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Event Details. There will be a special 'Toddler Section' behind the protective home plate screen. Muddy and Muddonna will make special appearances in the 'Toddler Section'.

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A toddler dance cam will be featured on the video display during the game. Swimsuits are encouraged!

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Toddlers and parents are invited to run the bases after the game! Interventions studied were needle decompression of tension pneumothoraces and tourniquet application for exsanguinating extremity injuries. Results: One hundred thirty-four trauma patients were treated at the Role 3 MMU during the study period. Six patients had eight tourniquets applied.

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Five tourniquets were applied to four patients appropriately and saved their lives. There was one case of misuse where a venous tourniquet was applied. There was one case of overuse where one patient had two tourniquets placed for 4 hours on extremities with no vascular injury. There were seven cases where needle decompression was underused: Seven patients presented with vital signs absent with no needle decompression. There was one case of overuse of needle decompression.

There were seven cases of misuse where the patients were decompressed too medially. Conclusions: Tourniquets save lives. Needle decompression can save lives, but is usually performed in patients with multiple critical injuries.


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  • TCCC instructors must reinforce proper techniques and indications for each procedure to ensure that the quality of care provided to injured soldiers on the battlefield remains high. The Department of Defense DoD faces unprecedented challenges as the Nation confronts balancing a strong military to confront threats with the realities of diminishing financial resources.

    That each warfighter is a critical resource was underscored the Special Operations principal tenet "humans are more important than hardware. This article is the first in a new series relating to HPO, and we define the term and concept of HPO, describe other phrases used e. Last, we introduce an integrated model for HPO. Keywords: human performance optimization ; demands ; resource ; OODA loop. Keywords: interviews ; Viola, Steven.

    SERE schools are responsible for preparing military members for these situations, but the concept of SERE medicine is not particularly well defined. To provide a comprehensive working description of SERE medicine, operational and training components were examined. Ideally, medical lessons taught in SERE training are based on actual documented events.

    Unfortunately, the existing body of literature is dated and does not appear to be expanding.

    In this article, four distinct facets of SERE medicine are presented to establish a basis for future discussion and research. Recommendations to improve SERE medical curricula and data-gathering processes are also provided. Keywords: SERE ; survival, evasion, resistance, escape ; captivity ; isolation ; wilderness. Introduction: Prehospital care documentation is crucial to improving battlefield care outcomes.

    This study documents length of time and accuracy of U. Army Combat Medic trainees in completing the minimum preestablished required fields on the TCCC card, establishing a baseline for point-of-injury cards. Design and Methods: This was a prospective observational study in which U.

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    Army combat medic trainees were timed while recording data on the TCCC card in both the classroom and simulated combat environment. Results: We enrolled U. Conclusion: Results imply that the TCCC card is well designed to quickly and accurately record prehospital combat injury information.

    Further investigation and future studies may compare other prehospital data collection methods with the TCCC card in terms of timely and accurate data collection. Background: Public health personnel from the 28th Combat Support Hospital in Baghdad, Iraq, conducted an outbreak investigation in response to many local cases of gastrointestinal GI illness presenting to U. The investigation was conducted to identify the source of the illness, assess the extent of cases, and make recommendations to prevent similar outbreaks.

    Methods and Materials: For this retrospective cohort study, medical records and patient outbreak questionnaires were reviewed. A patient case, relative to the outbreak, was defined as any person who had developed a GI illness and presented for medical evaluation to either sick call or an emergency service at a diplomatic or military medical facility in Baghdad from 30 September to 12 October Results: A total of people met the case definition. Other symptoms included abdominal cramps, fatigue, and headache. Five salad ingredients had significantly elevated levels of Escherichia coli.

    Conclusion: Mitigation strategies to reduce the probability of similar outbreaks include purchasing food solely from approved vendors or thoroughly cooking all foods, including fruits and vegetables. Keywords: gastrointestinal illness ; Escherichia coli ; public health. Closed circuit underwater breathing apparatus UBA have gained popularity in recreational diving.

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    Closed circuit UBAs carry a unique set of risks to the diver. We present the case of a diver who lost consciousness while diving and had pulmonary abnormalities. The case is illustrative of the diving related problems associated with closed circuit UBA that a physician may be faced with. The genus Acinetobacter has long been associated with war wounds. Indeed, A baumannii was responsible for so many infected wounds during Operation Iraqi Freedom that it was given the nickname "Iraqibacter.

    A junii is an infrequently reported human pathogen. Here, we report a case of a slow-healing wound infection with A junii in a woman on the island of Oahu. This case highlights the pathogenic potential of this organism and the need for proper wound care when dealing with slow-healing wounds of unknown etiology. It also underscores the need for identifying species of Acinetobacter that are not A baumannii to better understand the epidemiology of slow-healing wound infections. Keywords: Acinetobacter junii ; emerging infection ; Hawaii ; Oahu ; wound.

    Keywords: sedation ; analgesia ; prolonged field care ; guidelines. Androgen use outside of legitimate medical therapy is a perceived concern that is drawing attention across military and specifically Special Operations Forces SOF communities. For leadership and the medical community to properly address the issue and relate to those individuals who are using or considering use, it will be crucial to understand the scope of the problem. Limited data suggest that the prevalence of androgen use may be increasing, and inferences made from the scientific literature suggest that SOF may be a population of concern.

    While risks of androgen use are well known, there are little data specific to military performance that can be applied to a rigorous risk:benefit analysis, allowing myths and poorly supported theories to perpetuate within the community. Further efforts to define the potential benefits balanced against the short- and longterm risks should be undertaken.

    Providers within the SOF community should arm themselves with information to engage androgen users and leadership in meaningful discussion regarding androgen use. Keywords: androgen steroids ; protein building. Increasing data and anecdotal operational reports are supporting the early, aggressive, prehospital application of tourniquets in potentially life-threatening extremity trauma. Especially in the civilian urban setting where transport times are short, the benefit in terms of lives saved far outweighs the potential risk to the extremity.


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    • The popular press has reported frequently on law enforcement- applied tourniquets, but to date, no group has published a scientific review of any of these cases. This case report suggests that law enforcement personnel can be trained to safely identify indications for tourniquet application, properly apply them with limited training, and function as effective first care providers. Keywords: tourniquet ; law enforcement ; tactical medicine.

      Medical intelligence is an underused or sometimes misapplied tool in the protection of our Soldiers and the execution of nonkinetic operations. The somewhat improved infrastructure of the operational environment in Iraq and Afghanistan led to an inevitable sense of complacency in regard to the threat of disease nonbattle injury DNBI. The picture changed somewhat in with the advent of the village stability program and the establishment of SOF camps in austere locations with degraded living situations rife with exposure risks.

      In addition, the increasing deployments to unstable locations around the globe, reminiscent of typical Special Operations Forces SOF missions before the Global War on Terrorism, indicate a need for better preparation for deployment from the standpoint of disease risk and force health protection. A knowledge gap has developed because we simply did not need to apply as stringent an evaluation of DNBI risk in environments where improved life support mitigated the risk for us.

      The tools necessary to decrease or even eliminate the impact of DNBI exist but they must be shared and implemented. This article will present four vignettes from current and former SOF Force Health Protection personnel starting with a simple method of executing Medical Intelligence Prep of the Environment MIPOE and highlighting situations in which it either was or could have been implemented to mitigate risk and decrease the impact on mission accomplishment and individual operators.

      A follow-on article will present vignettes of the successful application of MIPOE to nonkinetic operations.

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      Keywords: Medical Intelligence Prep of the Environment ; nonkinetic operations ; disease nonbattle injury. Regner D , Frykholm P. Background: Airway management is a critical skill that may be essential in the battlefield. Methods: Eight military medics with limited clinical experience and no airway management experience secured the airway on 19 intrahospital anesthetized patients using the LTS-D and the LMA. Each patient was treated with both airway adjuncts in a randomized order.

      Each medic was studied on at least two and not more than three patients. Success of insertion, number of attempts, and time to correct placement with verified ventilation were recorded. With the second patient, the first-attempt success rate was For all patients, the accumulated first-attempt success rate was On the second intervention with the LMA, there was a significant decrease in mean time to verified ventilation, from Conclusion: This study suggests that for the safe use of the laryngeal tube suction by inexperienced airway providers, a clinical training program is required.

      We therefore recommend the LMA as the primary airway adjunct for military medics, despite a hypothetically inferior protection from aspiration. Keywords: airway ; airway management ; combat ; education ; laryngeal tube ; laryngeal tube suction ; laryngeal mask ; military medicine ; supraglottic airway. Military personnel are at an increased risk for exposure to arthropod- borne and zoonotic pathogens. The prevalence of these pathogens has not been adequately described in the country of Georgia.

      As the Georgian military moves toward an increased level of capability and the adoption of European Union and North Atlantic Treaty Organization standards, international field exercises will become more frequent and will likely involve an increasing number of international partners. This study was undertaken with the goal of defining the arthropod-borne and zoonotic pathogen threat in Georgia so force health protection planning can proceed in a rational and data-driven manner.

      To estimate disease burden, blood was taken from 1, Georgian military recruits between October and February and screened for previous exposure to a set of bacterial and viral pathogens using a antibody-based, serologic procedure. The highest rate of exposure was to Salmonella enterica serovar Typhi, and the lowest rate of exposure was to Coxiella burnettii the causative agent of Q fever.

      These data provide insight into the prevalence of arthropod-borne infections in Georgia, fill a critical knowledge gap, will help guide future surveillance efforts, and will inform force health protection planning. This enabled a single rescuer to focus attention and provide care for other critical aspects of a multisystem trauma patient. Keywords: articulating tactical traction splint ; pulseless forearm fracture ; fracture. Background: The purpose of this study was to assess the skills of trainers using different junctional tourniquet models to control groin bleeding in a manikin.

      Materials and Methods: In assessments, 17 trainers used four junctional tourniquet models three times each to control simulated hemorrhage.