Page 22 - JSOM Spring 2020

o celebrate our 20 years in publication, we are going to Spring 2003, Volume 3, Edition 2, Page 22
present a segment called Then and Now. For the next Intraosseous Vascular Access in Adults: Current Status and
Tfour editions, we are going to compare where we were Military, Michael A. Dubick, PhD; John B. Holcomb, MD
in SOF medicine 15 to 20 years ago in contrast to where we
are today. To do this, we looked at JSOM articles on a specific ABSTRACT Austere far-forward battlefield environments
topic, then and now. The topic of the first edition of this year present numerous obstacles in providing adequate medical
is “whole blood.” Because there was very little talk of its use in care to the injured Soldier. In addition to logistic constraints
this environment in the early publications, we took this search that limit the volume of isotonic crystalloid fluids available
out to 2008. to resuscitate the injured Soldier, hypotension, environmental
and tactical conditions including the wearing of MOPP gear,
Back in the early days . . . when we were still a USSOCOM and/or the presence of mass casualties can combine to lead to
publication, the JSOM year started with the Winter Ed and excessive delays in obtaining vascular access . . .
ended the year with the Fall Ed. In 2011, along with the change
to being published outside the military, we changed over to Ed The article goes on to say, “While methods of improved hem-
1 being Spring through Ed 4 being Winter. This information orrhage control and the type and amount (weight and cube)
will assist in looking up the full articles. of resuscitation fluids have been debated, the actual route of
fluid, drugs, and blood administration in the pre-hospital envi-
The information provided is either a segment of the article or ronment has been critically examined only lately.”
the abstract. If you are a digital subscriber, you will be easily
able to follow along and read the full articles. If you do not Fall 2004, Volume 4, Edition 4, P-age 34
have a digital subscription, you still have access to the first In-Flight Transfusion of Packed Red Blood Cells on a Com-
10 years online. To find these articles, go to our website; un- bat Search and Rescue Mission: A Case Report from Opera-
der the JSOM dropdown menu, go to FULL JOURNALS and tion Enduring Freedom, Ronald Place, MD; Brad West, ANC;
scroll to the bottom of the Page. Unlike the current Flipbook Richard Bentley, MD
digital versions, the first 10 years are PDF documents.
Previously published in Military Medicine: International Jour-
nal of AMSUS, 169, 3:181, 2004.
SOF MEDICAL TRUTHS ABSTRACT Injuries on the battlefield can occur far from

1. Humans Are Our Hardware the nearest medical treatment facility. This is especially likely
2. You Bleed Just As Much In Peace As You Do In War for downed pilots and Special Operations personnel. Some of
3. Quantity Is No Substitute For Quality Medical Care these injuries lead to significant blood loss requiring transfu-
4. SOF Medics Must Be Totally Competent Always sion. We present two cases of injured coalition force members
5. SOF Cannot Be Mass Reproduced during Operation Enduring Freedom that illustrate the poten-
tial need for a transfusion capability at the site of injury to
prevent death. Consideration should be given to augmenting
transfusion capabilities in military environments with predict-
ably long evacuation times.
ARTICLES ON WHOLE BLOOD, THEN
Winter 2006, Volume 6, Edition 1, Page 14
Summer 2001, Volume 1, Edition 2, Page 63 Walking Donor Transfusion in a Far Forward Environment,
Third World Blood Resuscitation, Editorial by COL Warner Robert Malsby III, DO; James Frizzi, MD; Peter Ray, MD;
Anderson John Raff, MD
MAJ Lutz et al report an interesting case of HIV exposure This article previously appeared in Southern Medical Journal.
through a novel, but perhaps predictable mechanism, a fight 98(8):809-810, August 2005.
bite. However, he also raises the issue of using blood and ABSTRACT This case report details the walking donor
blood products (B/ BP) in his and other Third World AOs. The transfusion (WDT) option for management of exsanguinat-
need to carry post-exposure prophylaxis (PEP) is self-evident ing hemorrhage performed in an austere environment. It has
and authorized; the vexing problem is, will PEP protect from civilian application in situations where local blood supply is
HIV inadvertently received during trauma B/BP resuscitation? overwhelmed by demand due to a natural or manmade (e.g.,
terrorist) disaster. WDT is discussed in light of alternative
Spring 2003, Volume 3, Edition 2, Page 10 transfusion techniques and the history of WDT is briefly dis-
USASOC Component Surgeons Input, COL Rocky Farr cussed. We feel that walking donor transfusion is appropriate
The author reported that blood and how far forward to take for use in extreme cases of patient exsanguination.
it has been an issue: SFC XXX from my office attended a
blood expert meeting in Washington, DC and we have sub-
mitted a draft policy on blood forward and walking donors
to USSOCOM.

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