With each edition of the journal, Doctors Alex Merkle and Josh Randles will review select articles from the journal. These articles will be selected based on merit, interest, and application for operators in the field.
We hope you find these Podcasts as informative and enjoyable as we do.
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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.
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. Don't forget to follow us on our Social Media platforms @jsomonline.
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.
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".
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'.
In this episode of the JSOM Podcast, Alex reviews the article about the Inventory of Combat Medics' Aid Bags; Josh breaks down a basic science article about biomarkers in evacuated patients and Rick Hines from the JSOMTC opines about freeze dried plasma in our guest review. In addition, Dr. Jae Choi and Dr. Andriy Batchinsky provide in-depth information on their research into HMGB1 proteins.
Volume 2 of the Journal Podcast reviews the Winter 2019 Journal of Special Operations Medicine. This podcast will focus on the following articles:
Welcome to the inaugural edition of the official JSOM podcast! In this edition, we'll be providing a brief review of:
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.
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.
Deputy/Paramedic, Special Enforcement Bureau, Emergency Services Detail, Los Angeles County Sheriff's Department
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!
Regiment Surgeon (R) 160th SOAR
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.
The Evolution of TCCC and the COTCCC
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.
PFC Antibiotics and CPG Review
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.
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!
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.
Prolonged Field Care (PFC)
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!
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.
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.
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.
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.
We had the opportunity to catch up with MAJ Andrew Fisher, MS-4, PA-C, LP for 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 (Armed Forces Blood Program) and was used extensively in WWII and the Korean War.
But times change and lessons learned are lost to the sands of time as one generation of peacetime military surgeons hands off the reigns to the next.
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. Seeing the benefit (and need) of whole blood in the pre-hospital environment, the Rangers "led the way" in creating and implementing a prehospital blood program that continues to be the gold standard to which other services and components are beholden.
We end with a look toward the future. There may be room for the implementation of whole blood programs within civilian settings and conventional forces.
Join us for the second in our 20th Anniversary interview series as we chat with MSgt Shawn Anderson, Pararescue Medical Program Manager. We get to learn more about his background and career. This discussion leads us through 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, when used in patients with shock, didn't work very well. Hypoperfused muscle resulted in sub-optimal analgesia, and could often create delayed hypotension when the histaminic agent finally did get distributed within the vasculature. As we all know, the turn of the century brought with it a resurgence in the use of ketamine; first used extensively for surgical anesthesia during the Vietnam War. As Rocky Farr would remind us - nothing is new, its just old ideas made new again.
The JSOM 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 during the past 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 has for the way forward. We hope you enjoy the informative discussion about changes past, present, and future to TCCC.
The Journal of Special Operations Medicine has become an increasingly relevant source of information for Tactical and Emergency Medical Services personnel. Our statistics show that a large number of people who identify as EMS professionals are actively following us on social media. In an effort to strengthen our committment to sharing and receving relevant information with the EMS community, we will be spotlighting bonus episodes of the EMS World podcast on the JSOM podcast stream.
For combat medics assigned to the U.S. Special Operations Command, the prehospital setting is an invaluable learning environment. In this episode, assistant editor Valerie Amato chats with Ricky Ditzel, a DOD flight paramedic and former combat medic, about his experience training with Special Operations Combat Medic (SOCM) at Cooper Univ. Hospital (NJ) EMS and trauma center staff to prepare for deployment.
We hope you will find these select episodes as informative as we do and encourage you to check out the entire EMS World podcast archive.
We have a couple of ambitious young go-getters who have taken on the task of introducing and discussing the important topics in each issue of the JSOM. Alex Merkle has been on the editorial board of the Journal of Special Operations Medicine for several years, and provides expert reviews and analysis for many of the submissions to our journal. Josh Randles also lectures and teaches our SOF medics, keeping our front-line medics up-to-date on the latest techniques and procedures.
Alex currently works in emergency surgery at a tertiary referral hospital. He still pays homage to his pre-hospital roots by volunteering with a Search and Rescue team in the Lake Tahoe area, where he gets to refine his austere medicine, technical rescue and Nordic mountaineering skills. Alex attended the Army's Surgical/Critical Care PA fellowship at Brooke Army Medical Center and subsequently supported SOCOM. Previously he worked medical support missions in isolated postings across Alaska, remote Pacific islands and Antarctic field camps.
Josh is unsure if the beatings actually improve morale, but thinks a prospective randomized trial could probably clear that up for ya. He is a Physician Assistant in the US Army assigned to a surgical team out of North Carolina. Aside from waxing poetic about medical literature he enjoys hiking, rock climbing, ceramics and dancing in the rain.