Page 11 - JSOM Spring 2025

concludes that embedding clinicians within tactical groups may More Than a Score: Evaluating Military Veterans’ Success
enhance survival rates, operational success, and cost-effectiveness. When Applying to Medical School: Campbell and colleagues
sought to determine whether veterans’ comparatively lower GPAs
and MCAT scores negatively affect their chances of success when
applying to medical school. The authors found that despite lower
academic metrics, the military applicant acceptance rate to MD
programs was 41.7% compared to 40.7% for all applicants;
therefore, veterans should not be deterred from seeking a path of
service in medicine because of these perceived limitations.

ONGOING SERIES
Attack CANINE MEDICINE
timeline.
Optimal Prehospital Practices for Airway Emergencies of
Military Working Dog Combat Casualties: In this crossover,
randomized trial, Palmer and colleagues evaluated the feasibility
of performing surgical cricothyrotomy (CTT) in lieu of tube tra-
cheostomy (TT) as the first-line emergent surgical airway access
technique in military working dogs (MWDs). Participants were
five emergency medicine physician residents trained in performing
CTT in people but not canines, and five early career veterinarians
(DVM group), trained in performing TT in canines but not trained
in performing CTT in canines, who performed a CTT and TT on 10
Miscommunication and Risk in the Military Pre-Hospital En- canine cadavers. The researchers’ findings support selecting CTT
vironment: A Case Series and Review: In this case series, Elzey over TT as a viable ‘go-to’ emergent surgical airway technique for
and colleagues analyze four instances of miscommunication in the MWDs owing to shorter procedural time and significantly less in-
military prehospital environment. Based on the civilian literature, duced tissue trauma to the airway and surrounding structures with
recommendations for reducing these incidents in the military pre- CTT. Furthermore, both groups reported an overall strong positive
hospital environment include pre-coordination communication response to CTT when compared with TT in multiple areas.
that continues through final patient movement; closed loop com-
munication in all real-time treatment and handoffs; readbacks for THERE I WAS
high-consequence interventions or drug administration; establish- Special Operations Forces Lessons Learned: Beirut Blast: In
ment of standardized brevity calls for well-rehearsed behaviors; this first-hand account, LeBlanc and colleagues describe lessons
and development of realistic methods for standard, thorough doc- learned from the care and eventual evacuation of a Servicemember
umentation that considers the challenges associated with treat- injured in the Beirut Port Explosion of 4 August 2020.
ment environments and patient movement.
Successful Management of Battlefield Traumatic Cardiac Ar- UNCONVENTIONAL RESILIENCE
rest Using the Abdominal Aortic and Junctional Tourniquet Social Determinant of Unconventional Resilience: Tactical En-
(AAJT): A Case Series: Androshchuk and Verba describe a series gagement in Family Formations: In this eighth installment of
of cases from the War in Ukraine, in which patients had an Ab- a nine-part series, Jeschke and colleagues expand their operation
dominal Aortic and Junctional Tourniquet – Stabilized (AAJT-S) model to encompass family formations. The authors use illustrative
placed following traumatic cardiac arrest due to exsanguination. quotes to define the social determinant of family formations and
The authors conclude that AAJT-S effectively manages massive provide background on how we merge family systems theory with
hemorrhage and TCA on the battlefield, given that it (along with military formations; thematize various types of family formations
the administration of whole blood and CPR) produced a 100% that optimize or degrade unconventional resilience; and relate tacti-
success rate in achieving return of spontaneous circulation in these cal engagement with family formations to our metaphor of bag sets.
patients, one of whom could be followed for 12 months and was
found to be neurologically intact. THE WORLD OF SPECIAL OPERATIONS MEDICINE
Profiling “Noncombat” Musculoskeletal Injuries in Special
Operations Forces: A Systematic Review: In this systematic
review, Dresti and colleagues analyzed five themes related to mus-
culoskeletal injuries sustained by Special Operations Forces (SOF)
personnel—incidence, anatomical location, nature, mechanism,
and risk factors. Their findings inform injury prevention strategies
The abdominal aortic and junctional within SOF populations; notably, reducing run mileage and alter-
tourniquet – stabilized (AAJT-S) applied nating running with weight load walking, educating Operators on
to a combat casualty in Ukraine. proper lifting technique, and analyzing force plate testing data to
guide program design and implementation.
TCCC UPDATES
Tactical Combat Casualty Care & En Route Combat Casualty
Care: Selected Abstracts from 2024
EDITORIALS
Blood Supply Challenges in a Denied Combat Environment: BOOK REVIEW
Riley and colleagues address transfusion dilemmas medical teams Horse Soldiers: The Extraordinary Story of a
might face in a contested, degraded, and operationally limited Band of U.S. Soldiers Who Rode to Victory in
combat environment, which are not addressed in the current clin- Afghanistan
ical practice guidelines related to transfusion. Topics covered in
this editorial include regulations, expired blood, storage tempera-
ture deviation, and walking blood banks.

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