refrigerator, which kept the SWB units below the threshold for 780 minutes (i.e., 13 hours), despite a higher average ambient temperature of almost +10°C (50°F). Conclusion: Combining active and passive refrigeration methods will increase the time before SWB rises above the threshold temperature. We demonstrate an adaptable approach of preserving blood product temperature despite refrigeration power failure in austere settings, thereby maintaining mission readiness to increase the survival of potential casualties.

ABSTRACT



Acute kidney injury (AKI) is a serious, often silent, medical condition with diverse etiologies and complex pathophysiology. We discuss the case of a patient injured in a single vehicle rollover. Included is a discussion of prevention and supportive care, with a focus on electrolyte repletion, fluid correction, minimization of nephrotoxic exposures, and identification and treatment of the root cause.

ABSTRACT

This year is the 80th anniversary of the Women's Army Auxiliary Corps. The passage of this seminal legislation - sponsored by Edith Nourse Rogers - formalized the role of women in the US military and compensated them for their service and in the event of injury or illness. Rogers was a pioneer in her own right. A trailblazer for women and a staunch advocate for military veterans' healthcare, Rogers was forged by her wartime experiences. The authors describe Rogers' contributions as a congresswoman during World War II and during her 35 years of public service in the House of Representatives. Congresswoman Rogers was foundational to the modern US healthcare system.

Keywords: veterans; military personnel; military medicine; school admission criteria; schools, medical; education, medical; women

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.

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LANDSTUHL, RP, GERMANY

11.28.2022

Story by Marcy Sanchez  

Landstuhl Regional Medical Center

Just days following the rigorous three-week syllabus of the U.S. Army’s physically and mentally demanding Expert Field Medical Badge, two Soldiers from Landstuhl Regional Medical Center joined a third Soldier, to compete for LRMC’s 2022 Best Medic title.

The competition, held Nov. 16-18, held at a local level by most Active-Duty, National Guard and Reserve Army units, is formally known as the Command Sergeant Major Jack L. Clark, Jr. Best Medic Competition and culminates with Soldiers representing their respective units at an Army-wide event.

Competitors included U.S. Army Sgt. Jhoshua Alfaro, a behavioral health specialist at U.S. Army Health Clinic Baumholder; U.S. Army Sgt. Eli Jeanquart, a biomedical equipment specialist at LRMC, and Sgt. 1st Class Peter Bassman, a combat medic at LRMC.

Read more of this story here.

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