ABSTRACT

The current United States Navy and North Atlantic Treaty Organization (NATO) maritime strategy is coalescing around the concept of Distributed Maritime Operations (DMOs) to prepare for future large-scale combat operations with peer or near-peer competitors. As a result, individual components of naval forces will be more geographically dispersed and operating at a significant time and distance from higher levels of medical care. We developed a series of educational scenarios informed by real-world events to enhance the ability of Role 1 medical caregivers to apply the principles of Prolonged Casualty Care during current routine, crisis, and contingency DMOs.

Social Determinant of Unconventional Resilience: Tactical Engagement with Bonding Patterns

Jeschke EA, Wyma-Bradley J, Baker JB, Dorsch J, Huffman SL. 24(1). 90 - 94. (Journal Article)

ABSTRACT

Building upon our strategic framework and operational model, we will discuss findings from our ethnographic study, entitled: "The Impact of Catastrophic Injury Exposure on Resilience in Special Operations Surgical Teams (SOSTs)," to explain the tactical nature and importance of social determinants within our new characterization of unconventional resilience. Our fourth paper in this series, will explain how bonding patterns establish the quality of intra- and interpersonal connections that create a tensive conduit for the pressure of performance within our operational model, allowing for dynamic freedom of maneuver to take place in ambiguity. We will use qualita- tive quotes to illustrate various ways SOST medics relate to themselves, other people, and the Special Operations Forces (SOF) culture. To achieve our goals, we will: 1) provide an in- troduction to social determinants as tactical engagement with unconventional resilience; 2) define the social determinant of bonding patterns as extrapolated from qualitative data as well as use qualitative data to thematize various types of bonding patterns; and 3) relate tactical engagement with bonding pat- terns to our metaphor of bag sets. We conclude by gesturing to the importance of bonding patterns in orienting SOF medics' proprioception and kinesthesia in the SOF performance space.

ABSTRACT

Background: Blood is a highly valuable medical resource that necessitates strict guidelines to ensure the safety and well-being of the recipient. Since the onset of the war in Ukraine there has been an increased demand for training in emergency fresh whole blood transfusion (EFWBT) to improve damage control resuscitation capabilities. To meet this demand, we developed, implemented, and evaluated a training program aimed at enhancing Ukrainian EFWBT proficiency. Methods: Eight Ukrainian healthcare professionals (UHPs), including six physicians and two medics, completed our training, derived from the Joint Trauma System Clinical Practice Guidelines, Tactical Combat Casualty Care (TCCC) Guidelines, 75th Ranger Regiment Ranger O-Low Titer (ROLO) program, and Marine Corps Valkyrie program. Participants were assessed on their confidence in the practical application and administrative oversight requirements of an EFWBT program. A cross-comparison was conducted between a larger data set of third-year medical students from the Uniformed Services University and the UHPs to determine the statistical significance of the program. Results: The difference in mean scores of UHPs during preand post-training was statistically significant (p<0.001). Additionally, the average rate of improvement was greater for the UHPs compared with the third-year medical students (p=0.000065). Conclusion: Our study revealed that the application of an EFWBT training program for UHPs can significantly increase confidence in their ability to conduct EFWBTs on the battlefield. Further larger-scale research is needed to determine the impact of this training on performance outcomes.

Keywords: Ukraine; fresh whole blood; transfusion medicine; emergency medical services; Russian-Ukrainian War



The JSOM podcast digs deeper into the articles and subjects that matter to our readers. Our podcast hosts, Captains Alex Merkle and Josh Randles, tackle articles from the journal based on merit, interest, and application for operators in the field. The Spring 24 episode is here!

Current Episode

Our JSOM podcast team will be reviewing the following articles for our Spring podcast: 

Development and Implementation of a Standard Operating Procedure for Military Working Dog Blood Collection, Storage, and Transport by Elizabeth L. Evernham, Benjamin T. Fedeles, and Kayla M. Knuf (https://www.jsomonline.org/FeatureArticle/2024128Evernham.pdf)

Derivation of a Procedural Performance Checklist for Bifemoral Veno-Venous Extracorporeal Membrane Oxygenation Cannula Placement in Operational Environments by Elizabeth Powell, Richard Betzold, et al. (https://www.jsomonline.org/FeatureArticle/2024132Powell.pdf)

Emergency Fresh Whole Blood Transfusion Training for Ukrainian Health Professionals in Austere Environments by Zachery L. Brown, Joshua P. Cuestas, Kevin J. Matthews, Jonathan T. Shumaker, Durwood W. Moore, and Rebekah Cole (https://www.jsomonline.org/FeatureArticle/2024138Brown.pdf)

JSOM Guest Editor Captain Cam Strawn reviews Development and Implementation of a Standard Operating Procedure for Military Working Dog Blood Collection, Storage, and Transport. Capt Strawn serves as an Air Force Combat Rescue Officer and combat veteran who teaches leadership as an Assistant Professor of Aerospace Studies at Brigham Young University, where he is also completing a premedical post-baccalaureate program. He is a SOFtoSOM Scholar applying to medical school this year.

JSOM Guest Authors

Emergency Fresh Whole Blood Transfusion Training for Ukrainian Health Professionals in Austere Environments authors SFC Zachery Brown and HM1 Kevin John Matthews are

interviewed by our podcaster team about their article. SFC Zachery Brown enlisted in the Army on 15 September 2009. He has served with the 75th Ranger Regiment for the past 13 years: 7 years in the 1st Ranger Battalion and 6 years in the Regimental Reconnaissance Company (RRC). He served as a Ranger Squad Leader, Regimental Reconnaissance Team (RRT) Medical Sergeant, RRT Assistant Team Sergeant, and RRC Operations NCOIC and has nine combat deployments to Afghanistan, Iraq, and Syria, amounting to over 500 Special Operations Raids. In 2021, the Uniformed Services University of Health Services (USUHS) selected him for one of seven Army slots for the 24-month Cohort 9, Enlisted to Medical Degree Preparatory Program (EMDP2). This program prepares top-performing enlisted Servicemembers to apply to medical school. He is currently enrolled as a graduate student and aims to continue serving our nation and global community as a military physician and medical officer in the United States Army. SFC Brown earned a BS in Biology, Bio-Engineering Concentration, from the University of Arkansas in 2008, an MS in Strategic Leadership from the University of Charleston, and is currently working towards completing an MS in Biology at George Mason University.

Hospital Corpsman First Class, HM1 (FMF/ SW) Kevin John Matthews enlisted in the Navy in 2016. Operationally, HM1 Matthews served as the Senior Line Corpsman, Scout Sniper Platoon, Weapons Company, 1st Battalion, 4th Marines, deploying to Africa and the Middle East aboard the 15th Marine Expeditionary Unit (MEU) in 2021. Upon returning from deployment, the Navy Education and Training Office (NETO) selected HM1 Matthews as a Combat Trauma Management and Valkyrie Emergency Fresh Whole Blood Transfusion training instructor. He oversees the training of all medical personnel attached to Marine Corps expeditionary ground forces at 1st Marine Division, Camp Pendleton, CA. Hand-selected by the Division Surgeon, he was appointed the founding Course Manager for the inaugural Prolonged Casualty Care Course, preparing forward-deployed Corpsmen to sustain casualties beyond the “Golden Hour” in resource-limited environments and austere terrain. In 2021, USUHS selected HM1 Matthews for one of seven Navy slots for the EMDP2. He is currently enrolled as a graduate student and aims to continue to serve our nation and global community as a physician and Medical Officer in the United States Navy. HM1 Matthews earned a BA in History, Middle Eastern Concentration, from the University of California San Diego in 2014 and worked as an EMT-B and Ocean Lifeguard for the San Diego Fire Rescue Department from 2014 to 2016. Additional current and prior professional qualifications include PHTLS, ABLS, TCCC Instructor, Personal Watercraft Operator for High-Surf Rescues, and AHA BLS Instructor. 

The Journal of Special Operations Medicine is proud to have the support of many great sponsors and media partners. Our sponsors are leaders in the field of military medical technology. Please help support these companies by following the links below to learn more about their missions and the products they offer. This section also features peridoic promtional information for events and conferences, including the 2024 SOMA Scientific Assembly. 

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Visit https://jsom.us/Library for a full list of institutions currently subscribing to the JSOM. We are beginning a campaign to expand our institutional subscriptions. If you think your company would benefit from an institutional subscription, let us know! We'll be happy to talk to you and get the ball rolling. You don't have to be a university or medical center to subscribe - we have many EMS units, government agencies, and military medical units in the United States and abroad.

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If your institution is not on the list and you want more information about our institutional access, contact our subscriptions manager, Dr. Scott Graverson.

For over 20 years, the Journal of Special Operations Medicine (JSOM) has brought important, lifesaving information to the Special Operations Forces (SOF) community. And over the years, as our audience and readership has expanded into over 80 countries, physicians, military and tactical medics, and other medical professionals working in unconventional environments rely on the JSOM for breakthrough research at the intersection of operational medicine and tactical casualty care. Our peer-reviewed research and interactive clinical content make the JSOM a must-read for:

• Physicians
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For these reasons, many of the world’s top medical technology companies and medical device distributors make the JSOM a cornerstone of their advertising programs. And with a strong multichannel and social media presence, the JSOM offers the most dynamic print and digital media options at cost-effective prices. For medical marketers worldwide looking to reach our niche audience, the JSOM is the gold standard. For more information, please see our attached media kit.

Coming Soon from the Journal of Special Operations Medicine published by Breakaway Media, LLC

We are excited to announce the upcoming publication of Tell Them Yourself: It's Not Your Day To Die*, by Frank Butler, Kevin O'Connor, and Jeff Butler.

It's an extraordinary, true account of how a small group of world-class trauma experts joined forces with America’s best combat medics to rewrite the battlefield medicine rule book and then sell these revolutionary new concepts to a disbelieving medical world.

This is the definitive record of how TCCC came to be and how these protocols forever changed the way care is provided to those wounded in combat, written by the men who fought for the change.

*This highly anticipated book will premiere at the 2024 Special Operations Medical Association symposium. Dr. Frank Butler will be at the JSOM booth #611 signing copies. The book will then be available to purchase on the JSOM website on or around May 20th.



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