Page 5 - Journal of Special Operations Medicine - Winter 2014

working dogs used in civilian law enforcement, with a goal colleagues examine the pressure and effectiveness similari-
of improving the treatment of injuries, as well as equipment ties and differences between the Ratcheting Medical Tour-
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and training, to reduce deaths. Complementing this work niquets Tactical RMT and Mass Casualty RMT models and
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on enhancing the care and health of dogs, McCown and his the Combat Application Tourniquet (C-A-T ).
team conducted an in-depth point prevalence survey to de-
termine the seroprevalence of tick-borne pathogens, based Adding to the literature on the care of battlefield casual-
on three populations of dogs in Colombia. ties in the prehospital arena, Le Clerc and coauthors pres-
ent “Predicting When to Administer Blood Products During
The need to conserve Servicemembers by caring for their Tactical Aeromedical Evacuation,” in which they compare
wounds has been a priority for millennia. Greek physician and evaluate a US/UK study of the administration of blood
Hippocrates (ca. 460–377 bc) advised his disciples, “He who products, analyzing differences and recommending future
would become a surgeon, let him join an army and follow strategy. And battlefield casualty care experience continues
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it.” During the Third Battle of Ypres in 1917, “the ‘little to be an invaluable resource to civilian prehospital trauma
red cross on a little flag’ meant the difference between life care. The optimal field management of open chest wounds
and death. It was the emblem of the medical corps—the remains a focus of scientific investigation and clinical deci-
stretcher-bearers, orderlies, doctors, nurses and many others sion making, and Margolis and colleagues provide a review
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who often risked their own lives to care for the wounded.” on the “Management of Open Chest Wounds in Tactical
Foremost in the goals of readers of the JSOM are the pre- Emergency Casualty Care: Application of Vented Versus
vention and rapid assessment of both injury and illness to Nonvented Chest Seals.”
Servicemembers. With that in mind, from the perspective
of USAF Pararescuemen, McBratney and coauthors discuss n n n
“Pilot Ejection, Parachute, and Helicopter Crash Injuries.” Dr Gary and his colleagues evaluated the compressive func-
Barnard and his colleagues investigate “Prehospital and En tion of the JETT in the reduction of pelvic ring injuries in
Route Cricothyrotomy Performed in the Combat Setting” a cadaveric model and present their findings in “Imaging
and conclude that the majority of combat cricothyrotomies Comparison of Pelvic Ring Disruption and Injury Reduction
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were performed by the evacuation helicopter medic rather With Use of the Junctional Emergency Treatment Tool for
than the prehospital combat medic. They recommend that Preinjury and Postinjury Pelvic Dimensions.” And in a re-
prehospital military medics receive training in decision mak- search animal model, Dr Hillis and her team conducted an
ing and be provided with adjuncts to facilitate this lifesaving “Evaluation of NuStat , a Novel Nonimpregnated Hemo-
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procedure. static Dressing, Compared With Combat Gauze in Severe
Traumatic Porcine Hemorrhage Model.” The authors investi-
In a new “Injury Prevention” presentation, Knapik discusses gated immediate hemorrhage control, stability, and the use
“Injuries and Injury Prevention During Foot Marching.” In of fluids. Both of these research studies have results appli-
our “Clinical Corner” this month, Banting and Meriano re- cable to care in the field.
view the course of action on presentation of a local man
who has a sore throat during a village stability operation. In n n n
“Preventive Medicine,” Stanley and Faulkenberry describe In “Performance Psychology as a Key Component of Human
“The 227th Medical Detachment’s Role in Response to Su- Performance Optimization,” Herzog and Deuster describe
perstorm Sandy,” highlighting many lessons learned related how mental-skills training can be applied to improve per-
to disaster assistance for use by SOF medical personnel and formance on mission-related tasks. Enjoy this thorough dis-
articulating the application and functionality of a preventive cussion and learn how mental-skills training can also help in
medicine team or detachment in humanitarian assistance preventing SOF personnel from experiencing PTSD symp-
and disaster response. And Vigilante and Scribner describe toms and improve self-esteem in Warfighters recovering
the pathophysiology, causes, course, diagnosis, and man- from injury and illness.
agement of erythema nodosum in this issue’s “Picture This.”

O’Hara, Serres, Dodson, Wright, Ordway, Powell, and Wade References
reviewed the literature on “The Use of Dexamethasone in 1. http://www.army.mil/news/africa/.
Support of High-Altitude Ground Operations and Physi- 2. Neely JG, Karni RJ, Nussenbaum B, et al. Practical guide
cal Performance.” Acute exposure to high altitude, even to understanding the value of case reports. Otolaryngol
in asymptomatic subjects, results in small cognitive deficits Head Neck Surg. 2008;138:261–264.
that can be reversed with dexamethasone. The review indi- 3. http://www.historynet.com/battlefield-medics-saving
cates that dexamethasone is an effective form of treatment -lives-under-fire.htm.
for acute mountain sickness, high-altitude cerebral edema,
and high-altitude pulmonary edema, and the authors pro- Source: Map from Creative Commons.
vide commonly used dosages. In “Tourniquet Pressures:
Strap Width and Tensioning System Widths,” Wall and her

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