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

{"title":"Perceived Performance Traits of Blood Warming Devices Among Special Warfare Medics.","authors":"Seth Williams, Wayne N Papalski, Matthew A Tovar, Lorie Gower, Christopher D Treager, Eric J Koch, Eric F Sulava, Emily E Friedrich, Brittany Dellinger","doi":"10.55460/J.Spec.Oper.Med.2026.Z5DF-QPQB","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.Z5DF-QPQB","url":null,"abstract":"<p><strong>Background: </strong>Hypothermia is a major driver of trauma-induced coagulopathy on the battlefield. Several portable blood warmers have been developed for use in forward-deployed prehospital environments; however, end-user preferences for device use have not previously been investigated.</p><p><strong>Methods: </strong>A convenience sample of Naval Special Warfare (NSW) Corpsmen (HMs, n=35) were surveyed regarding their perceived usability of five blood warmer devices: the QinFlow®, M Warmer, Buddy Lite®, Thermal Angel™, and the North American Rescue (NAR) Quantum®. The Likert-based survey was built around evaluating three domains: ease of use, device ruggedness, and perceived device efficacy. Responses were quantified and compared using the Kruskal-Wallis test and the chi-square test, as appropriate. Statistical significance was defined as P<.05. Qualitative responses were summarized into major themes.</p><p><strong>Results: </strong>The M Warmer received the highest overall scores in all three domains with statistically significant differences identified across most comparisons to other warmers. Qualitative analysis reinforced these findings, emphasizing the importance of compactness, intuitive deployment, and device reliability in austere environments. The M Warmer was the most frequently preferred device (45%, P=.0067), with users citing portability, rapid setup, and compatibility with existing gear as key advantages.</p><p><strong>Conclusion: </strong>In this cohort of NSW HMs, user-centered evaluation of field blood warmers identified the M Warmer as the most operationally favorable device. Preferences were shaped not only by perceived effectiveness but by factors directly relevant to forward-deployed settings: portability, intuitive operation, and logistical simplicity. These findings underscore the importance of integrating end-user feedback into medical equipment acquisition.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"11-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492037","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":"Case Report on the Augmentation of Cognitive Processing Therapy with Spiritual Counseling to Address Faith-Based Concerns for an Operator with High Religiosity.","authors":"Blake Schroedter, Mark Schimmelpfennig, Jonathan W Murphy","doi":"10.55460/J.Spec.Oper.Med.2026.3AAM-LY7L","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.3AAM-LY7L","url":null,"abstract":"<p><p>This case report describes treatment of a Special Operations Forces (SOF) Operator with high religiosity experiencing posttraumatic stress disorder (PTSD) and moral injury after exposure to indirect combat-related trauma via real-time audiovisual drone feed. The patient completed virtual massed cognitive processing therapy (CPT) augmented by a single spiritual counseling session to address faith-based concerns interfering with trauma processing. Initial symptom exacerbation occurred early during CPT, but following spiritual counseling, the patient engaged more fully in therapy, leading to a significant reduction in PTSD and depressive symptoms. This case highlights the importance of identifying and addressing faith-related moral injury early in treatment and suggests that integrating spiritual counseling with CPT may enhance outcomes for Operators and other Servicemembers suffering with vicarious posttraumatic stress stemming from indirect combat exposure.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"97-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470327","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":"Relationship Between Age and Performance of Police Tactical Group Candidates and Officers Completing an Occupationally Relevant Specialist Police Physical Assessment.","authors":"Shane D Irving, Jeremy Robinson, Ben Schram, Rodney Pope, Robin Orr","doi":"10.55460/J.Spec.Oper.Med.2026.R9KS-GFTU","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.R9KS-GFTU","url":null,"abstract":"<p><strong>Background: </strong>Police Tactical Group (PTG) officers, in general, are older than their general duties counterparts. The nature of the occupational role scope demands a high level of fitness; thus, physical assessments are essential. This research investigated the relationship between officer age and completion times for an occupationally relevant physical fitness assessment in specialist police officers.</p><p><strong>Methods: </strong>Retrospective data were collected from 34 male PTG officers (age 37.8 [SD 6.5] y); height 181.6 [SD 6.7] cm; body mass 91.5 [SD 10.9] kg) and 18 male PTG candidates (age 32.1 [SD 5.0] y; height 183.7 [SD 5.8] cm; body mass 89.4 [SD 8.7] kg) competing in the RUSH assessment. The RUSH consisted of alternating directional sprints, crawls, 80kg mannequin drags (10-20m), and adopting shooting positions. Operational personal protective equipment (PPE; 22.2 [SD 4.90] kg) was worn.</p><p><strong>Results: </strong>PTG officers were significantly older (P=.002) and carried significantly lighter PPE loads (P<.001). There were no significant differences in mean RUSH times between PTG officers (105.1 seconds [SD 14.6s]) and candidates (111.7 (SD 9.2) s, P=.056). Correlations and a backward stepwise regression model were consistent in indicating that neither age nor group was a statistically significant predictor of RUSH time. PPE weight was not significantly predictive of RUSH time when entered alone in a regression model.</p><p><strong>Conclusion: </strong>Age was not a significant predictor of RUSH times; as such, the RUSH can be used for initial candidates and for older qualified personnel. Ongoing physical strength and conditioning practices undertaken by PTG officers may mitigate age-related fitness loss.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"53-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349766","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":"Convergent Validity and Test-Retest Reliability of the Blast Exposure Threshold Survey Among Army Special Operations Forces.","authors":"Eric Shumski, Deanna Pinnow, Christy Mote, Steven Wilcox, Dale Welsh, Jamie N Hershaw","doi":"10.55460/J.Spec.Oper.Med.2026.VDPC-JO1S","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.VDPC-JO1S","url":null,"abstract":"<p><strong>Introduction: </strong>The Blast Exposure Threshold Survey (BETS) is a self-report questionnaire assessing lifetime generalized blast exposure value (GBEV). This study examined GBEV convergent validity and GBEV and BETS item-by-item test-retest reliability.</p><p><strong>Methods: </strong>In this prospective-cohort study, Army Special Operations Forces (ARSOF) trainers and trainees completed the BETS and a demographic intake form one week before Special Forces Advanced Urban Combat (SFAUC) training. BETS was also administered 1 and 8 weeks post-training. Spearman's rho correlations assessed convergent validity from pre-SFAUC time points. A two-way mixed effect, consistency, single rater intraclass correlation coefficient (ICC3,1 [95%CI]) and percent agreement analyzed test-retest reliability for post-SFAUC time points.</p><p><strong>Results: </strong>Forty-one participants (17.1% trainers; mean age: 32.8 [SD 5.7] y), and 13 participants (7.7% trainers; mean age: 33.2 [SD 5.6] y; 49.7 [SD 6.5] days between test-retest) were included in convergent validity and test-retest analyses, respectively. GBEV displayed moderate convergent validity with all proxy measures of blast exposure (rho-range=0.595-0.672, P<.001 all). GBEV displayed moderate test-retest reliability (ICC3,1=0.576 [95% CI 0.160-0.818]). Individual weapon categories were poor-moderate (ICC3,1-range=0.070-0.766). Items within each section displayed poor-excellent test-retest reliability (ICC3,1range=-0.145-0.843). The difference and average from both post-SFAUC timepoint were strongly correlated indicating worse recall with higher GBEV (n=13, rho=0.907, P<.001).</p><p><strong>Conclusions: </strong>GBEV has strong convergent validity but poor-moderate test-retest reliability. Caution should be used when interpreting BETS results, especially in populations experiencing excessive blast exposures. However, our small sample size limits the interpretability of the results.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"64-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349831","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":"First Island Chain Experiences Using Team Awareness Kit (TAK) for Medical Communications.","authors":"Adam Brust, Jacob H Cole, Scott B Hughey, Joshua Kotler, Kyle Checchi, Chase Tabor, Darryl Arfsten, Andrew Lin","doi":"10.55460/J.Spec.Oper.Med.2026.E33B-H2D7","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.E33B-H2D7","url":null,"abstract":"<p><p>The Team Awareness Kit (TAK, also called Tactical Assault Kit) has significant potential to improve medical regulation in combat operations. TAK is a software package able to be used by individuals in the field which provides geospatial infrastructure and military situational awareness. While it is widely used by non-medical military units, most medical forces have not yet integrated it, particularly for casualty tracking. TAK offers better emission control and detailed medical data than traditional communication systems. Two examples of its use described in this report are from exercises with III Marine Expeditionary Force (MEF) in the Indo-Pacific. Key lessons included: 1) full integration of TAK into Health Services Support (HSS) for improved patient outcomes, 2) managing information overload through standardized workflows, and 3) clear medical control (MEDCON) to optimize casualty care. Recommendations include establishing a communications plan, regulating communication between care echelons, and standardizing TAK workflows for casualty care and medical logistics. TAK proved to be a low-cost, effective tool for medical command and control, and should be further considered for adoption across Joint and Partner Forces.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"16-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476170","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":"Testing the Emergency Evacuation Hyperbaric Stretcher for Fit in Small Military and Civilian Helicopters.","authors":"Nicholas M Studer, Kaighley D Brett","doi":"10.55460/J.Spec.Oper.Med.2026.CUVA-RU2M","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.CUVA-RU2M","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperbaric oxygen (HBO2) therapy is essential for the treatment of diving injuries in the field, but typically requires larger recompression chambers with limited porta-bility. The Emergency evacuation hyperbaric stretcher (EEHS) offers a portable solution for prehospital HBO2, particularly in remote or austere environments. However, it's compatibility with smaller evacuation aircraft remains uncertain.</p><p><strong>Methods: </strong>A commercially available EEHS (Hyperlite 1) was tested for fit and operational computability in both a U.S. Coast Guard Air-bus MH-65 \"Dolphin\" and an Airbus H145 helicopter with a configuration typical of civilian air ambulances.</p><p><strong>Results: </strong>The EEHS could not be fully accommodated in the MH-65 with-out the side doors remaining open and obstructing the rescue swimmer's seat. These limitations may pose challenges to the safe transport of an EEHS during standard operational scenar-ios, necessitating additional logistical support and introducing potential safety risks. The EEHS did fit within the H145, op-timally without a large transport cot in place. In both cases, the required tie-down straps were unavailable.</p><p><strong>Conclusion: </strong>Un anticipated airframe limitations may impede the timely evacuation of a diving casualty to advanced care. These find-ings highlight the importance of planning for the use of the EEHS including careful consideration of the potential aircraft platforms available. Further research is recommended to assess newer EEHS models and to improve aircrew and clinician fa-miliarity with EEHS transportation requirements.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"90-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476186","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 3rd ISTC Medical Symposium (Pfullendorf 2025): From Lessons Observed to Capabilities Delivered.","authors":"Oronzo Chiala, Jennifer Pregler, Anargyros Parathyras, Stijn Spruytte, Julian Goehring, Jace Kennemer, Michael R Hetzler, Michael Turconi, Juan R Grado, Stacy A Shackelford, Michael A Broussard","doi":"10.55460/J.Spec.Oper.Med.2026.1GZ4-0P29","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.1GZ4-0P29","url":null,"abstract":"","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"101-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445925","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":"Lab Evaluation of X8T-T2G Tourniquet.","authors":"Piper Lynn Wall, Charisse M Buising, Mary Jonas","doi":"10.55460/J.Spec.Oper.Med.2026.EB59-1U75","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.EB59-1U75","url":null,"abstract":"<p><strong>Background: </strong>We evaluated pressures and tightening-system use of 3.8cm-wide, self-securing-strap/redirect-and-tightening-system X8T-T2G tourniquets (X8Ts).</p><p><strong>Methods: </strong>Applied left/right, mid-arm and mid-thigh, 40 recipients, first completion one-click-past arterial occlusion, release 100s later. Compared to concurrent study: four 3.8cm-wide, windlass-rod-tightening-system tourniquets (n=30 each).</p><p><strong>Results: </strong>All X8T reached occlusion and completion without securing struggles. Maintaining occlusion till release, 3 arms/25 thighs required additional click once, 2/2 required twice, and 1 thigh required thrice. Nineteen arms large enough for X8T pressure monitoring: occlusion median 298mmHg (minimum 188, interquartile range 262, 322, maximum 335), first completion 338mmHg (219, 310, 372, 391), pre-release 304mmHg (172, 270, 323, 342). Thigh pressures: occlusion 359mmHg (273, 334, 388, 478), first completion 393mmHg (308, 366, 426, 489), pre-release 368mmHg (289, 339, 390, 462); each< respective windlass-rod tourniquet pressures (every P<.030). Arm clicks: occlusion 5 (0, 4, 7, 10), first completion 6 (1, 5, 8, 11), pre-release 7 (1, 5, 8, 11); first completion and pre-release tightening-system rotation<windlass-rod tourniquets (every P<.0001, 10 clicks=180°). Thigh clicks: occlusion 13 (6, 10, 16, 39), first completion 14 (7, 11, 17, 40), pre-release 15 (7, 12, 18, 41); first completion and pre-release tightening-system rotation<windlass-rod tourniquets (one pre-release P=.072, all other P<.005). Clicks after first completion took 2s (1, 2, 3, 4); faster than 66 additional uses of windlass-rod tightening systems (medians 10-18s, every P<.0001).</p><p><strong>Conclusions: </strong>X8Ts were arterially occlusive with simple, self-securing, tightening-system advances. Versus windlass-rod systems, first completion and pre-release pressures and total tightening-system rotation were lower, and completion of tightening-system use after first completion was faster.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"34-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492030","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":"High-Altitude Pulmonary Edema Management in a Special Operator.","authors":"Jafet Ojeda Rodriguez, David Shumway, Pricilla Tubbs, Madelaine Leek, Darrell Nettlow","doi":"10.55460/J.Spec.Oper.Med.2026.X6OP-09X7","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.X6OP-09X7","url":null,"abstract":"<p><p>This case report delves into the challenges in diagnosis and management of a 30-year-old Army Special Forces officer who experienced respiratory distress during high-altitude training in Nepal, where he gained 3,000m in elevation over 3 days. Notably, the patient was prophylactically treated with acetazolamide but did not receive nifedipine or tadalafil. At an elevation of 13,550 feet (4,130m), the patient developed classic high-altitude pulmonary edema (HAPE) symptoms as well as concomitant respiratory symptomatology of breathlessness and worsening productive cough. The complexity of this case lay in managing HAPE in a remote, resource-limited environment with a small rescue window. We analyze the treatment alternatives used and ones not used, such as the portable hyperbaric chamber, and emphasize the necessity for standard-ized HAPE prophylaxis in appropriate personnel to prevent disruption to mission and loss of operational capabilities.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"93-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273017","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":"Standardizing Tourniquet Reassessment and Conversion Across TCCC Tiers: TCCC Guidelines Proposed Change 25-2.","authors":"Eric J Koch, Michael Andersen, George A Barbee, Antonio Boyd, Cyril Clayton, Christopher W Hewitt, John C Maitha, Michael A Remley, Alexandre Nguyen, Joseph Kaleiohi, Harold R Montgomery, Travis G Deaton, Frank K Butler, Jennifer M Gurney","doi":"10.55460/J.Spec.Oper.Med.2026.M4V1-O3Y7","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.M4V1-O3Y7","url":null,"abstract":"<p><p>Operational experience from the Russo-Ukrainian War revealed frequent use of tourniquets that were not medically indicated and an increase in ischemic complications from prolonged tourniquet application as a consequence of extended evacuation times. In response to this, the Committee on Tactical Combat Casualty Care (CoTCCC) convened a working group to evaluate whether tourniquet reassessment and conversion practices should extend to the All Service Member (ASM) level. With input from NATO and partner nations, the Working Group developed a standardized, time-based algorithm that provides plain language guidance for reassessment, repositioning, and conversion. The proposed change replaces the term replacement with repositioning, affirms a reassessment window within 2 hours for nonmedical personnel, and limits conversion beyond 2 hours to medical personnel. These updates will expand lifesaving capability to nonmedical responders, reduce preventable morbidity and mortality from tourniquet use, and align TCCC principles with current operational realities.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"105-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445949","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}