Page 6 - JSOM Winter 2017

by Allison Esposito, Managing Editor

IN BRIEF Fitzgerald and colleagues’ “Humanitarian Surgical Missions:
Guidelines for Successful Anesthesia Support” provides check-
Wittich discusses a timely topic for clinicians both in the lists and supply lists to assist in proper planning and execu-
United States and abroad in “Female Mutilation as a Concern tion for anesthetic support of humanitarian surgical missions,
for Special Operations and Tactical Emergency Medical Sup- which can result in an “extremely satisfying sense of accom-
port Medics.” plishment and a rewarding experience both for the team who
deliver care and the patients who receive care.”
FEATURE ARTICLES
April and his colleagues designed and executed a training cur-
We lead this issue with the “Extraglottic Airways in Tactical riculum focused on high-yield–based medical skills to prevent
Combat Casualty Care: TCCC Guidelines Change 17-01, 28 death on the battlefield for non-English–speaking members of
August 2017,” from Otten, Montgomery, and Butler. the Turkish, Azerbaijani, and Albanian militaries deployed to
Afghanistan. They report their results in “Advise and Assist: A
Next, in “Assessment of User, Glove, and Device Effects on Basic Medical Skills Course for Partner Forces.” And in “Expe-
Performance of Tourniquet Use in Simulated First Aid,” Kragh rience With Prehospital Damage Control Capability in Modern
and colleagues report that “[i]n simulated first aid with tourni- Conflict: Results From Surgical Resuscitation Team Use,” Du-
quets used to control bleeding, users had major effects on most Bose and his team review 12 years of after-action reports from
performance metrics. Glove effects were significant for three SRTs and analyze demographics, interventions, and outcomes.
of eight glove types. Tourniquet device effects occurred only
with continuous metrics and were often dominated by user In “Diagnostic Accuracy of Emergency Bedside Ultrasonogra-
effects.” And in “Effects of Distance Between Paired Tourni- phy to Detect Cutaneous Wooden Foreign Bodies: Does Size
quets,” Wall et al. found that “[v]ery proximal placement has Matter?” Fleming and associates “found poor diagnostic accu-
a pressure advantage; however, pairs and very proximal lo- racy for the use of ultrasound to detect wooden foreign bodies
cations may be less likely to maintain occlusion. Increasingly in a standard tissue model” and “also found no significant as-
proximal placements also increase tissue at risk; therefore, dis- sociation between foreign body size and diagnostic accuracy.”
tal placements and minimal intertourniquet distances should
still be recommended.” D’Angelo and colleagues’ “Expeditionary Resuscitation Surgi-
cal Team: The US Army’s Initiative to Provide Damage Con-
“Use of Physical Therapists to Identify and Treat Musculo- trol Resuscitation and Surgery to Forces in Austere Settings”
skeletal Injuries at ‘The Tip of the Trident,’” by Shaw and as- concludes that the “ERST was conceptualized to fill a void in
sociates, illustrates how the use of physical therapists to treat emergent battlefield care and is showing promise to care for
musculoskeletal injuries, a significant problem for deployed those in harm’s way.”
units, can keep personnel effective and able to complete their
missions. The “Efficacy of the Mnemonic Device ‘MARCH/PAWS’ as a
Checklist for Pararescuemen During Tactical Field Care and
“Staff Attitudes Regarding Tactical Evacuation” is provided by Kosequat and associates.
the Impact of a Therapy Dog
Program on Military Behav- ONGOING SERIES
ioral Health Patients,” by
Brisson and Dekker, shows CANINE MEDICINE
that in their study, “[m]ost “Clinical Update: The Risk of Opioid Toxicity and Naloxone
staff members (86%) believed Use in Operational K9s,” by Palmer and Gautier, describes the
the animal-assisted therapy potential risks associated with opioid exposure as well as the
dog program had a positive use of naloxone as it pertains to the Operational canine.
impact on the behavior health
patients, including improved CLINICAL CORNER
patient mood, greater patient Banting and Meriano
relaxation, improved patient review the approach to
attitude toward therapy, and “Hand Injuries,” includ-
increased social interactions ing understanding the
among patients.” potential functional out-
comes of the injury and
In “The SOF Truths for Army Special Operations Forces Sur- the risk of infection.
gical Teams,” Baker and colleagues discuss key insights for
manning and training Army SOF Forward Resuscitative Surgi- HUMAN PERFORMANCE OPTIMIZATION
cal Teams to high SOF standards through the lens of the “SOF In another discussion of musculoskeletal injuries (MSK-Is),
Truths.” de la Motte and her colleagues describe in “Optimizing

4 | JSOM Volume 17, Edition 4/Winter 2017