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ATP-P Handbook 10th Edition (978-0-9966297-6-8)

The Advanced Tactical Protocols-Paramedic (ATP-P) Handbook is an essential reference tool for the tactical and combat medics, SWAT team members, and medical professionals operating in austere environments.

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*** For orders of 10 or more, please contact us at subscriptions@jsomonline.org for pricing ***

Customers living in Europe can purchase the ATP-P 10th Edition through WERO GmbH and save a significant amount of money on shipping and processing. The ATP-P 10th can be purchased at this link.

Before you buy, you will receive an offer with your total price, including shipping and VAT.


Kunden mit Wohnsitz in Europa können die ATP-P 10th Edition über die WERO GmbH erwerben und dabei erheblich an Versand- und Bearbeitungskosten sparen. Das ATP-P 10th kann unter diesem Link erworben werden.

Vor dem Kauf erhalten Sie ein Angebot mit Ihrem Gesamtpreis, inklusive Versand und Mehrwertsteuer.

$53.00
Ranger Medic Handbook 2020 Updates (978-1-7332239-6-6)
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 by Breakaway Media and by digital subscription on the Journal of Special Operations Medicine website. This handbook is offered on Water/Tear Proof Paper. The 2020 Updates is the official and current edition of the Ranger Medic Handbook.

*** For orders of 10 or more, please contact us at subscriptions@jsomonline.org for pricing ***

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Print: 978-1-7332239-6-6

Customers living in Europe can purchase the Ranger Medic Handbook 2020 Updates through WERO GmbH and save a significant amount of money on shipping and processing. The RMH can be purchased at this link.

Before you buy, you will receive an offer with your total price, including shipping and VAT.

Kunden, die in Europa leben, können die Ranger Medic Handbook 2020 Updates über die WERO GmbH erwerben und dabei erheblich an Versand- und Bearbeitungskosten sparen. Das RMH kann unter diesem Link erworben werden.

Vor dem Kauf erhalten Sie ein Angebot mit Ihrem Gesamtpreis, inklusive Versand und Mehrwertsteuer.
$60.00
Pararescue Medical Operations (PJ MED) Handbook 8th ed (978-1-7332239-4-2)
The Pararescue Medical Operations Handbook is designed to form the basis of medical practice during both Rescue Operations and training mishaps for USAF Pararescuemen (PJs).

This revised handbook includes an outline of the principles of PJ medicine and the patient assessment checklist. This approach to patients is slightly modified from traditional primary and secondary surveys to reflect both a more efficient and a comprehensive approach to combat trauma based on PJ experience and data from Overseas Contingency Operations.

Portions of the Tactical Combat Casualty Care (TCCC) guidelines and the ATP Tactical Medical Emergency Protocols (TMEPS) that pertain to the Pararescue are included and have been modified to suit the PJ mission. The goal remains to have all PJs work to a single standard. The section on prolonged care has been modified and expanded based on PJ experiences.

*** For orders of 10 or more, please contact us at subscriptions@jsomonline.org for pricing ***

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This version of the PJ Handbook is printed on waterproof, tearproof paper and is spiral bound with a 1/2" ring.
$60.00
Standard Medical Operations Guide (SMOG) CY 2021 (978-1-7366242-2-7)

This current set of medical guidelines were developed through a collaboration of Emergency Medicine professionals, experienced Flight Medics, Aeromedical Physician Assistants, Critical Care Nurses, and Flight Surgeons. There has been close coordination in the development of these guidelines by the Joint Trauma System, Committee of En Route Combat Casualty Care and the Committee of Tactical Combat Casualty Care. The shared goal is to ensure excellent en route care that is standard across all evacuation and emergency medical pre-hospital units. All these enhancements and improvements will advance en route care across the services and the Department of Defense. This handbook was published in April 2021

*** For orders of 10 or more, please contact us at subscriptions@jsomonline.org for pricing ***

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$51.00
Advanced Ranger First Responder Handbook
Advanced Ranger First Responder Handbook (978-1-7332239-8-0)
The Advanced Ranger First Responders are entrusted with an advanced skillset of procedures, medications, and training. They are trained on specific first responder medical skills to provide a higher level of trauma response during Ranger operations. The ARFR is expected to provide limited scope trauma and emergency care in a tactical or austere setting; they may work independently or in support of a medical provider. They are proficient at advanced medical procedures and basic medication administration. The skills in this handbook enhance the basics of Tactical Combat Casualty Care (TCCC)

*** For orders of 10 or more, please contact us at subscriptions@jsomonline.org for pricing ***

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Customers living in Europe can purchase the Advanced Ranger First Responder Handbook 2021 Updates through WERO GmbH and save a significant amount of money on shipping and processing. The ARFR can be purchased at this link.

Before you buy, you will receive an offer with your total price, including shipping and VAT.

Kunden mit Wohnsitz in Europa können die Advanced Ranger First Responder Handbook 2021 Updates über die WERO GmbH erwerben und dabei erheblich an Versand- und Bearbeitungskosten sparen. Die ARFR kann unter diesem Link erworben werden.

Vor dem Kauf erhalten Sie ein Angebot mit Ihrem Gesamtpreis, inklusive Versand und Mehrwertsteuer.
$38.00
Fall 2018 Journal (Vol 18 Ed 3)

Vol 18 Ed 3
Fall 2018 Journal of Special Operations Medicine
ISSN: 1553-9768

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$43.00
Prolonged Field Care in Support of Operation Inherent Resolve, 2016

Blaine C, Abbott M, Jacobson E 18(3). 120 - 123 (Journal Article)

The authors present their experience in emergency and longterm medical care by Special Operations Forces (SOF) medical providers in an austere environment. In this case, a Special Forces Operational Detachment-Alpha (SFOD-A) was deployed in support of Operation Inherent Resolve, partnered with indigenous combat forces.

$40.00
Draw-over Anesthesia Bringing the "Dark Art" Back Into the Light

Graves MW, Billings S 18(3). 125 - 133 (Journal Article)

$40.00
Knowledge Versus Suspicion

Turconi M, Dare C, Hampton K 18(3). 124 (Journal Article)

$40.00
Damage Control Resuscitation in Prolonged Field CareDamage Control Resuscitation in Prolonged Field Care

Fisher AD, Washbum G, Powell D, Callaway DW, Miles EA, Brown J, Dituro P, Baker JB, Christensen JB, Cunningham CW, Gurney JM, Lopata J, Loos PE, Maitha J, Riesberg JC, Stockinger Z, Strandenes G, Spinella PC, Cap AP, Keenan S, Shackelford SA 18(3). 109 - 119 (Journal Article)

$40.00
How the International Special Training Centre Is Training World-Class Medics: An Outline of the NATO Special Operations Combat Medic Course

Christensen JB 18(3). 103 - 108 (Journal Article)

The North Atlantic Treaty Organization (NATO) Special Operations Combat Medic (NSOCM) course is specifically designed to train 24 highly selected Special Operations Forces (SOF) members to treat trauma and nontrauma patients who have life-threatening diseases and/or injuries. The NSOCM course is held at the International Special Training Centre (ISTC) in Pfullendorf, Germany, and exemplifies ISTC's mission to build interoperability and strengthening alliances between multinational partners. The 24-week NSOCM course is taught by subject matter experts and SOF members from around the globe. Building interoperability and capacity with common NATO standards is crucial to medical support of all future SOF missions where military units and other small elements will be vitally dependent on each other for combined missions at the regional, national, or NATO level. A better understanding and knowledge of the current SOF medic role and the capabilities they need to bring to the battlefield will help advance their scope from the "classic" trauma scenarios to the more advanced clinical medicine and prolonged field care situations. The NSOCM must become a critical-thinker and be able to recognize and treat these health risks and conditions in remote, austere environments, finding the right solution with a limited arsenal at their disposal. The ISTC-NSOCM course is designed to help bridge this gap and raise situational awareness for the NATO on-the-ground medical professionals to ensure "the more they know the more apt they are to save a life." In essence, it is ISTC's goal to meet these challenges by training NSOCMs to meet these multidimensional demands. This article outlines ISTC's development and design of the NSOCM course and new adaptations as we move forward into our third year of training world-class medics.

$40.00
Osteoarthritis: Pathophysiology, Prevalence, Risk Factors, and Exercise for Reducing Pain and Disability

Knapik JJ, Pope R, Orr R, Schram B 18(3). 94 - 102 (Journal Article)

Osteoarthritis (OA) is a disorder involving deterioration of articular cartilage and underlying bone and is associated with symptoms of pain and disability. The incidence of OA in the military increased over the period 2000 to 2012 and was the first or second leading cause of medical separations in this period. Risk factors for OA include older age, black race, genetics, higher body mass index, prior knee injury, and excessive joint loading. Animal studies indicate that moderate exercise can assist in maintaining normal cartilage, and individuals performing moderate levels of exercise show little evidence of OA. There is considerable evidence that among individuals who develop OA, moderate and regular exercise can reduce pain and disability. There is no firm evidence that any particular mode of exercise (e.g., aerobic training, resistance exercise) is more effective than another for reducing OA-related pain and disability, but limited research suggests that exercise should be lifelong and conducted at least three times per week for optimal effects.

$40.00
Norovirus

Burnett MW 18(3). 92 - 93 (Journal Article)

$40.00
Cognitive Agility as a Factor in Human Performance Optimization

Ross J, Miller L, Deuster PA 18(3). 86 - 91 (Journal Article)

Cognitive agility reflects the capacity of an individual to easily move back and forth between openness and focus. The concept is being translated into a tool to help train leaders to perform well in the "dynamic decision-making context." Cognitive agility training (CAT) has the potential to increase emotional intelligence by improving an individual's ability to toggle between highly focused states to levels of broad, outward awareness, which should enable dynamic decision-making and enhance personal communication skills. Special Operations Forces (SOF) Operators must work in rapidly evolving, complex environments embedded with multiple high-risk factors. Generally, success in these operational environments requires the ability to maintain highly focused states. However, SOF Operators must also be able to transition rapidly back to their roles within their families, where a more outwardly aware state is needed to allow flexibility in emotional responses. CAT addresses these seemingly conflicting requirements. Successful CAT must reflect the methodologies and culture already familiar within the SOF community (i.e., "live" scenario-based activities) to replicate challenges they may encounter when operationally deployed and when at home. This article provides an overview of cognitive agility, the potential benefits, applications that could be used for training SOF Operators to improve their cognitive agility to optimize performance, and sample training scenarios. The issue of what metrics to use is also discussed.

$40.00
The Combat Application Tourniquet Versus the Tactical Mechanical Tourniquet

Beaven A, Ballard M, Sellon E, Briard R, Parker PJ 18(3). 75 - 78 (Journal Article)

Background: Exsanguination from limb injury is an important battlefield consideration that is mitigated with the use of emergency tourniquets. The Combat Application Tourniquet (C-A-T®) is the current British military standard tourniquet. Methods: We tested the self-application of a newer tourniquet system, the Tactical Mechanical Tourniquet (TMT), against self-application of the C-A-T. A total of 24 healthy British military volunteers self-applied the C-A-T and the TMT to their mid thigh in a randomized, sequential manner. Popliteal artery flow was monitored with a portable ultrasound machine, and time until arterial occlusion was measured. Pain scores were also recorded. Results The volunteers allowed testing on their lower limbs (n = 48 legs). The C-A-T was applied successfully to 22 volunteers (92%), and the TMT was successfully applied to 17 (71%). Median time to reach complete arterial occlusion was 37.5 (interquartile range [IQR], 27-52) seconds with the C-A-T, and 35 (IQR, 29-42) seconds with the TMT. The 2.5-second difference in median times was not significant (ρ = .589). The 1-in-10 difference in median pain score was also not significant (ρ = .656). The success or failure of self-application between the two tourniquet models as assessed by contingency table was not significant (p= .137). Conclusion: The TMT is effective when self-applied at the mid thigh. It does not offer an efficacy advantage over the C-A-T.

$40.00
Does Pain Have a Role When It Comes to Tourniquet Training?

Alterie J, Dennis AJ, Baig A, Impens A, Ivkovic K, Joseph KT, Messer TA, Poulakidas S, Starr FL, Wiley DE, Bokhari F, Nagy KK 18(3). 71 - 74 (Journal Article)

Background: One of the greatest conundrums with tourniquet (TQ) education is the use of an appropriate surrogate of hemorrhage in the training setting to determine whether a TQ has been successfully used. At our facility, we currently use loss of audible Doppler signal or loss of palpable pulse to represent adequate occlusion of vasculature and thus successful TQ application. We set out to determine whether pain can be used to indicate successful TQ application in the training setting. Methods: Three tourniquet systems (a pneumatic tourniquet, Combat Application Tourniquet® [C-A-T], and Stretch Wrap and Tuck Tourniquet™ [SWAT-T]) were used to occlude the arterial vasculature of the left upper arm (LUA), right upper arm (RUA), left forearm (LFA), right forearm (RFA), right thigh (RTH), and right calf (RCA) of 41 volunteers. A 4MHz, handheld Doppler ultrasound was used to confirm loss of Doppler signal (LOS) at the radial or posterior tibial artery to denote successful TQ application. Once successful placement of the TQ was noted, subjects rated their pain from 0 to 10 on the visual analog scale. In addition, the circumference of each limb, the pressure with the pneumatic TQ, number of twists with the C-A-T, and length of TQ used for the SWAT-T to obtain LOS was recorded. Results: All 41 subjects had measurements at all anatomic sites with the pneumatic TQ, except one participant who was unable to complete the LUA. In total, pain was rated as 1 or less by 61% of subjects for LUA, 50% for LFA, 57.5% for RUA, 52.5% RFA, 15% for RTH, and 25% for RCA. Pain was rated 3 or 4 by 45% of subjects for RTH. For the C-A-T, data were collected from 40 participants. In total, pain was rated as 1 or less by 57.5% for the LUA, 70% for the LFA, 62.5% for the RUA, 75% for the RFA, 15% for the RTH, and 40% for the RCA. Pain was rated 3 or 4 by 42.5%. The SWAT-T group consisted of 37 participants for all anatomic locations. In total, pain was rated as 1 or less by 27% for LUA, 40.5% for the LFA, 27.0% for the RUA, 43.2 for the RFA, 18.9% for the RTH, and 16.2% for the RCA. Pain was rated 5 by 21.6% for RTH application, and 3 or 4 by 35%. Conclusion: The unexpected low pain values recorded when loss of signal was reached make the use of pain too sensitive as an indicator to confirm adequate occlusion of vasculature and, thus, successful TQ application.

$40.00
Chemical Contamination Transfer in the Management of War Casualties

Collectif MCV T 18(3). 67 - 70 (Journal Article)

The use of chemical weapons agents (CWAs) was suspected in recent conflicts, during international conflicts, terrorist attacks, or civil wars. Little is known about the prevention needed for caregivers exposed to the risk of contamination transfer. We present a case of chemical contamination of health servicemembers during the management of casualties.

$40.00
Facial Trauma Care in the Austere Environment

Farber SJ, Kantar RS, Rodriguez ED 18(3). 62 - 66 (Journal Article)

As the United States continues to increase its use of Special Operations Forces worldwide, treatment of craniomaxillofacial (CMF) trauma must be adapted to meet the needs of the warfighter. The remoteness of Special Operations can result in potentially longer times until definitive treatment may be reached. A significant portion of Servicemembers incur injury to the CMF region (42%). Severe CMF trauma can result in substantial hemorrhage and airway compromise. These can be immediately life threatening and must be addressed expeditiously. Numerous devices and techniques for airway management have been made available to the forward provider. A thorough review of nonsurgical and surgical airway management of the patient with facial injury for the forward provider and providers at receiving facilities is provided in this article. Techniques to address flail segments of the facial skeleton are critical in minimizing airway compromise in these patients. There are many methods to control hemorrhage from the head and neck region. Hemorrhage control is critical to ensure survival in the austere environment and allow for transport to a definitive care facility. Associated injuries to the cervical spine, globe, skull base, carotid artery, and brain must be carefully evaluated and addressed in these patients. Management of vision- threatening orbital compartment syndrome is critical in patients with CMF injuries. Because the head and neck region remains relatively vulnerable in the warfighter, combat CMF trauma will continue to occur. Forward providers will benefit from a review of the acute treatment of CMF traumatic injury. Properly triaging and treating facial injuries is necessary to afford the best chance of survival for patients with a devastating combat CMF injury.

$40.00
Implementation and Evaluation of a First-Responder Bleeding-Control Training Program in a Rural Police Department

Reed JR, Carman MJ, Titch FJ, Kotwal RS 18(3). 57 - 61 (Journal Article)

Background: In the prehospital environment, nonmedical first responders are often the first to arrive on the scene of a traumatic event and must be prepared to provide initial care at the point of injury. In civilian communities, these nonmedical first responders often include law enforcement officers. Hemorrhage is a major cause of death in trauma, and many of these deaths occur in the prehospital environment; therefore, prehospital training efforts should be directed accordingly toward bleeding control. Methods: A bleeding control training program was implemented and evaluated in a rural police department in Pinehurst, North Carolina, from February to April 2017. A repeated measures observational study was conducted to evaluate the training program. Measured were self-efficacy (pre- and post-test), knowledge (pretest, post-test 1 [immediate], post-test 2 [at 4 weeks]), and limb-tourniquet application time (classroom, simulation exercise). Results: The study population was composed of 28 police officers (92.9% male) whose median age was 37 (interquartile range, 22-55) years. Mean self-efficacy scores, equating to user confidence and the decision to intervene, increased from pre- to post-training (34.54 [standard deviation (SD) 4.16] versus 35.62 [SD 4.17]; p = .042). In addition, mean knowledge test scores increased from pre- to immediately post-training (75.00 [SD 16.94] versus 85.83 [SD 11.00]; p = .006), as well as from preto 4 weeks post-training (75.00 [SD 16.94] versus 84.17 [SD 11.77]; p = .018). Lower limb-tourniquet application times were more rapid in the classroom than during the simulation exercise (23.06 seconds [SD 7.68] versus 31.91 seconds [SD 9.81]; p = .005). Conclusion: First-responder bleeding-control programs should be initiated and integrated at the local level throughout the Nation. Implementation and sustainment of such programs in police departments can save lives and enhance existing law enforcement efforts to protect and serve communities.

$40.00
A Pilot Study of Four Intraosseous Blood Transfusion Strategies

Auten JD, Mclean JB, Kemp JD, Roszko PJ, Fortner GA, Krepela AL, Walchak AC, Walker CM, Deaton TG, Fishback JE 18(3). 50 - 56 (Journal Article)

Background: Intraosseous (IO) access is used by military first responders administering fluids, blood, and medications. Current IO transfusion strategies include gravity, pressure bags, rapid transfusion devices, and manual push-pull through a three-way stopcock. In a swine model of hemorrhagic shock, we compared flow rates among four different IO blood transfusion strategies. Methods: Nine Yorkshire swine were placed under general anesthesia. We removed 20 to 25mL/kg of each animal's estimated blood volume using flow of gravity. IO access was obtained in the proximal humerus. We then autologously infused 10 to 15mL/kg of the animal's estimated blood volume through one of four randomly assigned treatment arms. Results: The average weight of the swine was 77.3kg (interquartile range, 72.7kg-88.8kg). Infusion rates were as follows: gravity, 5mL/min; Belmont rapid infuser, 31mL/min; single-site pressure bag, 78mL/min; double-site pressure bag, 103mL/min; and push-pull technique, 109mL/min. No pulmonary arterial fat emboli were noted. Conclusion: The optimal IO transfusion strategy for injured Servicemembers appears to be single-site transfusion with a 10mL to 20mL flush of normal saline, followed immediately by transfusion under a pressure bag. Further study, powered to detect differences in flow rate and clinical complications. is required.

$40.00
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