Journal of Special Operations Medicine

A U.S. Soldier on a night patrol hears a gunshot, feels a sharp pain in the right side, and yells, “I’m hit.” The unit medic quickly moves to the casualty’s side. The wounded Soldier thinks of the family waiting at home and says to the medic: “Doc—will you please tell my family that I love them.” The medic responds, “Hey—shut up! I got this. You’re gonna be fine, and you’re going home to your family—you can tell them yourself. It’s not your day to die.” Far beyond any other battlefield trauma care program in history, Tactical Combat Casualty Care has enabled America’s combat medics to make good on that promise.

Josh and Alex sit down with coauthor Jeff Butler to discuss the motivation and inspiration for the book, "Tell Them Yourself: It's Not Your Day to Die." Tell Them Yourself is the extraordinary account of how a small group of world class trauma experts joined forces with America’s best combat medics to rewrite the rule book in battlefield medicine - and then to sell these revolutionary new concepts to a disbelieving medical world.

Thousands of Americans wounded in combat died in Vietnam - when they could easily have been saved. More deaths than in the Twin Towers on 9/11. More deaths than Pearl Harbor. In 1990, there had been very little progress made in battlefield trauma care since the Civil War. But the revolutionary new concepts embodied in Tactical Combat Casualty Care (TCCC) have changed that landscape dramatically.

Against great odds, TCCC has reduced the incidence of preventable deaths among combat casualties to the lowest level in history and has been credited with saving the lives of thousands of our nation’s wounded Servicemembers in the recent conflicts in Iraq and Afghanistan. TCCC is now mandated by the U.S. Department of Defense as the nation’s standard for battlefield trauma care.

TCCC has forever changed the way care will be provided to America’s combat wounded and is now being used by militaries around the world and in civilian prehospital trauma care as well.

This is a medical book like no other because it is a combat medical story like no other. Published by Breakaway Media, this book is available at https://jsom.us/TTY

We Would Love Your Feedback Please email [email protected].

Follow us on Social Media @jsomonline or on our website https://www.jsomonline.org

Our JSOM Podcast team of Alex Merkle and Josh Randles will be reviewing the following articles for our Summer podcast:

Advancing Combat Casualty Care Statistics and Other Battlefield Care Metrics by Jud C. Janak, Russ S. Kotwal, Jeffrey T. Howard, Jennifer M. Gurney, Brian J. Eastridge, John B. Holcomb, Stacy S. Shackelford, Robert A. De Lorenzo, Ian J. Stewart, and Edward L. Mazuchowsk (https://www.jsomonline.org/FeatureArticle/2024211Janak.pdf)

Evaluation of a Rebreathing System for use with Portable Mechanical Ventilators by Thomas Blakeman, Maia Smith, and Richard Branson (https://www.jsomonline.org/FeatureArticle/2024234Blakeman.pdf)

The Effect of Critical Task Auto-failure Criteria on Medical Evaluation Methods in the Pararescue Schoolhouse by Ian Richardson, Michael Lauria, Brian Gravano, Jeffrey Swenson, and Stephen Rush (https://www.jsomonline.org/FeatureArticle/2024267Richardson.pdf)

JSOM Guest Author

Advancing Combat Casualty Care Statistics and Other Battlefield Care Metrics author Jud C. Janak will be interviewed by our podcaster team about the article.

Jud C. Janak, PhD, has over 10 years of experience as an epidemiologist and applied biostatistician in the private sector, public sector, and academia. He has published over 50 peer-reviewed studies on topics related to traumatic injury, accelerated aging, chronic disease, and real-world pharmacoepidemiology. He completed a post-doctoral fellowship at the U.S. Army Institute for Surgical Research where he focused on traumatic brain and genitourinary injuries. He was Director of Epidemiology and Biostatistics for the Department of Defense Joint Trauma System from 2017 to 2020. He also served as the lead epidemiologist for the Military Trauma Preventable Death Working Group. He was an Associate Director of Epidemiology at CorEvitas from 2020 to 2023. His current responsibilities focus on leveraging real-world patient and clinical registry data to study the safety and effectiveness of FDA-approved therapies as a Principal Epidemiologist in the Real-World Data Research and Analytics group at Merative. Dr. Janak received his master’s and doctoral degrees in Epidemiology from the University of Texas Health Science Center School of Public Health.

We Would Love Your Feedback Please email [email protected].

Follow us on Social Media @jsomonline or on our website https://www.jsomonline.org

Our JSOM Podcast team of Alex Merkle and Josh Randles will be reviewing the following articles for our Spring podcast:

Our JSOM Podcast team of Alex Merkle and Josh Randles will review the following articles for our Spring podcast:

Development and Implementation of a Standard Operating Procedure for Military Working Dog Blood Collection, Storage, and Transport by Elizabeth L. Evernham, Benjamin T. Fedeles, and Kayla M. Knuf (https://www.jsomonline.org/FeatureArticle/2024128Evernham.pdf)

Emergency Fresh Whole Blood Transfusion Training for Ukrainian Health Professionals in Austere Environments by Zachery L. Brown, Joshua P. Cuestas, Kevin J. Matthews, Jonathan T. Shumaker, Durwood W. Moore, and Rebekah Cole (https://www.jsomonline.org/FeatureArticle/2024138Brown.pdf)

JSOM Guest Editor Captain Cam Strawn reviews Development and Implementation of a Standard Operating Procedure for Military Working Dog Blood Collection, Storage, and Transport. Capt Strawn serves as an Air Force Combat Rescue Officer and combat veteran who teaches leadership as an Assistant Professor of Aerospace Studies at Brigham Young University, where he is also completing a premedical post-baccalaureate program. He is a SOFtoSOM Scholar applying to medical school this year.

JSOM Guest Authors

Emergency Fresh Whole Blood Transfusion Training for Ukrainian Health Professionals in Austere Environments authors SFC Zachery Brown and HM1 Kevin John Matthews are

interviewed by our podcaster team about their article. SFC Zachery Brown enlisted in the Army on 15 September 2009. He has served with the 75th Ranger Regiment for the past 13 years: 7 years in the 1st Ranger Battalion and 6 years in the Regimental Reconnaissance Company (RRC). He served as a Ranger Squad Leader, Regimental Reconnaissance Team (RRT) Medical Sergeant, RRT Assistant Team Sergeant, and RRC Operations NCOIC and has nine combat deployments to Afghanistan, Iraq, and Syria, amounting to over 500 Special Operations Raids. In 2021, the Uniformed Services University of Health Services (USUHS) selected him for one of seven Army slots for the 24-month Cohort 9, Enlisted to Medical Degree Preparatory Program (EMDP2). This program prepares top-performing enlisted Servicemembers to apply to medical school. He is currently enrolled as a graduate student and aims to continue serving our nation and global community as a military physician and medical officer in the United States Army. SFC Brown earned a BS in Biology, Bio-Engineering Concentration, from the University of Arkansas in 2008, an MS in Strategic Leadership from the University of Charleston, and is currently working towards completing an MS in Biology at George Mason University.

Hospital Corpsman First Class, HM1 (FMF/ SW) Kevin John Matthews enlisted in the Navy in 2016. Operationally, HM1 Matthews served as the Senior Line Corpsman, Scout Sniper Platoon, Weapons Company, 1st Battalion, 4th Marines, deploying to Africa and the Middle East aboard the 15th Marine Expeditionary Unit (MEU) in 2021. Upon returning from deployment, the Navy Education and Training Office (NETO) selected HM1 Matthews as a Combat Trauma Management and Valkyrie Emergency Fresh Whole Blood Transfusion training instructor. He oversees the training of all medical personnel attached to Marine Corps expeditionary ground forces at 1st Marine Division, Camp Pendleton, CA. Hand-selected by the Division Surgeon, he was appointed the founding Course Manager for the inaugural Prolonged Casualty Care Course, preparing forward-deployed Corpsmen to sustain casualties beyond the “Golden Hour” in resource-limited environments and austere terrain. In 2021, USUHS selected HM1 Matthews for one of seven Navy slots for the EMDP2. He is currently enrolled as a graduate student and aims to continue to serve our nation and global community as a physician and Medical Officer in the United States Navy. HM1 Matthews earned a BA in History, Middle Eastern Concentration, from the University of California San Diego in 2014 and worked as an EMT-B and Ocean Lifeguard for the San Diego Fire Rescue Department from 2014 to 2016. Additional current and prior professional qualifications include PHTLS, ABLS, TCCC Instructor, Personal Watercraft Operator for High-Surf Rescues, and AHA BLS Instructor.

We Would Love Your Feedback Please email [email protected].

Follow us on Social Media @jsomonline or on our website https://www.jsomonline.org

Our JSOM Podcast team of Alex Merkle and Josh Randles will be reviewing the following articles for our Spring podcast:

Our JSOM Podcast team of Alex Merkle and Josh Randles will review the following articles for our Spring podcast:

Development and Implementation of a Standard Operating Procedure for Military Working Dog Blood Collection, Storage, and Transport by Elizabeth L. Evernham, Benjamin T. Fedeles, and Kayla M. Knuf (https://www.jsomonline.org/FeatureArticle/2024128Evernham.pdf)

Derivation of a Procedural Performance Checklist for Bifemoral Veno-Venous Extracorporeal Membrane Oxygenation Cannula Placement in Operational Environments by Elizabeth Powell, Richard Betzold, et al. (https://www.jsomonline.org/FeatureArticle/2024132Powell.pdf)

Emergency Fresh Whole Blood Transfusion Training for Ukrainian Health Professionals in Austere Environments by Zachery L. Brown, Joshua P. Cuestas, Kevin J. Matthews, Jonathan T. Shumaker, Durwood W. Moore, and Rebekah Cole (https://www.jsomonline.org/FeatureArticle/2024138Brown.pdf)

JSOM Guest Editor Captain Cam Strawn reviews Development and Implementation of a Standard Operating Procedure for Military Working Dog Blood Collection, Storage, and Transport. Capt Strawn serves as an Air Force Combat Rescue Officer and combat veteran who teaches leadership as an Assistant Professor of Aerospace Studies at Brigham Young University, where he is also completing a premedical post-baccalaureate program. He is a SOFtoSOM Scholar applying to medical school this year.

JSOM Guest Authors

Emergency Fresh Whole Blood Transfusion Training for Ukrainian Health Professionals in Austere Environments authors SFC Zachery Brown and HM1 Kevin John Matthews are interviewed by our podcaster team about their article. SFC Zachery Brown enlisted in the Army on 15 September 2009. He has served with the 75th Ranger Regiment for the past 13 years: 7 years in the 1st Ranger Battalion and 6 years in the Regimental Reconnaissance Company (RRC). He served as a Ranger Squad Leader, Regimental Reconnaissance Team (RRT) Medical Sergeant, RRT Assistant Team Sergeant, and RRC Operations NCOIC and has nine combat deployments to Afghanistan, Iraq, and Syria, amounting to over 500 Special Operations Raids. In 2021, the Uniformed Services University of Health Services (USUHS) selected him for one of seven Army slots for the 24-month Cohort 9, Enlisted to Medical Degree Preparatory Program (EMDP2). This program prepares top-performing enlisted Servicemembers to apply to medical school. He is currently enrolled as a graduate student and aims to continue serving our nation and global community as a military physician and medical officer in the United States Army. SFC Brown earned a BS in Biology, Bio-Engineering Concentration, from the University of Arkansas in 2008, an MS in Strategic Leadership from the University of Charleston, and is currently working towards completing an MS in Biology at George Mason University.

Hospital Corpsman First Class, HM1 (FMF/ SW) Kevin John Matthews enlisted in the Navy in 2016. Operationally, HM1 Matthews served as the Senior Line Corpsman, Scout Sniper Platoon, Weapons Company, 1st Battalion, 4th Marines, deploying to Africa and the Middle East aboard the 15th Marine Expeditionary Unit (MEU) in 2021. Upon returning from deployment, the Navy Education and Training Office (NETO) selected HM1 Matthews as a Combat Trauma Management and Valkyrie Emergency Fresh Whole Blood Transfusion training instructor. He oversees the training of all medical personnel attached to Marine Corps expeditionary ground forces at 1st Marine Division, Camp Pendleton, CA. Hand-selected by the Division Surgeon, he was appointed the founding Course Manager for the inaugural Prolonged Casualty Care Course, preparing forward-deployed Corpsmen to sustain casualties beyond the “Golden Hour” in resource-limited environments and austere terrain. In 2021, USUHS selected HM1 Matthews for one of seven Navy slots for the EMDP2. He is currently enrolled as a graduate student and aims to continue to serve our nation and global community as a physician and Medical Officer in the United States Navy. HM1 Matthews earned a BA in History, Middle Eastern Concentration, from the University of California San Diego in 2014 and worked as an EMT-B and Ocean Lifeguard for the San Diego Fire Rescue Department from 2014 to 2016. Additional current and prior professional qualifications include PHTLS, ABLS, TCCC Instructor, Personal Watercraft Operator for High-Surf Rescues, and AHA BLS Instructor.

We Would Love Your Feedback Please email [email protected].

Follow us on Social Media @jsomonline or on our website https://www.jsomonline.org

Our JSOM Podcast team of Alex Merkle and Josh Randles will be reviewing the following articles for our Winter podcast:

Optimizing Brain Health of United States Special Operations Forces by Brian L. Edlow, Natalie Gilmore, Samatha L. Tromly, et al. (www.jsomonline.org/FeatureArticles/2023447Edlow)

Bluetooth Tactical Headsets Improve the Speed of Accurate Patient Handoffs by Daniel J. Stinner, Cory McEvoy, Michael A. Broussard, et al.(www.jsomonline.org/FeatureArticles/2023475Stinner.pdf)

Effectiveness of Sternal Intraosseous Device in Patients Presenting with Circulatory Shock: A Retrospective Observational Study by Allyson M. Hynes, Shyam Murali, Gary A. Bass, et al. (www.jsomonline.org/FeatureArticles/2023481Hynes.pdf)

JSOM Guest Medic:

Our guest medic for this quarter is Ricky Ditzel, who will review “Optimizing Brain Health of United States Special Operations Forces” by Edlow and colleagues. Ricky and his two siblings’ adolescent lives were defined by chaos. Inspired to make a positive change for his family, he enlisted in the Army and served as a U.S. Army Special Operations Flight Paramedic. In this role, Ricky treated U.S. and Allied forces servicemembers who suffered from the acute and chronic effects of traumatic brain injury. These experiences propelled Ricky to become a neurodegenerative disease researcher and vocal advocate for brain and mental health. Ricky believes strongly in a life of service and consistently seeks opportunities to support underserved communities and promote health equity. He believes the current healthcare structure reduces access to care for individuals with neurologic disabilities because of limitations associated with public transportation, specialty care access, and education. Driven towards research and finding solutions to increase the quality of life for people with neurological disabilities, Ricky is pursuing a career as a physician. He plans to create a neurologic center of excellence that will provide comprehensive multidisciplinary outpatient care under one roof. Ricky is the Chairman of the Special Operations Forces to School of Medicine (SOF to SOM) (https://www.softosom.org/), a board member of Neuroacanthocytosis Advocacy USA, and the Special Operations Medical Association. He will continue to serve his country and community while doing his best to honor the legacies of those who have gone before him. “For they loved to fight, fought to win, and would rather die than quit. Night Stalkers don’t quit!”

JSOM Guest Author Interview

Our guest author interview will be with Cory McEvoy, author of “Bluetooth Tactical Headsets Improve the Speed of Accurate Patient Handoffs.” Cory is a former 18D who served with 1-1SFG(A) and USASOC. Cory has deployed to both humanitarian and combat zones as an 18D and has been involved with many research projects, with his primary interest being repetitive and low-level blast. Cory left the Army in 2023 and is in the process of applying to medical school.

Follow us on Social Media @jsomonline or on our website https://www.jsomonline.org

Our JSOM Podcast team of Alex Merkle and Josh Randles will be reviewing the following articles for our Fall podcast:

Slow Intravenous Infusion of a Novel Damage Control Cocktail Decreases Blood Loss in a Pig Polytrauma Model by Nathan J. White, MD, MS, et al. (www.jsomonline.org/FeatureArticles/2023350White.pdf)

Pain Control and Point-of-Care Ultrasound: An Approach to Rib Fractures for the Austere Provider by Reece Snyder, PA-C, et al. (www.jsomonline.org/FeatureArticles/2023370Snyder.pdf)

Phosphorus Burn Management with Multimodal Analgesia by Luc Saint-Jean, MD et al. (www.jsomonline.org/FeatureArticles/2023382Saint-jean.pdf)

JSOM Guest Medic EditorTechnical Sergeant Derek Fyksen will be reviewing Pain Control and Point-of-Care Ultrasound: An Approach to Rib Fractures for the Austere Provider. TSgt Fyksen is currently an Air Force PJ. He enlisted in the U.S. Marine Corps in 2011 and served three years at 1st Marine Raider Battalion before transferring to the Air Force to pursue becoming a Pararescueman in 2017. After his separation from the Air Force, Derek intends to pursue a joint MD/MPH program.

JSOM Guest Author Interview

Dr. Luc Saint-Jean is affiliated with the 1st Specialized Medical Unit, Versailles, France. He will be reviewing his article, Phosphorus Burn Management with Multimodal Analgesia.

Josh Randles will review Slow Intravenous Infusion of a Novel Damage Control Cocktail Decreases Blood Loss in a Pig Polytrauma Model.

SO1 Brentyn Jones, Navy SEAL/SOCM, currently, working in the Tactical Medical Training Department, will be review Prevalence of Trauma-Induced Hypocalcemia in the Prehospital Setting. Patrick Thompson is affiliated with the Trauma, Hemostasis & Oxygenation Research Network, Bergen, Norway. He will be review Risk of Harm in Needle Decompression for Tension Pneumothorax. CPT Josh Randles will review The Impact of Special Operations Medics and Corpsmen on Military Medical Student Training: A Qualitative Study. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

Our guest medic editor this quarter, SSG Blake Wright, enlisted in 2013 and has since served in various roles across the 173d, 82d Airborne, and USASOC. He currently serves as a Special Operations Flight Medic and has future aspirations of applying to the Inter-Service Physician Assistant Program. He will review The Effect of Prehospital Blood Transfusion on Patient Body Temperature from the Time of Emergency Medical Services Transfusion to Arrival at the Emergency Department. Our author interview will be with Sean M. Stuart, DO, FACEP, FAAEM, FAWM Commander, Medical Corps, US Navy (Naval War College). Commander Stuart received his Doctor of Osteopathic Medicine from the Philadelphia College of Osteopathic Medicine in 2009. CDR Stuart reported to the 3rd Battalion, 3rd Marines, where he served as the Battalion Surgeon from 2010 to 2013. During this time, CDR Stuart deployed twice to support Operation Enduring Freedom. He also served as the Director of Medical Readiness for 3d Marines. CDR Stuart also served as the Deputy Regimental Surgeon, coordinating medical support for developing Marine Rotational Force–Darwin and RIMPAC exercises. He pioneered the development of a combat training curriculum, created a training tactical simulation laboratory, and served as the Director of Operational Training. In 2014, CDR Stuart began his emergency medicine residency training. After graduating, CDR Stuart assumed the role of MEU Surgeon for the 13th Marine Expeditionary Unit. In 2019, CDR Stuart returned to Naval Medical Center Portsmouth as academic faculty. In 2022, CDR Stuart was selected to attend the Naval War College. CDR Stuart is board-certified in Emergency Medicine, holds a faculty appointment as Assistant Professor of Military and Emergency Medicine at the Uniformed Services University of the Health Sciences, and is a Fellow of the American College of Emergency Physicians, American Academy of Emergency Medicine, and the Academy of Wilderness Medicine. He will review iTClamp-Mediated Wound Closure Speeds Control of Arterial Hemorrhage With or Without Additional Hemostatic Agents on p. 87 of the Winter 2022 edition. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

Our guest medic editor this quarter is Devin DeFeo, a former SOF medic. 2LT DeFeo enlisted in the Army in 2004 and served as an 18D with 1SFG(A) and USASOC. As a medic, he authored the concept for MARCHE2 for TCCC in the chemical, biological, radiological, and nuclear (CBRN) environment published in JSOM, which later formed the framework for the Joint Trauma System Clinical Practice Guidelines on CBRN medicine and the CBRN chapter in the Ranger Medical Handbook. He then participated in the Enlisted to Medical Degree Preparatory Program (EMDP2) at George Mason University, earning a master of science in biology. He is currently a third-year medical student at the Uniformed Services University of the Health Sciences (USUHS). 2LT DeFeo is considering a residency in emergency medicine. He will be reviewing Does Mental and Visual Skills Training Improve High-Value Target Identification and Marksmanship Among Elite Soldiers? by J. Jay Dawes, et al. (p. 22). Our author interview is with Michael J. Egnoto, PhD (An Exploratory Comparison of Water-Tamped and -Untamped Explosive Breaches: Practical Applications for the Tactical Community via Pilot Study). Dr Egnoto is affiliated with the Walter Reed Army Institute of Research, Forest Glen Annex, Silver Spring, MD. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.

This podcast is focused on research and contributions made by women in service to the military. We start with a review of "Women in US Military History" by Gretchen Garceau-Kragh. Guest medic HM1(FMF/EXW) Eric Dodson reviews "Active Warfighter Resilience: A Descriptive Analysis" by Nikki Barczak-Scarborov, et. al. Finally, we give an objective review of "Operation Blood Rain Phase 2: Evaluating the Effect of Airdrop on Fresh and Stored Whole Blood." The review is complemented by an interview with lead author Dr. (LtCol.) Roselyn Fuentes. Be sure to follow us on our Social Media platforms @jsomonline https://jsom.us/Podcast.