Page 42 - Journal of Special Operations Medicine - Fall 2015

Major Benov, MC, is a resident in general surgery in the APPENDIX 1:
Israeli Defense Force. He has served as Battalion Surgeon and JUNCTIONAL TOURNIQUET SKILL TRAINING
then Brigade Surgeon, and he was also deputy of the Trauma
and Combat Medicine Branch. He was a fellow at the USAISR Tourniquet training is accomplished using the crawl–
and has returned to Israel. walk–run technique. Students are given a block of in-
struction on hemorrhage control techniques, one of
LTC Marcozzi, MC, is a US Army emergency physician serv- which will be junctional tourniquets. They are given a
ing the White House. He has experience with Special Opera- skill sheet with each individual step in the application
tions Forces.
process of the tourniquet. An instructor demonstrates
the correct application three times, once in slow motion,
COL Shackelford, MC, USAF, is an experienced trauma
surgeon at the Joint Trauma System at the USAISR; she has once where each step is highlighted, and, finally, at com-
war surgery experience and has published several studies on bat speed. This allows the students to see what the cor-
operational medicine topics. rect technique looks like from the beginning. They are
then given the devices and will practice their application
Maj Cox is a US Air Force nurse instructor at the Combat Ca- on manikins and on each other, using their skill sheet.
sualty Care Course of the USAMEDDC&S, Fort Sam Hous- They repeat this process several times while the instruc-
ton, Texas. tors supervise and answer any questions the students
have. After repeating this process multiple times, they
LTC Mann-Salinas is a Task Area Manager for the Systems will have memorized the steps in the process and under-
of Care for Complex Patients Research Task Area at USAISR, stand how the device is applied. This is the crawl phase.
Fort Sam Houston, Texas. She has expertise in simulation and
training.
Next, the students are not told to apply the device, but
are given a scenario in which they must choose which
hemorrhage control measure is best for a specific ca-
sualty. This requires the students to think about all the
techniques they have learned, and then choose the tech-
nique that is best for this situation. They must then cor-
rectly apply the device to the casualty. The instructors
are there to coach, correct their mistakes, and answer
Special Operations Medical Association any questions. This is the walk phase.
Invites you to Exhibit at the
Finally, the students are given a casualty with unknown
2015 SOMA Symposium wounds and on whom they must perform a casualty as-
Translating SOF Lessons Learned to the sessment; they must find the wounds, and apply the cor-
Conventional Forces rect lifesaving intervention to the casualty. The casualty
December 14-16, 2015 may have more than one wound, usually a life-threat-
ening wound and a minor wound, to add a decision
To learn more about exhibiting at process to the event. The student must choose which
the 2015 SOMA Symposium visit: to treat initially and perform the correct intervention.
www.specialoperationsmedicine.org Instructors supervise, coach, correct performance, and
answer questions. This is the run phase. We can also ma-
nipulate the environment by adding variable elements
such as darkness, smoke, battlefield sounds, and mul-
tiple casualties with different wounding patterns.

The final examination requires one student to demon-
strate to one instructor that they can perform this skill
in a specific time. If not successful, the student will re-
ceive additional training and will be retested. They get
three attempts to successfully complete the skill. This is
one-on-one performance testing.

This is the same process used to train all skills. Different
manikins (task trainers) are employed and students are
given different skill sheets with the instructions for the
specific steps for a given skill.

30 Journal of Special Operations Medicine Volume 15, Edition 3/Fall 2015