Page 8 - JSOM Spring 2023

FEATURE ARTICLES The Effect of Prehospital Blood Transfusion on Patient Body
Warning: Tourniquets Risk Frostbite in Cold Weather: This Temperature from the Time of Emergency Medical Services
study concludes that an association between tourniquet use Transfusion to Arrival at the Emergency Department: Data
and frostbite exists, but not as cause and effect. Tourniquet from this study are favorable in support of warmed prehos-
use increases the risk of the cold causing frostbite by allowing pital blood transfusion in preventing body- temperature de-
faster cooling of a limb due to reduced blood flow and lack crease in critically ill patients.
of cold-induced vasodilation. Such frostbite occurs in low fre- Emergency Reflex Action Drills and the Problem with Stress:
quency but at high severity. This article outlines the psychological, cognitive, and behav-
Threat Appraisal, Recovery Operations, and PTSD Symptoms ioral effects of stress that affect performance and necessitate
Among US Air Force Rescue Personnel: The results of this development of emergency reflex action drills. It also reviews
study support the contributing role of threat appraisal to post- the scientific underpinnings behind how humans have adapted
traumatic stress disorder among military personnel whose pri- cognitive behavioral techniques to manage under high-stress
mary duties entail exposure to injury and death under hostile situations, and it recommends the adoption of these cognitive
and dangerous conditions. tactics via emergency reflex action drills to enhance clinical
practice and provides an example in the context of airway
Improving Outcomes Associated with Prehospital Combat management.
Airway Interventions—An Unrealized Opportunity: Findings
from this study suggest that training and technology advances Effectiveness of and Adherence to Triage Algorithms Dur-
in airway resuscitation are necessary to achieve mortality im- ing Prehospital Response to Mass Casualty Incidents: This
provements in potentially survivable airway injuries in the pre- literature review showed that triage systems are relatively in-
hospital combat setting. accurate and infrequently used. Their use is limited by chaos,
mortal danger, and low adoption by EMS providers. These
results suggest the need to further simplify the triage process.
Motion Analysis: An Objective Assessment of Special Oper-
ations Forces and Tactical Medics Performing Point-of-Care
Volume of Ultrasound: This study found that the integration of motion
procedures analysis into point-of-care ultrasound training for Special
during the Operations Forces combat and tactical medics could provide
study period. objective assessments of proficiency and identify areas for de-
liberate practice in a more standardized fashion.

A Systematic Review of Prehospital Combat Airway Manage-
ment: This systematic literature review summarizes the exist-
ing prehospital combat airway data. The evidence base was Medic performing a
found to be heterogeneous. RUSH exam using a
portable ultrasound
Epidemiology of Musculoskeletal Injuries Among Naval probe.
Special Warfare Personnel: This study found that musculo-
skeletal injuries, especially those affecting the lower extrem-
ity and those occurring during physical training, continue to
cause considerable morbidity and financial cost among Special
Warfare Combatant-Craft Crewmen Operators and Crewman
Qualification Training students.
Approach to Handling Atypical Field Blood Transfusion Sce-
Special Warfare Crewman narios: This literature review presents the recommendations of
Combat-craft QualificationTraining several experts in transfusion medicine for managing atypical
Crewman Students field transfusion scenarios.
CASE REPORTS
Cold Weather Injury in a Special
Operations Aviation Crew Mem-
ber: A Case Report: We present a
case of a Special Operations crew
chief with cold weather digital in-
Combat
7.9% jury while at the Arctic Isolation
Course in Alaska and his subse-
quent clinical course.

Activity when musculoskeletal injury occurred among 142 SWCC Initial cold weather injury with sensate,
Operators and 187 CQT students during a one-year period. firm, white plaque.
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