Page 11 - JSOM Fall 2025

CASE REPORTS Advocating for the Prehospital Administration of Low-Titer O+
Esophageal Perforation Following Explosive Injury: A Case Re- Whole Blood: Dispelling Myths and Misinformation: In this com-
port: To highlight the importance of considering esophageal injury mentary, Stephen P. Wood advocates for integrating low- titer O whole
in explosive trauma, Fairburn and colleagues describe the case of a blood into prehospital protocols, arguing that commonly cited con-
38-year-old male who sustained a mid-esophageal perforation after a cerns over inadequate rewarming, transfusion reactions, or risks to
pressurized diesel fuel cap exploded, hitting his face. Endoscopic eval- pregnant women are likely to have minimal impact and a clinically
uation confirmed the perforation, and he was successfully treated with negligible risk.
esophageal stenting and IV antibiotics.
ONGOING SERIES
HUMAN PERFORMANCE OPTIMIZATION
Capability-Based Blueprinting: Lessons Learned in Scaling
Community-Based Health and Performance Needs Assessments:
Chamberlin and colleagues conducted capability-based blue printing
in collaboration with Weapons Armament System communities at
Initial CT of chest
showing large volume three installations to determine whether a blueprint created within a
pneumomediastinum. career field at a specific installation could provide actionable insight
that is transferable to members of the same career field at other in-
stallations with different mission requirements. They found that gain-
ing an understanding of career-field–critical tasks and the associated
health and performance priorities at one installation can provide some
transferable knowledge, such as physical, ergonomic, and nutritional
demands; however, continual learning is still necessary.
Penetrating Axilla Injuries and Ceramic Plate Coverage: A Spe-
cial Operations Case Series: Using after-action reports from a single INFECTIOUS DISEASES
Special Operations unit, Carlton and colleagues evaluated the efficacy Hydatid Disease: Jason Jarvis provides an overview of hydatid dis-
of current armor configurations in reducing mortality and morbidity ease, which is transmitted to humans through the ingestion of Echino-
associated with axilla injuries. Findings support the role of side plates coccus granulosus eggs, as well as its treatment and prevention. From
in mitigating these injuries but highlight the need for expanded cover- 2000 to 2024, the U.S. Veterans Health Administration found 1,059
age using improved material technologies. diagnoses of the disease in their system.
Real-Time Reduction in Optic Nerve Sheath Diameter Following PROLONGED CASUALTY CARE
Hypertonic Saline Bolus in a Patient with Penetrating Traumatic
Brain Injury: A Case Report: Alexandri and colleagues present the Definitive Field Care: The Modern Application of a Historical
case of a level 1 trauma patient with a penetrating traumatic brain in- Strategy: Hiles and colleagues describe definitive field care (DFC)—a
jury (TBI). Based on the authors’ review of the literature, this appears medical strategy that places full responsibility for definitive treatment
to be is the first reported case showing real-time reduction in optic on the initial provider. Such an approach is needed when evacuation
nerve sheath diameter (ONSD) following treatment with 3% hyper- is impossible due to tactical, environmental, or political constraints.
tonic saline in a patient with a penetrating TBI. They conclude that They argue that, as irregular warfare becomes more prevalent, for-
that ONSD measurement has potential for neurocritical monitoring in mally recognizing, studying, and integrating DFC into military and
austere, resource-limited environments, including prolonged field care. humanitarian medical planning is essential.
A Back-to-Basics Approach for Resuscitation: Storage and Trans-
portation of Whole Blood in Chest Harness: Geracci and colleagues
tested a chest harness as simple, reliable technique for preserving a
unit of blood in the field. During a search and rescue exercise, 1 unit of Relationship between
blood was drawn and stored in the rescuer’s chest pocket for 13 hours Special Operations and
irregular warfare (Joint
while performing rigorous training. Despite temperatures as low as Publication 3-05, Special
4°C (40°F), the blood remained liquid and appeared viable, suggesting Operations, 16 July 2014).
that body heat may help maintain adequate storage temperature for
whole blood.

UNCONVENTIONAL MEDICINE
Image of the interior Effectiveness of External Hemorrhage Compression Device of
chest pocket in which the Abdominal Aorta in Hemorrhagic Shock: A Systematic Re-
the blood was stored. view of the Literature: Kuusisto and colleagues conducted a system-
atic review of the literature to assesses the efficacy of the abdominal
aortic and junctional tourniquet (AAJT) in improving survival rates
in patients with hemorrhagic shock. No conclusions could be drawn
based on the sparce literature involving humans. However, the authors
EDITORIALS stress that the AAJT remains a forward-thinking and viable option
Vascular Ultrasonography Performed by Special Operations for improving trauma resuscitation protocols and that further studies,
Forces Combat Medics: A Feasibility Study: In this feasibility particularly randomized and controlled clinical trials, are required to
study by Turner and colleagues, 25 combat medics in the Netherlands advance this important research.
Armed Forces performed and recorded ultrasound measurements of
the inferior vena cava (IVC) and popliteal vein (PV) after participating TCCC UPDATES
in a microteaching course by a vascular surgeon and following 2 min- Triage in Action: A Principles-Based Approach to Mass Casualty
utes of practice. The procedures were observed by a vascular surgeon. Management in Tactical Combat Casualty Care
All but one participant recorded the correct vessels. Recordings of the
IVC and PV were achieved in a mean time of 50 (SD 26) seconds 2025 SOMSA ABSTRACTS
and 1 minute and 26 seconds (SD 55s), respectively, proving that a
microteaching program is effective in this context for military medical Special Operations Medical Association Training, Education &
personnel with little to no ultrasound experience. Scientific Assembly 2025: Recognized Research Track Abstracts

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