Page 6 - Journal of Special Operations Medicine - Fall 2016

by Allison Esposito, Managing Editor

Skeleton Traction, Compartment Syndrome, TMA syndromes, which represent a group of disorders
Pectoralis Major Injury, and Thrombotic defined by shared characteristics of microangiopathic
Microangiopathy Syndrome hemolytic anemia, thrombocytopenia, and organ injury
from pathologic small-vessel thrombosis. Evaluation and
This issue’s four Case Reports cover some unique situa- management in the field require astute clinical judgment
tions and provide thorough discussions of each entity. In and empiric supportive treatment until evacuation occurs.
“A Skeletal Traction Technique for Proximal Femur Frac-
ture Management in an Austere Environment,” Lidwell
and Meghoo aim to enable the reader to (1) recognize n n n
the role of skeletal traction in managing proximal femur Goforth and Antico’s Editorial “TCCC Standardization:
fractures in an austere environment, (2) identify the key The Time Is Now” emphasizes that while great strides in
steps in placing transfemoral skeletal traction pins, and prehospital care TCCC have been made in the past 14
(3) identify options and requirements for building a trac- years, the lack of institutional standardization is one of
tion construct in resource-limited environments.
the remaining challenges of trauma care.
Image showing 550 paracord being used to lash the
disposable pin driver from an external fixation set, allowing Tourniquets, Oxygen Concentrators,
for a swivel arm that does not interfere with the knee. Ballistic Protection, and Schistosomiasis

In “Evaluation of Models of Pneumatic Tourniquet in
Simulated Out-of-Hospital Use,” Kragh, Aden, and Du-
bick provide laboratory data on the differential perfor-
mance of models of pneumatic tourniquets to inform
decision-making of potential field assessment by mili-
tary users.

(A) Emergency and Military Tourniquet. (B) Tactical
Pneumatic Tourniquet 3-inch (TPT3).
A B

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In “Lower Extremity Compartment Syndrome From
Prolonged Limb Compression and Immobilization Dur- “Fraction of Inspired Oxygen Delivered by Elisée 350
™
ing an Airborne Operation,” Smedick and Van Wyck Turbine Transport Ventilator With a Portable Oxygen
present the case of a 19-year-old Army paratrooper who Concentrator in an Austere Environment,” by d’Aranda
developed acute anterior and lateral compartment syn- and colleagues, was reported in the French military FSU
drome of the lower extremity after being immobilized in Niamey, Niger, in January 2015 to measure the Fio
2
in an aircraft for hours with several hundred pounds achievable when the Elisée 350 was used with an oxy-
of equipment compressing his lower extremities. “Pec- gen concentrator as the only source of oxygen.
toralis Major Injury During Basic Airborne Training,”
by McIntire, Boujie, and Leasiolagi, presents the case In “Medical Provider Ballistic Protection at Active
of an active-duty Servicemember who sustained a pec- Shooter Events,” Stopyra and his group put forth that
toralis major injury while exiting an aircraft during the in keeping with current recommendations, body armor
Basic Airborne Course. And Croom and Tracy’s “Throm- is not mandatory for medical responders paired with
botic Microangiopathy Syndrome in a Basic Under- armed law enforcement teams providing care at active
water Dem olition/SEAL Student” includes a discussion of shooter incidents. Body armor in good condition can

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