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

{"title":"Special Operations Forces Lessons Learned: Beirut Blast.","authors":"Zachary J Leblanc, Matthew A Bergens, Isabella R McKinney, Brian L Edlow, Mark Shapiro, Francisca Aguilar, Rachel E Bridwell, Ricky M Ditzel","doi":"10.55460/1I1Z-Z7TQ","DOIUrl":"10.55460/1I1Z-Z7TQ","url":null,"abstract":"<p><p>The Beirut Port Explosion of 4 August 2020 posed significant medical challenges for relief teams and caused diverse blast injuries to individuals in the area. Several days after the explosion occurred, a Special Operations Forces (SOF) medic provided care for a Servicemember who developed neurologic symptoms that led to his medical evacuation out of Lebanon. These relief efforts underscore the need for vigilant post-blast monitoring and consideration of long-term consequences.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"85-88"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076562","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}

{"title":"Tactical Combat Casualty Care & En Route Combat Casualty Care: Selected Abstracts from 2024.","authors":"Harold R Montgomery","doi":"10.55460/6208-YG5D","DOIUrl":"10.55460/6208-YG5D","url":null,"abstract":"","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626886","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}

{"title":"Successful Management of Battlefield Traumatic Cardiac Arrest Using the Abdominal Aortic and Junctional Tourniquet (AAJT): A Case Series.","authors":"Dmytro Androshchuk, Andriy Verba","doi":"10.55460/7FEV-3ZRK","DOIUrl":"10.55460/7FEV-3ZRK","url":null,"abstract":"<p><p>The Russo-Ukrainian war's prolonged warfare, resource constraints, and extended evacuation times have forced significant adaptations in Ukraine's medical system - including technological advancements and strategic resource placement. This study examined if the Abdominal Aortic and Junctional Tourniquet - Stabilized (AAJT-S) could manage traumatic cardiac arrest (TCA) at forward surgical stabilization sites (FSSS) as an adjunct to damage control surgery. Six patients in severe hypovolemic shock presented at an FSSS during fighting in Bakhmut (July 2022) and Slovyansk (May 2023). Following TCA due to exsanguination, the AAJT-S was applied 2cm below the umbilicus. Cardiopulmonary resuscitation (CPR) and transfusion (blood and/or plasma) were initiated. All six patients were resuscitated. None required vasopressor support post-resuscitation. Five survived to the next level of care. One died awaiting evacuation, and another of wounds after 10 days. Four survived to discharge. Three were followed and neurologically intact, and no death records matched the fourth's name and date of birth at 18 months. Follow-up was limited, but one patient was neurologically intact at one year. The AAJT-S effectively resuscitated TCA patients. It increased mean arterial pressure, focused resuscitative efforts on the upper torso, simplified care, and preserved crucial field resources. An alternative to traditional emergency thoracotomy, AAJT-S could replace or complement resuscitative endovascular balloon occlusion of the aorta in pre-hospital settings, given its ease of application by combat medics. AAJT-S, alongside blood transfusion and CPR, achieved 100% success in return of spontaneous circulation and effectively managed TCA in a wartime FSSS.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598570","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}

{"title":"The Use of Different Types of Supraglottic Airway Devices by Medics on a Manikin with Night Vision Goggles: A Pilot Study.","authors":"Christoph Janig, Thomas Hummel, Manfred Berres, Arnulf Willms, Tim Piepho","doi":"10.55460/SKUJ-KOPM","DOIUrl":"10.55460/SKUJ-KOPM","url":null,"abstract":"<p><strong>Introduction: </strong>Under normal conditions, the use of a supraglottic airway device (SAD) is safe and effective. There are situations in military environments in which such devices must be used in the dark (e.g., to conceal the team's position). The aim of our study was to evaluate the use of different SADs using night vision goggles (NVG) on a manikin.</p><p><strong>Methods: </strong>A group of 53 medically trained soldiers (paramedics, emergency medical technicians [EMTs] and Combat First Responders Bravo) was given a brief demonstration of how to place three different types of SAD in a manikin's airway. This was followed by randomized use in ambient light and then, after the room was darkened, with NVG. Differences in terms of placement success, placement time, and observed usage problems were compared.</p><p><strong>Results: </strong>Attempt success rates were >91% for all SADs used both in ambient light and with NVG. Median placement times differed significantly between ambient light and NVG (ambient light/NVG: i-gel, 7.2/15.1s; standard laryngeal mask airway [LMA], 15.4/21.5s; laryngeal tube [LT], 13.4/24.3s). In the direct comparison of the various SADs, the i-gel laryngeal mask airway was placed significantly faster than a standard LMA (P<.0001) and the LT (P<.0001).</p><p><strong>Conclusions: </strong>Our study proves that the use of NVG has a measurable impact on the speed of placement but does not prolong placement to a clinically significant extent on a manikin. In addition, there was no significant difference in the placement success for each SAD in ambient light or with NVG. Furthermore, all participants were able to read the size information on the various SADs when wearing NVG and were thus able to make a proper size selection. It would, however, make use easier if additional size markings were added. SADs can be applied quickly and safely on the manikin even when NVG are worn. Differences in the use of the various types of SAD are not relevant from a clinical perspective. Using NVG while placing a SAD seems to be safe for the patient and might increase safety for the care provider in tactical situations by maintaining concealment in dark environments.</p>","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":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076523","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}

{"title":"Effect of Fresh Whole Blood Donation on Human Performance in United States Special Forces.","authors":"Alex P Houser, Mario A Soto, Kathryn S Bell, Paul G Goldberg, Kevin J Cronin, Rick C Caldwell, Brian K Schilling","doi":"10.55460/7TZF-0HBX","DOIUrl":"10.55460/7TZF-0HBX","url":null,"abstract":"<p><strong>Background: </strong>Fresh whole blood has been the standard of care for the treatment of hypovolemia secondary to blood loss in the Tactical Combat Casualty Care guidelines since 2014. Current recommendations from the Prolonged Field Care Working Group state that the impact on mission performance is not degraded with 1 unit (450mL) of donation. Because there is limited information on combat performance after donation, the purpose of this investigation was to examine the effects of blood donation on simulated battlefield tasks in U.S. Special Forces Soldiers.</p><p><strong>Methods: </strong>A total of 17 U.S. Special Forces Soldiers participated in this study. Soldiers served as their own controls and were subject to blinded blood draw and a sham draw, which were ordered randomly and separated by 6 days. Outcome measures consisted of performance, capillary blood lactate, salivary osmolality, heart rate, and estimated core temperature. These measures were taken at baseline, then immediately following a 1,200-m shuttle run, 3-event stress shoot, and 5-mile run, all while wearing a typical combat load.</p><p><strong>Results: </strong>There was a moderate-to-large, statistically significant (p<0.05) increase in shuttle run time due to blood donation (δ=12.5s, Hedges' g=1.0). We also detected moderate, statistically significant increases in shooting scores (δ=29.2s, Hedges' g=0.5) and 8-km run times (δ=3.9m, Hedges' g=0.7) due to blood donation. There was no interaction between event and blood draw condition for heart rate, estimated core temperature, blood lactate, or salivary osmolality. Blinding was only 26% effective, as Soldiers were able to correctly identify the procedure that they were subjected to 74% of the time.</p><p><strong>Conclusion: </strong>The moderate-to-large performance decrements found in this study are somewhat greater than those of previous studies. We believe that our results may be different due to the more demanding tasks that were performed after the blood draw in our investigation.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558717","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}

{"title":"Beyond Command: Exploring the Dynamics of the Military Medical Officer and Non-Commissioned Officer Relationship in Military Medicine.","authors":"Kiia Crawford, Makinna Farrell, Ariana Daukss Barilla, Amy F Hildreth, Rebekah Cole","doi":"10.55460/UH66-Y9QW","DOIUrl":"10.55460/UH66-Y9QW","url":null,"abstract":"<p><strong>Background: </strong>Military medical officers (MMOs) and noncommissioned officers (NCOs) serve critical roles within military healthcare teams, and a successful working relationship between them is essential for mission success. The purpose of this study is to explore our participant NCOs' insights into how MMOs and NCOs can foster positive working relationships.</p><p><strong>Methods: </strong>Utilizing a qualitative existential-phenomenological design, the research team interviewed eight medical NCOs twice through a focus group and individual interviews. Each interaction was transcribed and coded. Phenomenological analysis methods were applied to identify emergent themes.</p><p><strong>Results: </strong>Three interdependent themes were identified: (1) open communication, (2) trust in training, and (3) mutual mentorship. The MMO should establish and maintain open lines of communication. The MMO should understand NCO roles and abilities, and work to build trust through respect for their skills and contributions. Reciprocal learning is essential for professional development between MMOs and NCOs.</p><p><strong>Conclusion: </strong>Potential methods to integrate training into existing medical school curricula include interprofessional mentorship training and high-fidelity military medical simulations with opportunities for structured feedback.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"44-49"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630975","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}

{"title":"More Than a Score: Evaluating Military Veterans' Success When Applying to Medical School.","authors":"Peter Campbell, James Brooks, Tirone Young, Katrina S Nietsch, Jamie Frost, Matthew Tonkinson, Jacquelyn Chudow, Jacob M Appel, Valerie Parkas","doi":"10.55460/QHG2-0N30","DOIUrl":"10.55460/QHG2-0N30","url":null,"abstract":"<p><p>Due to the inherent nature of service in both military and medical careers, some veterans are drawn to medicine after completing military service. However, there are significant financial and academic barriers for veterans applying into medical fields. Average grade point average (GPA) and Medical College Admission Test (MCAT) score are two heavily weighted metrics in the medical school application process. Veterans often have less rigorous academic backgrounds and more limited preparation for the MCAT in comparison to traditional medical school applicants. As a result, veterans may be less competitive than traditional applicants through direct comparisons of GPAs and MCAT scor s. The authors' analysis focuses on whether this limitation affected veterans' success in applying to medical school. Using aggregated data from the American Association of Medical Colleges (AAMC), the authors analyzed the average GPAs and MCAT scores of applicants with any military experience (defined as \"military applicants\") compared to the pool of all applicants from 2018 to 2024. During this period, military applicants to U.S. MD programs had an average GPA that was 0.16 points lower and average MCAT score 3.4 points below the average of all applicants. Despite lower academic metrics, the military applicant acceptance rate to MD programs was 41.7% compared to 40.7% for all applicants. Veterans should not be deterred from seeking a path of service in medicine by below average GPAs or MCAT scores. Medical school admissions over the past 6 years show that medical school admission committees value the perspective, life experience, and skills military veterans bring to medicine despite their lower GPAs and MCAT scores.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"74-77"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558719","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}

{"title":"Traumatic Hyphema with Commotio Retinae in a Special Operations Environment.","authors":"Scott R Bird, Kaytlin Hack, John W Kircher, Rachel E Bridwell","doi":"10.55460/Q09D-3I9E","DOIUrl":"10.55460/Q09D-3I9E","url":null,"abstract":"<p><p>Traumatic ocular injuries from both combat- and noncombat-related activity remain a significant burden in active duty Ser- vicemembers and present a diagnostic and therapeutic challenge to Special Operations medics with limited resources in far forward and remote areas. Blunt ocular injury, whether from sports or battlefield engagement, can result in a variety of eyesight-threatening injuries, including hyphema, commotio retinae, iritis, uveitis, and open globe injury. The management of these conditions often requires teleconsultation with ophthalmology and potential evacuation, which is tailored to the resources available for the Special Operations Forces medic. The authors present a case of sports-related traumatic hyphema complicated by commotio retinae in a Special Operations unmanned aircraft systems (UAS) operator, requiring teleconsultation and evacuation to specialty care. The authors additionally provide tailored prehospital strategies for the management of these unique but imperative injuries.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774793","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}

{"title":"Committee on Tactical Combat Casualty Care (CoTCCC) Update.","authors":"Harold R Montgomery","doi":"10.55460/ZVDM-AM8I","DOIUrl":"10.55460/ZVDM-AM8I","url":null,"abstract":"","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814920","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}

{"title":"On Saving - The Psychosocial Benefit of Saving Lives in War and Society.","authors":"Russ S Kotwal, Robert L Mabry, Jeffrey T Howard","doi":"10.55460/XLYN-MH81","DOIUrl":"10.55460/XLYN-MH81","url":null,"abstract":"<p><p>Posttraumatic stress can result from combat and noncombat-related experiences. Conditioning military forces to be lethal or to save lives may influence responses to stress. Training to respond to casualties and to save lives should be a universal practice among medical and non-medical personnel when preparing for combat operations and battlefield casualties. National security requires a strong military. A strong military is reliant on a strong society that is cohesive as well as economically and spiritually intact. Cohesion is vital to the overall health and development of a society. A lack of cohesion can result in excess mortality and a reduction in life expectancy. Cohesion expands social networks and increases social capital that provides support for its military and overall population. Cohesion and leadership are needed to defend our nation, preserve national security, improve societal health, and save lives.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774777","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}