Harrington RD. 09(4). 3 - 10. (Journal Article)
Special Operations Forces (SOF) medics trained to deliver comprehensive dental care (extractions and fillings) to a population in a contested area can be one of the more important elements in a successful UW campaign. This article will highlight and review an inexpensive, lightweight, highly portable dental system that allows the SOF medic to deliver these vital dental services in the field.
Hollingsworth DJ. 09(4). 11 - 15. (Journal Article)
Musculoskeletal injuries are a primary cause of morbidity and missed training throughout the military. Only a handful of studies have been performed which focus on the Special Operations community. This study was performed to determine a baseline understanding of the prevalence of musculoskeletal injuries within an operational element of the newly formed Marine Corps Special Operations Command. The results of this survey reveal that nearly one-third of all members of 1st Marine Special Operations Battalion, Delta Company, experienced pain or physical limitation due to a musculoskeletal injury. Of those who were injured, nearly 30% reported that their injury impacted their ability to train during their pre-deployment training cycle. These results confirm that musculoskeletal injuries are a significant problem within the Marine Corps Special Operations Command. Further investigation is warranted to examine etiological factors resulting in these injuries and changes to training regimens that may result in decreased injuries.
Retrospective analysis of patient records from two 1st Battalion, 7th Special Forces Group combat rotations in Operation Enduring Freedom reveals a high volume of medical activity over a wide range of medical issues managed by Special Forces Medical Sergeants (MOS 18Ds). The initial training curriculum for 18Ds has been modified to provide graduating 18Ds with a refresher course and updated credentialing before reporting to their first unit. However, due to the high operational tempo, subsequent biannual refresher training has proven difficult for at least one Special Forces unit. Units must plan ahead between deployments to balance medic recredentialing with unit pre-mission training and individual non-medical training.
Remick KN. 09(4). 20 - 25. (Journal Article)
Special Operations Forces need trauma surgical support that is flexible and rapidly mobile. Current operations in the Afghanistan Theater of Operations required the U.S. Army 772nd Forward Surgical Team (FST) to provide support for Special Operations missions and conventional missions on short-notice using its mobile Surgical Resuscitation Team (SRT). The 772nd FST's experience over a 15-month deployment validates the concept of and the requirement for the SRT. This paper provides a framework for planners to design and implement this capability for support of U.S. Army Special Operations Forces (ARSOF).
Tobin JM. 09(4). 32 - 35. (Journal Article)
The current war has, like past conflicts, presented the medical community with opportunities to innovate novel approaches to old problems. Although trauma anesthesia is provided adequately in the majority of cases, a standardized approach for treating these complex and critically ill patients is lacking. While this technique was developed for anesthesia in non-permissive environments, the principles suggested here could serve as a template for trauma anesthesia in other environments as well. The algorithm is designed as a standardized protocol in an effort to simplify the approach to these complex patients who often present in a dynamic environment. A list of required equipment is included to serve as a guide for preparation prior to employment of the algorithm.
Over the last decade, our understanding of biochemical changes that occur in the brain following an injury has increased dramatically. Although we have been able to discern and image severe injury and traumatic changes using techniques like computed tomography (CT) and magnetic resonance imaging (MRI) for decades, we have only recently begun to understand the physiologic changes that occur following a mild traumatic brain injury. Understanding the pathophysiology of a disease process enables healthcare providers to treat their patients better, but military healthcare providers shoulder the additional burden of conserving the fighting force. Neurocognitive testing in concert with clinical acumen and conservative profiling enables providers to protect their patients from further injury; while educating the patient and the chain of command will prevent additional injury and long-term cognitive sequelae, ultimately preserving the fighting force.
Geers D. 09(4). 43 - 52. (Journal Article)
Special Operations Forces (SOF) Operators need a variety of individual medical items that can generally be broken down into three types of medical kits: a major trauma kit, to treat major traumatic wounds; an inuse medical kit, to prevent or treat anticipated common medical conditions during operations; and a survival medical kit, to treat minor injuries and ailments when in a survival/evasion situation.
Present and future Special Forces missions will require prolonged care of the trauma patient. The Special Forces Medic and Independent Duty Corpsman must be prepared to deal with these situations in the most challenging and austere environments. The implementation of damage control resuscitation for prolonged trauma care can maximize results with minimal support while preventing death, priming the patient for surgical success, and expediting recovery. Establishing this model of care and equipping medics with the essential equipment will have a lasting effect on the survival rate of our casualties, and negate the enemy's political victories when American and allied lives are lost.
Previously published in The Journal of the American Board of Family Medicine 22 (4): 399-407 (2009) Reprinted in the JSOM with permission granted by the Chief Editor of the The Journal of the American Board of Family Medicine
Recreational scuba diving is a growing sport worldwide, with an estimated 4 million sport divers in the United States alone. Because divers may seek medical care for a disorder acquired in a remote location, physicians everywhere should be familiar with the physiology, injury patterns, and treatment of injuries and illnesses unique to the underwater environment. Failure to properly recognize, diagnose, and appropriately treat some diving injuries can have catastrophic results. In addition, recreational dive certification organizations require physical examinations for medical clearance to dive. This article will review both common and potentially life-threatening conditions associated with diving and will review current evidence behind fitness to dive considerations for elderly divers and those with common medical conditions.
Zimmerman DJ. 09(4). 80 - 83. (Previously Published)
Previously Published in The Year in Speical Operations 2009. Reprinted with Permission
Reed B. 09(4). 96 - 98. (Journal Article)
Bottoms M. 09(4). 107 - 109. (Journal Article)
Johnson DC. 09(4). 110 - 112. (Journal Article)