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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
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.
$35.00
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.

$49.00
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
Independent Duty Medical Technician (IDMT) Protocols Handbook (2021 ed) (978-1-7366242-1-0)

US Air Force Independent Duty Medical Technician (IDMT), Medical and Dental Treatment Protocols, Ed 2.3 Handbook published in January 2021 is a resource for Air Force IDMT medical personnel with advanced skills and knowledge. These protocols are the product of a concerted effort by representatives from all major command surgeons offices with the express goal to standardize  the  care  IDMTs  are  permitted  to  provide regardless of location and command affiliation. These protocols clearly define the scope of care parameters that the IDMT is expected and trained to work within. These treatment protocols are designed as a guide to accepted step-by-step treatments for medical disorders that may be encountered by IDMTs in the field

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

Table of Contents

$58.00
20th Anniversary Collector's Edition

The 20th Anniversary Collector's Edition features all 4 editions of the 2020 Journal of Special Operations Medicine. Each edition features a retrospective look at the evolution of SOF Medicine and TCCC protocols.

The Spring edition focuses on the use of whole blood, Summer deals with Hemorrhage Control, Fall looks at Prolonged Field Care, and Winter dives into the changes to TCCC.

Regular price for all 4 journals is $160 - buy the set for $128 - a 20% savings!

$128.00
Summer 2021 Journal (Vol 21 Ed 2)

Vol 21 Ed 2
Summer 2021 Journal of Special Operations Medicine
ISSN: 1553-9768

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$40.00
Fall 2021 Journal (Vol 21 Ed 3)

Vol 21 Ed 3
Fall 2021 Journal of Special Operations Medicine
ISSN: 1553-9768

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Available for preorder. Estimated ship date is September 30th 2021

$40.00
Tactical Combat Casualty Care Scenario: Management of a Gunshot Wound to the Chest in a Combat Swimmer

21(3). 138 - 142 (Journal Article)

Tactical Combat Casualty Care (TCCC) has always emphasized the need to consider the tactical setting in developing a plan to care for wounded unit members while still on the battlefield. The TCCC Guidelines provide an evidence-based trauma care approach to specific injuries that may occur in combat. However, they do not address what modifications might need to be made to the basic TCCC guidelines due to the specific tactical setting in which the scenario occurs. The scenario presented below depicts a combat swimmer operation in which a unit member is shot while in the water. The unit casualty response plan for a combat swimmer who sustains a gunshot wound to the chest while on a mission is complicated by the inability to perform indicated medical interventions for the casualty while he is in the water. It is also complicated by the potential for ballistic damage to his underwater breathing apparatus and the need to remain submerged after wounding for at least for a period of time to avoid further hostile fire. Additionally, there is a potential for a cerebral arterial gas embolism (CAGE) and/or a tension pneumothorax to develop while surfacing because of the decreasing ambient pressure on ascent. The tactical response may be complicated by limited communications between the mission personnel while submerged and by the vulnerability of the mission personnel to antiswimmer measures if their presence is compromised.

$37.00
First Aid UCV (Green Cross) for Prehospital Medicine in Social Commotion Situations

21(3). 126 - 133 (Journal Article)

Venezuela is living in a delicate social and political crisis that has taken thousands of lives. Beginning in March 2017, a series of continuous and increasingly violent demonstrations has taken place, with a high number of civilian casualties. These demonstrations typically have been outside the range of action of the government prehospital services. In addition, the number of casualties frequently overwhelmed the abilities of the available rescue services. Out of the need for a first aid team that could operate in this violent scenario, First Aid UCV (Central University of Venezuela) was created. A large number of professionals with medical, rescue, and tactical medicine experience integrated this new team, modifying their training and practice to adapt to a scenario in which unarmed medical students and medical doctors performed extractions, provided first aid, and managed the transport of demonstration casualties, doing so even when team members were sometimes targeted by the government police and military forces. This method has had successful results in all 60 operations conducted to date, with a total of 5,000 casualties being extracted among civilians, the military, and the police force. Only one member of the team was injured during the operations, and no deaths were reported during the process.

$37.00
Lessons Learned From a Traumatic Brain Injury Mass Casualty Incident

21(3). 123 - 125 (Journal Article)

In January 2020, an American base was attacked by the largest theater ballistic missile strike in history. This case report covers the resulting mass casualty (MASCAL) incident. In this case, we defined this incident as a MASCAL due to a lack of medical personnel available to properly and timely evaluate the patients. There was no loss of life during the attack but there were > 80 traumatic brain injuries (TBIs). This article focuses on lessons learned from diagnosing and treating Soldiers during a TBI MASCAL event.

$37.00
Timeline of Psychological and Physiological Effects Occurring During Military Deployment on a Medical Team

21(3). 118 - 122 (Journal Article)

Background: The negative effects of deployment on military mental health is a topic of major interest. Predeployment and postdeployment assessments are common, but to date there has been little to no intradeployment assessment of military members. This study attempts to determine the physiological and psychiatric effects on Servicemembers over the course of deployment, to provide a baseline data set and to allow for better prediction, prevention, and intervention on these negative effects. Methods: A retrospective analysis was performed on physiological and psychiatric data collected on a single deployed medical team between 16 January 2020 and 12 July 2020. Patient health screening questionnaires (PHQ-9) and physiological measurements were completed serially twice weekly on five active-duty military volunteers for the entirety of a scheduled 6-month deployment. Results: Depression symptom development followed a linear trend (p = .0149) and severity followed a quadratic trend (p < .001) over a length of a deployment. Weight (p = .435) and pulse (p = .416) were not statistically altered. Mean arterial pressure (MAP) had a statistically significant reduction (p < .001). Conclusion: In this specific population, there was a linear relationship between time deployed and depression symptoms and severity. Depression symptom severity decreases toward the end of deployment but does not return to baseline before deployment's end.

$37.00
Blood Transfusion as a Therapeutic Maneuver

21(3). 111 - 117 (Journal Article)

$37.00
Update on Minimalist Running Shoes

21(3). 107 - 110 (Journal Article)

This article provides updated information comparing minimalist running shoes (MRS) to conventional running shoes (CRS). Our previous review found that, compared with running in CRS, transitioning to MRS resulted in lower energy cost and less ground contact occurring at the forefoot, resulting in lower impact forces. There was some increased risk of injury with MRS, although data were conflicting. A more recent 26-week study involved 30 trained runners using CRS and 31 using MRS. The proportion of training time in the assigned shoes increased by 5% each week. After the first 6 weeks of transition (35% of training time in the assigned shoe), energy cost was lower and 5-km running time faster in MRS compared with CRS. No further improvement occurred from weeks 6 to 26. There were no significant differences in injury incidence in the two groups (CRS = 37%, MRS = 52%; p = .24). Running-related pain was higher in the MRS group in the knee, shin, calf, and ankle and increased at these locations as running mileage increased. Risk of injury in MRS increased as participant body weight increased. These more recent data suggest that MRS can improve performance, but most runners should limit running in MRS to 35% of training time and in situations where optimal performance is desired (e.g., races, fitness tests).

$37.00
Telementorship in Underway Naval Operations: Leveraging Operational Virtual Health for Tactical Combat Casualty Care

21(3). 93 - 95 (Journal Article)

Background: Virtual health (VH) may enhance mentorship to remote first responders. We evaluated the feasibility of synchronous bidirectional VH to mentor life-saving procedures performed by deployed novice providers. Methods: Video teleconferencing (VTC) was established between the USNS Mercy (T-AH 19) underway in the Pacific Ocean to Naval Medical Center San Diego using surgeon teleconsultation. The adult simulated clinical vignette included injuries following a shipboard explosion with subsequent fire. The pediatric simulated vignette included injuries that resulted from an improvised explosive device (IED) blast. Using VTC, augmented reality (AR) goggles, and airway simulation equipment, corpsmen (HMs) received visual cues to perform advanced life-saving procedures. Results: In adult scenarios, 100% of novice hospital HMs performed tasks on first attempt (n = 12). Mean time for tourniquet placement was 46 seconds (standard deviation [SD], 19 seconds); needle thoracostomy, 70 seconds (SD, 67 seconds); tube thoracostomy, 313 seconds (SD, 152 seconds); and cricothyroidotomy, 274 seconds (SD, 82 seconds). In pediatric scenarios, 100% of novice HMs performed tasks on first attempt (n = 5). Mean time for tube thoracostomy completion was 532 seconds (SD, 109 seconds). Conclusion: VH can enhance the training and delivery of trauma care during prolonged field care in resource-limited settings.

$37.00
Caffeine Gum Does Not Improve Marksmanship, Bound Duration, Susceptibility to Enemy Fire, or Cognitive Performance During Tactical Combat Movement Simulation

21(3). 86 - 92 (Journal Article)

Background: Military personnel supplement caffeine as a countermeasure during unavoidable sustained wakefulness. However, its utility in combat-relevant tasks is unknown. This study examined the effects of caffeinated gum on performance in a tactical combat movement simulation. Materials and Methods: Healthy men (n = 30) and women (n = 9) (age = 25.3 ± 6.8 years; mass 75.1 ± 13.1 kg) completed a marksmanship with a cognitive workload (CWL) assessment and a fire-andmove simulation (16 6-m bounds) in experimental conditions (placebo versus caffeinated gum, 4mg/kg). Susceptibility to enemy fire was modeled on bound duration during the fireand- move simulation. Results: Across both conditions, bound duration and susceptibility to enemy fire increased by 9.3% and 7.8%, respectively (p = .001). Cognitive performance decreased after the fire-and-move simulation across both conditions (p < .05). However, bound duration, susceptibility to enemy fire, marksmanship, and cognitive performance did not differ between the caffeine and placebo conditions. Conclusion: These data do not support a benefit of using caffeinated gum to improve simulated tactical combat movements.

$37.00
Efficacy of Commercial Chest Seal Adherence and Tension Pneumothorax Prevention: A Systematic Review of Quantitative Studies

21(3). 78 - 85 (Journal Article)

Background: Penetrating thoracic injuries account for an essential subset of battlefield and civilian injuries that result in death. Current recommendations are to use commercially available nonocclusive chest seals. We review current evidence for which chest seal(s) is likely to be the most effective in treating open pneumothoraces. Methods: A systematic review was conducted in accordance with the PRIMSA 2009 standard systematic review methodology, except where noted. The databases Pubmed, MEDLINE, CINAHL, Scopus, and gray sources were searched for all English-language, full-manuscript, experimental, quantitative studies of humans and animals concerning seal adherence or their efficacy at preventing tension pneumothoraces published between 1990 and 2020. A numerical analysis was used to provide the consensus recommendation. Results: Of 683 eligible identified articles [PubMed 528 (77.3%), Scopus 87 (12.7%), CINAHL 67 (9.8%), one (0.1%) unpublished], six (0.9%) articles were included. Synthesis of all studies' results suggests a consensus recommendation for the Hyfin Vent Chest Seal and Russell Chest Seal. These two were the most effective chest seals, as previously investigated in a quantifiable, experimental study. Conclusion: While chest seals are recommended in civilian and military prehospital medicine to improve patient survival, current evidence concerning the individual device's efficacy is limited. Further scientific, quantitative research is needed to clarify which commercially available chest seals are most effective and provide patients with penetrating chest trauma the best possible method for preventing or mitigating tension pneumothoraces.

$37.00
Self-Reported Musculoskeletal Injury Healthcare-Seeking Behaviors in US Air Force Special Warfare Personnel

21(3). 72 - 77 (Journal Article)

Purpose: This study evaluated the musculoskeletal injury (MSKI) self-reporting behaviors among active-duty Air Force Special Warfare personnel to explore potential limitations of injury surveillance approaches. Methods: Participants completed a 47-item survey between December 2018 and March 2019 regarding their MSKI history. Participants were asked if they sought medical care for symptoms consistent with MSKIs and reasons they did or did not report their injuries. Injury reporting rates were calculated with descriptive statistics and rank ordering was utilized to determine frequency. Results: A total of 398 airmen reported 1,057 injuries occurring in the previous 12-month period, including 508 (48%) injuries identified as not reported to medical personnel. Approximately 55% (N = 579) of all injuries were described as gradual onset. The most common reason for not reporting injuries (28.8%, N = 62) was "fear of potential impact on future career opportunities." Conclusion: Approximately half of MSKIs in this sample of US Air Force Special Warfare personnel were not reported to medical personnel. The underreporting of injuries may pose unknown levels of risk and negatively impact military readiness levels.

$37.00
Blood Product Administration During Transport Throughout the US Africa Command Theater of Operation

21(3). 66 - 70 (Journal Article)

Background: United States Africa Command (US AFRICOM) is one of six US Defense Department's geographic combatant commands and is responsible to the Secretary of Defense for military relations with African nations, the African Union, and African regional security organizations. A full-spectrum combatant command, US AFRICOM is responsible for all US Department of Defense operations, exercises, and security cooperation on the African continent, its island nations, and surrounding waters. We seek to characterize blood product administration within AFRICOM using the in-transit visibility tracking tool known as TRAC2ES (TRANSCOM Regulating and Command & Control Evacuation System). Methods: We performed a retrospective review of TRAC2ES medical evacuations from the AFRICOM theater of operations conducted between 1 January 2008 and 31 December 2018. Results: During this time, there were 963 cases recorded in TRAC2ES originating within AFRICOM, of which 10 (1%) cases received blood products. All patients were males. One was a Department of State employee, one was a military working dog, and the remainder were military personnel. Of the ten humans, seven were the result of trauma, most by way of gunshot wound, and three were due to medical causes. Among human subjects receiving blood products for traumatic injuries, a total of 5 units of type O negative whole blood, 29 units of packed red blood cells (pRBCs), and 9 units of fresh frozen plasma (FFP) were transfused. No subjects underwent massive transfusion of blood products, and only one subject received pRBCs and FFP in 1:1 fashion. All subjects survived until evacuation. Conclusions: Within the TRAC2ES database, blood product administration within AFRICOM was infrequent, with some cases highlighting lack of access to adequate blood products. Furthermore, the limitations within this database highlight the need for systems designed to capture medical care performance improvement, as this database is not designed to support such analyses. A mandate for performance improvement within AFRICOM that is similar to that of the US Central Command would be beneficial if major improvements are to occur.

$37.00
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