Page 10 - JSOM Winter 2023

FEATURE ARTICLES on the human brain are not completely understood, Edlow
Effects of Tourniquet Features on Application Processes: In and colleagues discuss the development and implementation
this the first of two related articles, Wall and colleagues ex- of a reliable diagnostic test for repeated blast brain injury
amined the effects of emergency-use limb tourniquet design (rBBI) and the benefits of such a tool for the Special Operation
features on application processes. Participants included 2 male Forces community. The authors explore establish priorities for
tourniquet recipients and a convenience sample of 64 appli- such a test, including the need to define rBBI and recovery,
ers who watched training videos and then each applied eight categorize Operators with blast exposure, and create a diag-
types of tourniquets. The researchers found that self-securing nostic risk assessment matrix to facilitate individualized care
systems have process advantages. and operational flexibility.

Effects of Airway Localization Device Use During Surgical
Cricothyrotomy on Procedural Times and Confidence Levels
of Pre-Hospital Personnel: Using a 6-in-1 model, Schlocker
and colleagues evaluated the effect of an airway localization
device (ALD) on surgical cricothyrotomy (SC) success rates
and prehospital provider confidence. Two groups—35 U.S.
Navy hospital corpsmen 10 Navy Special Operation Forces
members—were randomly assigned to SC sequences of ALD/
no ALD or no ALD/ALD. Procedural times were longer with
ALD than without; however, this finding may have no clini-
cal significance. User confidence in their ability to successfully
perform an SC increased after two procedures using an airway
model.

Tourniquets.

Effects of Tourniquet Features on Application Processes A 6-in-1 model (Strategic
Times: In this companion article, Wall and colleagues exam- Operations, Inc.) assembled
ined the association of tourniquet design features on applica- with the 3-D printed
tion times. They concluded that suboptimal processes increase laryngeal inserts, and
application times and that optimal design features for effective kin overlays (Laerdal, ™
Inc.) The Control-Cric
tourniquet applications are self-securing strap/redirect systems System (Pulmodyne,
with clips that could be easily identified and used and self- Inc.) and the assembled
securing tightening systems. airway localization device
(ALD) are placed on the
mannequin torso at the
Touch start of procedure.
Strap Tightening 1 st Last
Events: "Go" Secured System Occlusion Occlusion "Done"
st
Timed Go to Strap Secured Touch Tightening System 1 Occlusion
Segments: to 1 Occlusion to Done
st
Go to Touch Tightening System
Touch Tightening System Last Occlusion
to Last Occlusion to Done
Timeline. Unconventional Resilience: An Operational Model: In this the
third of nine complementary articles, Jeschke and colleagues
The Impact of Progressive Simulation-Based Training on Tour- argue that resilience is better understood as cohesive adapta-
niquet Application: Cole and colleagues explore the impact tion within a Special Operation Forces (SOF) environment.
of progressive simulation-based training on medical students’ To this end, they compare conventional and unconventional
tourniquet application skills. In the summer of 2022, 150 resilience, show how unconventional resilience functions at
second-year military medical students participated in the Ad- multiple levels, and describe how their operational model
vanced Combat Medical Experience. This training approach of unconventional resilience links to tactical performance
was associated with improvements in performance ratings and through social determinants.
application times, making it effective educational intervention
for this population. A Brief Primer on the Concept of the Neuroweapon for U.S.
Military Medical Personnel: In this brief review, Washing-
Optimizing Brain Health of United States Special Operations ton and colleagues introduce military medical personnel to
Forces: Acknowledging that effects of repeated blast exposure the concept of the neuroweapon—an emerging concern for

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