Page 6 - JSOM Summer 2019

CASE REPORTS Best Tourniquet Holding and Strap Pulling Technique: The
The case of cutis marmorata in conjunction with neurological default for best tourniquet strap-application technique is to
symptoms in a 57-year-old man after aggressive diving is pre- hold above the buckle and pull the strap tangential to the limb
sented in Mottled, Blanching Skin Changes After Aggressive at the buckle. Additionally, neither strength nor experience
Diving. guarantees desirable strap pressures in the absence of pressure
knowledge.
Differential Diagnosis of an Unusual Snakebite Presentation
in Benin: Dry Bite or Envenomation? highlights an unusual Resilience and Suicide in Special Operations Forces: State
case of snakebite with persistent neuropathy despite an appar- of the Science via Integrative Review: Because of overall in-
ent lack of envenomation and a number of snakebite-specific consistency in military resilience research, studies have limited
variables that complicated the initial assessment, diagnosis, external validity, and cannot be applied beyond sampled pop-
and treatment of the patient. ulations. Resilience cannot be responsibly offered as a solution
to mitigating posttraumatic stress disorder nor suicide without
detailed study of both in SOF. An Editor’s Note follows.
The western purple- The Use of the Abdominal Aortic and Junctional Tourni-
glossed snake
Photographed by Stephen Spawls in Ghana. of many mildly Model compares the ability of the AAJT and Combat Gauze
(Amblyodipsas
quet Versus Combat Gauze in a Porcine Hemicorporectomy
unicolor) is one
to stop hemorrhagic bleeding from a hemicorporectomy in a
venomous, non–
front-fanged species
swine model.
found in Benin that
fits the description
Development of a Field-Expedient Vascular Trauma Simula-
of the snake seen by
tor describes the creation of a field-expedient vascular trauma
the patient.
trainer for noncompressible torso hemorrhage using a Penrose
drain, intravenous tubing, suture, and a cardboard box.
Use of Atomized Intranasal Tranexamic Acid as an Adjunc-
tive Therapy in Difficult-to-Treat Epistaxis presents a case Impact of Continuous Ketamine Infusion Versus Alternative
series of three patients with difficult-to-treat epistaxis where Regimens on Mortality Among Burn Intensive Care Unit
standard treatment methods were not effective and the authors Patients: Implications for Prolonged Field Care compares
used atomized intranasal TXA as part of a stepwise treatment in-hospital mortality between intubated burn intensive care
approach. unit (ICU) patients receiving prolonged ketamine infusion last-
ing ≥7 days or until death versus controls.
TCCC CRITICAL DECISION
CASE STUDIES Sulfur Mustard Exposure: Review of Acute, Subacute, and
Three TCCC circulation case studies are presented. Long-Term Effects and Their Management provides a con-
temporary overview of sulfur mustard injury and its manage-
SPECIAL ARTICLE ment in the acute, subacute, and chronic periods.
Cypress Creek EMS Basic Tactical Operational Medical
Support Course is an international, 80+-hour, 8-day total im-
mersion course in tactical EMS open to personnel with any
medical background to educate, train, and prepare them to
operate within a tactical law enforcement environment. This
course provides certification in the NAEMT’s TCCC, as well
as 91+ hours of CE/CHE credit in the three disciplines of EMS,
fire, and law enforcement.
FEATURE ARTICLES
Ease of Use of Emergency Tourniquets on Simulated Limbs Acute effects of mustard gas exposure. Images demonstrate erythema
of Infants: Deliberate Practice investigated the application of and vesicle formation 4–6 hours after initial exposure.
emergency tourniquets in very young children.
A Comparison of Prehospital Versus Emergency Depart-
ment Intubations in Iraq and Afghanistan compares survival
in the combat setting among patients undergoing prehospital
versus emergency department intubation.
Handrail simulates an infant
limb for deliberate practice of
tourniquet use. Survival of Casualties Undergoing Prehospital Supraglottic
Airway Placement Versus Cricothyrotomy contrasts the sur-
vival of causalities undergoing cricothyrotomy versus supra-
glottic airway placement.

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