Page 8 - Journal of Special Operations Medicine - Spring 2017

by Allison Esposito, Managing Editor

HOW IT WORKS WHITE PAPER
In “Liberating the Oppressed: Research Knowledge Teeter and his colleagues present “Resuscitative Endo-
Differentials and Ethical Investigation in Special Op- vascular Balloon Occlusion of the Aorta: Pushing Care
erations Forces Clinical Science,” Academic Content Forward” and assert that their “study demonstrates
Advisory Editor Kate Rocklein Kemplin and F. Young that nonsurgeon and nonphysician providers can learn
Bowling present the first in a series on what research is, the steps required for REBOA after arterial access is
ethics, how to start doing research, what statistics are established. Although insertion is relatively straight-
forward, the inability to gain arterial access percuta-
appropriate and what they mean, how to critique an neously is prohibitive in providers without a surgical
article, and the basics of when and how to go through skillset and should be the focus of further training.”
the institutional review board.

IN BRIEF
CASE REPORTS
Monti describes a novel ultrasound gel alternative that
“A Modern Case Series of Resuscitative Endovascular may be better suited for resource-constrained environ-
Balloon Occlusion of the Aorta (REBOA) in an Out-of- ments than standard ultrasound gel in “A Novel Ul-
Hospital, Combat Casualty Care Setting,” by Manley trasound Transmission Gel for Resource-Constrained
and colleagues, presents “to our knowledge, . . . the Environments.”
first series to demonstrate the feasibility and effective-
ness of REBOA in modern combat casualty care and
the first to describe use of the ER-REBOA catheter.”

Field expedient, portable resuscitation and operative area Commercially available
deployed in an austere environment area of opportunity. glucomannan powder
supplement.

FEATURE ARTICLES
In “Cat on a Hot Tin Roof: Mechanical Testing of Mod-
els of Tourniquet After Environmental Exposure,”
O’Conor and his associates mechanically assessed
models of emergency tourniquet after 18 months of
environmental exposure to weather to better under-
stand risk of component damage.

“Effectiveness of Pulse Oximetry Versus Doppler for
Pham and associates discuss the case of a 10-year-old Tourniquet Monitoring,” by Wall and colleagues, con-
local national with paraphimosis who required invasive cludes that “use of a pulse oximeter to monitor limb
reduction in a deployed austere environment in Africa tourniquet effectiveness will result in some instances
in “Invasive Reduction of Paraphimosis in an Adoles- of an undetected weak arterial pulse being present. If
cent Male While in a Deployed Austere Environment.” a pulse oximeter waveform is obtained from a location
distal to a tourniquet, the tourniquet should be tight-
In “A Soldier With an Exertional Heat Injury, Ischemic- ened. If a pulsatile waveform is not detected, vigilance
Appearing Electrocardiogram, and Elevated Tropo- should be maintained.”
nins: A Clinical Case Report,” Schauer and Pfaff note
that “Ischemic-appearing ECG and troponin findings In “Pediatric Trauma: Management From an Austere
may be noted after heat injury.” Prospective,” stating that “there is scant literature . . .

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