Page 8 - JSOM Fall 2023

FEATURE ARTICLES method of access. The authors propose an algorithm for pre-
Comparison of DripAssist to Traditional Method for Achiev- hospital vascular access based on the findings of this review.
ing Rate Infusions by U.S. Army Medics: Golden and col-
leagues compared the performance of the DripAssist, an in-line
device that allows users to automatically monitor and adjust
infusion rates, with that of traditional method. In a laboratory
setting, 22 medics achieved significantly faster time to infusion FIGURE 1 Secret partisan
with the DripAssist. Use of the DripAssist was also associated hospital built in Podgrmecˇ,
with significantly higher accuracy with respect to drip rate and Bosnia, 1944.
volume administered over 1 hour and the device was preferred
by the participants over the traditional method.

Use of Intranasal Analgesia in French Armed Forces: A
Cross-Sectional Survey: Montagnon and colleagues report the
results of their survey of 259 French military physicians sta-
DripAssist tioned in France or abroad. Most respondents reported famil-
device iarity with intranasal analgesia, but only 18% stated they had
features. used it. Accordingly, the authors recommend specific training
to optimize the use of this method of analgesia, especially
given its promising use in austere environments.

A Novel Scale to Assess Psychological Strategies in Explo-
sive Ordnance Disposal Technicians: Taylor and colleagues
describe the development and validation of the U.S. Navy Ex-
Survey of Military Physician Receptivity to Telemedicine and plosive Ordnance Disposal Combat Mindset Scale- Training
Perceived Telemedicine-Amenable Conditions in Turkey: In (CMS-T). the tool incorporates 5 subscales to evaluate the
2021 Çetin and Yıldırım surveyed Turkish military physicians domains of relaxation, attentional-emotional control, goal
working as research assistants in a training and research hos- setting-visualization, internal dialogue, and automaticity. The
pital on their attitudes toward telemedicine. All but one of the findings of this study show that the CSM-T offers a reliable
47 respondents affirmed the desire for an expert medical con- strategy to monitor and improve readiness in the context of
sultation while treating patients in the field. The vast majority explosive ordnance disposal training.
of participants stated that telemedicine centers should employ Slow Intravenous Infusion of a Novel Damage Control Cock-
emergency medicine specialists in particular and that telemed- tail Decreases Blood Loss in a Pig Polytrauma Model: White
icine centers would be particularly useful in the context of and colleagues report on their testing of a damage control
medical evacuations.
resuscitation cocktail for polytrauma in a pig model. The
What a Special Operations Cognitive Assessment Should cocktail, composed of hydroxyethyl starch in Ringer’s lactate
Look Like: Biggs and colleagues sought to determine the op- solution, vasopressin, and fibrinogen concentrate, was admin-
timal method of assessing cognitive functions within a Special istered in 9 animals with polytrauma as either a continuous
Operations context. The authors propose a cognitive task as- infusion or in 2 bolus doses. Infusion outperformed bolus on
sessment based on drift diffusion modeling, which features 3 measures of hemorrhage and resuscitation, which highlight the
criteria: relevance, optimization, and speed. They describe in importance of infusion rate in damage control resuscitation.
detail of these types of tasks, examples of which include threat/ Unconventional Resilience: A Strategic Framework: In the
non-threat scenarios.
second of nine articles on catastrophic injury exposure on
Yugoslav Guerrilla Hospital Design Features and Operation resilience in Special Operations surgical teams, Jeschke and
in World War II: Colesar and Baker characterize 19 locations colleagues establish the value of a strategic framework for de-
that formed the innovative hospital system used by Yugoslav fining resilience. The authors describe in detail unconventional
Guerrillas in the second World War. These hospital sites often resilience—a process that “promotes change-agency through
featured two-level bunkers to conceal casualties and supplies the force of movement”—a concept they developed through
from the Nazis as well as triage and clearing centers and hid- surgical team member interviews and focus groups.
den back-up facilities.
Artificial Blood Development: Implications for Military Medi-
Combat Vascular Access: A Scoping Review: Smith and col- cine: Melanson and colleagues review military blood manage-
leagues report the result of their scoping review to determine ment practices and military-specific uses of individual blood
the best method for obtaining vascular access in a combat envi- components in light of ongoing challenges in the development
ronment. Twenty-four relevant studies were included the anal- of blood alternatives. The authors conclude that engineered
ysis, which suggested intravenous canulation as the preferred blood products hold great promise for military medicine, as

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