Page 151 - 2022 Spring JSOM

Special Operations Medical Association Tourniquet US Army Surgeon Col Jennifer Gurney Visits Personnel at
Conversion Webinar 16 September 2021 The 37 Military Hospital In Accra, Ghana
SOMA recently hosted a 1-hour tourniquet conversion zoom Col Jennifer Gurney, a surgeon with the US Army Institute
webinar led by Dr Mike Shertz, emergency physician, EMS of Surgical Research at the Joint Base San Antonio – Fort Sam
medical director, and prior Special Forces medic. Other panel- Houston, TX, visits personnel at the 37 Military Hospital
ists were SGT Samuel Fredrickson, ATP, and CPT Kaoru Song, in Accra, Ghana, as part of a preexercise planning phase for
MD, representing end-users of the tourniquet conversion task a Medical Readiness Exercise scheduled to take place in
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as recently modified in the 75 Ranger Regiment, and JSOM June. Medical readiness exercises provide a real-world en-
Senior Editor, Dr John F. Kragh Jr, a subject matter expert vironment where medical professionals from both militar-
at the US Army Institute of Surgical Research. ies can build and strengthen medical treatment capability
and capacity by honing their skills while also learning dif-
Tourniquet conversion is a basic skill required by military med- ferent protocols from their counterparts. For the full story
ics. In Afghanistan and Iraq, the US military had quick evac- by Staff Sgt Amanda Fry, Southern European Task Force,
uation times, and casualties were able to reach definitive care Africa, ACCRA, GHANA, go to https://www.dvidshub.net/
rapidly. Unfortunately, evacuation times are unlikely to remain news/414320/surgeon-devotes-career-battlefield-trauma-care
brief in future military settings. Civilian transport times vary
widely from urban to rural areas under normal circumstances,
let alone in an active violent incident or mass casualty event. 21-606: Casualty Operations for Special Operations
Complicating the discussion, there is a plethora of definitions During Large-Scale Combat Operations (CAC login
and descriptions being used interchangeably (e.g., TQ down- required)
This paper illustrates the challenges associated with casualty
grade, TQ exchange, TQ upgrade, TQ replacement, etc.), care for SOF in LSCO and clearly defines the role of the Re-
which adds to the confusion. Tourniquet conversion protocols ligious Support (RS) Team in ensuring proper honor of the
are not well established in either the military or civilian set- fallen and adequate care for the unit and family. It addresses
tings, and training varies greatly between organizations. This temporary interment, isolated interment, hasty burial, family
1-hour question-based webinar combined years of tourniquet notification, and recovery of remains through disinterment.
research, hard-earned experience from the Ranger Regiment From the Center for Army Lessons Learned 4 QTR, FY21
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using their well-established tourniquet conversion procedure, quarterly newsletter.
and current practices of tourniquet conversion in civilian law
enforcement and EMS.
Harvey Schlossberg, Cop With A PhD in
SOMA’s Christie Ross coordinated the effort, Teleflex was Defusing a Crisis, Dies at 85
the sponsor, and Ricardo Flores helped in Q&A. About 507 A psychologist who had worn the blue, Schlossberg coached
people registered, of whom approximately 254 participated, thousands of New York City police officers in hostage nego-
representing 30 nations from six continents. The webinar tiations, creating a model for law enforcement. He choreo-
was a complete success, and key points raised in the webinar graphed what became a model law enforcement strategy for
included: safely ending standoffs with hostage takers. In a pioneering
• Tourniquet conversion (TC) is infrequently done by in- training film he made for the New York Police Department
dividuals but commonly done by health systems. in 1973, Schlossberg said that in a hostage situation, police
• Tourniquet use and TC aftercare often drop out of sto- officers “all believed, ‘If you gave me the right gun with the
ries, conversations, health cards/records, and registries. right bullet, I can put everybody out.’” “But I don’t think it
• TC is an obscure task, vice tourniquet application; TC is works that easy,” he said. “That’s a Hollywood thing.” In-
often unclear, unfocused, skipped, or forgotten. stead, he counseled patience and “crisis intervention ther-
• Few caregivers get any TC experience, rarely a lot; expe- apy.” Read about his fascinating life at https://www.nytimes
rienced ones say TC takes time and can be hard. .com/2021/05/27/nyregion/dr-harvey-schlossberg-dead.html
• People get ready: prepare now, before the need arises.
• Awareness gaps exist: who does, teaches, supervises, Thich Nhat Hanh (1926–2022), Zen Buddhist Monk and
and stewards tourniquet conversion? Mindfulness Pioneer
• TC caregiving, doctrine, research, development, educa- Thich Nhat Hanh was a Vietnamese Zen Buddhist monk who
tion, training, and policy are all in flux now. was a pioneer of mindfulness, helping bring the practice to the
• Start with an approved algorithm, practice, rehearse, West. Nhat Hanh became a powerful symbol of peace, nomi-
and develop experience for individuals and systems. nated by Dr Martin Luther King Jr for the Nobel Peace Prize
• In TC, novice: remove, beginner: assist, competent: in 1967. He established the Plum Village Monastery in south-
practice, proficient: teach, and expert: steward. west France and began spreading his teachings throughout
• Thermal management of injured limbs is a candidate re- the West. Nhat Hanh wrote dozens of books guiding readers
search priority such as from casualty care committees. toward peace and mindfulness, and he made Buddhism acces-
sible by suggesting that inner peace can be achieved through
TC interoperability gaps: diction, common framework, assist- living an ordinary life with awareness of things like breath
ing, teamwork, handoff, transfer, aftercare.
and joy. Read more about his life and philosophy at https://
In a similar effort and after the webinar, the US Army intro- www.legacy.com/news/celebrity-deaths/thich-nhat-hanh-1926
duced a task (number 081-000-2845) on Nov 8, 2021: Con- -2022-zen-buddhist-monk-and-mindfulness-pioneer/
vert Tourniquet to Other Hemostatic Adjunct(s).

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