Journal of Special Operations Medicine

Our JSOM Podcast team of Alex Merkle and Josh Randles will be reviewing the following articles for our Winter podcast: Optimizing Brain Health of United States Special Operations Forces by Brian L. Edlow, Natalie Gilmore, Samatha L. Tromly, et al. (www.jsomonline.org/FeatureArticles/2023447Edlow) Bluetooth Tactical Headsets Improve the Speed of Accurate Patient Handoffs by Daniel J. Stinner, Cory McEvoy, Michael A. Broussard, et al.(www.jsomonline.org/FeatureArticles/2023475Stinner.pdf) Effectiveness of Sternal Intraosseous Device in Patients Presenting with Circulatory Shock: A Retrospective Observational Study by Allyson M. Hynes, Shyam Murali, Gary A. Bass, et al. (www.jsomonline.org/FeatureArticles/2023481Hynes.pdf) JSOM Guest Medic: Our guest medic for this quarter is Ricky Ditzel, who will review “Optimizing Brain Health of United States Special Operations Forces” by Edlow and colleagues. Ricky and his two siblings’ adolescent lives were defined by chaos. Inspired to make a positive change for his family, he enlisted in the Army and served as a U.S. Army Special Operations Flight Paramedic. In this role, Ricky treated U.S. and Allied forces servicemembers who suffered from the acute and chronic effects of traumatic brain injury. These experiences propelled Ricky to become a neurodegenerative disease researcher and vocal advocate for brain and mental health. Ricky believes strongly in a life of service and consistently seeks opportunities to support underserved communities and promote health equity. He believes the current healthcare structure reduces access to care for individuals with neurologic disabilities because of limitations associated with public transportation, specialty care access, and education. Driven towards research and finding solutions to increase the quality of life for people with neurological disabilities, Ricky is pursuing a career as a physician. He plans to create a neurologic center of excellence that will provide comprehensive multidisciplinary outpatient care under one roof. Ricky is the Chairman of the Special Operations Forces to School of Medicine (SOF to SOM) (https://www.softosom.org/), a board member of Neuroacanthocytosis Advocacy USA, and the Special Operations Medical Association. He will continue to serve his country and community while doing his best to honor the legacies of those who have gone before him. “For they loved to fight, fought to win, and would rather die than quit. Night Stalkers don’t quit!” JSOM Guest Author Interview Our guest author interview will be with Cory McEvoy, author of “Bluetooth Tactical Headsets Improve the Speed of Accurate Patient Handoffs.” Cory is a former 18D who served with 1-1SFG(A) and USASOC. Cory has deployed to both humanitarian and combat zones as an 18D and has been involved with many research projects, with his primary interest being repetitive and low-level blast. Cory left the Army in 2023 and is in the process of applying to medical school. Follow us on Social Media @jsomonline or on our website https://www.jsomonline.org

Our JSOM Podcast team of Alex Merkle and Josh Randles will be reviewing the following articles for our Fall podcast: Slow Intravenous Infusion of a Novel Damage Control Cocktail Decreases Blood Loss in a Pig Polytrauma Model by Nathan J. White, MD, MS, et al. (www.jsomonline.org/FeatureArticles/2023350White.pdf) Pain Control and Point-of-Care Ultrasound: An Approach to Rib Fractures for the Austere Provider by Reece Snyder, PA-C, et al. (www.jsomonline.org/FeatureArticles/2023370Snyder.pdf) Phosphorus Burn Management with Multimodal Analgesia by Luc Saint-Jean, MD et al. (www.jsomonline.org/FeatureArticles/2023382Saint-jean.pdf) JSOM Guest Medic EditorTechnical Sergeant Derek Fyksen will be reviewing Pain Control and Point-of-Care Ultrasound: An Approach to Rib Fractures for the Austere Provider. TSgt Fyksen is currently an Air Force PJ. He enlisted in the U.S. Marine Corps in 2011 and served three years at 1st Marine Raider Battalion before transferring to the Air Force to pursue becoming a Pararescueman in 2017. After his separation from the Air Force, Derek intends to pursue a joint MD/MPH program. JSOM Guest Author Interview Dr. Luc Saint-Jean is affiliated with the 1st Specialized Medical Unit, Versailles, France. He will be reviewing his article, Phosphorus Burn Management with Multimodal Analgesia. Josh Randles will review Slow Intravenous Infusion of a Novel Damage Control Cocktail Decreases Blood Loss in a Pig Polytrauma Model.

SO1 Brentyn Jones, Navy SEAL/SOCM, currently, working in the Tactical Medical Training Department, will be review Prevalence of Trauma-Induced Hypocalcemia in the Prehospital Setting. Patrick Thompson is affiliated with the Trauma, Hemostasis & Oxygenation Research Network, Bergen, Norway. He will be review Risk of Harm in Needle Decompression for Tension Pneumothorax. CPT Josh Randles will review The Impact of Special Operations Medics and Corpsmen on Military Medical Student Training: A Qualitative Study. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

Our guest medic editor this quarter, SSG Blake Wright, enlisted in 2013 and has since served in various roles across the 173d, 82d Airborne, and USASOC. He currently serves as a Special Operations Flight Medic and has future aspirations of applying to the Inter-Service Physician Assistant Program. He will review The Effect of Prehospital Blood Transfusion on Patient Body Temperature from the Time of Emergency Medical Services Transfusion to Arrival at the Emergency Department. Our author interview will be with Sean M. Stuart, DO, FACEP, FAAEM, FAWM Commander, Medical Corps, US Navy (Naval War College). Commander Stuart received his Doctor of Osteopathic Medicine from the Philadelphia College of Osteopathic Medicine in 2009. CDR Stuart reported to the 3rd Battalion, 3rd Marines, where he served as the Battalion Surgeon from 2010 to 2013. During this time, CDR Stuart deployed twice to support Operation Enduring Freedom. He also served as the Director of Medical Readiness for 3d Marines. CDR Stuart also served as the Deputy Regimental Surgeon, coordinating medical support for developing Marine Rotational Force–Darwin and RIMPAC exercises. He pioneered the development of a combat training curriculum, created a training tactical simulation laboratory, and served as the Director of Operational Training. In 2014, CDR Stuart began his emergency medicine residency training. After graduating, CDR Stuart assumed the role of MEU Surgeon for the 13th Marine Expeditionary Unit. In 2019, CDR Stuart returned to Naval Medical Center Portsmouth as academic faculty. In 2022, CDR Stuart was selected to attend the Naval War College. CDR Stuart is board-certified in Emergency Medicine, holds a faculty appointment as Assistant Professor of Military and Emergency Medicine at the Uniformed Services University of the Health Sciences, and is a Fellow of the American College of Emergency Physicians, American Academy of Emergency Medicine, and the Academy of Wilderness Medicine. He will review iTClamp-Mediated Wound Closure Speeds Control of Arterial Hemorrhage With or Without Additional Hemostatic Agents on p. 87 of the Winter 2022 edition. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

Our guest medic editor this quarter is Devin DeFeo, a former SOF medic. 2LT DeFeo enlisted in the Army in 2004 and served as an 18D with 1SFG(A) and USASOC. As a medic, he authored the concept for MARCHE2 for TCCC in the chemical, biological, radiological, and nuclear (CBRN) environment published in JSOM, which later formed the framework for the Joint Trauma System Clinical Practice Guidelines on CBRN medicine and the CBRN chapter in the Ranger Medical Handbook. He then participated in the Enlisted to Medical Degree Preparatory Program (EMDP2) at George Mason University, earning a master of science in biology. He is currently a third-year medical student at the Uniformed Services University of the Health Sciences (USUHS). 2LT DeFeo is considering a residency in emergency medicine. He will be reviewing Does Mental and Visual Skills Training Improve High-Value Target Identification and Marksmanship Among Elite Soldiers? by J. Jay Dawes, et al. (p. 22). Our author interview is with Michael J. Egnoto, PhD (An Exploratory Comparison of Water-Tamped and -Untamped Explosive Breaches: Practical Applications for the Tactical Community via Pilot Study). Dr Egnoto is affiliated with the Walter Reed Army Institute of Research, Forest Glen Annex, Silver Spring, MD. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

This podcast is focused on research and contributions made by women in service to the military. We start with a review of "Women in US Military History" by Gretchen Garceau-Kragh. Guest medic HM1(FMF/EXW) Eric Dodson reviews "Active Warfighter Resilience: A Descriptive Analysis" by Nikki Barczak-Scarborov, et. al. Finally, we give an objective review of "Operation Blood Rain Phase 2: Evaluating the Effect of Airdrop on Fresh and Stored Whole Blood." The review is complemented by an interview with lead author Dr. (LtCol.) Roselyn Fuentes. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

The Summer podcast features articles written primarily by medics and non-physicians. This entire journal is focused on the Critical Care aspect of SOF Medicine, so we wanted to invite the tip of the spear medics to talk about their research in this podcast. The first article is, "Analgesia and Sedation in the Prehospital Setting: A Critical Care Viewpoint" by Taylor DeRosiersm et. al. "Mechanical Ventilation: A Review for Special Operations Medical Personnel" by Jonathan Friedman and Seth Assar follows. We finish up with, "Airway Management With Noninvasive Positive Pressure Ventilation" by Papalski, Siedler, and Callaway. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

In this episode of the JSOM Podcast, Alex and Josh start by reviewing, "Use of Walking Blood Bank at Point of Injury During Combat Operations: A Case Report" by Gaddy, et. al. Associate Editor Rico Pesce and guest reviewer Pete Moreno review "Comprehensive Ultrasound Course for Special Operations Combat and Tactical Medics" by Fatima, et. al. Lastly, Alex and Josh review a 2-part series on Stress Inoculation Training. Part 1 is "The Development and Preliminary Evaluation of a Psychological Performance Training Protocol"; Part 2 is "A Pilot Study Among Explosive Ordnance Disposal Special Warfare Enablers", both by Jackson, et. al. Don't forget to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

The Spring podcast is a little late, but well worth the wait! In this podcast, our experts Josh and Alex review articles from Dr. Alexander Iteen and Dr. Hossam Abdou. Guest Medic PJ Pelaez reviews the article from PA Brett TerBeek. Josh and Alex are joined by Dr. Jonathan Morrison, coauthor of the Swine Polytrauma article. Their discussion delves into the particulars of the research and adds an element of fidelity to the manuscript. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

In this episode of the JSOM Podcast, Alex and Josh start by reviewing, "Timeline of Psychological and Physiological Effects Occurring During Military Deployment on a Medical Team" by Hall, et. al. Guest reviewer Rico Pesce and SSG Meredith Cole review "Blood Product Administration During Transport Throughout the US Africa Command Theater of Operation," by Schauer, et. al. Josh and Alex discuss, "Impact of a 10,000m Cold-Water Swim on Norwegian Naval Special Forces Recruits" with author Jorgen Melau. Don't forget to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

In this episode of the JSOM Podcast, Alex and Josh review 3 articles from the Summer journal. They review articles on Infectious Myositis in the Austere Setting by Simon Sarkisian, Autopy-Determined Atherosclerosis in SOF Forces by Russ Kotwal, and 23.4% Hypertonic Saline by Eric DeSousy for the Summer journal. Don't forget to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

We are honored to sit with Dr. Russ Kotwal, President of the Special Operations Medical Association. In this interview, Dr. Kotwal talks about the Association and the upcoming SOMSA symposium, to be held in Charlotte, North Carolina from June 28 - July 2, 2021. This year's scientific assembly will be held in-person, following current CDC and state of North Carolina health guidelines. Visit our Social Media @jsomonline https://jsom.us/Podcast

In this episode of the JSOM Podcast, Alex and Josh begin the podcast with an interesting open discussion about recent cases of patients travelling to Mexico to receive plastic surgery during the COVID-19 pandemic. Josh and Alex provide their analysis on the articles outlining the Secondary Traumatic Stress in Emergency Services Systems (STRESS) Project and Conversion of the AAJT to REBOA in a Swine Hemorrhage model. Guest reviewer, Naval Special Warfare medic PJ Pelaez discusses the article on Performance Characteristics of Fluid Warming Technology for Austere Environments. Visit our Social Media @jsomonline https://jsom.us/Podcast

We close out the 20th anniversary interview series with another of the pillars of our SOF medical community - Doc Rush from pararescue. He helps us learn more about the tremendous advances in special operations en route care over the last 20 years. We also get to hear about his background and how he serendipitously become involved with pararescue in the latter part of his civilian physician career. Looking back through the retrospectoscope, he is able to describe the training and level of en route care provided at the turn of the last century. We learn about the many different aeromedical platforms used in GWOT, their capabilities, and the different mission sets by reviewing Doc Rush's own article "Forward aeromedical evacuation: A brief history, lessons learned from the Global War on Terror, and the way forward for US policy" (2013). Alex also has a great discussion of the literature, such as Dr Mabry's "Impact of critical care–trained flight paramedics on casualty survival during helicopter evacuation in the current war in Afghanistan" (2012). Doc Rush is able to guide listeners through an outstanding tutorial about how to change policy and improve patient care through the use of tailored research that is leveraged to relevant policymakers. As always, our guest concludes the interview by reminding us that the most important thing each of us can do to improve combat trauma care is to report your patient data to the JTS. We need your help to analyze patient data and provide data driven improvements in care. Visit our Social Media @jsomonline https://jsom.us/Podcast

We take a swing into civilian practice with the world-renowned rotor wing tactical detail from Los Angeles. Steve helps us better understand the original transfer of tactical skills from military to law enforcement setting after the Korean war. We then find out about the absorption of tactical medicine into special weapons and tactics (SWAT) teams and its recent drastic evolution, thanks to the hard-won lessons from the battlefield. Our interview ends with an outstanding overview of the difference between a tactical medic, tactical medicine, and TEMS (which Alex, obviously, didn’t understand). Please let us know what you think about our foray into civilian medicine! Visit our Social Media @jsomonline https://jsom.us/Podcast

The Journal had the great pleasure to sit down and chat with one of the great leaders in SOF medicine, recently retired Dr Redman. He uses his extensive experience developing and improving prehospital REBOA care delivery to give us a wide-ranging education on the topic. We review the original of REBOA in the Korean Conflict and its subsequent translation into civilian cardiothoracic practice before recent use in trauma surgery. Our guest then teaches us about recent SOF prehospital REBOA experience and their lessons learned. We then wrap up with an excellent summary of the JTS REBOA CPG and Dr Redman’s personal recommendations going forward. Don’t miss another outstanding interview from one of our SOF medicine leader. Visit our Social Media @jsomonline https://jsom.us/Podcast

In this episode of the JSOM Podcast, Alex and Josh discuss the articles "Life and Limb In-Flight Surgical Intervention: Fifteen Years of Experience by Joint Medical Augmentation Unit Surgical Resuscitation Teams" and "Austere Surgical Team Management of an Unusual Tropical Disease: A Case Study in East Africa". Guest reviewer medic SGT Greg Spencer reviews "An Analysis and Comparison of Prehospital Trauma Care Provided by Medical Officers and Medics on the Battlefield". Finally, Alex and Josh review "Case Series on 2g Tranexamic Acid Flush From the 75th Ranger Regiment Casualty Database" with author MSG Simon Gonzalez. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

We end the year with a discussion from none other than THE Dr Frank Butler. He helps us review the state of combat care 20 years ago when the JSOM and TCCC both started. We learn about how he came to have an interest in improving the quality and delivery of combat care and the many different evolving roles he has had in combat casualty care. He also teaches us about how we arrived at recent changes in TCCC and future directions in care. Please join us for our great discussion with the plank holder of TCCC. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

We end the year with a discussion from none other than THE Dr Frank Butler. He helps us review the state of combat care 20 years ago when the JSOM and TCCC both started. We learn about how he came to have an interest in improving the quality and delivery of combat care and the many different evolving roles he has had in combat casualty care. He also teaches us about how we arrived at recent changes in TCCC and future directions in care. Please join us for our great discussion with the plank holder of TCCC. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Dr Maves had so much information packed into his interview that we couldn't keep it all within the hardball. It's like a double chocolate cake with chocolate chips; too much goodness! We've broken the interview into two pieces, the main interview and Dr Maves' excellent review of the current JTS wound care CPG. Please join us for both and let us know what you think! Visit our Social Media @jsomonline. https://jsom.us/Podcast.