Page 5 - Journal of Special Operations Medicine - Summer 2016

lessons learned over the last 14 years of war that in- n n n
clude: (1) tourniquet use reliably stops bleeding from
limb wounds and prevents mortality in prehospital In addition, JSOM Associate Editors LTC David R.
settings; and (2) brief tourniquet use appears to be King, MD, FACS, and Piper L. Wall, DVM, PhD, and
safe. These 2 lessons have become so evident that ci- their colleagues have provided “Tourniquet Effective-
vilian emergency medical systems have begun using ness When Placed Over the Joint Service Lightweight
them, albeit unevenly. Collection and interpretation Integrated Suit Technology” and “Pressures Under
of data of casualties with tourniquet use have showed 3.8cm, 5.1cm, and Side-by-Side 3.8cm-Wide Tourni-
that such intervention has lifesaving benefit through 2 quets,” respectively.
mechanisms: control of both ongoing hemorrhage and
shock severity. The next generation of interventions in This issue also features up-to-date information on field
bleeding control involves developing the skill sets, ed- sterilization, animal-versus-synthetic model testing,
ucation, and standards of tourniquet users which may cooling technology, underwater inner ear barotrauma,
improve hemorrhage control in wars to come. and the National TEMS Competency Domains. Case re-
ports cover herpes zoster on the Sinai Peninsula, prehos-
n n n pital walking blood bank, and an anthrax presentation.

We are fortunate to have three contributions in this is- Our Ongoing Series experts present a variety of use-
sue from Dr Kragh: “Preliminary Measures of Instructor ful information on nausea, pain as a barrier to per-
Learning in Teaching Junctional Tourniquet Users,” by formance, Japanese encephalitis, program-induced
John F. Kragh Jr, MD; James K. Aden 3rd, PhD; Stacy cumulative overload, tattoos, personal hydration sys-
A. Shackelford, MD; Michael A. Dubick, PhD; “Prelimi- tem water reservoirs, and Niger’s CASEVAC Success.
nary Comparison of Pneumatic Models of Tourniquet
for Prehospital Control of Limb Bleeding in a Manikin,” Fascinating reviews of Modern Irregular Warfare in
by Ruby Gibson; James K. Aden 3rd, PhD; Michael A. Defense Policy and as a Military Phenomenon by
Dubick, PhD; John F. Kragh Jr, MD; and “SWAT Is a Friedrich August Freiherr and Team of Teams: New
Lifestyle; It’s a Way of Life: Ray Casillas on a Career in Rules of Engagement for a Complex World by Gen-
Operational Medicine,” interviewed by John F. Kragh eral (Ret) Stanley McChrystal et al. round out this is-
Jr, MD. sue. We hope you enjoy it all!

Preventing death: Façade
of Fulton County Health
Department, Atlanta, GA,
across the street from Grady
Memorial Hospital.

Photograph by Dr Kragh

In This Issue iii