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Archive for the ‘Medical’ Category

SCUBAPRO Sunday – Cramps When Diving

Sunday, August 21st, 2022

We’ve always been told that dehydration and accumulation of lactic acid were the driving causes of cramps. Sports drinks have made a ton of money selling us on that, but there is little scientific evidence to support these connections. For dehydration to be a driving factor, you’d probably be displaying clinical signs of dehydration; dizziness, tiredness, dry mouth, lips, and eyes. Instead, the cause of cramps may lie in the reflex nerves that control the muscle. Two sensory receptors are involved: muscle spindles and the Golgi tendon organ (GTO). The GTO senses changes in muscle tension. It lies in the tendonous area at the end of the muscle fiber. If the GTO is stimulated, it sends a reflex signal via the spine and causes the muscle to relax. The muscle spindle is embedded in the muscle itself. The reverse situation occurs if the muscle spindle is stimulated, and a muscle contraction occurs.

Cramp occurs when the reflex’s central nervous system (CNS) control is lost. The GTO becomes inhibited, and the muscle spindles become hyperactive. This leads to sustained activation of the muscle. If we follow this theory, then a muscle’s hyperexcitability is the basis of cramping; therefore, stretching should counteract the cramp. And guess what? We’ve known that for years. Stretches must be held for 15-30 seconds or until the muscles relax. After the cramp has gone, avoiding exercise for the next hour and applying heat will help. This allows the muscle and the CNS to recover.

So how do you avoid leg cramps in the first place?

Usually, you are told to maintain hydration and salt. But with some of the newer studies, that might not help as much as you think, at least for diving. It’s hard to do a controlled trial on yourself; hydrating one leg and not the other is impossible. Instead, we need to think about maintaining healthy reflex arcs. Poor flexibility caused by prolonged sitting, poor posture, or inefficient biomechanics will make it more likely that the reflex malfunctions.

Age is also a factor, and divers who haven’t ever experienced cramps may do so as you get older. Both aspects are increased body weight and eccentric muscle contraction (where the muscle lengthens as the load is greater than the force the muscle can produce). Many publications suggest that the diver’s choice of fins may be the biggest driver of cramps. Weak leg muscles need a smaller, thinner, flexible fin; athletic legs can drive wider, longer, stiffer blades. Fin manufacturers add several features to improve performance, ribs, channels, vents, and the material of the blade. I do believe that they help a lot also. I get a lot less cramps now that I use the SCUBAPRO Seawing Nova, Go Sports, and the New Seawing Supernovas. The SeaWing’s have rips in the fins to help not push on your feet as much when you kick. There are two types of Seawing Nova.

The Seawing Nova and the Seawing Nova Gorillas and there is now the new Seawing Supernovas. The Gorillas are a stiffer fin, and they are great for a working diver or someone in good shape. So, pick the right one for the job you are doing and the environment you will be in. I have been using the Supernovas and I love them, and I have not had any cramps. I am not saying it won’t happen but 6 months in and I am very happy with them.

Your footwear should not be too tight as this will restrict circulation and bone movement in your foot. With the new Supernovas you can adjust the tension on the heel strap. IT has three positions you can set it for. If you are diving in the winter and you add a dive sock to your booties to keep you warm, what you are doing is restricting your circulation, and that will make you cold and cause cramps. If you want to add layers have different sizes booties. The strap should not bite into the back of your heels too tightly, pushing on your Achilles tendon. This can happen if your footwear is too big and you are shoving your foot in and barely getting your strap around you heal or you are afraid you will lose your fin, so you pull the strap tight. Something that could help with this is a self- adjusting fin, like a bungee strap or a steel spring. This will help keep the right pressure on your heel.

However, it’s more likely that repetitive finning motions are driving CNS fatigue and loss of control of the reflex. If you feel cramps starting, change your position, change your fin stroke, and maybe try to float for a bit and allow the CNS to reset. I have used one leg to fin while stretching the other out and trying to keep up with my swim buddy more than once. The other thing that can help is wearing compression clothing. I have been using compression socks for long flights, long dives, workouts, and recovery for a while, making a huge difference. I did a 3-mile ocean swim a couple of months back and didn’t use the sock I usually wear, and I cramped up a lot. I am a massive fan of DFND USA clothing.

Cramping generally affects people that have taken a long break from finning. I say finning and not diving because you don’t have to dive to fin. So, like all your other skills, shooting, moving, and communicating. You need to practice finning, so you stay in finning shape. You should try and swim a couple of times a week. When you are in the pool, swimming with fins on will help strengthen all the smaller muscles. When you are at the gym, don’t just do arms. Do functional workouts that include a lot of exercises for your calves and strengthening the specific muscle groups that cramp when diving. Also try and include foot flexing exercises, as one of the other reasons for cramping is your feet are not used to being pointed for long periods of time,

They include toe raises, one-leg drop squats, and calf raises. Lastly stretch a lot. I am bad at doing it until my knees and body hurts and they I am like “why do I hurt? Oh, Yaa I need to stretch” I am a fan of Active Isolation Stretching (AIS). I carry 1in tubular nylon with me everywhere I travel, it lives in my bags. You can google it and you will find out how to do it. I have used it since BUDS to help with knee pain and it always does.

First Tactical Medicine Fellowship Launched at TTUHSC El Paso

Sunday, August 21st, 2022

EL PASO, Texas — Texas Tech University Health Sciences El Paso is putting together a team of health care heroes who will run toward danger to save victims of violent crimes before the scene is clear.

The newly formed TTUHSC El Paso Tactical Medicine Program includes the first Tactical Medicine Fellowship in Texas, and the fourth nationally. The fellowship is a one-year program, and a new fellow will be chosen every July.

Tactical medicine is a specialty in which health care providers, in this case physicians, respond to critical incidents to provide first aid to victims, law enforcement or anyone else at an on-going crime scene. This new program can save lives because when rendering aid in a mass violence situation, minutes can make the difference between life and death.

Stephen Schwartfeger, M.D., is the first doctor who has been accepted into the fellowship. He is also a graduate of the TTUHSC El Paso Emergency Medicine residency program. For the next six months, he will train at the El Paso Community College Law Enforcement Academy and graduate with full police credentials.

“Being the first fellow means there will be trial and error components to work through, and having the opportunity to provide direct input into how the program will develop is an invaluable aspect to being the first fellow,” said Dr. Schwartfeger, who is also studying for his emergency medicine board certification. “The specific appeal to tactical medicine is being able to work with and alongside law enforcement. It’s a way of giving back to them and the community at the same time.”

Once Dr. Schwartfeger completes his police training, he will begin working with the rest of the Tactical Medicine team, which consists of four Texas Tech Physicians of El Paso doctors. The team is led by Robert Root, D.O., an emergency medicine specialist who spent four years as an emergency medicine doctor in the U.S. Army.

As the medical practice of the Foster School of Medicine, the physicians who comprise TTP El Paso each hold faculty appointments at the medical school, where they teach the next generation of doctors.

“We will be delivering health care to individuals who are caught in dangerous environments, such as gunshot or stabbing victims,” said Dr. Root, who was deployed in Afghanistan and stationed at William Beaumont Army Medical Center prior to joining TTUHSC El Paso. “We will bridge that gap between police and paramedics, who have to wait about three to four blocks away until the scene is cleared and declared safe by officers. In certain situations, a patient needs medical care while the scene is still active and there’s still a potential danger.”

Dr. Root said tactical medicine is a small but growing field in many metropolises across the country, including Dallas, San Antonio, and Houston, but this will be the first regionally. They are currently working with the El Paso Police Department’s SWAT team, but Dr. Root would eventually like to provide 24/7 coverage for all El Paso law enforcement. He envisions a relationship where the Tactical Medicine team would regularly train with law enforcement teams, provide on-scene support during dangerous situations, and help teach life-saving techniques to officers in the region.

“We’re trying to help in the best way we can. Unfortunately, there are people out there who try to hurt our communities through mass violence,” Dr. Root said. “These incidents aren’t new, but they are more salient. El Paso’s experience in 2019 shows us that it can happen here, and we need to be prepared. We’ve all heard the motto ‘El Paso Strong,’ and this program is a concrete action to make El Paso stronger.”

As the program grows, Dr. Root hopes there will be more physicians and fellows added to the team. Currently all the physicians on the Tactical Medicine team are emergency medicine doctors, but he said any specialty that has experience with trauma injuries are welcome. He would also like to include cross training with paramedics and fire departments. Dr.Schwartfeger added that he hopes to be a part of that expansion.

“El Paso has a large and diverse law enforcement community due to its position with the border. There are many opportunities for us to work with multiple agencies and help elevate the medical training and support we can offer the law enforcement community,” Dr.Schwartfeger said.

“Hopefully after completing the fellowship, I’ll continue working with the program and its development, while also working as an emergency medicine doctor, learning and growing as a physician, and providing emergency care to this wonderful community.”

TTUHSC El Paso is the only health sciences center on the U.S.-Mexico border and serves 108 counties in West Texas that have been historically underserved. It is the only health sciences center along the U.S.-Mexico border designated as a Title V Hispanic-Serving Institution, preparing the next generation of health care heroes, 48% of whom identify as Hispanic and are often first-generation college students.

TTP El Paso is the region’s largest multispecialty medical group practice, with over 250 specialists providing world-class patient care right here at home. Our physicians are dedicated to excellence and committed to caring for Borderplex patients at convenient locations across the city so families never need to leave the region to find the latest medical and treatment opportunities.

Blue Force Gear Releases Limited-Edition Vickers Medic Slings

Friday, August 19th, 2022

POOLER, GA – Blue Force Gear has released a limited-edition, metal hardware version of its specialty Vickers Medic Sing.

The Vickers Medic Sling was developed based on the input of Special Forces 18 Delta medics and other combat medics. They wanted a sling with a greater range of adjustment than the Standard Vickers Sling but without the disadvantages commonly attributed to tailed slings. The quick adjusters found at both ends of the sling provide increased adjustment for anyone looking for a sling with greater flexibility, not just medics.

“The Medic Sling has been a long-time fan favorite, so it was time we brought it back,” explained Stephen Hilliard, Senior Director of Product Development for Blue Force Gear. “We wanted to do something a little different this time around, and we eventually landed on a limited-edition sling with all metal hardware. We haven’t released a Medic Sling with this configuration since 2011.”

The Vickers Medic Sling works the same way as the Blue Force Gear Standard Vickers Sling but features a Quick Adjuster Pull Tab at each end. This results in a greater range of adjustment, allowing the user to better secure their weapon when in the Rear Sling position. The Vickers Medic Slings also feature machined aluminum quick adjusters and steel triglides, adding another unique element to this special edition sling. All the hardware is made with premium US materials and has a lifetime guarantee.

The Vickers Medic Sling is not a regularly stocked item. This is a limited-edition release, and once they’re gone, they’re gone. For more information, visit blueforcegear.com/vickers-medic-sling.

High Speed Gear Announces the ReFlex Hanger IFAK System

Monday, August 15th, 2022

SWANSBORO, N.C. – Aug. 15, 2022 – High Speed Gear® has introduced the ReFlex™ Hanger IFAK System into their line of ReFlex™ IFAK products.

The ReFlex™ IFAK was developed with direct input from active-duty medical personnel. It’s a two-piece system, med roll and hanger carrier, that is designed to attach directly to the hook and loop of a plate carrier to carry organized medical supplies with ambidextrous accessibility. The system, constructed primarily with heavy-duty nylon laminate, allows rapid deployment of medical supplies and was designed around the medical supplies included in the U.S. Army-issued IFAK. The ReFlex™ Hanger and ReFlex™ Med Roll can be purchased together or separately.

The ReFlex™ Hanger is the fourth IFAK accessory added to HSGI’s ReFlex IFAK product line up. Also included is the ReFlex™ IFAK system, ReFlex™ Vehicle Mount, and ReFlex™ Leg Rig. The ReFlex™ Hanger was field tested by U.S. Army Special Forces operators prior to its release. This new medical pouch fills the gap for those who use drop-down/hanger style pouches to carry their medical equipment under the front of their plate carriers and chest rigs.

“The ReFlex™ IFAK System is one of those products that continue to develop into more variations that suit our end users’ needs.” Said Bill Babboni, HSGI’s chief operating officer. “The ‘Hanger’ simply allows users another way to carry their life-saving medical equipment that may be more tailored to how they go to business.”

The ReFlex™ Hanger IFAK System is available for purchase on the High Speed Gear® website at ReFlex™ Hanger.

The Big Gear Show 2022 – Hustle Clean Body Wipes

Thursday, August 4th, 2022

Hustle Clean Body Wipes kill 99.9% of germs using benzalkonium chloride which is FDA approved and alcohol-free. They also contain aloe vera, witch hazel, and vitamin E and are great for freshening up when you can’t hit the shower right away.

Each box contains 10 individually-wrapped wipes. Available unscented, fresh, and lavender.

hustleclean.com/products/the-body-wipe-1

ERDC, Transatlantic Division Team Recognized with USACE Innovation Award

Tuesday, August 2nd, 2022

VICKSBURG, Miss. – A team from the U.S. Army Engineer Research and Development Center’s (ERDC) Geotechnical and Structures Laboratory (GSL), the U.S. Army Corps of Engineers (USACE), Transatlantic Division and the USACE Protective Design Center was recently recognized with the 2022 USACE Innovation of the Year Award.

The team developed simple and effective bunker enclosure door designs for the U.S. Central Command (CENTCOM) to help reduce risk for traumatic brain injury (TBI) to bunker occupants. The new designs sought to reduce the peak pressures experienced by an individual seeking shelter in a bunker by more than 90 percent.

CENTCOM’s area of responsibility encompasses more than 4 million square miles and stretches from Kazakhstan to Yemen.

“The ERDC team, in coordination with the Transatlantic Division, developed modifications to existing bunker designs to reduce TBI vulnerability and provide design recommendations to the Army to address force protection challenges concerning current personnel bunkers,” said Bart Durst, ERDC-GSL director.

Throughout the research and design process, team members leveraged the Department of Defense’s High Performance Computing systems at ERDC to conduct more than 120 high-fidelity simulations of door designs and configurations.

The innovative solution was developed within a very short timeline using the survivability knowledge maintained through ERDC’s Expedient Passive Protection program and their computational capabilities. The team was able to deliver the project in six months.

“I am extremely proud of ERDC-GSL’s contribution to this team and this project,” Durst said. “These innovations will tremendously benefit warfighters across the globe in the execution of their mission. These retrofits provided rapid solutions to address an urgent need for expeditionary force protection to reduce TBI vulnerabilities.”

ERDC Public Affairs

How Drones Will Transform Battlefield Medicine, Save Lives

Wednesday, July 27th, 2022

FALLS CHURCH, Va. (AFNS) —  

Blood loss or “bleeding out” is the leading cause of preventable death on the battlefield, military health experts say.

So, one of the best ways to save lives during combat operations is to provide blood products to forward-deployed medics and corpsmen as soon as possible.

During the wars in Iraq and Afghanistan, getting the needed blood products to injured warfighters was typically not a major challenge when the U.S. military controlled the skies and maintained a nearby network of medical facilities.

“We were pretty reliant on medevac ‘dust off’ to deliver our blood,” said Air Force Col. (Dr.) Stacy Shackelford, Joint Trauma System chief.

However, in future conflicts against a “near-peer” adversary, Shackelford said, that could be far more difficult. Injured troops may have to remain at the frontlines for days while needing blood transfusions or other major medical care.

The solution: Drones may become essential to combat medicine.

“I think it’s going to come down to drone delivery of blood by some type of unmanned vehicle that can fly in and drop off more blood or more bullets, whatever is needed,” Shackelford said.

Resupply by Drones

“We think that drone resupply of blood and immediate-need medical products are really just around the corner,” said Dr. Adam Meledeo, a research scientist for coagulation and blood research at the U.S. Army Institute of Surgical Research at Joint Base San Antonio-Fort Sam Houston, Texas.

“There are multiple off-the-shelf solutions that are being considered,” and the Defense Health Agency is funding several other innovations to optimize the ability to provide drones in the battle space, Meledeo said.

Yet using drones to resupply blood and other medical supplies will be challenging.

“There’s obviously trade-offs between some of these different platforms, such as making sure that we have a vehicle that’s fast, and somewhat stealthy … and has a very large battery that will be able to keep it airborne for a much longer period of time if it needs to loiter somewhere in anticipation of there being a problem,” Meledeo said.

“There’s also been some talk of outfitting some of our combat hardware drones that are already in use with alternative payloads that would be able to supply blood, medical supplies and really just about anything, such as MRE’s, ammunition, and water” to frontline medics or service members caring for wounded Soldiers, he explained.

Blood Resupply

“The primary issue with blood resupply is that it has to be maintained at specific temperatures, as do a number of pharmaceuticals including certain pain medications, and antibiotics,” Meledeo explained.

“The biggest technological hurdles right now are being able to maintain those temperatures inside those drone payloads very consistently, at a variety of altitudes, and a variety of different ambient conditions for potentially lengthy periods of time, without drawing too much power away from the system itself,” Meledeo continued.

The Marines Corps used drones for resupply during an exercise in Australia. Drones have also been used in Rwanda and Uganda to transport medical supplies to rural areas across mountain ranges and in bad weather, Meledeo said.

“I think that we’re going to get there much faster than we had initially anticipated,” he said.

The use of drones for future near-peer conflicts is starting to filter down into the operational forces as a potential solution in the near term, he noted.

Wounded Warrior Evacuation

“In the long term, there are a number of lines of effort, such as involving drones for the extraction of patients,” Meledeo said.

U.S. partner countries are examining some of these platforms that can evacuate a patient rapidly without risking other personnel in potentially contested airspace, he added.

How does one transport casualties stealthily?

“Part of it is marking the vehicles appropriately with standard medical nomenclature. That gives you the Geneva Convention protection. But obviously, we go up against certain enemies that will not care about that at all,” he explained.

Artificial Intelligence

Stealth technology continues to improve. When it comes to drones, “it may be just a matter of keeping the drones low to the ground, and that they’re being piloted by an artificial intelligence system,” Meledeo explained.

“So, hopefully, AI will be faster to react than a human would be. But even still, I think there are a lot of concerns about” the use of drones to extract wounded warfighters.

“The long-term goal … is to actually have some sort of robotics onboard these drones that would be doing medical care to the patient during transport,” he said.

DARPA AI Initiative

A new Defense Advanced Research Projects Agency initiative called “The In the Moment Program” aims to ultimately give AI systems the same complex, rapid decision-making capabilities as military medical staff and trauma surgeons who are in the field of battle based on algorithms of care and decision-making capabilities.

One example is smart tourniquets that will be able to detect whether they need to be released. Other automatically guided solutions include IV placement or catheter placement, Meledeo said.

“It sounds like science fiction. It is still a little bit science fiction, but it’s not as far off as it may sound,” he said.

“At least on a rudimentary level, the community is already pursuing a lot of automated solutions or artificial intelligence-derived solutions for automation of different medical processes.”

This research is underway but there’s no timeline on this concept.

“Hopefully, we’ll be able to get some confident results from some of these different technologies that are going to be packaged together in this system and enable the drones to then not only resupply at the point of injury, but also actually take care of the transportation and the management of patients during that transportation.”

By Janet A. Aker, Military Health System Communications

Special Warfare Training Wing Physical Medicine Technician Embeds with NASA

Saturday, July 23rd, 2022

JOINT BASE SAN ANTONIO-CHAPMAN TRAINING ANNEX, Texas  –  

From advancing force development of future Air Force Special Warfare Airmen to working with astronauts, life has been far from boring for the SWTW’s Staff Sgt. Emily Valdovinos.

Valdovinos was hand-selected to assist the NASA Astronaut Strength, Conditioning and Rehab Group to help develop personalized strength, conditioning, and rehabilitative plans for NASA astronauts with Crew-3 after they returned from the International Space Station for their 45-day reconditioning period.   

“Emily was specifically selected based on the skillset she has worked so hard to achieve for herself,” said Maj. Danielle Anderson, musculoskeletal medicine and rehabilitation lead, ASCR Group. “With her passion for human performance, dedication to ensuring the highest quality of service is delivered, and her energetic professionalism, Staff Sgt. Valdovinos was the perfect NCO to support our team.”

The mission of the ASCR Group is to optimize the performance and physical readiness of the astronaut corps by utilizing an interdisciplinary team approach, evidence-based practice, and emerging science and technology throughout an astronaut’s lifespan. The team focuses on optimizing the astronaut’s physical performance as he or she prepares for, lives in, and returns from the ISS.

At the SWTW, Valdovinos serves as the non-commissioned officer in charge of performance rehabilitation for the Special Warfare Candidates Course and Pre-Dive Course, where her experience working with SWTW trainees directly transfers to working with NASA astronauts.

“In [both the SWTW and NASA], I work hand in hand with a multi-disciplinary team to provide the best possible care to our caseload,” said Valdovinos. “I work directly under a physical therapist alongside a strength coach and athletic trainer to help develop personalized strength, conditioning, mobility, and rehabilitative plans for each person who needs assistance; we do ruck marches every week, throw sandbags, and are on a very strict workout schedule at NASA, just like the SWTW.”

In addition to working with astronauts, Valdovinos has also been afforded many unique opportunities available only at NASA while embedded with the ASCR Group.

Valdovinos joined in a live call to the ISS with Crew-4, toured NASA’s Neutral Buoyancy Lab where astronauts train for extravehicular activities (space walks), visited the Apollo Mission Control Center, learned about the various exercise equipment available to astronauts while in space, and much more.

When asked what she will take away from her time working at NASA, Valdovinos stressed the importance of the multi-disciplinary team and its ability to work seamlessly together to provide the best level of care for the individual, regardless of whether that individual is an astronaut, SWTW trainee, or AFSPECWAR operator.

“Personally, I have grown in many ways as a professional and as a person,” said Valdovinos. “I feel incredibly humbled to have even been considered for this position as it has been my dream to train astronauts and support the Space Exploration mission ever since I was young.”

Members of SWTW provide initial training for all AFSPECWAR training specialties, including combat controllers, pararescue, special reconnaissance and tactical air control party Airmen.

To learn more about SW Airmen or other U.S. Air Force Special Warfare career opportunities, go to www.airforce.com/careers/in-demand-careers/special-warfare.

By 1st Lt Xiaofan Liu

Special Warfare Training Wing Public Affairs