Page 9 - JSOM Fall 2024

IN BRIEF escalations of care. Ultimately, the patient’s condition improved
Winston Churchill’s Mother and the Inked Operator: Health once he was transferred to a tertiary facility in Singapore.
Risks and Biokinetics of Tattoo Inks: In this brief report, Anna
M. Gielas summarizes recent medical research on both new
and older tattoos, to inform Special Operations Forces med-
ical personnel about the potential health implications of this
common practice.
CASE REPORTS
Limitations of Triage in Military Mass Casualty Response: A
Case Series: Rush and colleagues analyzed data from a series
of 29 mass casualty events (MASCALs) that were managed
by military medics in the prehospital setting. Consistent with
findings in the civilian MASCAL literature, the team’s findings
indicate that formal triage systems, including the use of named
algorithms, colored markers, and more than three total catego-
ries, are rarely employed in military MASCALs, signaling the
need for simplified approaches.
Limb Hemorrhage Control Failure with Counterfeit Tourni-
quet: A Ukrainian War MEDEVAC Case Report: Lagazzi and
colleagues present the case of a 19-year-old male who died
following traumatic lower limb amputation in Ukraine. His
death was the result of mechanical failure of a Combat Appli-
cation Tourniquet (CAT)-like tourniquet during transport to
an urban trauma center and delayed recognition of the subse-
quent bleeding. This case underscores the need for robust qual-
ity control measures and the establishment of strict regulations
against deploying counterfeit tourniquets. Map of patient evacuation from 1) Bandara Gatot Subroto Airfield
to 2) Tanjung Baru (first civilian hospital), 3) Palembang (second
civilian hospital), 4) Palembang Airport for air evacuation to
ONGOING SERIES 5) Singapore Changi Airport and ultimately to 6) a tertiary care
INFECTIOUS DISEASES hospital in Singapore.
Sandfly Fever: Jason Jarvis provides an overview of the ap-
pearance, behavior, and geographic distribution of the biting UNCONVENTIONAL RESILIENCE
sandfly—the species known for transmitting a number of vi- Social Determinant of Unconventional Resilience: Tactical
ruses to humans and animals, including sandfly fever. The au- Engagement in Medical-Martial Creativity: In this sixth in-
thor also lists comparable diseases for differential diagnosis of stallment of a nine-part series, Jeschke and colleagues seek
suspected sandfly fever and concludes with steps to prevent to etablish that medical-martial creativity supports Special
outbreaks of this virus from disrupting military operations. Operations Forces (SOF) medics’ ability to fluidly modulate
pressure amid real-time military medical decision-making in
LEST WE FORGET austere environments. To this end, the authors use qualitative
Vascular Repair in Wartime Casualties: Younce quotes to explore how medics working in Special Operations
and colleagues describe a critical advance—vas- Surgical Teams express medical-martial creativity in support
cular repair in the care of the war-wounded of unconventional resilience.
during the Korean War, which was pioneered by
Dr. Carl Hughes. They also review the medical THE WORLD OF SPECIAL OPERATIONS MEDICINE
advances that occurred during this conflict and Use of Loco-regional Anesthesia in Austere Environments: A
explore how lessons learned in Korea influence Review by and for Special Forces Medics: The author reports
Dr. Carl W. Hughes on the findings of a survey sent to 35 Special Operations med-
practice today.
ical providers and suggests possible solutions to challenges as-
PROLONGED CASUALTY CARE sociated with pain management on the battlefield. The survey
Prolonged Care for Presumed Typhoid Encephalitis in Indo- showed that, although most providers had already received
nesia: In this case report, Berrios and colleagues highlight the lectures on regional anesthesia, 83% were not trained in it,
limitations of medical care in both the prehospital and hospi- and 54% had never been made aware of multimodal analge-
tal settings associated with host nation facilities. An otherwise sia. These findings, along with a literature review, highlight
healthy 19-year-old Servicemember presented to a battalion aid knowledge and skills gaps in loco-regional anesthetic tech-
station in the Sumatra region of Indonesia with altered mental niques within the Special Operations Forces community.
status and other signs concerning for undifferentiated infec-
tion. Workup at a local hospital revealed Salmonella enterica 2024 SOMSA ABSTRACTS
infection (typhoid); however, even after initiation of empiric Special Operations Medical Association Training, Education
treatment for typhoid encephalitis, medical care proved chal- & Scientific Assembly 2024 – Recognized Research Track
lenging in the resource-limited local facilities despite multiple Abstracts

In This Issue | 7