Journal of special operations medicine : a peer reviewed journal for SOF medical professionals最新文献_第10页

Social Determinant of Unconventional Resilience: Tactical Engagement in Medical-Martial Creativity. 非常规复原力的社会决定因素：医疗-军事创造力中的战术参与。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-10-02 DOI: 10.55460/DEK2-DD7J

Erika Ann Jeschke, Jennifer Armon, Jared Wyma-Bradley, Jay B Baker, John Dorsch, Sarah Lynn Huffman

{"title":"Social Determinant of Unconventional Resilience: Tactical Engagement in Medical-Martial Creativity.","authors":"Erika Ann Jeschke, Jennifer Armon, Jared Wyma-Bradley, Jay B Baker, John Dorsch, Sarah Lynn Huffman","doi":"10.55460/DEK2-DD7J","DOIUrl":"10.55460/DEK2-DD7J","url":null,"abstract":"Building on our strategic framework and operational model, we will discuss findings from our ethnographic study entitled, \"The Impact of Catastrophic Injury Exposure on Resilience in Special Operations Surgical Teams (SOST).\" Our goal is to establish that medical-martial creativity supports Special Operation Forces (SOF) medics' ability to fluidly modulate pressure amid real-time military medical decision-making in austere environments. We will use qualitative quotes to explore how SOST medics express medical-martial creativity in support of unconventional resilience. We continue to highlight tactical engagement by using bag sets as a metaphor for understanding the practical performance of this social determinant. To achieve our goals, we will: 1) define the social determinant of medical-martial creativity and provide a brief background on creativity; 2) thematize various ways in which medical-martial creativity is optimized or degraded; and 3) relate tactical engagement with medical-martial creativity to our metaphor of bag sets. We conclude by gesturing to how medical-martial creativity enables SOF medics' ingenuity, which allows them to freely maneuver complex real-time decision-making to support SOF mission success.","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"84-89"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Audit and Inventory of Federal Law Enforcement Agency Tactical Medic Bags. 对联邦执法机构战术医疗包的审计和清点。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/0NS2-Z6OS

Joshua G Knapp, Nelson Tang

引用次数: 0

Incidence of Traumatic Brain Injuries within the Prehospital Trauma Registry System. 院前创伤登记系统中创伤性脑损伤的发生率。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/6RSJ-GXLF

Stephen F Braden, Brit J Long, Julie A Rizzo, Michael D April, Bradley A Dengler, Steven G Schauer

{"title":"Incidence of Traumatic Brain Injuries within the Prehospital Trauma Registry System.","authors":"Stephen F Braden, Brit J Long, Julie A Rizzo, Michael D April, Bradley A Dengler, Steven G Schauer","doi":"10.55460/6RSJ-GXLF","DOIUrl":"10.55460/6RSJ-GXLF","url":null,"abstract":"Background: Traumatic brain injury (TBI) is often underreported or undetected in prehospital civilian and military settings. This study evaluated the incidence of TBI within the Prehospital Trauma Registry (PHTR) system.Methods: We reviewed PHTR and the linked Department of Defense Trauma Registry (DoDTR) records of casualties from January 2003 through May 2019 for diagnostic data and surgical reports.Results: A total of 709 casualties met inclusion criteria. The most common mechanism was blast, including 328 (51%) in the non-TBI and 45 (63%) in the TBI cohorts. The median injury severity scores in the non-TBI and TBI cohorts were 5 and 14, respectively. The survival scores in the non-TBI and TBI cohorts were 98% and 92%, respectively. Subdural hematomas, followed by subarachnoid hemorrhages were the most common classifiable brain injuries. Other nonspecific TBIs occurred in 85% of the TBI cohort casualties. Seventy-two cases (10%) were documented by the Role 1 clinician. Based on coding or operative data, 15 of the 72 (21%) were identified as TBIs. Of the 637 cases, which could not be decided based on coding or operative data, TBI was suspected in 42 (7%) cases based on Role 1 records.Conclusions: Over 1 in 10 casualties presenting to a Role 1 facility had a TBI requiring transfer to a higher level of care. Our findings suggest the need for improved diagnostic technologies and documentation systems at Role 1 facilities for accurate TBI diagnosis and reporting.","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"24-33"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of a Rebreathing System for Use with Portable Mechanical Ventilators. 评估与便携式机械通风机配合使用的再呼吸系统。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/9E9N-X3QB

Thomas Blakeman, Maia Smith, Richard Branson

{"title":"Evaluation of a Rebreathing System for Use with Portable Mechanical Ventilators.","authors":"Thomas Blakeman, Maia Smith, Richard Branson","doi":"10.55460/9E9N-X3QB","DOIUrl":"10.55460/9E9N-X3QB","url":null,"abstract":"Introduction: Maximizing the capabilities of available lowflow oxygen is key to providing adequate oxygen to prevent/treat hypoxemia and conserve oxygen. We designed a closed-circuit system that allows rebreathing of gases while scrubbing carbon dioxide (CO2) in conjunction with portable mechanical ventilators in a bench model.Methods: We evaluated the system using two portable mechanical ventilators currently deployed by the Department of Defense-Zoll 731 and AutoMedx SAVe II-over a range of ventilator settings and lung models, using 1 and 3L/min low-flow oxygen into a reservoir bag. We measured peak inspired oxygen concentration (FiO2), CO2-absorbent life, gas temperature and humidity, and the effect of airway suctioning and ventilator disconnection on FiO2 on ground and at altitude.Results: FiO2 was =0.9 across all ventilator settings and altitudes using both oxygen flows. CO2-absorbent life was >7 hours. Airway humidity range was 87%-97%. Mean airway temperature was 25.4°C (SD 0.5°C). Ten-second suctioning reduced FiO2 22%-48%. Thirtysecond ventilator disconnect reduced FiO2 29%-63% depending on oxygen flow used.Conclusion: Use of a rebreathing system with mechanical ventilation has the potential for oxygen conservation but requires diligent monitoring of inspired FiO2 and CO2 to avoid negative consequences.","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Committee on Tactical Combat Casualty Care (CoTCCC) Position Statement on Prolonged Casualty Care (PCC): 01 May 2024. 战术战斗伤员救护委员会（CoTCCC）关于长期伤员救护（PCC）的立场声明：2024 年 5 月 1 日。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/RWAU-AVBM

Michael A Remley, Dan Mosley, Sean Keenan, Travis G Deaton, Harold R Montgomery, Russ S Kotwal, George A Barbee, Lanny F Littlejohn, Justin Wilson, Curtis Hall, Paul E Loos, John B Holcomb, Jennifer M Gurney

引用次数: 0

Lumbar Paraspinal Compartment Syndrome in an Active-Duty Army Special Operations Aviation Soldier. 一名现役陆军特种作战航空兵的腰椎旁隔膜综合征。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/VNL5-YENS

Christopher Wagner, Gerrit Davis, Matthew Donato, Patrick Bedard, Rachel E Bridwell

{"title":"Lumbar Paraspinal Compartment Syndrome in an Active-Duty Army Special Operations Aviation Soldier.","authors":"Christopher Wagner, Gerrit Davis, Matthew Donato, Patrick Bedard, Rachel E Bridwell","doi":"10.55460/VNL5-YENS","DOIUrl":"10.55460/VNL5-YENS","url":null,"abstract":"Lumbar paraspinal muscle compartment syndrome is an uncommon, rapidly progressive, and potentially devastating injury with fewer than 40 cases reported in the literature. It initially mimics nonemergent causes of low back pain, disproportionately affects young men, and is most often secondary to acute physical exertion. The disease process is commonly associated with rhabdomyolysis. Diagnostic tools include physical examination, measurement of lactate and creatine kinase levels, MRI, and direct compartment pressure measurement. While medical and nonoperative management strategies have been explored, the gold standard for treatment is emergent lumbar fasciotomy. Opioid and non-steroidal pain management, as well as physical therapy, are the mainstays of post-treatment recovery, with many surgical patients reporting complete symptom resolution at long-term follow-up. This article discusses the case of a 27-year-old, male, active-duty, Special Operations Aviation Soldier who presented to the emergency department and was found to have lumbar paraspinal muscle compartment syndrome.","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"73-77"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advancing Combat Casualty Care Statistics and Other Battlefield Care Metrics. 推进战斗伤亡护理统计和其他战场护理指标。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/XBJF-AQPX

Jud C Janak, Russ S Kotwal, Jeffrey T Howard, Jennifer M Gurney, Brian J Eastridge, John B Holcomb, Stacy A Shackelford, Robert A De Lorenzo, Ian J Stewart, Edward L Mazuchowski

{"title":"Advancing Combat Casualty Care Statistics and Other Battlefield Care Metrics.","authors":"Jud C Janak, Russ S Kotwal, Jeffrey T Howard, Jennifer M Gurney, Brian J Eastridge, John B Holcomb, Stacy A Shackelford, Robert A De Lorenzo, Ian J Stewart, Edward L Mazuchowski","doi":"10.55460/XBJF-AQPX","DOIUrl":"10.55460/XBJF-AQPX","url":null,"abstract":"Aggregate statistics can provide intra-conflict and inter-conflict mortality comparisons and trends within and between U.S. combat operations. However, capturing individual-level data to evaluate medical and non-medical factors that influence combat casualty mortality has historically proven difficult. The Department of Defense (DoD) Trauma Registry, developed as an integral component of the Joint Trauma System during recent conflicts in Afghanistan and Iraq, has amassed individual-level data that have afforded greater opportunity for a variety of analyses and comparisons. Although aggregate statistics are easily calculated and commonly used across the DoD, other issues that require consideration include the impact of individual medical interventions, non-medical factors, non-battle-injured casualties, and incomplete or missing medical data, especially for prehospital care and forward surgical team care. Needed are novel methods to address these issues in order to provide a clearer interpretation of aggregate statistics and to highlight solutions that will ultimately increase survival and eliminate preventable death on the battlefield. Although many U.S. military combat fatalities sustain injuries deemed non-survivable, survival among these casualties might be improved using primary and secondary prevention strategies that prevent injury or reduce injury severity. The current commentary proposes adjustments to traditional aggregate combat casualty care statistics by integrating statistics from the DoD Military Trauma Mortality Review process as conducted by the Joint Trauma System and Armed Forces Medical Examiner System.","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Effect of Critical Task Auto-failure Criteria on Medical Evaluation Methods in the Pararescue Schoolhouse. 关键任务自动失败标准对伞兵学校医疗评估方法的影响。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/VG7D-H3WA

Ian Richardson, Michael J Lauria, Brian Gravano, Jeffrey F Swenson, Stephen C Rush

{"title":"The Effect of Critical Task Auto-failure Criteria on Medical Evaluation Methods in the Pararescue Schoolhouse.","authors":"Ian Richardson, Michael J Lauria, Brian Gravano, Jeffrey F Swenson, Stephen C Rush","doi":"10.55460/VG7D-H3WA","DOIUrl":"10.55460/VG7D-H3WA","url":null,"abstract":"Background: Medical training and evaluation are important for mission readiness in the pararescue career field. Because evaluation methods are not standardized, evaluation methods must align with training objectives. We propose an alternative evaluation method and discuss relevant factors when designing military medical evaluation metrics.Methods: We compared two evaluation methods, the traditional checklist (TC) method used in the pararescue apprentice course and an alternative weighted checklist (AWC) method like that used at the U.S. Army static line jumpmaster course. The AWC allows up to two minor errors, while critical task errors result in autofailure. We recorded 168 medical scenarios during two Apprentice course classes and retroactively compared the two evaluation methods.Results: Despite the possibility of auto-failure with the AWC, there was no significant difference between the two evaluation methods, and both showed similar overall pass rates (TC=50% pass, AWC=48.8% pass, p=.41). The two evaluation methods yielded the same result for 147 out of 168 scenarios (87.5%).Conclusions: The AWC method strongly emphasizes critical tasks without significantly increasing failures. It may provide additional benefits by being more closely aligned with our training objectives while providing quantifiable data for a longitudinal review of student performance.","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"67-71"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Role of Motivation to Excel in the Etiology of Exertional Heat Stroke. 出类拔萃的动机在劳累性中暑病因中的作用。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/4TIV-HQLO

Kirsten Lalli, Nisha Charkoudian, Yonatan Moreh, David W Degroot

{"title":"The Role of Motivation to Excel in the Etiology of Exertional Heat Stroke.","authors":"Kirsten Lalli, Nisha Charkoudian, Yonatan Moreh, David W Degroot","doi":"10.55460/4TIV-HQLO","DOIUrl":"10.55460/4TIV-HQLO","url":null,"abstract":"Exertional heat stroke (EHS) is a medical emergency characterized by elevated body temperature and central nervous system dysfunction, and it can include dizziness, confusion and loss of consciousness, as well as long-term organ and tissue damage. EHS is distinct from classic, or passive, heat stroke and is most commonly observed during intense physical activity in warfighters, athletes, and laborers. EHS is an ongoing non-combat threat that represents a risk to both the health and readiness of military personnel. Potential risk factors and their mitigation have been the subject of investigation for decades. One risk factor that is often mentioned in the literature, but not well quantified, is that of individual motivation to excel, wherein highly trained military personnel and athletes exert themselves beyond their physiological limits because of a desire to complete tasks and goals. The motivation to excel in tasks with high standards of achievement, such as those within elite military schools, appears to create an environment in which a disproportionately high number of exertional heat illness casualties occur. Here, we review existing biomedical literature to provide information about EHS in the context of motivation as a risk factor and then discuss five cases of EHS treated at Martin Army Community Hospital at Fort Moore, GA, from 2020 to 2022. In our discussion of the cases, we explore the influence of motivation on each occurrence. The findings from this case series provide further evidence of motivation to excel as a risk factor for EHS and highlight the need for creative strategies to mitigate this risk.","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"28-33"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141093989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidence of Coagulopathy After Resuscitation at a Role 1 Facility: The Prehospital Trauma Registry Experience. 角色 1 机构复苏后凝血病的发生率：院前创伤登记处的经验。

Journal of special operations medicine : a peer reviewed journal for SOF medical professionals Pub Date : 2024-06-25 DOI: 10.55460/NDT8-BU2B

Brannon L Inman, Brit J Long, Michael D April, Andrew D Fisher, Julie A Rizzo, Steven G Schauer

{"title":"Incidence of Coagulopathy After Resuscitation at a Role 1 Facility: The Prehospital Trauma Registry Experience.","authors":"Brannon L Inman, Brit J Long, Michael D April, Andrew D Fisher, Julie A Rizzo, Steven G Schauer","doi":"10.55460/NDT8-BU2B","DOIUrl":"10.55460/NDT8-BU2B","url":null,"abstract":"Background: The development of acute traumatic coagulopathy is associated with increased mortality and morbidity in patients with battlefield traumatic injuries. Currently, the incidence of acute traumatic coagulopathy in the Role 1 setting is unclear.Methods: We queried the Prehospital Trauma Registry (PHTR) module of the Department of Defense Trauma Registry (DoDTR) for all encounters from inception through May 2019. The PHTR captures data on Role 1 prehospital care. Data from the PHTR was linked to the DoDTR to analyze laboratory data and patient outcomes using descriptive statistics. We defined coagulopathy as an international normalized ratio (INR) of ≥1.5 or platelet count ≤150×109/L.Results: A total of 595 patients met the inclusion criteria; 36% (212) met our definition for coagulopathy, with 31% (185) carrying low platelet numbers, 11% (68) showing an elevated INR, and 7% (41) with both. The baseline (no coagulopathy) cohort had a mean INR of 1.10 (95% CI 1.09-1.12) versus 1.38 (95% CI 1.33-1.43) in the coagulopathic cohort. The mean platelet count was 218 (95% CI 213-223) ×109/L in the baseline cohort versus 117 (95% CI 110-125) ×109/L in the coagulopathic cohort.Conclusions: Our findings indicate a high incidence of coagulopathy in trauma patients. Approximately one-third of wounded patients had laboratory evidence of coagulopathy upon presentation to a forward medical care facility. Advanced diagnostic facilities are therefore needed to facilitate early diagnosis of acute traumatic coagulopathy. Blood products with a long shelf life can aid in early correction.","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"61-66"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0