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The United States Army Veterinary Corps January – March 2009 Perspective 1 MG Russell J. Czerw A Corps Challenged, Capable, and Committed 5 BG Timothy K. Adams Food and Water Risk Assessment: A Decision Tool for the Tactical Commander 7 CW3 Chris Heryford, VC, USA Quality Assurance, Networking, and Collaboration Actions by the 12 DoD Veterinary Food Analysis and Diagnostic Laboratory LTC Roger W. Parker, VC, USA Food and Waterborne Disease Threats 15 COL Marc E. Mattix, VC, USA A Veterinary Service Squad Deployment in Support of Operation Iraqi Freedom 21 CPT Marla Brunell, VC, USA Veterinary Civil Action Programs in Afghanistan: Pros, Cons, and How 25 MAJ Jessica McCoy, VC, USAR Overview of Combat Trauma in Military Working Dogs in Iraq and Afghanistan 33 MAJ Janice L. Baker, VC, USAR; et al Military Working Animal Chemical, Biological, Radiological, and Nuclear 38 Protection and Medical Countermeasures MAJ Kelley L. Evans, VC, USA Validation and Operational Application of a Rapid Method for Rabies Antigen Detection 42 LTC Greg A. Saturday, VC, USA; LTC Robin King, VC, USA; Leslie Fuhrmann, MS B Virus (Cercopithecine Herpesvirus 1) Therapy and Prevention Recommendations 46 LTC Christopher E. Keller, VC, USA Directed Energy (Laser) Induced Retinal Injury: 51 Current Status of Safety, Triage, and Treatment Research LTC Deborah L. Whitmer, VC, USA; Bruce E. Stuck, ScD, MS Opportunities for Military Medical Officers: The Epidemic Intelligence Service 57 at the Centers for Disease Control and Prevention CPT Kristina McElroy, VC, USAR The 3rd Army Rescue of the Lipizzaners 59 MAJ Boris Brglez, VC, USA ALSO IN THIS ISSUE Fresh Frozen Plasma 64 LTC Clayton D. Simon, MC, USA; et al Total Intravenous Anesthesia on the Battlefield 68 LTC Paul Barras, AN, USA; et al Should We Teach Every Soldier How to Start Intravenous Fluids? 73 MAJ Robert L. Mabry, MC, USA; MAJ Peter J. Cuenca, MC, USA Abstracts from the US Army-Baylor Doctoral Program in Physical Therapy 76 A Professional Publication of the AMEDD Community Online issues of the AMEDD Journal are available at http://www.cs.amedd.army.mil/references_publications.aspx January – March 2009 The Army Medical Department Center & School PB 8-09-1/2/3 LTG Eric B. Schoomaker The Surgeon General Commander, US Army Medical Command MG Russell J. Czerw Commanding General US Army Medical Department Center and School By Order of the Secretary of the Army: Official: JOYCE E. MORROW GEORGE W. CASEY, JR Administrative Assistant to the General, United States Army Secretary of the Army Chief of Staff DISTRIBUTION: Special 0835304 The Army Medical Department Journal [ISSN 1524-0436] is published quarterly for information; and provide a peer-reviewed, high quality, print medium to encourage The Surgeon General by the US Army Medical Department Center & School, ATTN: dialogue concerning healthcare initiatives. MCCS-HSA Ste 135, 1750 Greeley Road, Fort Sam Houston, TX 78234-5078. Views expressed are those of the author(s) and do not necessarily reflect official US Army or US Army Medical Department positions, nor does the content change or CORRESPONDENCE: Manuscripts, photographs, official unit requests to receive supersede information in other Army Publications. The Journal reserves the right to edit copies, and unit address changes or deletions should be sent to the Journal at the all material submitted for publication (see inside back cover). above address. Telephone: (210) 221-6301, DSN 471-6301 CONTENT: Content of this publication is not copyright protected. Material may be DISCLAIMER: The Journal presents clinical and nonclinical professional information reprinted if credit is givento the author(s). to expand knowledge of domestic & international military medical issues and OFFICIAL DISTRIBUTION: This publication is targeted to US Army Medical technological advances; promote collaborative partnerships among Services, Department units and organizations, and other members of the medical community components, Corps, and specialties; convey clinical and health service support worldwide. Perspective Major General Russell J. Czerw The focus of this issue of the AMEDD Journal is the US Army Veterinary Corps, a small component of the Army Medical Department, but one that plays an indispensable role in safeguarding the health and well- being of Soldiers, Marines, Sailors, and Airmen throughout the world. Moreover, in this increasingly dangerous environment of potential threats from many sources, large and small, the Veterinary Corps has become a vital resource of homeland defense capabilities, lending their expertise in epidemiology, biohazard control, and especially in the protection of the food and water supply. Articles in this issue reflect the broad range of responsibilities and activities of Army veterinary professionals, from directed energy injury research to the care and rehabilitation of severely injured military working dogs. Army veterinary professionals do it all, and I am happy for this opportunity to showcase their expertise and capabilities. The AMEDD Journal welcomes BG Timothy Adams, request a food and water risk assessment prior to the Chief of the Army Veterinary Corps, to this issue deployment. Veterinary or preventive medicine with an excellent overview of the evolving specialists will go to the area and evaluate the potential responsibilities and challenges of the Corps, and the sources of food and water as to the level of risk each philosophical and organizational approaches which are poses, and make recommendations towards mitigation necessary to deal with them. His observations articu- of those risks. This information provides the late the sense of dedication, responsibility, and loyalty deployment commander with the knowledge needed to that is the hallmark of today’s Army, and reflected make crucial decisions regarding providing food and every day in the performance and achievements of our water to the troops. CW3 Heryford provides a detailed, Army healthcare professionals. clearly articulated description of what is involved in such assessments, and how the information should be Department of Defense Directive 6400.4 1 dictates the used by those responsible for the health of deploying missions for the Army Veterinary Corps. The first troops. Next, LTC Roger Parker, the Director of the policy of the DoD Veterinary Service Program is DoD Veterinary Food Analysis and Diagnostic “Ensure food ingredients and food products are safe, Laboratory here at Fort Sam Houston, has contributed wholesome, and meet quality standards.”1(p2) This a very informative article describing the roles and responsibility is featured in 3 articles. First, CW3 responsibilities of the laboratory, and the detailed Chris Heryford describes a valuable capability offered control measures to ensure quality assurance. by the Veterinary Command to assist commanders of Additionally, he describes the extensive systems of units scheduled for short-term deployments into collaboration among testing laboratories nationwide, foreign countries, whether for infrastructure rebuild- including military and other federal agencies, as well ing, humanitarian assistance, or military training. as local, state, and university resources. Finally, COL Quite often these deployments are into areas with little Marc Mattix presents an excellent article which is a or no regulation or standards of food handling, storage, primer on existing threats to the food and water preparation, or delivery, and limited knowledge of supplies of developed countries, and how such threats available potable water sources. The commander can are addressed and countered. The Army Veterinary January – March 2009 1 Perspective Corps is front and center in this effort, and COL how such trauma is handled in the field. As is usually Mattix makes the importance of that role very clear. the case in the Army where doctrine and standing procedures do not fit the situation at hand, time and Veterinary units have been deploying in support of again our skilled and dedicated medical and veterinary Operations Iraqi Freedom and Enduring Freedom since professionals have adapted, cooperated, and found the beginning of the Global War on Terror. The next 2 ways to save the lives of these valuable resources. articles focus on such deployments to the respective MAJ Baker et al also present carefully developed theaters, presenting different perspectives on the recommendations as to doctrine, training, and organi- mission requirements and the challenges faced in zation based on real world experience and success. In accomplishing them. CPT Marla Brunell’s article that the current environments are probably the details the various categories of support provided template for future conflicts, this article is a must read during the 64th Medical Detachment (VS) deployment for those planning for the future employment and care to southwest Asia and northeast Africa. The veterinary of military working dogs. personnel were organized into small squads at various locations, each of which was responsible for the entire MAJ Kelley Evans’ article discusses another aspect of spectrum of veterinary support: food inspections, both care which must be considered for military working receipt and storage; medical support for the assigned animals. The dangers to Soldiers represented by the military working dogs; stray animal control; and chemical, biological, radiological, and nuclear threats examination of local animals brought into the base are understood and addressed by doctrine, training, compound.