1. A&L NET
a. NOTICE TO A&L NET MEMBERS: Due to a Combat Training Center rotation beginning and the holidays immediately following, A&L NET will be going into reduced activity and intermittent summary emails until January. Thank you all for joining A&L NET and sharing with others, I greatly appreciate it. We are all stronger together. Please share this community with those around you. Enjoy the holidays!
b. FRAGO 9 TO HQDA EXORD 225-21, COVID-19 STEADY STATE OPERATIONS (CUI), DTG: 110221Z NOV 21. This FRAGO provides guidance for Civilian vaccination requirements, attestation and verification procedures for Civilians and Contractors, and publishes additional information related to vaccination administration. There are 13 additional annexes included with the FRAGO. Some key provisions in this FRAGO: https://www.milsuite.mil/book/docs/DOC-1078792
c. AMEDD COMMISSIONING BRIEFINGS IN-PERSON 7-8 DECEMBER AT FORT STEWART. AMEDD Commissioning Program qualifications and application procedures will be briefed by the Program Manager from Fort Knox, KY. https://www.milsuite.mil/book/docs/DOC-1077136
2. New and Updated Medical Regulations, CPGs, and Guidelines
a. FRAGO 8 TO HQDA EXORD 225-21, COVID-19 STEADY STATE OPERATIONS (CUI), DTG: 012359Z NOV 21. Some key items from this FRAGO: https://www.milsuite.mil/book/docs/DOC-1061833
b. FORCE HEALTH PROTECTION GUIDANCE (SUPPLEMENT 23) - REVISION 2 - DEPARTMENT OF DEFENSE GUIDANCE FOR CORONAVIRUS DISEASE 2019 VACCINATION ATTESTATION, SCREENING TESTING AND VACCINATION VERIFICATION, 8 NOV 21. On 9 September 2021, in issuance of Executive Order 14043, the President of the United States required Coronavirus-19 (COVID-19) vaccination for all Federal employees in order to ensure the health and safety of the Federal workforce and individuals interacting with the Federal workforce. Employees are considered fully vaccinated two weeks after completing the second dose of a two-dose COVID-19 vaccine or two weeks after receiving a single dose of a one-dose COVID-19 vaccine. Employees must be vaccinated by November 22, 2021. This memo prescribes actions to implement this requirement for Department of the Army Civilian employees. https://www.milsuite.mil/book/docs/DOC-1076657
3. Medical FORSCOM WIAS, ARNG, and USAR Positions
a. ARNG/USAR MEDICAL POSITIONS/JOBS AVAILABLE AS OF 10 NOV 21. AGR: MISSISSIPPI ARMY NATIONAL GUARD MOS QUALIFIED 68W, SR INSTRUCTOR POSITION OPENING, HATTIESBURG, MS. https://www.milsuite.mil/book/docs/DOC-1077026
4. Medical MILPERs, ALARACTs, Directives, and Announcements
a. UNITED STATES FORCES KOREA (USFK) REGULATION 40-9, FORCE HEALTH PROTECTION (FHP) REQUIREMENTS FOR THE KOREAN PENINSULA, 20 OCT 2021. This regulation supersedes USFK Regulation 40-9 dated 8 Feb 2018. This regulation establishes policies and procedures, covers minimum FHP requirements, and assigns FHP peninsula responsibilities. This guidance applies to Department of Defense (DoD) personnel (uniformed, civilian, contractors, and volunteers) traveling or deploying to the Korean peninsula and working under the auspices of the DoD for more than 30 days https://www.milsuite.mil/book/docs/DOC-1079256
b. MILPER MESSAGE 21-433, FISCAL YEAR 2022 (FY22) RESERVE COMPONENT (RC), LIEUTENANT COLONEL (LTC), ARMY MEDICAL DEPARTMENT (AMEDD), ARMY NATIONAL GUARD OF THE UNITED STATES (ARNGUS), ARMY RESERVE ACTIVE GUARD RESERVE (AR AGR), AND ARMY RESERVE NON-ACTIVE GUARD RESERVE (AR NON-AGR), COMPETITIVE CATEGORIES, PROMOTION SELECTION BOARD (PSB) ZONES OF CONSIDERATION, ISSUED:[11/9/2021 7:06:49 AM]. Subject promotion selection boards will convene on or about 8 Mar 22, to consider eligible (AMEDD) Majors (MAJ) on the Reserve Active Status List (RASL) for promotion to Major (LTC). The board will recess on or about 24 Mar 22. https://www.hrc.army.mil/Milper/21-433
c. MILPER MESSAGE 21-431, ELIGIBILITY CRITERIA FOR RESERVE COMPONENT OFFICERS REQUESTING TO DEFER PROMOTION CONSIDERATION (OPT OUT) FROM THE FISCAL YEAR 2022 RESERVE COMPONENT LIEUTENANT COLONEL ARMY MEDICAL DEPARTMENT PROMOTION SELECTION BOARD (FY22 RC LTC AMEDD PSB), ISSUED: [11/8/2021 1:06:44 PM]. This message describes the specific eligibility criteria to allow Reserve Component (RC) officers to defer promotion consideration for (Opt Out of) the FY22 RC LTC AMEDD PSB. This only applies to officers in the Primary Zone. https://www.hrc.army.mil/Milper/21-431
d. MILPER MESSAGE 21-430, FISCAL YEAR 2022 (FY22) ACTIVE COMPONENT (AC), MAJOR (MAJ), MEDICAL CORPS (MC), AND DENTAL CORPS (DC), PROMOTION SELECTION BOARDS (PSB) ZONES OF CONSIDERATION, ISSUED: [11/8/2021 7:55:08 AM]. Subject selection boards will convene on or about 7 Feb 22 to consider eligible Captains (CPT) on the Active Duty List (ADL) for promotion to MAJ. The boards will recess on or about 18 Feb 22. https://www.hrc.army.mil/Milper/21-430
e. MILPER MESSAGE 21-429, FISCAL YEAR 2022 (FY22) RESERVE COMPONENT (RC), COLONEL (COL), ARMY MEDICAL DEPARTMENT (AMEDD), ARMY NATIONAL GUARD OF THE UNITED STATES (ARNGUS), ARMY RESERVE ACTIVE GUARD RESERVE (AR AGR), AND ARMY RESERVE NON-ACTIVE GUARD RESERVE (AR NON-AGR), COMPETITIVE CATEGORIES (CC), PROMOTION SELECTION BOARDS (PSB) ZONES OF CONSIDERATION, ISSUED: [11/8/2021 7:52:00 AM]. Subject promotion selection board will convene on or about 8 Mar 22, to consider eligible (AMEDD) Lieutenant Colonels (LTC) on the Reserve Active Service List (RASL) for promotion to COL. The board will recess on or about 24 Mar 22. https://www.hrc.army.mil/Milper/21-429
f. MILPER MESSAGE 21-428, FISCAL YEAR 2022 (FY22) ACTIVE COMPONENT (AC), MAJOR (MAJ), ARMY NURSE CORPS (AN), MEDICAL SERVICE CORPS (MS), ARMY MEDICAL SPECIALIST CORPS (SP), AND VETERINARY CORPS (VC), PROMOTION SELECTION BOARD (PSB) ZONES OF CONSIDERATION, ISSUED: [11/8/2021 7:47:21 AM]. Subject selection boards will convene on 8 Mar 22 to consider eligible Captains (CPT) on the Active Duty List (ADL) for promotion to MAJ. The boards will recess on or about 18 Mar 22. https://www.hrc.army.mil/Milper/21-428
g. MILPER MESSAGE 21-427, AMENDMENT TO MILPER MESSAGE NUMBER 21-355, ELIGIBILITY CRITERIA FOR OFFICERS REQUESTING CONSIDERATION TO OPT IN TO THE FISCAL YEAR 2022 (FY22) COLONEL (COL) ARMY MEDICAL DEPARTMENT (AMEDD) PROMOTION SELECTION BOARD (PSB), ISSUED: [11/5/2021 3:59:15 PM]. Paragraph 9e is amended to read: The suspense date for submitting a request to Opt In for Early Consideration is 12 November 2021, 2359 Eastern Standard Time. https://www.hrc.army.mil/Milper/21-427
h. MILPER MESSAGE 21-426, AMENDMENT TO MILPER MESSAGE NUMBER 21-354, ELIGIBILITY CRITERIA FOR OFFICERS REQUESTING CONSIDERATION TO OPT IN TO THE FISCAL YEAR 2022 (FY22) LIEUTENANT COLONEL (LTC) ARMY MEDICAL DEPARTMENT (AMEDD) PROMOTION SELECTION BOARD (PSB), ISSUED: [11/5/2021 3:54:39 PM]. Paragraph 9e is amended to read: The suspense date for submitting a request to Opt In for Early Consideration is 12 November 2021, 2359 Eastern Standard Time. https://www.hrc.army.mil/Milper/21-426
i. MILPER MESSAGE 21-424, AMENDMENT TO THE FISCAL YEAR 2022 (FY22) ACTIVE COMPONENT (AC), COLONEL (COL), ARMY NURSE CORPS (AN), MEDICAL SERVICE CORPS (MS), ARMY MEDICAL SPECIALIST CORPS (SP) AND VETERINARY CORPS (VC) PROMOTION SELECTION BOARD (PSB) ZONES OF CONSIDERATION, ISSUED: [11/5/2021 3:43:45 PM]. This message amends MILPER Message 21-369, issued 29 Sep 21. See the message for changes. https://www.hrc.army.mil/Milper/21-424
5. Discussions on Medical Case Studies, Research, Guidelines, and Updates
a. GREEN FIELDS OF FRANCE; MORTUARY AFFAIRS IN PEER CONFLICT. A key component in the combat effectiveness of American military formations, the morale of U.S. Servicemembers is singularly vulnerable to the effects of a high-casualty conflict.8The examples above give a general sense of the complexity and difficulties associated with recovering and processing large numbers of remains in single events. https://www.milsuite.mil/book/docs/DOC-1080357
b. CASE-CONTROL ANALYSIS OF PREHOSPITAL DEATH AND PROLONGED FIELD CARE SURVIVAL DURING RECENT US MILITARY COMBAT OPERATIONS – AUG 2021. BLUF: Prolonged field care practices and capabilities are required in a variety of current, low-intensity, decentralized conflicts and will remain important in future military conflicts which may necessitate delayed evacuations. The findings of this analysis cover the spectrum of prehospital care, early damage-control resuscitation, and PFC. Tourniquets, blood transfusion, airway, and ventilatory support are frequently required, potentially lifesaving prehospital interventions for seriously injured casualties. Future studies are needed to identify the PFC survival benefits of specific advances in prehospital interventions and early lifesaving resuscitation practices, including the timing of required treatments. https://www.milsuite.mil/book/docs/DOC-1076418
c. CLINICAL UTILIZATION OF DEPLOYED MILITARY SURGEONS - AUG 2021. BLUF: Surgical cases for military surgeons were uncommon in Africa. The low volumes have implications for skill retention, morale, and sustainability of military surgical end strength. Reduction in deployment lengths, deployment location adjustments, and/or skill retention strategies are required to ensure clinical peak performance and operational readiness. Failure to implement changes to current practices to optimize surgeon experience will likely decrease surgical readiness and could contribute to decreased retention of deployable military surgeons to support global operations. https://www.milsuite.mil/book/docs/DOC-1076420
d. LANCET - COVID-19 COMMUNITY TRANSMISSION AND VIRAL LOAD KINETICS IN VACCINATED VS. UNVACCINATED. Background The SARS-CoV-2 delta (B.1.617.2) variant is highly transmissible and spreading globally, including in populations with high vaccination rates. We aimed to investigate transmission and viral load kinetics in vaccinated and unvaccinated individuals with mild delta variant infection in the community. https://www.milsuite.mil/book/docs/DOC-1078776
e. RADIO FREQUENCY IDENTIFICATION REQUIREMENT ISSUE AND RESOLUTION. ISSUE: Retained Surgical Item (RSI) events continue to occur and put patients at risk. RESOLUTION: The U.S. Central Command (USCENTCOM) Surgeon directed the procurement and use of RFID devices and solutions in all Role 2 and Role 3 USCENTCOM facilities by 01 Jul 2020. https://www.milsuite.mil/book/docs/DOC-1080367
f. PROLONGED CASUALTY CARE: BRIDGING THE MEDICAL CARE GAP FOR LSCO. Attached are presentation material used for the Prolonged Casualty Care: Bridging the Medical Care Gap for LSCO live seminar held Wed, Aug 11, 2021. Presentations from the event include: INDOPACOM “Scene Setter” and Medical Planning for Large Scale Combat Operations (LSCO)/Multi Domain Operations (MDO); Prolonged Casualty Care (PCC) Gap Analysis, Joint Trauma System (JTS) Presentation/Discussion on PCC Clinical Practice Guidelines (CPG’s) and Standardized Training Program of Instruction (POI); Path to Prolonged Care Competency: Medical Simulation Training Center (MSTC) Delayed Evacuation Casualty Management (DECM) to Medical Center of Excellence (MEDCoE) PCCM; Tyranny of Time/Distance: Commander’s Perspective. Afternoon presentations include: Equipping for PCC and Panel Discussion: Putting It All Together (Problems and Challenges). https://www.milsuite.mil/book/docs/DOC-1080196
g. EMV+ ZOLL 731 PATIENT DISCONNECT ALARM ISSUE, PROBLEM, MITIGATION FROM PI CORNER, JOINT TRAUMA SYSTEM. ISSUE: Four reported Zoll 731 Ventilator malfunctions from Jun 2020 to May 2021. MITIGATION: Use only blue circuits for Zoll 731. Use the white circuit for the Impact 754 Ventilator only. https://www.milsuite.mil/book/docs/DOC-1076353
h. JTS NEWSLETTER FALL 2021. https://www.milsuite.mil/book/docs/DOC-1076352
6. Army Medicine News
a. Army Medicine News 18 Nov 21.Hot Topics: OSHA, Adjustment Disorder, Food Insecurity, Fully Vaccinated Definition, Pfizer COVID Booster, Back to Normal, Moderna COVID Booster. https://www.milsuite.mil/book/docs/DOC-1080238
7. Class VIII, Supporting Material, Obscure NSNs, and Ordering Information
a. COMBAT MEDIC AID BAG ADDITIONAL NSNS ADDED. https://www.milsuite.mil/book/docs/DOC-1064599
8. FORSCOM Casualty Response
a. 1-41 FA TACSOP DATED MAY 2016 UPLOADED. https://www.milsuite.mil/book/docs/DOC-1077215
b. 1-18 IN, 2ABCT, 1 ID BANSHEE MEDIC TACSOP DATED 30 JUN 17 UPLOADED. https://www.milsuite.mil/book/docs/DOC-1077213
9. Role 4 Definitive Care and Programs
a. COVID VACCINES INDICATION SUMMARY SLIDE - NOVEMBER 2021 UPLOADED BY OTSG. https://www.milsuite.mil/book/docs/DOC-1077696
b. COVID-19 CLINICAL OPERATIONS GUIDELINES GROUP PRESENTATION SLIDES 17 NOV 2021 UPLOADED. https://www.milsuite.mil/book/docs/DOC-1079864
10. CMS and MSTCs
a. FORT BRAGG MSTC FY22 SCHEDULE UPLOADED. https://www.milsuite.mil/book/docs/DOC-1071194
b. DISCUSSION: DOES THE USE OF KETAMINE IN SUSPECTED TBI INCREASE MORTALITY? https://www.milsuite.mil/book/docs/DOC-1080412
c. PSYCHOLOGICAL/PHYSIOLOGICAL EFFECTS DURING DEPLOYMENT, BLOOD PRODUCT ADMINISTRATION, IMPACT OF COLD-WATER SWIM FROM THE JOURNAL OF SPECIAL OPERATIONS MEDICINE PODCAST FALL 2021. In this episode of the JSOM Podcast, Alex and Josh start by reviewing, "Timeline of Psychologiacl and Physiological Effects Occurring During Military Deployment on a Medical Team" by Hall, et. al. Guest reviewer Rico Pesce and SSG Meredith Cole review "Blood Product Administration During Transport Throughout the US Africa Command Theater of Operation," by Schauer, et. al. Josh and Alex discuss, "Impact of a 10,000m Cold-Water Swim on Norwegian Naval Special Forces Recruits" with author Jorgen Melau. https://www.milsuite.mil/book/docs/DOC-1080392
d. MEDICAL SIMULATION TRAINING CENTER (MSTC) PROGRAM RESOURCES AND DOCUMENTS. https://www.milsuite.mil/book/docs/DOC-1080369
11. Medical Courses
a. MILITARY TROPICAL MEDICINE COURSE ANNOUNCEMENT 2022. See the Military Tropical Medicine Course - 2022 Announcement. The virtual option will open NLT 5 July 2022 with a deadline of 31 Mar 2023. It is asynchronous, self-paced, and ~110 hours of recorded lectures (equivalent to 4 weeks of didactics). https://www.milsuite.mil/book/docs/DOC-1076876
b. MCBC - MEDICAL MANAGEMENT OF CHEMICAL & BIOLOGICAL CASUALTIES COURSE. https://www.milsuite.mil/book/docs/DOC-1076962
c. TACTICAL COMBAT MEDICAL CARE (TCMC). The Tactical Combat Medical Care course is based upon the injury patterns of combat casualties and the constraints to deliver medical care on the battlefield and in urban warfare. Students will train on the concepts of tactical combat medical care given realistic scenarios to include Army equipment, supplies and evacuation capabilities during combat. https://www.milsuite.mil/book/docs/DOC-1077712
d. MEDICAL EFFECTS OF IONIZING RADIATION (MEIR) COURSE. The Medical Effects of Ionizing Radiation (MEIR) Course is post-graduate level instruction concerning the biomedical consequences of radiation exposure, how the effects can be reduced, and how to medically manage casualties. The training includes nuclear incidents that can occur on or off the battlefield and that go beyond nuclear weapons events. It covers thoroughly all four of the key subjects: health physics, biological effects of radiation, medical/health effects, and psychological effects. https://www.milsuite.mil/book/docs/DOC-1077731
12. MEDCoE Lessons Learned and Project Warrior
a. NEW PRODUCTS FROM CENTER OF ARMY LESSONS LEARNED. This month, the CALL team is working diligently to deliver the Defender Pacific 21 and Operation Allies Welcome collection reports. You should be seeing both of those products later this fall. We also have a team on the ground in Korea preparing to collect on Warfighter 22-2; this report will add to the already robust series of observations we’ve posted this year in support of the Mission Command Training Program. https://www.milsuite.mil/book/docs/DOC-1076376
b. 1QTRFY22 MEDCOE-LL-NEWSLETTER 20211027. https://www.milsuite.mil/book/docs/DOC-1075630
Please share this message with anyone seeking updates to stay current with medicine, casualty response and prevention, lessons learned, case studies, etc. It's time to increase transparency and communication rapidly and effectively to the lowest level to ensure we all have a common operating picture of medical operations. Messages will be sent on a weekly basis pending content and availability. Thanks for your time and support.
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