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Exertional Rhabdomyolysis: Epidemiology, Diagnosis, Treatment, and Prevention

Knapik JJ, O'Connor FG 16(3). 65 - 71 (Journal Article)

Exertional rhabdomyolysis (ER) is a medical condition whereby damage to skeletal muscle is induced by excessive physical activity in otherwise healthy individuals. The individual performs so much activity that he/ she presumably depletes local muscle energy stores and muscle cells are unable to maintain cellular integrity, resulting in cell damage and the release of cellular contents, with resultant secondary complications. In the military services, the incidence of ER appeared to increase in the period 2004 to 2015. Risk factors for ER include male sex, younger age, a prior heat injury, lower educational level, lower chronic physical activity, and activity in the warmer months of the year. Acute kidney injury is the most serious potential complication of ER and is thought to be due to a disproportionate amount of free myoglobin that causes renal vasoconstriction, nephrotoxic effects, and renal tubular obstructions. Patients typically present with a history of heavy and unaccustomed exercise with muscle pain, swelling, weakness, and decreased range of motion, largely localized to the muscle groups that were involved in the activity. Diagnostic criteria include the requisite clinical presentation with a serum creatine kinase level at least level 5 times higher than the upper limit of normal and/ or a urine dipstick positive for blood (due to the presence of myoglobin) but lacking red blood cells under microscopic urinalysis. Core treatment is largely supportive with aggressive fluid hydration. Although the great majority of individuals return to activity without consequence, patients should initially be stratified into high and low risk for recurrence, and those at high risk provided additional evaluation. Risk of ER in normal healthy individuals can be reduced by emphasizing graded, individual preconditioning before beginning a more strenuous exercise regimen after recommended work/rest and hydration schedules in hot weather, and discussing supplements and medications with knowledgeable medical personnel.

$35.00
The Hidden Complexity of Biological "Dirty Bombs": Implications for Special Operations Medical Personnel

Washington MA, Blythe J 16(4). 82 - 84 (Journal Article)

The recent capture of a terrorist in Belgium carrying explosives, fecal matter, and animal tissue may indicate a shift from conventional weapons to crude bacteriological preparations as instruments of terror. It is important to note that although such weapons lack technological sophistication, bacteria are inherently complex, unpredictable, and undetectable in the field. Therefore, it is important that Special Operations medical personnel understand the complications that such seemingly simple devices can add to the treatment of casualties in the field and subsequent evaluation in the clinic.

$35.00
Prolonged Field Care of a Casualty With Penetrating Chest Trauma

Barnhart G, Cullinan W, Pickett JR 16(4). 99 - 101 (Case Reports)

As Special Operations mission sets shift to regions with less coalition medical infrastructure, the need for quality long-term field care has increased. More and more, Special Operations Medics will be expected to maintain casualties in the field well past the "golden hour" with limited resources and other tactical limitations. This case report describes an extended-care scenario (>12 hours) of a casualty with a chest wound, from point of injury to eventual casualty evacuation and hand off at a Role II facility. This case demonstrates the importance of long-term tactical medical considerations and the effectiveness of minimal fluid resuscitation in treating penetrating thoracic trauma.

$35.00
Telemedicine to Reduce Medical Risk in Austere Medical Environments: The Virtual Critical Care Consultation (VC3) Service

Powell D, McLeroy RD, Riesberg J, Vasios WN, Miles EA, Dellavolpe J, Keenan S, Pamplin JC 16(4). 102 - 109 (Journal Article)

One of the core capabilities of prolonged field care is telemedicine. We developed the Virtual Critical Care Consult (VC3) Service to provide Special Operations Forces (SOF) medics with on-demand, virtual consultation with experienced critical care physicians to optimize management and improve outcomes of complicated, critically injured or ill patients. Intensive-care doctors staff VC3 continuously. SOF medics access this service via phone or e-mail. A single phone call reaches an intensivist immediately. An e-mail distribution list is used to share information such as casualty images, vital signs flowsheet data, and short video clips, and helps maintain situational awareness among the VC3 critical care providers and other key SOF medical leaders. This real-time support enables direct communication between the remote provider and the clinical subject matter expert, thus facilitating expert management from near the point of injury until definitive care can be administered. The VC3 pilot program has been extensively tested in field training exercises and validated in several real-world encounters. It is an immediately available capability that can reduce medical risk and is scalable to all Special Operations Command forces.

$35.00
Case of a 5-Year-Old Foreign National Who Sustained Penetrating Abdominal Trauma

McLeroy RD, Ellis JL, Karnopp JM, Dellavolpe J, Gurney J, Keenan S, Powell D, Riesberg J, Edwards M, Matos R, Pamplin JC 16(4). 110 - 113 (Journal Article)

Objective: Review application of telemedicine support for penetrating trauma. Clinical context: Special Operations Resuscitation Team (SORT) deployed in Africa Area of Responsibility (AOR) Organic expertise: Internal Medicine physician, two Special Operations Combat medics (SOCMs), and one radiology technician Closest surgical support: Non-US surgical support 20km away; a nonsurgeon who will perform surgeries; neighboring country partner-force surgeon 2 hours by fixedwing flight. Earliest evacuation: Evacuated 4 days after presentation to a neighboring country with surgical capability.

$35.00
Fall 2012 Journal (Vol 12 Ed 3)
Vol 12 Ed 3
Fall 2012 Journal of Special Operations Medicine
ISSN: 1553-9768
$20.00
Spring 2012 Journal (Vol 12 Ed 1)
Vol 12 Ed 1
Spring 2012 Journal of Special Operations Medicine
ISSN: 1553-9768
$20.00
Winter 2012 Journal (Vol 12 Ed 4)
Vol 12 Ed 4
Winter 2012 Journal of Special Operations Medicine
ISSN: 1553-9768
$20.00
Winter 2013 Journal (Vol 13 Ed 4) (Digital Download Only)
Vol 13 Ed 4
Winter 2013 Journal of Special Operations Medicine
ISSN: 1553-9768 This edition is currently out of print and is available as a PDF download only. Upon completion of your purchase, this title will be added to your account and you may download it immediately.
$20.00
Fall 2013 Journal (Vol 13 Ed 3) (Digital Download Only)
Vol 13 Ed 3
Fall 2013 Journal of Special Operations Medicine
ISSN: 1553-9768 This edition is currently out of print and is available as a PDF download only. Upon completion of your purchase, this title will be added to your inventory and you may download it immediately.
$20.00
Summer 2013 Journal (Vol 13 Ed 2) (Digital Download Only)
Vol 13 Ed 2
Summer 2013 Journal of Special Operations Medicine
ISSN: 1553-9768 This edition is currently out of print and is available only as a PDF download. Upon completion of your purchase, this title will be added to your account and you may download it immediately.
$20.00
Spring 2013 Journal (Vol 13 Ed 1) (Digital Download Only)
Vol 13 Ed 1
Spring 2013 Journal of Special Operations Medicine
ISSN: 1553-9768 This edition is currently out of print and is available as a PDF download. Upon completion of your purchase, this title will be added to your account and you will be able to download it immediately.
$20.00
Spring 2014 Journal (Vol 14 Ed 1)
Vol 14 Ed 1
Spring 2014 Journal of Special Operations Medicine
ISSN: 1553-9768
$20.00
Fall 2014 Journal (Vol 14 Ed 3)
Vol 14 Ed 3
Fall 2014 Journal of Special Operations Medicine
ISSN: 1553-9768
$20.00
Winter 2014 Journal (Vol 14 Ed 4)
Vol 14 Ed 4
Winter 2014 Journal of Special Operations Medicine
ISSN: 1553-9768
$20.00
Spring 2015 Journal (Vol 15 Ed 1) (Digital Download Only)
Vol 15 Ed 1
Spring 2015 Journal of Special Operations Medicine
ISSN: 1553-9768 This edition is out of print and is available as a PDF download only. Upon receipt of payment, this title will be added to your account and you may download it at your convenience.
$30.00
Summer 2015 Journal (Vol 15 Ed 2)
Vol 15 Ed 2
Summer 2015 Journal of Special Operations Medicine
ISSN: 1553-9768
$30.00
Fall 2015 Journal (Vol 15 Ed 3)
Vol 15 Ed 3
Fall 2015 Journal of Special Operations Medicine
ISSN: 1553-9768
$30.00
Winter 2016 Journal (Vol 16 Ed 4)

Vol 16 Ed 4
Winter 2016 Journal of Special Operations Medicine
ISSN: 1553-9768

View the Table of Contents
$36.75
Summer 2017 Journal (Vol 17 Ed 2) (Digital Download Only)

This edition is out of print and is available as a digital download only. Upon completion of payment, the title will be added to your inventory and you will receive a link in your email to download this title.

Vol 17 Ed 2
Summer 2017 Journal of Special Operations Medicine
ISSN: 1553-9768

Table of Contents
$36.75
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