Fall 2018 Tacticaldefensemedia.com ADVANCING HEALTH ACROSS THE FORCE COMMANDER’S CORNER LTG Nadja Y. West The Surgeon General n WAMC Pain Management n DMRTI Commanding General n BAMC Laser Scar Center n Mass Burn Care U.S. Army Medical Command n Henry Jackson Foundation n PEO DHMS n Freeze-Dried Blood Plasma n DHA Clinical Care EXPANDING YOUR HORIZONS FOR ENROUTE CASUALTY CARE EMV+® 731 Series ResQPOD® ITD Ventilator Propaq® M Monitor ResQGARD® ITD A rugged, lightweight ventilator The standard in vital signs monitoring, Noninvasive impedance threshold devices with real altitude compensation for with optional defibrillation, pacing, (ITDs) that improve blood flow and reduce all levels of care. and Real CPR Help® intracranial pressure1,2 ZOLL continues its commitment to broadening its portfolio for the military. With the addition of new products via recent acquisitions, ZOLL has the most comprehensive solutions for military critical care. From monitoring and airway management to enhanced perfusion, ZOLL is focused on providing you with lifesaving technologies that are portable and effective throughout all echelons of care. 1Lurie KG, et al. J Med Soc Toho. 2012;59(6):304-315. 2Convertino VA, et al. Resp Care. 2011;56(6):846-857. Learn more about ZOLL’s resuscitation solutions at www.zoll.com/military or call 1-800-804-4356. © 2015 ZOLL Medical Corporation, Chelmsford MA, USA. EMV +, ResQGARD, ResQPOD, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the U.S. and/or other countries. Propaq is a registered trademark of Welch Allyn. All other trademarks are the property of their respective owners. MCN MP 1506 0016 COMBAT & CASUALTY CARE FALL 2018 APPLYING BALANCED CARE ANY PLACE, ANY WHERE As an overseer of the Military Health System (MHS), the Defense Health Agency (DHA) is tasked with ensuring the MHS extends to contingency and combat-theater operations. By Dr. Paul Doan 4 Features COMMANDER'S CORNER PG 8 PG 22 Managing the Maximizing Medical Intricacies of Pain Research through a Single Womack Army Medical MHS Enterprise Center (WAMC), Ft. Bragg, Dr. Joseph Caravalho Jr., NC, is at the forefront of a President and CEO, Henry EXPANDING YOUR HORIZONS DoD-wide campaign to target M. Jackson Foundation and mitigate the effects of on partnering to advance long-term opiate use. military medicine FOR ENROUTE CASUALTY CARE By Dr. (COL) Donald Algeo PG 24 PG 14 Meeting the Bleed Head On Enabling Health U.S. Special Operations Optimization Command (USSOCOM) is Through Data Mobility fielding freeze-dried blood Program Manager for plasma to mitigate Joint Operational Medicine hemorrhagic trauma 10 Information Systems, By USSOCOM PEO Defense Healthcare Communications Management Systems LTG Nadja Y. West By COL Michael Greenly PG 26 The Surgeon General Encompassing Full Medical Commanding General ® ® EMV+ 731 Series ResQPOD ITD PG 16 Mission Preparedness U.S. Army Medical Command Ventilator Propaq® M Monitor ResQGARD® ITD The Defense Medical Joint Base San Antonio, TX Optimizing Mass Readiness Training Institute Casualty Burn Care (DMRTI) puts focus on Joint U.S. Army Institute of A rugged, lightweight ventilator The standard in vital signs monitoring, Noninvasive impedance threshold devices medical readiness training Surgical Research (USAISR) with real altitude compensation for with optional defibrillation, pacing, (ITDs) that improve blood flow and reduce By DMRTI Leadership Team By COL Jerome Buller all levels of care. and Real CPR Help® intracranial pressure1,2 Departments 2 Insights PG 18 ZOLL continues its commitment to broadening its portfolio for the military. With the addition of new products via Lifting the Limitations of recent acquisitions, ZOLL has the most comprehensive solutions for military critical care. From monitoring and Scarring Wound Trauma Advertisers Index/ MAJ Nathaniel Miletta (Dr.), 28 Calendar of Events airway management to enhanced perfusion, ZOLL is focused on providing you with lifesaving technologies that Chief, Laser Surgery and Scar are portable and effective throughout all echelons of care. Center (LSSC), Brooke Army Medical Center (BAMC) 1Lurie KG, et al. J Med Soc Toho. 2012;59(6):304-315. Cover: Col. Paul Phillips, a U.S. Army Reserve 2Convertino VA, et al. Resp Care. 2011;56(6):846-857. orthopedic surgeon with the 228th Combat Support Hospital, San Antonio, TX, and Col. John Johannigman, a U.S. Army Reserve general Learn more about ZOLL’s resuscitation solutions at SCAN & SIGN UP FOR YOUR surgeon, work together on a simulated surgery promotional photo shoot for Army Reserve www.zoll.com/military or call 1-800-804-4356. marketing and recruiting in a field hospital at Ft. SUBSCRIPTION Hunter Liggett, CA. (U.S. Army Reserve photo by © 2015 ZOLL Medical Corporation, Chelmsford MA, USA. EMV +, ResQGARD, ResQPOD, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the U.S. www.tacticaldefensemedia.com | In Print, Online, and Digital MSgt Michel Sauret) and/or other countries. Propaq is a registered trademark of Welch Allyn. All other trademarks are the property of their respective owners. MCN MP 1506 0016 www.tacticaldefensemedia.com Fall 2018 | Combat & Casualty Care | 1 INSIGHTS The Fall 2018 issue of Combat & Casualty Care sheds light on some challenges in sus- taining current day DoD force health. It is with great pride that we present readers with an ISSN: 2159-7103 | Online ISSN: 2159-7197 informative cover interview featuring perspective from the Office of the Army Surgeon General Published by Tactical Defense Media, Inc. and Commanding General, U.S. Army Medical Command, LTG Nadja West. With many shared All Rights Reserved. Reproduction without force health challenges and some unique to the most powerful land force in the world, LTG permission is strictly forbidden. ©2018 West speaks to initiatives for greater automation in surgical care, holistic combat trauma treatment, and more one-to-one doctor patient interaction. Since its establishment in 2013, the Defense Health Agency (DHA) has been a major entity Tactical Defense Media publications are free to in establishing high level standardization and regulation across the Military Health System. members of the U.S. military, employees of the U.S. With a greater emphasis on holistic care in clinical and long-term care, the DHA is ensuring government, non-U.S. foreign service based in the coordination in healthcare distribution from contingency to combat theater operations world- U.S. and defense contractors. All TDM publications wide. One of the more recent obstacles to quality of life in military healthcare has been in the are sent electronically to international readers. area of pain management and the use of opioids to mitigate pain of many types. Womack Army Medical Center, Ft Bragg, NC, is at the forefront of DoD pain management practice, Mailing Address employing various opiate and non-opiate-based forms of relief, many of which are centered Tactical Defense Media, Inc. around psychological pain control and how they can aid the physical. PO Box 12115 Silver Spring, MD 20908-0115 USA Telephone: (301) 974-9792 On burn care, the U.S. Army Institute of Surgical Research (USAISR) Burn Center, Ft. Fax: (443) 637-3714 Detrick, MD, is leading Army/Joint DoD efforts to provide advanced care through Burn Flight www.TacticalDefenseMedia.com Team intervention in combat and disaster zones. COL Jerome Buller, USAISR Commanding [email protected] Officer, tells about lessons learned from many mass casualty situations where enhanced burn [email protected] care response is needed most. With burn injury often resulting in scar tissue, MAJ Nathaniel [email protected] Miletta, Chief, Laser Surgery and Scar Center, Brooke Army Medical Center, Joint Base San Tactical Defense Media Antonio, TX, speaks to laser surgical technology being used to enable patient outcomes not Publications long ago thought impossible. From the field, the Fall issue takes a look at the latest in the use of freeze-dried blood plasma with U.S. Special Forces as well as novel vaccine development to treat rodent-born viral threats. As part of our organizational focus, we present a special interview with Dr. Joseph Caravalho, President and CEO of the Henry M. Jackson Foundation, Bethesda, MD, who discusses efforts to enhance military medicine and its application. Also, the Defense Medical Readiness Training Institute (DMRTI) gives us a look at some cutting-edge training techniques that DMRTI is using to help prepare the next generation of field medical personnel. Your comments and suggestions are welcome. Thank you for the continued readership! and Christian Sheehy Sonia Bagherian Editor Publisher [email protected] [email protected] WARFIGHTERS Jeremy Dow Cathy Kieserman TACTICAL Copy Editor Office Administrator [email protected] [email protected] ANNUAL GEAR GUIDE Jittima Saiwongnuan Ellie Collins Graphic Designer Circulation [email protected] [email protected] DISCLAIMER: Tactical Defense Media (TDM) is privileged to publish work by members of the military and government personnel. We make a special effort to allow writers to review their articles before Proud Members publication, critique our edits, and make changes. TDM typically follows, but is not bound by, the AP Stylebook and reserves the right to determine the style, including but not limited to capitalizations and other grammatical