Page 83 - JSOM Winter 2025
P. 83
The ongoing war in Ukraine has also shown that healthcare https://www.ndr.de/nachrichten/schleswig-holstein/GSG-9-
facilities are intentionally targeted, contravening international Stationierung-in-SH-Infrastruktur-in-der-Ostsee-schuetzen-,
humanitarian law and the Geneva Conventions. A maritime eliteeinheit100.html
strategy to counter this threat towards hospital ships and mar- 4. Ferrari R. Writing narrative style literature reviews. Medical Writing.
2015;24(4):230–235. doi:10.1179/2047480615Z.000000000329
itime patient transport will be needed. 41,42 5. Hight M, Less K. Management of hypothermia and immer-
sion injuries. In: Tadlock, MD, Hernandez AA, eds. Expedi-
In the Baltic Sea during 2024, there has been a marked increase tionary Surgery at Sea. Springer; 2023:579–597. doi:10.1007/
in severe GPS disturbances, impacting both military and civil- 978-3-031-21893-4_28
ian air traffic as well as maritime vessels. Such disruptions 6. Melau J, Hisdal J, Solberg PA. Impact of a 10,000-m cold-water
43
can hinder mission execution, delay casualty evacuations, and swim on Norwegian Naval Special Forces recruits. J Spec Oper
Med. 2021;21(3):55–59. doi:10.55460/qe23-511p
compromise telemedical consultations. Additionally, recurrent 7. Kitchen L, Tilley L, Bennett B, et al. “Clinical Practice Guidelines for
sabotage targeting energy infrastructure and communication Hypothermia: Prevention and Treatment.” Joint Trauma System.
cables has further underscored the evolving nature of hybrid Published March 13, 2024. Accessed February 16, 2025. https://
threats in the region. 44 tccc.org.ua/en/guide/hypothermia-prevention-and-treatment-cpg
8. Cheung SS. Responses of the hands and feet to cold exposure.
Temperature (Austin). 2015;2(1):105–120. doi:10.1080/233289
Conclusion 40.2015.1008890
9. Brajkovic D, Ducharme MB, Frim J. Relationship between body
Maritime operations conducted by SOF and SWAT units re- heat content and finger temperature during cold exposure. J Appl
quire specialized medical approaches to address hypothermia, Physiol (1985). 2001;90(6):2445–2452. doi:10.1152/jappl.2001.
drowning risks, trauma in confined spaces, fall-related injuries, 90.6.2445
respiratory hazards, and motion- or impact-related impair- 10. Adams LM, Tadlock MD. Management of the drowned patient. In:
ments. Through targeted training, adapted trauma protocols, Tadlock MD, Hernandez AA, eds. Expeditionary Surgery at Sea.
Springer; 2023: 569–578 doi:10.1007/978-3-031-21893-4_27
and specialized equipment, tactical medics are prepared to 11. Flaherty A, Martinez L. How 2 elite Navy SEALs drowned in plain
support their teams in some of the most challenging environ- sight in anti-terror mission. ABC news. October 11, 2024. Ac-
ments. With the increasing demand for maritime missions in cessed February 16, 2025. https://abcnews.go.com/Politics/how-
counter-smuggling, counter terrorism, counter hybrid warfare, 2-elite-navy-seals-drowned-anti-terror-mission-somalia-report/
and hostage rescue operations, continuously evolving medical story?id=114682399
practices will be vital to ensuring both operational success and 12. Parenteau M, Stockinger Z, Hughes S, et al. “Clinical Practice
personnel safety. Looking ahead, future research should not be Guidelines for Drowning Management.” Joint Trauma System.
limited to risk mitigation and core medical issues but should Published February 26, 2024. Accessed February 16, 2025. https://
tccc.org.ua/en/guide/drowning-management-cpg
also investigate ways to maintain or enhance operator perfor- 13. Glassberg E, Lipsky AM, Abramovich A, Sergeev I, Hochman O,
mance in maritime environments. This is paramount not only Ash N. A dynamic mass casualty incident at sea: lessons learned
for protecting the health and safety of personnel but also for from the Mavi Marmara. J Trauma Acute Care Surg. 2013;75(2):
ensuring the delivery of effective medical care and, ultimately, 292–297. doi:10.1097/TA.0b013e318294662d
achieving mission success. 14. Calvano CJ, Enzenauer RW, Eisnor DL, LaPorta AJ. Tactical light-
ing in Special Operations Medicine: survey of current preferences.
J Spec Oper Med. 2013;13(4):15–21. doi:10.55460/7FAH-U3C2
Author Contributions 15. Gellerfors M, Svensén C, Linde J, Lossius HM, Gryth D. Endo-
FG was involved in conceptualization (lead); writing the orig- tracheal intubation with and without night vision goggles in a he-
inal draft; analysis; and writing review and editing. ML was licopter and emergency room setting: a manikin study. Mil Med.
involved in the investigation and writing review and editing. 2015;180(9):1006–1010. doi:10.7205/MILMED-D-14-00583
JM was involved in the investigation and writing review and 16. Lambert EW, Simpson RB, Marzouk A, Unger DV. Orthopaedic
editing. DT was involved in conceptualization (supporting); injuries among survivors of USS COLE attack. J Orthop Trauma.
supervision; and writing review and editing. 2003;17(6):436–441. doi:10.1097/00005131-200307000-00008
17. Sebreros BA, Wisniewski P, Lindholm P, Boswell GE, Volk CG. Inci-
dence of respiratory pathogens in naval special warfare sea, air, and
Disclaimer land team candidates with swimming-induced pulmonary edema.
The views expressed in this article are those of the authors and Chest. 2023;163(5):1185–1192. doi:10.1016/j.chest.2022.11.023
do not reflect the official policy or position of their affiliated 18. Tadlock MD, Edson TD, Cancio JM, et al. War at sea: burn care
institutions. challenges—past, present and future. Eur Burn J. 2023;4(4):605–
630. doi:10.3390/ebj4040041
Disclosures 19. Fortin JL, Locatelli C, Desmettre T, Capellier G. Fire on board
The authors have nothing to disclose. naval ships. Analysis and management of the toxicological risk.
Int Rev Armed Forces Med Serv. 2011;84(4):61–68.
Funding 20. Borza ML, Blonien NE. Swimming-induced pulmonary edema
No external funding was received for the preparation of this found in a U.S. Navy Basic Underwater Demolition/SEAL Re-
cruit. Cureus. 2022;14(9):e29417. doi:10.7759/cureus.29417
manuscript. 21. Steele S, Brahmbhatt S, Patel D. Swimming-induced pulmonary
edema: evaluation, diagnosis, and treatment. Curr Sports Med
References Rep. 2024;23(4):124–129. doi:10.1249/JSR.0000000000001157
1. Singh MV, Ray S, Goyal S, Singh RJ, Sharma R. Tactical Combat 22. Tyagi R, Sharad Tendolkar M, Handa A. Swimming-induced pul-
Casualty Care in the Navy–challenges and way ahead. J Mar Med monary edema with review of literature. Med J Armed Forces In-
Soc. 2019;21(2):105–107. doi:10.4103/jmms.jmms_67_19 dia. 2021;78(4):485–488. doi:10.1016/j.mjafi.2021.01.008
2. Blanchet K, Rubenstein L, Taithe B, Fast L. Have attacks on health- 23. Spinks A, Wasiak J. Scopolamine (hyoscine) for preventing and
care become the new normal? A public health call to action for treating motion sickness. Cochrane Database Syst Rev. 2011;2011
armed conflicts before it is too late. Confl Health. 2023;17(1):56. (6):CD002851. doi:10.1002/14651858.CD002851.pub4
doi:10.1186/s13031-023-00555-4 24. Wibble T, Engström J, Verrecchia L, Pansell T. The effects of me-
3. NDR. GSG 9 Stationierung in SH: Infrastruktur in der Ostsee clizine on motion sickness revisited. Br J Clin Pharmacol. 2020;86
schützen. Published October 11, 2024. Accessed February 16, 2025. (8):1510–1518. doi: 10.1111/bcp.14257
High-Risk Maritime Operations | 81

