Page 13 - JSOM Fall 2020

of the tool’s development. The SSFS is capable of generating Far Forward Gaps in Hemorrhagic Shock and Prolonged Field
baseline assessments for research related to SF/SP. It is also Care: An Update of ALM Fluid Therapy for Field Use: Future
capable of generating unique SF/SP profiles for individuals and expeditionary missions are expected to occur in more remote
groups, which can shape programs and inform tailored coach- austere environments where combat medics and casualties may
ing for optimized performance. have to wait up to 7 days before resupply or safe evacuation.
Currently, there is no effective fluid therapy for hemorrhagic
INJURY PREVENTION shock (HS) at the point-of-injury and continuum-of-care
This is second of a two-part series on the history and effec- over this extended period. We have been developing a small-
tiveness of mouthguards (MGs) for protection from oro- volume IV or IO ALM therapy for noncompressible HS and
facial injuries: Mouthguards for the Prevention of Orofacial have shown in preclinical models that it extends survival to 3
Injuries in Military and Sports Activities: Part 2, Effectiveness days, reduces abdominal bleeding by 60%, blunts inflamma-
of Mouthguard for Protection From Orofacial Injuries. More tion, corrects coagulopathy, preserves platelet function, and
well- designed studies are needed on the effectiveness of MGs prevents immunodeficiency.
during military training. Despite some methodological lim-
itations, the current data suggest that MGs can substantially Management of Critically Injured Burn Patients During an Open
reduce the risk of orofacial injuries in sport activities. MGs Ocean Parachute Rescue Mission: Best practices and training
should be used in activities where there is a significant risk of for prolonged field care (PFC) are evolving. The New York
orofacial injuries Pararescue Team has used part task training, cadaver labs,
clinical rotations, and a complicated sim lab to prepare for
PROLONGED FIELD CARE PFC missions including critical care. This report details an
In Editorial on the Approach to Prolonged Field Care for the Atlantic nighttime parachute insertion to provide advanced
Special Forces Medical Sergeant: Balancing the Opportunity burn care to two sailors with 50% and 60% body surface area
Cost, the authors discuss the Department of Defense plans to burns.
adopt multidomain operations (MDO). MDO is defined as op-
erations that converge capabilities to overcome an adversary’s JSOM 20TH ANNIVERSARY SPECIAL INTERVIEWS
strengths across various domains by imposing simultaneous JSOM 20th Anniversary Special Interview Podcasts
dilemmas that achieve operational and tactical objectives.
Within this MDO construct, medical treatment expectations BOOK REVIEW
must shift accordingly as the ability to rapidly treat and evac- Resistance Operating Concept (ROC)
uate patients may be constrained by enemy action. Thus, the started its life as an academic treatise at
notion of prolonged field care (PFC) may be a necessity on the Special Operations Command Europe
future battlefield. (SOCEUR) in 2014. SOCEUR was at
this time commanded by Major General
(MG) Mike Repass, an US Army Special
Forces officer who began it while later
SOCEUR commanders and staffs aided
by other members of the wider Euro-
pean special operations community (not
just NATO members) continued the effort forward.

PRODUCT TECHNOLOGY
In Influence of Celox Rapid’s Mode of Action Under Normal
and Compromised Blood Conditions, the authors assess a new
design of vented chest seal dressing for both adhesion and vent
profile. The development of this new design for a vented chest
seal has been tested for adhesion and venting properties and
Ketamine Use for Prolonged Field Care Reduces Supply Use shown to have performance criteria suitable for the treatment
describes the prolonged treatment of a 38-year-old man with of open pneumothorax and design features that minimize the
a transpelvic gunshot wound requiring a diverting ostomy and risk of product failure during use.
cystostomy for damage control procedures with a comminuted
acetabular and femoral head fracture. The team used a ket-
amine drip for prolonged field care over 48 hours. The benefit
of using a ketamine drip included low supply requirement, ex-
cellent analgesia, and ease of administration, but side-effects
included somnolence and atelectasis necessitating oxygen sup-
plementation before evacuation.

US Air Force pararescuemen perform long-range ocean res-
cue missions for ill or injured civilians when advanced care
and transport are not available. A Case Series of Air Force
Pararescue Long-Range Ocean Rescues examines the details of
these missions, review patient treatments and outcomes, and
describe common tactics, techniques, and procedures for these
missions.

In This Issue | 11