Page 13 - JSOM Summer 2020

s promised, our Summer Then and Now looks at the 2002;2(2):14–17
last 20 years of tourniquet development and use. The
Asection closes with commentaries from John F. Kragh The Medical R&D Update section discusses that the BISC
Jr, MD/James K. Aden 3rd, PhD/Michael A. Dubick, PhD, and has been working with the Army Medical Department in the
Piper Wall, DVM, PhD/Charisse Buising, PhD. During the development of a one-handed tourniquet. After four years of
first 5 years, tourniquets were repeatedly mentioned but were “negotiating” one candidate has been selected. It is a rather
not the main subject matter of an article until 2004. The first simple device which may not be the 100% solution but will
JSOM occurrence of a research article concerning tourniquets suffice while the search goes on.
was a reprint in 2009. The first nonreprint JSOM tourniquet
research article was in 2011. Over the following years, JSOM 2002:2(3):15–16
progressively became the leading source for emergency-use Medical R&D Update states “The one-handed tourniquet has
tourniquet information. been through the preliminary design and configuration test with
distribution occurring in early August 2002. SOF Components
will be distributing them with instructions on how to use them”.

TOURNIQUETS/HEMORRHAGE 2003;3(1)
CONTROL ARTICLES, THEN Forward: Dr Hammer, USSOCOM Surgeon in his From the
Surgeon
2001;1(3):4–5 EXCERPT This year is about to end, and we can celebrate
some significant accomplishments as it winds down:
Efficacy of a Dry Fibrin Sealant Dressing for Hemorrhage
Control After Ballistic Injury Holcomb J, MacPhee M, Hetz S, 1. Hemostatic Dressings are making their way into the field
et al. and the hands of our forward medical providers. The Chi-
tosan Dressing is approved for use by the FDA and I got
EXCERPT The control of hemorrhage is a critical step in first
aid and field trauma care. Unfortunately, the materials and a message just this morning that the Fibrin Dressings are
methods available to stop bleeding in prehospital care (gauze moving forward to the theaters for deployment under an
dressings, direct pressure, and tourniquets) have not changed Investigational New Drug (IND) protocol, and as a backup
greatly in 2000 years. Even in good hands, they are not uni- to Chitosan as needed.
formly effective and the occurrence of excessive bleeding or 2. The One-Handed Tourniquet is forward to our troops and
fatal hemorrhage from an accessible site is not uncommon. is very functional. Additionally, the Rangers have put some
ratchet-type tourniquets forward, all trying to answer the
needs expressed by our far forward Medics/Corpsmen/PJs.
2001;1(3):8–11 3. We successfully brought back medics from OEF and have
Research and Development: Biomedical Research and Devel- their stories on record and we are directing our research to-
opment Update Clayton R ward fixes of “real problems” they encountered in the field.
4. The Tactical Combat Casualty Care panel of trauma ex-
EXCERPT EFFECTS OF INJECTABLE HEMOSTATIC
DRUGS: Optimal hemorrhage control represents the single perts from the services, the American College of Surgeons
greatest area where SOF medics can influence the traditionally (Trauma Panel), the PHTLS experts, and others are rewrit-
high killed in action (KIA) rate. These hemorrhagic deaths can ing the Advance Trauma Life Support protocols to meet
be divided into truncal and extremity type wounds. Extremity combat tactical requirements, making our training and
wounds are amenable to direct pressure, tourniquets and new equipment more relevant to today’s needs on the battle-
improved hemostatic dressings. Truncal hemorrhage accounts field. We will field their recommendations on hypotensive
for up to 90% of all hemorrhagic deaths on the battlefield. resuscitation, hemostasis, new analgesia for combat, new
New methods of hemorrhage control for truncal wounds are fluids for resuscitation, new routes of administration, new
required. This study will evaluate the effects of rFVIIa (inject- airway management solutions, new antibiotic protocols for
able hemostatic drug) after severe soft tissue trauma. trauma, etc. By the way, our new United States/Surgeon
General came to SOMA and reflected on his success as be-
ing a result of being a Special Forces 18D medic during the
2001;1(3):24–40
Vietnam era. He is a decorated veteran from that conflict.
United States Army Rangers in Somalia: An Analysis of Com- He also agrees that this work needs doing and is a volun-
bat Casualties on an Urban Battlefield Mabry R, Holcomb J, P teer on our panel of experts (he is a trauma surgeon, med-
Baker A, et al. ical professor, and the force behind a state EMS system in
Previously published J Trama 2000;49(3):515–529. his prior life). We are very fortunate!

2002;2(2):1 2003;3(4)
Forward: Dr Hammer, USSOCOM Surgeon states in his From Forward: Dr Hammer, USSOCOM Surgeon in his From the
the Surgeon that a one-handed tourniquet is on the way. Surgeon

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