Page 27 - JSOM Winter 2019

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permanent disability and nerve damage but is curable; if caught UNCONVENTIONAL MEDICINE
early and treated appropriately, it may resolve without long-last- In “There I Was”: A Cup of Improvisation, the authors relate their
ing consequences. Unfortunately, approximately 2 million people experience improvising a tourniquet in the austere environment.
worldwide have permanent disabilities due to leprosy. Because
leprosy is not common in the United States, the diagnosis can be
easily missed if clinicians do not think to look for it.
(left) Materials used
for the improvised
junctional tourniquet.
(right) Use of the
improvised junctional
Patient with M leprae infection tourniquet.
who presented with enlargement
of the auricular nerve.

Source: CDC, Hansen’s disease A Case for Improvised Medical Training. The hyperresourced,
(leprosy), 2017. uber-controlled, ultrareactive, constant environment that we have
come to know in the past 20 years should not be mistaken as the
https://www.cdc.gov/leprosy norm in conflict. In truth, unrealistic expectations of both com-
/health-care-workers/other
-hansens-disease.html/ manders and systems in resourcing is presently being reinforced
almost daily. Only in the past few years of this decade have the
majority of allied forces experienced challenge in resupply and
support in contingency operations. When logistical lines are cut,
limited, or untimely, we must know and exercise other means of
providing the highest level of medical care possible—if not with
In Powassan Virus, the Centers for Disease Control and Prevention indigenous ways and means, then by improvisation. History has
provides information on this virus that is rare but recently was the proved that improvised medicine can be capable, professional,
cause of the death of North Carolina Senator Kay Hagan. and ethically sound if practiced properly and to standards, the
price being time, education, and investment in the requirement.
INJURY PREVENTION Most often, these are already time-honored means of care.
United States Military Parachute Injuries: Part 2: Interventions
Reducing Military Parachute Injuries in Training and Operations is
part 2 of an article detailing the reduction in airborne-related in-
juries over time. Part 1 examined the early history of airborne op-
erations and provided evidence for the reduction in injuries over
time; part 2 discusses interventions associated with the decline in BOOK REVIEW
injury rates. Insurgent Women: Female Combatants in
Civil Wars
NATO SOCM RESEARCH
Some of the current methods of instruction used within interna-
tional armed forces courses are not always goal oriented and sat-
isfactory for both the teaching staff and the student. The Swiss
Armed Forces approach presented in Applying Swiss Armed Forces TCCC UPDATES
Training Didactics and Methodology for Tactical Combat Casualty
Care Training has been historically effective in preparing and sus- In CoTCCC Hail and Farewell, we say goodbye to Dr Frank Butler,
taining national conscription with large numbers of recruits and CAPT (SEAL) MC USN (Ret), as he retires from his 12-year tenure
new cadres every year. as the Chair of the Committee on TCCC and say hello to CAPT
Brendon Drew, who is now serving as the Interim Chairman.
SOFsono ULTRASOUND
Could He Stay or Should He Go Now? presents the sonographic
case of a teammate who had the sudden onset of severe right up-
per quadrant pain radiating to the scrotum.

The Butler family
minus son Jeff.

In This Issue | 25