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A&L NET Message Summary - 28 Apr 22

A&L NET words displayed over the foggy interior of a military vehicle with two soldiers in combat uniform providing patient care and a radio mic in a hand
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1. A&L NET

a. Events added to Calendar:

(1) Special Operations Medical Association Training, Education, Scientific Assembly, and Exhibition 2-6 May 22

(2) USU Health Systems/Informatics Research Interest Group: Simple Data Analysis Using Excel – Session 2, 10 May

(3) A First-in-Class, Non-Azole, Fungicidal Treatment for Women with Vulvovaginal Candidiasis – BREXAFEMME (R) (ibrexafungerp tablets) 5 May 22

(4) 33rd Annual May Day – UNC & AMSUS Trauma Conference 5-6 May 22

(5) Help your MI patients achieve lower LDL-C and reduce the risk of another MI, 12 May

(6) Military Families Research Interest Group: Care of the Military Family 18 May

(7) Migraine Myth Busters: Exploring the Role of a Preventive Treatment Option in Patients with Migraine 18 May

(8) Advancing the Health of US Service Women HPV-Related Cancers: A Growing Threat to US Military Health and Readiness 23 Jun 22

(9) Entering a New World of Postoperative Pain Management 2 Jun 22

2. New and Updated Medical Regulations, CPGs, and Guidelines

a. ATP 3-21.18 FOOT MARCHES. Appendix A - March Procedures, Appendix B - Movement Order and Movement Table, Appendix C - Posture and Body Mechanics, Appendix D - Training for the March, Appendix E - Foot Care, Appendix F - Related Injury and Illness Awareness.

b. CHEMICAL BIOLOGICAL RADIOLOGICAL NUCLEAR INJURY RESPONSE PART 2 MEDICAL MANAGEMENT UPDATED 25 MAR 2022 ID69. The following is a review of the medical management of specific chemical agents in the continuum of care from point of injury (POI) through Role 3. More detailed information is available in the Field Management of Chemical and Biological Casualties Handbook.1 Rapid reference cards are included for each category of agent.

c. AFC PAMPHLET 71-20-12 - ARMY FUTURES COMMAND CONCEPT FOR MEDICAL 2028. Smaller, lighter, and more mobile technology. The future medical force requires new technologies to become smaller, lighter, and more mobile in order to enable freedom of maneuver. Power generation, diagnostic imaging systems, surgical instrument sterilization, and oxygen generation are mission essential, but technological advances are critical to reduce the size and weight and increase mobility.

3. Medical FORSCOM WIAS, ARNG, and USAR Positions

a. 330TH MEDICAL BRIGADE, TPU, LTC/67AA, EXECUTIVE OFFICER VACANCY, FT. SHERIDAN, IL. The 330th Medical Brigade located at Ft. Sheridan, IL, is looking for the most qualified officer to fill the position of Executive Officer. This is a TPU vacancy.

b. 807TH MEDICAL COMMAND (DS) CG'S AIDE-DE-CAMP ANNOUNCEMENT - S: 15 MAY 2022. The 807th Medical Command (DS) is soliciting applications for qualified officers in the rank of O2/1LT to fill DCG's Aide-de-Camp Position. Location: Fort Douglas, UT. Suspense: 15 May 2022.

c. 8TH MEDICAL BRIGADE, TPU, O5/67A, BRIGADE XO VACANCY, STATEN ISLAND, NY. The 8th Medical Brigade Commander is soliciting applications for BDE Executive Officer O4(P)/O5, 67A/MS, TPU, Staten Island, NY.

d. 311TH FIELD HOSPITAL HHC COMMANDER VACANCY. The 311th Field Hospital Commander is soliciting applications for TPU Commander Position Vacancy. 311th FH HHC, O3, 05A, TPU, Blacklick, OH.

4. Medical MILPERs, ALARACTS, Directives, Orders, & Announcements

a. MILPER MESSAGE 22-121, FISCAL YEAR 2024 (FY24) COLONEL (COL) ARMY MEDICAL DEPARTMENT (AMEDD) CENTRALIZED SELECTION LIST (CSL) COMMAND/KEY BILLET BOARD, ISSUED: [4/13/2022 3:45:22 PM]. Subject selection board is scheduled to convene 13-17 June 2022 to consider eligible AMEDD colonels and promotable lieutenant colonels for CSL command/key billet designated positions for FY24. The CSL board is the first phase for Command and Key Billet officer selection. The CSL board will generate the invitation list to the second phase – the Medical Command Assessment Program 24 (MCAP 24).

b. MILPER MESSAGE 22-122, FISCAL YEAR 2024 (FY24) LIEUTENANT COLONEL (LTC) ARMY MEDICAL DEPARTMENT (AMEDD) CENTRALIZED SELECTION LIST (CSL) COMMAND/KEY BILLET BOARD, ISSUED: [4/13/2022 3:53:18 PM]. Subject selection board is scheduled to convene 13-17 June 2022 to consider eligible AMEDD lieutenant colonels and promotable majors for CSL command/key billet designated positions projected for FY24. Eligible AMEDD Active Component officers will be considered for command unless they take action to decline consideration. Officers will submit their preferences for Command/Key Billet by preferencing units within the AIM2 Portal online. Eligible officers who elect not to compete for FY24 CSL must access the AIM2 Portal and submit their reason for declination.

c. ARMY DIRECTIVE 2022-06, PARENTHOOD, PREGNANCY, AND POSTPARTUM, 19 APR 22. This directive updates Army policy and executes Secretary of Defense priorities. It incorporates evidence-based health and wellness guidance to improve quality of life, promote flexibility, and enable all Soldiers to safely continue their duties, return to readiness, perform critical assignments, and advance in their careers while growing their Families. It provides new/updated guidance concerning the Army Body Composition Program (ABC), physical fitness testing, uniform policy, operational and training deferments, professional military education, lactation accommodations, fertility treatment, convalescent leave, family care plans, active duty for operational support (ADOS), parental leave for the reserve components, leader education, and policy letters.

d. MILPER MESSAGE 22-133, ADMINISTRATIVE SUPPORT TO GRADUATE MEDICAL EDUCATION (GME), ISSUED: [4/19/2022 3:55:11 PM]. Purpose. To provide administrative guidance to Army units on the selection and assignment process of Regular Army (RA) Medical Corps (MC) officers for Graduate Medical Education (GME). The Joint GME Selection Board (JGMESB) convenes annually in or about mid-November or early December to consider RA MC Officers to attend GME.

e. MILPER MESSAGE 22-134, 2022 LTC KAREN WAGNER LEADERSHIP AWARD (KWLA), ISSUED: [4/20/2022 10:55:50 AM]. The United States Army Medical Command will award the 2022 LTC Karen Wagner Leadership Award (KWLA) to three Army Medical Department (AMEDD) Human Resource Managers-70F and two DA Civilians. The purpose of the KWLA is to recognize one Regular Army, one Army Reserve, one Army National Guard Officer and two DA Civilians (1 Military HR & 1 Civilian HR) who have demonstrated principles for which LTC Wagner stood for; leadership, technical competence, professionalism, and customer service.

f. FRAGO 20 TO HQDA EXORD 225-21 COVID-19 STEADY STATE OPERATIONS (CUI), DTG: 072206Z Apr 22. This order implements in part the Undersecretary of Defense for Personnel and Readiness (USD(P&R)) memorandum, "Consolidated Department of Defense Coronavirus Disease 2019 Force Health Protection Guidance" which was issued on 4 April 2022 (Annex RRRR, see para 2 below). This document consolidates FHP policies in response to the changing COVID-19 operational environment that include updates to: health protection conditions, vaccination, clinical and surveillance testing, disease surveillance, workplace safety, travel, meetings and other actions necessary to ensure the protection of the total force.

g. ARMY MED STRATEGIC VISION. MAN– Army Medicine must cultivate workforce talent and continue to recruit, develop and retain the most skilled medical professionals. We need to identify shortages and gaps, develop interim solutions, and present these challenges with proposed solutions to our leaders.

5. Discussions on Medical Case Studies, Research, Guidelines, and Updates

a. MOBILIZING THE AMEDD PPT. Mobilizing the AMEDD presented at the JTS CCCC Prehospital CME presentation on 4/14/2022.

b. COSCCC ABSTRACTS 2ND QUARTER 2022. Hemorrhagic Resuscitation, Whole blood, Use of Dried Plasma.

c. JTS Newsletter Winter 2022. The JTS Committee on Surgical Combat Casualty Care (CoSCCC) has stepped up to address the risks involved with the increasing use of single surgeon teams (SSTs) in deployed environments. The intent is to inform medical leaders, medical planners, operational commanders, and those who generate Service requirements of the potential risks of overutilization of SSTs.

6. Army Medicine News

a. ARMY MEDICINE NEWS 22 APR 22. Key topics: USAMRIID, Dover, pregnancy, postpartum, ARMEDCOM, Suicide Prevention, World Health Organization, MEDCoE, Mask Mandate, COVID Infection, parenthood, Army Reserve Suicide, Stand for Life Program, Disabled People and Military Service, Widow, Variant Proof COVID Vaccine, 2021 Health of the Force, 32d Medical brigade.

b. ARMY MEDICINE NEWS 21 APR 22. Key topics: CDC, BAMC, Korea, WBAMC, Fort Bliss, MHS Genesis, Mask Mandate, Omicron, Invictus Training Camp, RIA Health Clinic, Culture of Care, Unvaccinated Children, Immunocompromised and COVID.

7. FORSCOM Casualty Response and Prevention

a. DEFINITION OF "TERMINATION" WITH PREGNANCY IN REGULATIONS AND DIRECTIVES. Regulation and Department of Defense Directives are not consistent with the use of the word termination with pregnancy. To me, the use of termination with pregnancy means you ARE or ARE NOT pregnant. I also feel that termination is an older term used by the DoD folks who were/are writing regulations/directives and was not intended to be associated with how we consider the term today. See below.

b. MOVING THE AMEDD FROM COIN TO LSCO: HISTORICAL PERSPECTIVE. The military is obviously looking at a different operating environment, and at different foes. We’ve been in that position before: after Vietnam, the military re‐focused from COIN to LSCO.

c. PLATOON SIZE PROLONGED FIELD CARE FTX AAR. We conducted a trial FTX for prolonged field care scenarios last December; in nutshell, Medics who had additional training such as BCT3 and ACLS were far more superior outside of providing TCCC only. Every exercise was conducted in hours of low visibility and involved POI care, movement (foot or vehicle) stabilization at Role 1 and monitoring. Once the FTX was complete then we crafted this document and submitted to MEDCOE lessons learned.

d. DISCUSSION AND ANSWER: CAN ANYONE TELL ME IF THERE IS ANYWHERE IN WRITING THAT SAYS AN FLA SHOULD NOT TOW A VEHICLE OR BE TOWED USING A TOW BAR? Only applies to the A3 variant, specifically because the patient compartment is longer and sticks out well over the trailer tongue. When using a tow bar, you MUST remove the front d-loops and have the proper "feet" to attach a tow bar. Was an OC/T at JRTC for two years and watched a few vehicles get literally destroyed because they were towed incorrectly. Also seen plenty of FLA rear corners dented from towing and turning too sharp for the rear patient compartment overhang.

e. DISCUSSION: POSTING THIS TRYING TO DISPEL THE MYTH THE WE WORK UNDER A PA'S LICENSE. The Standard Medical Operating Guidelines (SMOG) for Critical Care Flight Paramedics_2022 states: "licensed [has legal authority issued by the State (Army EMS is the 51st State) to perform the skill or role].” I've been told throughout my career that we work under the PA's medical license, but no one has been able to show me that in regulation or policy. If you have seen it in writing, please point me in the right direction.

f. DOC TO DOC: A PEER LED SUPPORT GROUP VIA ZOOM FOR MILITARY MEDICAL PERSONNEL. Doc To Doc: A peer led support group via Zoom for military medical personnel featuring self help methods to cope with PTSD and survivor guilt (now called moral injury) facilitated by Guy Lamunyon, Combat Medic 101st Vietnam, Army Psych Mental Health Nurse, retired and VA Mental Health Nurse, retired.

g. DISCUSSION AND ANSWER: LINE 3 (9-LINE MEDEVAC), HAS IT BEEN UPDATED TO REMOVE URGENT SURGICAL AND CONVENIENCE? There is a lot of confusion here that we are trying to address as OC/Ts at JMRC right now. Here is the breakdown. There is a lot of confusion here that we are trying to address as OC/Ts at JMRC right now. Here is the breakdown.

8. Combat Medic Sustainment (CMS) and Medical Simulation Training Centers (MSTC)

a. PROLONGED FIELD CARE PODCAST 98: IMPORTANT LABS IN THE AUSTERE ENVIRONMENT. You don't need lab values to solve every problem, but for some things, it can be super helpful. I spoke with Doug about what are the really important labs to bring with you.

b. FWW MSTC POSTED: NEW DEPLOYED MEDICINE RESOURCES. Keep an eye on deployed medicine. More and more information and resources are being put on the website. The updated journal watch is out as well as the Surgical Combat Casualty Care- Role 2/3 modules with CPG's, references, podcasts and more.

c. b. FWW MSTC POSTED: LESSONS FROM UKRAINE. There is a very important lesson to learn from this. Read the last two sentences very carefully and maybe a few times. As a medic you should be striving to learn more and always get better.

d. FWW MSTC POSTED: Episode 35: TC 8-800 Medical Education and Demonstration of Individual Competence (MEDIC). Definitely worth a listen. MSG Black and MSG Twilligear talk about some of the changes especially pertaining to training combat medics.

e. PROLONGED CASUALTY CARE (PCC) (PROLONGED FIELD CARE) ARMY MEDICAL JOURNAL EDITION. The Army Medical Journal (open access) put out an entire edition covering topics in Prolonged Casualty Care (PCC) (Prolonged Field Care). It's definitely worth your time to give it a quick perusal.

9. MEDCoE Lessons Learned and Project Warrior

a. COMPANY LEADERSHIP THE FIRST 100 DAYS LESSONS AND BEST PRACTICES. This handbook serves as a primer for those who will lead a company as either a commander, first sergeant, or executive officer. It focuses on those first 100 days in position and aims to assist these leaders in thinking through their approach to their new leadership positions.

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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REVOKE MEMBERSHIP: If you no longer wish to be a member of A&L NET go to the A&L NET Home Page, look on the right side of the screen for the "Actions" box, and click on “Leave Community.”

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