Page 11 - JSOM Spring 2026

exposures; however, the small sample size limits the generaliz- Testing the Emergency Evacuation Hyperbaric Stretcher for
ability of results. Fit in Small Military and Civilian Helicopters: Studer and Brett
tested the emergency evacuation hyperbaric stretcher (EEHS)
for fit and operational computability in both a U.S. Coast
Guard Airbus MH-65 “Dolphin” and an Airbus H145 helicop-
ter with a configuration typical of civilian air ambulances. They
found that the MH-65 could not accommodated the EEHS
without the side doors remaining open and obstructing the
rescue swimmer’s seat, which may pose challenges to the safe
transport of an EEHS during standard operational scenarios.
The authors caution that further research is recommended to
assess newer EEHS models and to improve aircrew and clini-
cian familiarity with EEHS transportation requirements.
CASE REPORTS
High-Altitude Pulmonary Edema Management in a Special
Operator: Rodriguez and colleagues present the case of an
Army Special Forces officer who experienced respiratory dis-
Correlation matrix and heatmap between GBEV and proxy measures tress during high-altitude training in Nepal. The patient was
of blast exposure for convergent validity analysis (n=41). prophylactically treated with acetazolamide but did not re-
ceive nifedipine or tadalafil. In their report, the authors ana-
Contrast-Enhanced Focused Assessment with Sonography lyze both the treatments used as well as alternatives, such as
for Trauma (cFAST) Far Forward: Contrast Visualization Meth- the portable hyperbaric chamber. They emphasize the neces-
ods Testing of Six Field-Portable and Handheld Ultrasound sity for standardized prophylaxis for high-altitude pulmonary
Systems: As part of the methods-design process for a cFAST edema in appropriate personnel to prevent disruption to mis-
study, Alexandri and colleagues tested six handheld and por- sion and loss of operational capabilities.
table ultrasound systems for their ability to visualize contrast
enhancement: Philips Lumify, Butterfly IQ3, GE Vscan Air, Fuji- Case Report on the Augmentation of Cognitive Processing
film Sonosite Edge II, Fujifilm Sonosite M-Turbo. Contrast en- Therapy with Spiritual Counseling to Address Faith-Based
hancement was visualized only on the GE Vscan Air (as well as Concerns for an Operator with High Religiosity: Schroedter
the GE Venue, the cart-based comparator). The authors con- and colleagues describe the treatment of a Special Operations
clude that while the GE Vscan Air shows promise, further work Forces (SOF) Operator with high religiosity experiencing post-
is needed to determine whether system modifications, software traumatic stress disorder and moral injury after experienc-
upgrades, or dosing adjustments can enable cFAST capability ing indirect combat-related trauma via real-time audiovisual
in the far-forward environment. drone feed. This case highlights the importance of identifying
and addressing faith-related moral injury early in treatment
Night Vision Goggles: Influence on Cognition, Gait, and Tacti- and suggests that spiritual counseling combined with cognitive
cal Tasks: In a cohort of 12 participants, Rauth and colleagues processing therapy may enhance outcomes for those suffering
examined the biomechanical effects in the walking phase of an with vicarious posttraumatic stress.
obstacle clearance course and prefrontal cortex regional oxy-
gen saturation (rScO ) during embedded marksmanship and
2
cognitive tasks performed with and without night vision goo- Emergency evacuation
gles (NVGs). They found that with NVG use marksmanship hyperbaric stretcher loaded
performance decreased by 58.2%, but cognitive performance into H145 aircraft on floor,
was not impacted. Toe clearance increased by 32.2%, toe ve- viewed from side door.
locity decreased by 20.5%, and ankle dorsiflexion increased
by 24.0% with NVG. Additionally, they observed significant
reductions in rScO during Marksmanship 2 targets and Cog-
2
nitive Assessment tasks 1 and 2. The authors argue that these CONFERENCE PROCEEDINGS
findings demonstrate that NVG use poses persistent challenges The 3rd ISTC Medical Symposium (Pfullendorf 2025):
to operational performance, underscoring the need for fur- From Lessons Observed to Capabilities Delivered
ther research to develop strategies that mitigate these deficits
during critical low-light tasks. TCCC UPDATES
Standardizing Tourniquet Reassessment and Conversion
IN BRIEF Across TCCC Tiers: TCCC Guidelines Proposed Change 25-2
From Paper Tubes to Millimeter Waves: Fostering Biological
Operational Security: Anna M. Gielas highlights examples of
biological surveillance technologies and proposes a holistic re- BOOK REVIEW
sponse by conceptualizing the management of biological sig-
natures during operations as biological Operational Security Alone at Dawn: Medal of Honor Recipient
(bio-OPSEC). The author proposes that Special Operations John Chapman and the Untold Story of the
Forces medics can act as integrators between tactical medical World’s Deadliest Special Operations Force
knowledge and technical threat awareness, helping their teams
reduce bio-signatures in high-risk environments.

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