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Essential Items

Fall 2023

Winter 2023

The Winter 2023 Journal is available online and the print edition is in the mail

The articles and abstracts are available on the Publications Page. The PDF and Digital Flipbook are available as well!


ATP-P 11th Edition

ATP-P 11th Ed

The Advanced Tactical Paramedic Protocols Handbook - 11th Edition is currently available for purchase. If you have a digital subscription to the ATP-P Handbook, you can access it NOW with your subscription. If you don't have a digital subscription, you can sign up now and get immediate access.

This handbook contains the 2016-2019 updates, as well as updates to the C-TCCC protocols and the most current CPGs.

The print edition is currently available in the traditional paper and waterproof/tearproof paper.



Buy Now!


2022 Ranger Medic Handbook

Ramger Medic Handbook 2022

The Ranger Medic Handbook is the medical instruction handbook provided to Ranger Medics by the 75th Ranger Regiment. It is the premier resource for all Ranger Medics and is now available exclusively for purchase from Breakaway Media and by digital subscription on the Journal of Special Operations Medicine website. This handbook is offered on Water/Tear Proof Paper. The 2022 Updates is the official and current edition of the Ranger Medic Handbook.

You may order your handbook from the storefront now, and digital subscriptions are also available.


PJ MED OPS 8th Ed

PJ Medical Operations Handbook 8th edition 2021

This handbook is a significant update to the 7th edition.

The digital version is available NOW! If you have a subscription that includes access to the PJ Handbook, or if you would like to sign up for a subscription that includes the PJ Handbook, you can log in NOW and access the latest and greatest information!


Advanced Ranger First Responder Handbook

ARFR 2021

The Advanced Ranger First Responder Handbook is now avaiable for sale through our storefront, as well as digitally on our website. Wired subscribers will have access to the flipbook version of the ARFR Handbook, and mobile users can download the PDF to their tablet device.


Shared Science

The Journal of Special Operations Medicine (JSOM) and the Wilderness & Environmental Medicine (WEM) journal continue a long-standing shared science program. This opportunity is made possible through a reciprocal partnership between the journals. Select past articles appearing in WEM which may be of interest to JSOM readers can be accessed at no cost. Simply click on the WMS logo below or visit https://www.wemjournal.org/content/sharedscience to access articles for free.

Tactical Combat Casualty Care: Transitioning Lessons Learned from the Battlefield to other Austere Environments


Wilderness Medical Society
Special Operations Medical Association

The OFFICIAL Journal of the Special Operations Medical Association.

Click the logo for more information.

March 2024 Feature Article

Effectiveness of Sternal Intraosseous Device in Patients Presenting with Circulatory Shock: A Retrospective Observational Study

Winter 2023

Hynes A, Murali S, Bass GA, Kheirbek T, Qasim Z, George N, Yelon JA, Chreiman KC, Martin ND, Cannon JW. 23(4). 81 - 86. (Journal Article)

Abstract

Background: Hemorrhagic shock requires timely administration of blood products and resuscitative adjuncts through multiple access sites. Intraosseous (IO) devices offer an alternative to intravenous (IV) access as recommended by the massive hemorrhage, A-airway, R-respiratory, C-circulation, and H-hypothermia (MARCH) algorithm of Tactical Combat Casualty Care (TCCC). However, venous injuries proximal to the site of IO access may complicate resuscitative attempts. Sternal IO access represents an alternative pioneered by military personnel. However, its effectiveness in patients with shock is supported by limited evidence. We conducted a pilot study of two sternal-IO devices to investigate the efficacy of sternal-IO access in civilian trauma care. Methods: A retrospective review (October 2020 to June 2021) involving injured patients receiving either a TALON® or a FAST1® sternal-IO device was performed at a large urban quaternary academic medical center. Baseline demographics, injury characteristics, vascular access sites, blood products and medications administered, and outcomes were analyzed. The primary outcome was a successful sternal-IO attempt. Results: Nine males with gunshot wounds transported to the hospital by police were included in this study. Eight patients were pulseless on arrival, and one became pulseless shortly thereafter. Seven (78%) sternal-IO placements were successful, including six TALON devices and one of the three FAST1 devices, as FAST1 placement required attention to Operator positioning following resuscitative thoracotomy. Three patients achieved return of spontaneous circulation, two proceeded to the operating room, but none survived to discharge. Conclusions: Sternal-IO access was successful in nearly 80% of attempts. The indications for sternal-IO placement among civilians require further evaluation compared with IV and extremity IO access.

Keywords: intraosseous; resuscitation; sternum; sternal intraosseous; sternal vascular access; vascular access

Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths after Injury

Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States Servicemembers injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events.

This report documents the remarkable decrease in casualties killed in action during the wars in Iraq and Afghanistan and the role of the Joint Trauma System, the CoTCCC, and the TCCC Working Group in helping to make that happen. It also outlines a clear and comprehensive vision for a National Trauma System that will enable the civilian and the military sectors to work in concert to help prevent ALL potentially preventable deaths in trauma victims.

Download a free PDF copy of the IOM Report

What Our Readers are Saying

I just finished reading the fall edition of the JSOM and I am completely blown away!!!! It is absolutely packed with exceptional and relevant information that without a doubt, will assist SOF Tactical Health Care professionals in providing relevant and evidence based patient care. Thank you for providing what I consider a "World Class Medical Journal". The journal itself and the website have become my primary resource for knowledge in tactical medicine."

Robert M. Miller
North American Rescue
Chief Innovation Officer

"There is no peer-reviewed academic resource that equals the Journal of Special Operations Medicine for support of the medical and veterinary lead in Stabilization, Security, Transition and Reconstruction (SSTR) operations, combat and field medicine, and adaptation of Tactical Combat Casualty Care into Tactical Emergency Casualty Care for the law enforcement and emergency management community in 195 UN member countries. JSOM is a valuable resource as we continue the Millennium Medicine Project, targeting the global population that lacks access to basic surgical services and providing crisis management, security, and defense support in this demographic."

Stephen M. Apatow
President, Humanitarian Resource Institute
(UN:NGO:DESA) and H-II OPSEC: Defense Support:
Humanitarian and Security Operations

"Military units that have trained all of their members in Tactical Combat Casualty Care have documented the lowest incidence of preventable deaths among their casualties in the history of modern warfare - and JSOM is the first journal to publish every new change in TCCC."

Frank K. Butler, MD
Chairman, Committee on Tactical
Combat Casualty Care (CoTCCC)

"The past 30 years has brought an amazing professionalization of the specialty of Tactical Emergency Medical Support (TEMS). As new standards are set and the world faces increasingly complex security challenges, it is critical that the front line medical providers supporting military, intelligence, and law enforcement operations have a mechanism to expand their knowledge and share best practices. The Journal of Special Operations Medicine offers civilian readers access to the most cutting edge developments in the field including updates on Tactical Emergency Casualty Care (TECC), the National TEMS Imitative and Council (NTIC), and combat lessons learned. JSOM is the one-stop shop for best practice and future advancements in civilian TEMS. One of the unifying principles across humanitarian, expedition and disaster response medical operations is the ability to make complex decisions in uncertain environments. The Journal of Special Operations Medicine is one of the most unique platforms for experts to convey lessons learned and relevant scientific advances across specialties that historically have little interaction. Whether you work for Doctors Without Borders, a DMAT, or provide medical support for expeditions in austere environments, Journal of Special Operations Medicine is your journal."

David W. Callaway, MD
Director, Division of Operational and Disaster Medicine
Operational Medical Director, Carolinas MED-1
Co-Chairman, The Committee for Tactical Emergency Casualty Care (C-TECC)
Civilian Vice President, Special Operations Medical Association (SOMA)