Page 6 - Journal of Special Operations Medicine - Winter 2016

by Allison Esposito, Managing Editor

n a Case Report titled “Secondary Hypertension, not guarantee maintenance of arterial occlusion.
IErythrocytosis, and Unilateral Renal Cystic Disease in Given the opportunity, tourniquet applications should
a Submariner,” Forbes and Yeo describe the case of an be reassessed for continued arterial occlusion 5 or 10
active duty Servicemember who presented with a chief minutes after application.”
complaint of headache symptoms directly attributable
to erythrocytosis in the setting of negative JAK2 muta-
tion and normal EPO levels. Temporary
indentation
In this issue’s Editorial, “Pretrauma Interventions in immediately
Force Health Protection: Introducing the ‘Left of Bang’ after Ratcheting
Paradigm,” Eisenstein and colleagues discuss how the Medical
military metaphor “left of bang” fits into the medical Tourniquet
removal.
treatment of major trauma patients.

Schematic representation of “left of bang” trauma
interventions.

In “Trigger-Point Dry Needling for the SOF Medic,”
Cavett and Solarczyk propose that “trigger-point dry
needle therapy is an effective low-risk treatment for
pain associated with myofascial trigger points and
should be incorporated into the Special Operations
Forces Medic’s scope of practice.”

Moore and O’Hara present “Mitigating Exertional
Heat Illness in Military Personnel: The Science Behind
a Rice-Based Electrolyte and Rehydration Drink,” in
In the first Feature Article, Kragh and associates inves- which they put forth that “CeraSport, compared with
tigate the “Learning Curves of Emergency Tourniquet other ORSs and sports drinks, may offer benefits such
Use: Exploring for Utility in Training” and conclude as faster gastric emptying rates and improved absorp-
that “measures of learning readily available to tourni- tion from the gastrointestinal tract.”
quet instructors include effectiveness, pulse cessation,
time to effectiveness, windlass turn number, and pres- The US Naval Special Warfare’s Special Warfare Com-
sure under the tourniquet. All of these are candidate batant-Craft Crewmen operate on small, high-speed
measures for potentially useful feedback to trainees. boats while wearing tactical gear. The tactical gear
Plotting measures by experience showed quantified increases mission safety and success but may affect
learning of users and aided in generating hypotheses postural stability, potentially increasing risk for mus-
for future testing.” culoskeletal injury. Therefore, Morgan and coworkers
examined the effects of tactical gear on postural sta-
“Significant Pressure Loss Occurs Under Tourniquets bility during the Sensory Organization Test in “Postural
Within Minutes of Application,” by Rometti and co- Stability of Special Warfare Combatant-Craft Crewmen
workers, posits that “even without tourniquet move- With Tactical Gear.”
ment or limb muscle tension changes, pressure losses
occur within minutes under tourniquets. These pres- Pedler and colleagues used the Farnsworth-Munsell
sure losses are substantial with nonelastic tourniquets. hue test to determine color vision of normal sub-
Therefore, proper initial tourniquet application does jects under white, red-green, and blue flashlights to

iv