Journal of Special Operations Medicine

Spring 2023 JSOM Podcast Jun 06, 2023

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.

Winter 2022 JSOM Podcast Jan 17, 2023

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.

Fall 2022 JSOM Podcast Jul 25, 2022

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.

Summer 2022 JSOM Podcast Jul 25, 2022

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.

Spring 2022 JSOM Podcast Feb 07, 2022

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.

Winter 2021 JSOM Podcast Feb 07, 2022

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.

Fall 2021 JSOM Podcast Oct 12, 2021

In this episode of the JSOM Podcast, Alex and Josh start by reviewing, "Timeline of 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.

Summer 2021 JSOM Podcast Jul 12, 2021

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.

Interview with Dr. Russ Kotwal Jun 14, 2021

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

Spring 2021 JSOM Podcast Apr 14, 2021

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

Interview with Dr. Stephen Rush Apr 07, 2021

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

Interview with Deputy Steve Doucette, Los Angeles County Sheriff's Department Feb 14, 2021

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

Interview with Dr. Ted Redman, 160th SOAR Regimental Surgeon Jan 26, 2021

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

Winter 2020 JSOM Podcast Jan 04, 2021

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.

Interview with Dr. Frank Butler, CAPT, USN (Ret) - Part 1 Dec 23, 2020

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.

Interview with Dr. Frank Butler, CAPT, USN (Ret) - Part 2 Dec 23, 2020

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.

Interview with CAPT (Dr) Ryan C. Maves Nov 21, 2020

In one of our most scientifically robust discussions, we go down the rabbit hole with Dr Maves and learn about some of the advances in antibiotic selection and use in the PFC environment. He helps us learn about the many changes in antimicrobial therapy that the military has seen in the past 20 years; and how much is still the same from the past 50 years. In a separate section, he reviews the Joint Trauma System wound care clinical practice guidelines for us and helps discuss when different antibiotics would be appropriate for different situations. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with CAPT (Dr) Ryan C. Maves - Bonus Material Nov 21, 2020

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.

Interview with Jordan Benjamin Oct 15, 2020

Strategic SOF pivots to AFRICOM and INDOPACOM have brought a number of surprises, such as treating snakebites. We caught up with one of the current snakebite SMEs to learn what got him interested in the field and how the arena of snakebite care has developed over the past couple of decades. In yet another rousting bit of education, he breaks down the “hot off the press” Joint Trauma Service snakebite clinical practice guidelines and helps us better understand the underlying phys-iology that medical professionals should consider when caring for patients who may have suffered an envenomation injury. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Fall 2020 JSOM Podcast Oct 05, 2020

In this episode of the JSOM Podcast, Alex and Josh discuss the articles "Ketamine Administration by Special Operatinos Medical Personnel During Training Mishaps". Guest Rico Pesce breaks down the article, "Far Forward Gaps in Hemorrhagic Shock and Prolonged Field Care: An Update of ALM Fluid Therapy for Field Use". Alex and Josh also discuss, "Management of Critically Injured Burn Patients During an Open Ocean Parachute Rescue Mission". Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with LTC Jamie Riesberg Sep 15, 2020

We settle down to chat with one of the reigning champions of Prolonged Field Care (PFC), Dr Jamie Riesberg. He helps educate us about where the modern impetus for creating PFC treatments came from and what it looks like now. We review the thought process and resources available to the SOF medic practicing in the austere environment. Hope you enjoy learning about the recent developments in PFC as much as we do! Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with LTC Rich Lesperance Jul 01, 2020

The 20th Anniversary interview series continues with LTC Rich Lesperance. LTC Lesperance is a surgeon at Brook Army Medical Center. Rich came up through the enlisted ranks as a Special Forces Medic. He earned his commission through medical school and continues to serve the SpecOps community as a trauma surgeon. In this interview, LTC Lesperance discusses the effects of tranexamic acid on the breakdown of tissue during a trauma event. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with COL (Ret) John Kragh Jun 17, 2020

We continue our 20th Anniversary interview series with world-renowed tourniquet expert Dr. John Kragh. In this interview, Dr. Kragh takes us through his history in becoming a tourniquet expert as well as detailing the evolution of toruniquet use in combat situations as a battalion surgeon in Southwest Asia. Tourniquet use has evolved considerably even during the 20-years since the JSOM has been in publication. Be sure to read Dr. Kragh's contributions to this quarter's journal as a companion to this interview. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Summer 2020 JSOM Podcast Jun 17, 2020

In this episode of the JSOM Podcast, Alex and Josh discuss the article, "Step Duration Effects on Blood Loss in Simulated Designs of Tourniquet Use Procedure". Guest Will Price breaks down the article, "Clothing Effects on Limb Tourniquet Application", and authors Matt Douma and Peter Brindley discuss their article, "Temporizing Life-Threatening Abdominal-Pelvic Hemorrhage Using Proprietary Devices, Manual Pressure, or a Single Knee: An Integrative Review of Proximal External Aortic Compression and Even 'Knee BOA'. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with CMSgt Michael Rubio Jun 03, 2020

Please join us as we catch up with CMSgt Rubio, currently the commandant of the 351st Special Warfare Training Squadron of the PJ schoolhouse at Kirtland AFB. We had the privilege of hearing about his wide-ranging career as a SOF medic before diving into a discussion about the PJ training pipeline. It's a great opportunity to hear from the best about how PJ training has changed during the past 20 years, and get a glimpse of where it is heading in the future. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with MSG (Ret.) Rick Hines May 19, 2020

>Rick Hines has a long history in Special Operations and is currently an instructor Special Warfare Training Group. He teaches at the SF Medical Sergeant Recertification Course and focuses on anesthesia and surgical care in the austere environment. Rick and Josh have a long conversation discussing the benefits of recycling at the 18D course, historical basis and current practice of surgical care and anesthesia for the far forward special operations medic. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Spring 2020 JSOM Podcast Mar 20, 2020

In this episode of the JSOM Podcast, Alex reviews the Combat Medics' Aid Bag Inventory by Schauer, et. al.; Josh breaks down a basic science article about biomarkers in evacuated patients and Rick Hines from the JSOMTC opines about freeze dried plasma by Cuenca, et. al. in our guest review. In addition, Dr. Jae Choi and Dr. Andriy Batchinsky provide in-depth information on their research into HMGB1 proteins. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with MAJ Andy Fisher Mar 03, 2020

In this interview, MAJ Andrew Fisher gives us a great review of pre-hospital whole blood in the military; where we are now and how we got there. He reminds us that, "everything old is new again." The first whole blood transfusion research was done by the military in 1940 and was used extensively in WWII and the Korean War. Supply limitations during MASCAL events in the early 2000's led to authorization to use walking blood banks at fixed facilities, and the results were promising. Further evaluation led to codification of walking blood banks in deployed theatres when demand outstripped supply, driving the creation and implementation of a prehospital blood program that continues to be the gold standard. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with MSgt Shawn Anderson Feb 17, 2020

In this interview, we chat with MSgt Shawn Anderson, Pararescue Medical Program Manager. This interview focuses on the history of pre-hospital analgesia within the PJ (and SOF) community and how it has changed in the recent past. Only 20 short years ago, we were still using morphine on the battlefield, with little practice change since the civil war. Recent history has taught us that morphine auto-injectors didn't work very well with patients with shock. The turn of the century brought about a resurgence in the use of ketamine, used extensively during the Vietnam War. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Interview with MSG (Ret.) Harold "Monty" Montgomery Jan 29, 2020

The 20th anniversary special interview series starts off by chatting with former Army ranger and current SOMA president MSG (Ret) Harold "Monty" Montgomery about the evolution of TCCC over the last 20 years since the start of the JSOM. Monty also gives us a look to the future of TCCC and the plans the Committee on TCCC have for the way forward. We hope you enjoy the informative discussion about changes past, present and future to TCCC. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Winter 2019 JSOM Podcast Jan 08, 2020

This podcast reviews 3 articles. Shared Blood: Expeditionary Resuscitative Surgical Team (ERST-5) Use of Local Whole Blood to Improve Resuscitation of Host Nation Partner Forces by Melanie Bowman, et. al., The Good, the Bad, and the Future of Drones in Tactical/Operational Medicine by Keegan Bradley, and Guest host Ricky Ditzel, Research and Development lead @ SOM-C, will review Getting "SMART" on Shock Treatment: An Evidence-Based Mnemonic Acronym for the Initial Management of Hemorrhage by Patrick Thompson and Anthony Hudson. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

Fall 2019 JSOM Podcast Jan 01, 2020

This podcast reviews 3 articles. Getting Tourniquets Right = Getting Tourniquets Tight by Piper Wall, et. al.; Interventions Performed on Mulipurpose Military Working dogs in the Prehospital Combat Setting: A Comprehensive Case Series Report by Lauren Reeves, et. al.; and The Use of Tranexamic Acid in the Prehospital Setting: A Retrospective Study by Justus Boever, et. al. Visit our Social Media @jsomonline. https://jsom.us/Podcast.

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