Page 152 - JSOM Spring 2020

JSOM 20th Anniversary Special Interview Podcasts

MSG (Ret) Harold “Monty” Montgomery MAJ Andy Fisher
The JSOM 20th Anniversary Special We had the opportunity to catch up
Interview Series starts off by chatting with MAJ Andrew Fisher, MS-4, PA-C,
with former Army Ranger and current LP, MD candidate 2020, and chairman
SOMA president, MSG (Ret) Harold of National Stop the Bleed Month, for a
“Monty” Montgomery, about the evo- great review of prehospital whole blood
lution of TCCC during the past 20 years in the military—where we are now and
since the start of the JSOM. Monty also how we got there, which is in sync with
gives us a look to the future of TCCC this edition’s Then and Now topic,
and the plans the Committee on TCCC “Whole Blood.”
has for the way forward. We hope you
enjoy the informative discussion about changes past, present, He also reminds us that, “everything old is new again.” The
and future to TCCC. https://jsom.us/Monty first whole blood transfusion research was done by the mil-
itary in 1940 (Armed Forces Blood Program) and was used
MSgt Shawn Anderson extensively in WWII and the Korean conflict. But times change
and lessons learned are lost to the sands of time as one gen-
Be sure to listen in to our second 20th eration of peacetime military surgeons hands off the reins to
Anniversary interview series as we chat the next. Supply limitations during MASCAL events in the
with MSgt Shawn Anderson, Pararescue early 2000s led to authorization to use walking blood banks
Medical Program manager. We learn at fixed facilities, and the results were promising. Further eval-
more about his background and career uation led to codification of walking blood banks in deployed
as this discussion leads us through the theatres when demand outstripped supply. Seeing the benefit
history of prehospital analgesia within (and need) of whole blood in the prehospital environment, the
the PJ (and SOF) community and how Rangers “led the way” in creating and implementing a prehos-
it has changed in the recent past. Only pital blood program that continues to be the gold standard to
20 short years ago, we were still using which other services and components are beholden.
morphine on the battlefield, with little practice change since
the Civil War. Recent history has taught us that morphine au- We end with a look toward the future. There may be room for
toinjectors, when used in patients with shock, do not work the implementation of whole blood programs within civilian
very well. Hypoperfused muscle resulted in suboptimal anal- settings and conventional forces. https://jsom.us/Andy
gesia and could often create delayed hypotension when the
histaminic agent finally did become distributed within the vas-
culature. As we all know, the turn of the century brought with
it a resurgence in the use of ketamine—first used extensively
for surgical anesthesia during the Vietnam conflict. As Rocky
Farr would remind us—nothing is new; it’s just old ideas made
new again. https://jsom.us/Shawn

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