ALERT- reminder of changes to handbook from DEC 2016 MOAB: 1. Change in needle D. site to only 5th ICS Mid Axillary Line. 2. Addition of combat dose of ketamine for sedation.3. Administer TXA by slow IV push over 2-3 minutes giving a cc at a time.4.Discontinue training upper extremity and thigh fasciotomies, only leg (tip-fib) will remain for training. Do not perform fasciotomy without proper training and sign off. Next MOAB 21-22 JUN.
Doc Powell is an SF Group Surgeon and Army Intensivist (intensive care specialist). he discusses the basic science and practical aspects of what shock is "beyond hypoerfusion of tissues". The science of shock is complex and multifactorial. Doc Powell explains the concepts of tissue damage and the systemic inflammatory response. For those of you who want to understand what shock really is, this is an excellent discussion.
Stay tuned for news of the PJNY /103rd jump mission near the Azores for 2 burn patients last week. A night jump, lots of sophisticated medicine and complex exfil.
THAT OTHERS MAY LIVE.
Donate to the PararescueFoundation.org, we have several upcoming programs for brothers in need and their families.
Check out https://vimeo.com/216213346
The most frequent book I recommend is the TALENT CODE by Daniel Coyle. He studied how world class performers come to be and discussed the neuroscience behind it. This book was recommended to me by a former BUDS Commander and is part of the foundation of how I perform operational medical training. I encourage anyone who trains operators below them or in schoolhouses to listen to this and read the book.
Support the PARARESCUE FOUNDATION.
THAT OTHERS MAY LIVE.
Chief Atkins is a great PJ who has codified his lessons learned as a Leader in our career field. After discussing these on a walk around Lake Tahoe last month while training, I thought it would be great to have his share his thoughts on leadership. His four key principles include 1. work ethic, 2. positive attitude, 3. receptiveness, 4. self motivation. Enjoy this focused discussion on leadership.
Donate to the Pararescue Foundation.
Our Orthopedic Surgeon and 212th FLIGHT DOC discusses hip and knee injuries common to operators. He also discusses standard and emerging treatments and operations for these injuries, return to duty concepts, and time courses for healing.
Support the Pararescue Foundation- PLEASE!
Maj Erin Jenkins is an AF aerospace and exercise physiologist. In this episode she discusses the negative impact of fatigue and fatigue mitigation strategies. She covers the issues of mental and physical fatigue, sleep physiology and tips, and the problems with the lights from your computers and cell phones at night.
Support the pararescue foundation! Donate today.
Dr. Laureen Hill is the Chair of Anesthesiology at Emory University. In this episode, she discusses controversies regarding intubation, particularly in the pre-hospital setting, the supreme importance of bagging properly, and other lessons learned during decades of training medical providers how to intubate.
Please go to PararescueFoundation.org and make a donation.
In part 2 of our discussion with Bill, he discusses his experience in the Khobar Towers bombing, and the PJs who survived it and then helped organize and manage the CCP for hundreds.
Get Bill's two books on PJs- Guardian ANGEL and the novel TRICKLOCK, on Amazon or elsewhere where books are sold.
Support your brothers at PararescueFoundation.org
In this first of two conversations with Ret. PJ Bil Sine, he discusses the first Pararescue combat jump mission into a minefield.
Remember to support the PJ foundation at pararescuefoundation.org
Doc Smith was a member on the Wilderness Medical Society Guidelines for avalanche safety and rescue. He discusses, avalanche awareness, safety and mitigation protocols, rescue and resuscitation.
Here are some links he mentions is the discussion:
Ish had a long career doing missions and and has spent the last decade and a half thinking about the technical aspects of Rescue, what it means to be a PJ, how does rescue fit into the DOD mission set, and ends with an unplanned discussion of being on the X when you least expect it.
Ish has had an important impact on PJs and tech rescue.
SW reviews the highlights of the meeting including PJ combat medic presentation.
Go to RDCR.org to learn about a great meeting in Norway for mil resuscitation.
Try to attend the 2017 Special Operations Medical Association Scientific Assembly to network with SOF and learn from SOF.
21-25 MAY in Charlotte
Doc Smith is an Emergency Medicine Doc in Jackson, WY, member of the Teton SAR team and Med Director,NPS Doc, wilderness med consultant, and LTC in the US Army Reserves. He is one of the most experienced Wilderness Medical Providers around with lots of real world experience.
In this first of a series of wilderness medical podcasts, Doc Smith discusses a rescue after a lightning strike and MCI, and then reviews medical aspects of lightning strikes.
You can find and contact Doc Smith at wildernessdoc.com
Detailed minutes can be found on the NREMT website and in the JSOM.
Thanks to Capt (RET) Butler for permission to do this.
Doc Paynter is an orthopedic surgeon and Flight Doc for the 212th RQS. He previously was a full time AF Orthopedic Surgeon at Elmendorf. In this first of a series of discussions, Doc Paynter discusses injuries of the shoulder and general management issues. Doc P has a unique perspective as both a FS and orthopedic surgeon who is experienced with PJs and CROs.
Injuries of the bone, labrum, biceps, rotator cuff and joint are discussed with an emphasis on those injuries that are more commonly seen in operators.
Listen to the dramatic flight line response of a mishap and injury of two Naval Aviators. Two Navy SAR Corpsman provided advanced care on the "X" and then performed the TACEVAC with two PJs from the 304th who assisted. This overpressurization event was essentially a close range blast injury.
See this open source TV news story:
Moffet had a mission last week with HELO hoist of a critically il 14 yo from a cruise ship:
In part 2 with Keith, he discusses a dive recovery mission in Iraq, and MCI in Africa. We end with Keith with a description of the TOMS lab at Hurlburt.
Hear Keith discuss the mission drop at Hurby, planning and execution of rescue ops in Haiti in 2010. He also discusses the challenges and rewards of interacting with other teams and nations, as well as some of the technical aspects of earthquake ops as well as human tragedy. Shout out to Ish!
Also look for a book by Col Harvis on this mission called RESCUE FROM CHAOS: USAF RESPONDS TO DISASTER IN HAITI.
ALERT! Going forward we will use "ALERT" to let you know of real time changes in PJ medicine you need to know, or other important PJ news items. Please let your teammates and indoc buddies know about this. We also review Part 1 of MOAB 2016 highlights, lessons learned (LLs) in recent training, and celebrate the induction of retired PJs Scott Fales and Tim Wilkinson into the Air Commando Hall of Fame. Check out the youtube video of the induction
Dr Reggie O'Hara is an Air Force Research Lab Exercise Physiologist and endurance athlete. He has run 20 100 mile races. He discusses the normal and pathologic reactions to heat stress and strategies to counter heat related illness, as well as preparation and arrival from home station to hot environments - be it AZ or in the AOR.
Incredible story of the crash and rollover on Mt Hood with Chief Canfield. He talks about the mission drop and the wild ride he went on. Later in this episode he discusses Leadership issues in Pararescue.
If you have not seen it go to youtube and search Mt Hood helicopter crash. there are several clips but you can see Chief interviewed on the National Geographic segment.
Support the PJ Foundation! Go to Pararescuefoundation.org
If you are a PJ, do an event or fundraiser.
Dave Shuman is a prior 212th Chief. Dave is a true alpinist, big mountain skier and climber. He just summited two peaks over 20,000 feet in Nepal back to back. He still teaches rope rescue to PJs and performs safety operations for various organizations. Dave performed one of the most harrowing and exciting mountain rescues I have heard of. Enjoy this story.
Remember to support the Pararescue Foundation.
In part 2 Doug tackles the PT test question, how to maximize reward and minimize risk in training, and incorporating HPO programs into operational readiness. Check out Doug's website at www.resilientperformancept.com. Also look for some of his youtube posts.
Doug Kechijian is a PJ who obtained a Masters Degree in Exercise Physiology and obtained a Doctorate in Physical Therapy, both from Columbia University. In part 1 of this talk Doug reviews why HPO programs are important, why sports medicine and performance training should be viewed as a continuum, and what are the limitations of physical preparation in the context of special operations.
Within two weeks this fall, Moffet got two missions in the Pacific. But this one was different. UGI Bleeds, acute abdomens, and Burns are the most common diagnoses encountered on civil SAR ocean missions. You should always be prepared for these on the ANG teams.