Journal of special operations medicine : a peer reviewed journal for SOF medical professionals
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There are many challenges to treating life-threatening injuries for a healthcare provider deployed to a remote location in a combat setting. Once conventional treatment protocols for exsanguinating hemorrhage have been exhausted and no medical evacuation platform is available, a nonconventional method of treatment to consider is a fresh whole blood (FWB) transfusion. ⋯ While the ultimate outcome was death in this case report, the patient arrived to a surgical team 15 hours after his injury, alert and oriented. In this scenario, FWB transfusion gave this patient the best chance of survival.
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Observational Study
An observational study assessing completion time and accuracy of completing the tactical combat casualty care card by combat medic trainees.
Prehospital care documentation is crucial to improving battlefield care outcomes. Developed by United States Army Ranger Special Operations Combat Medics (SOCMs), the Tactical Combat Casualty Care (TCCC) is currently fielded to deployed units to record prehospital injury data. This study documents length of time and accuracy of U.S. Army Combat Medic trainees in completing the minimum preestablished required fields on the TCCC card, establishing a baseline for point-of-injury cards. ⋯ RESULTS imply that the TCCC card is well designed to quickly and accurately record prehospital combat injury information. Further investigation and future studies may compare other prehospital data collection methods with the TCCC card in terms of timely and accurate data collection.
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Special Operations Forces (SOF) medics have written and published numerous practice reflections that intricately describe their practice environments, clinical dilemmas, and suggestions for teaching and practice. The lack of translation of SOF medics experiential evidence to their curriculum has created a gap in evidence-based curriculum development. This study analyzed SOF medics learning and practice patterns and compared it to the evidence in the interdisciplinary clinical literature. After framing the problem, the literature was reviewed to determine appropriate tools by which perceptions and attitudes toward reflection-centered curricula could be measured. ⋯ Special Operations, medics, reflective practice, curricula BACKGROUND Special Operations Forces (SOF) medics practice in environments that are violent, austere, clandestine, and far removed from definitive hospital facilities. What was true almost 20 years ago?". . . academic demands of [Special Forces medic training] are roughly equivalent to those of an upper-level undergraduate curriculum in science or perhaps to those of first year medical school"?is even more challenging today. During this study, medics, physicians, and educators within the SOF medical community publicly and privately (ergo, names were redacted) expressed the need for curricular changes to teach SOF medics about the worst of clinical scenarios, such as situations in which evacuation of critically injured Soldiers to higher echelons of care is not possible or is prolonged, due to combat engagements or other complications. These experts consistently describe the need for curriculum derived from experienced medics practices, to guide force-wide knowledge acquisition and augment student medics professional development. Given the investigator?s clinical familiarity with SOF medics practice and evidence, senior, enlisted SOF medics and SOF medic instructors proposed that a doctoral-prepared nurse, whose clinical specialty was trauma, could spearhead academic focus and publication on the experiences and curriculum of SOF medics.
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Historical Article
Medical operations of the 6th ranger infantry battalion.
The author gives a history of the formation of the 6th Ranger Infantry Battalion and varied aspects of Ranger medical operations, including personnel composition of the medical detachment, the work of the battalion?s surgeon during combat and noncombat operations, medical aspects of operational planning, available medical supplies, medical evacuation procedures, and preventive care.
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The author describes a cricothyrotomy system that consists of two devices that, packaged together, are labeled the Control-Cric™ system. The Cric-Key™ was invented to verify tracheal location during surgical airway procedures?without the need for visualization, aspiration of air, or reliance on clinicians? fine motor skills. The Cric-Knife™ combines a scalpel with an overlying sliding hook to facilitate a smooth transition from membrane incision to hook insertion and tracheal control. In a recent test versus a traditional open technique, this system had a higher success rate and was faster to implement.