Page 9 - JSOM Spring 2018

FEATURE ARTICLES then compare the results of a commercially available, human-
blood lead testing system with those of a benchtop inductively
In “Laboratory Model of a Collapsible Tube to Develop Bleed- coupled plasma–mass spectrometry analysis technique.
ing Control Interventions: Effects of Compression on Flow,”
Griffin and associates address an awareness gap concerning “Ocular Injuries and Cultural Influences in Afghanistan Dur-
collapsible tube science and its application to control bleeding ing 5 Months of Operation Enduring Freedom,” by Paz and
in first aid.
colleagues, describes treating patients with explosive blast
injuries while serving at the NATO Role 3 Multinational
Medical Unit, Kandahar, Afghanistan. A disparity was noted
between the ocular injury patterns of US and Coalition forces
in comparison with their Afghan counterparts, and examina-
tions demonstrated the spectrum of ocular injuries that can
result from an explosive blast.

Photograph and computed tomography three-dimensional reformatted
image demonstrating, in a 35-year-old Afghan patient who had not
worn eye protection, a 4cm piece of curvilinear metal from the blast of
an improvised explosive device. The object penetrated the right orbital
Collapsible tube compressed between two pipes. floor and contacted the medial aspect of the right globe.
Brandon and associates offer tools to physicians, environmen-
Because “studies of military suicide and related mental health tal service officers, and Special Operations Medics for the pri-
constructs assert that Servicemembers in Special Operations mary prevention of lead poisoning in the conventional and the
Forces possess higher levels of resilience without providing austere or forward deployed environments in “Lead Exposure
an empirical basis for these statements, in “The Myth of Hy- in the Special Operations Shooter: How to Prevent Cognitive
perresilience: Evolutionary Concept Analysis of Resilience in Decline and Permanent Disability.”
Special Operations Forces,” Rocklein Kemplin and colleagues
performed a concept analysis to contextualize resilience in
the SOF community and provide accurate redefinitions on
which theoretical and methodological frameworks can be con-
structed reliably.
Vu and associates addressed “Intramuscular Tranexamic Acid
in Tactical and Combat Settings” and concluded that “[t]here
is currently insufficient evidence to support a strong recom-
mendation for or against IM administration of TXA in the
combat setting; however, there is an abundance of literature
demonstrating efficacy and safety of TXA use in a broad range
of patient populations. Balancing the available data and risk–
benefit ratio, IM TXA should be considered a viable treatment
option for tactical and combat applications. Additional stud-
ies should focus on the optimal dose and bioavailability of IM
dosing of patients in hemorrhagic shock, with assessment of
potential downstream sequelae.”
“Successful Use of Ketamine as a Prehospital Analgesic by
Pararescuemen During Operation Enduring Freedom: Our
Experience and Literature Review,” by Lyon and associates,
describes when ketamine is administered appropriately in the
clinical setting, it can provide analgesia, anxiolysis, and amne-
sia for patients with less respiratory depression and hypoten-
sion than equivalent doses of opioid analgesics.
In “Blood Lead Toxicity Analysis of Multipurpose Canines and
Military Working Dogs,” Reid et al. examine baseline lead levels
of multipurpose canines (MPCs) exposed to indoor firing ranges
compared with those of nontactical military working dogs with Lead exposure at a firing range.
limited or no exposure to the same environment. The authors (Used with permission from The Seattle Times.)
(continues on page 158)
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