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A&L NET milBook Message Summary - 27 Oct 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
Aid And Litter NET on milSuite

1. Aid and Litter NET milBook

a. Events added to Calendar:

(1) A First-in-Class, Non-Azole, Fungicidal Treatment for Women with Vulvovaginal Candidiasis – BREXAFEMME (R) (ibrexafungerp tablets) 16 Jun 22

(2) Help your MI patients achieve lower LDL-C and reduce the risk of another MI 21 Jun 22

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

(4) FRSD LL Seminar - 30 Jun 22

(5) Migraine Myth Busters: Exploring the Role of a Preventive Treatment Option in Patients with Migraine 20 Jul 22

(6) Advancing the Health of US Service Women – Webinar Series Development of a Vaginal and Urinary Symptom Self-Diagnosis and Self-Treatment Kit for Deployed Military Women 21 Jul 22

(7) XCOPRI® (cenobamate tablets) CV For The Treatment of Partial-Onset Seizures in Adults 28 Jul 22

(8) 2022 Joint Services Symposium on Emergency Medicine 25-26 Aug 22

b. CALLING ALL MEDICAL LEADERSHIP AND A&L NET MEMBERS. If you have a product that you worked hard on and are proud of, donate it to A&L NET for others to use. This month, we are calling for BEB Medical Platoon SOPs, but will accept anything you wish to donate. Go to the following link, donate your products, and help others.

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

a. US ARMY DOCTRINE SMARTBOOK. The Doctrine Smart Book is a concise collection of Army doctrine summaries that reflects current approved doctrine and is prepared by the Combined Arms Center at Fort Leavenworth, Kansas. Part one of the Doctrine Smart Book provides a visual representation of the Army’s capstone and keystone doctrinal hierarchy.

b. HYPERKALEMIA AND DIALYSIS IN DEPLOYED SETTING UPDATED 25_APR_2022_ID52. Acute kidney injury (AKI) is a recognized complication of combat trauma. According to the Department of Defense Trauma Registry (DoDTR) data, AKI was listed as a complication in 0.6% of combat casualties. This is likely an under-representation of the real incidence as it was required to be listed as a complication in the available documentation.

3. Medical FORSCOM WIAS, ARNG, and USAR Positions

a. 75TH FIELD HOSPITAL, TPU, E-8/MSG, 68W5M, 1SG/FIELD HOSPITAL SENIOR ENLISTED ADVISOR, TUSCALOOSA, AL. SUMMMARY OF DUTIES: The 1SG serves as the Senior Enlisted Advisor to the HHC Commander. 1SG duties include the following, but not limited to, mission command of the field hospital and attached hospital augmentation detachment and teams; supervises and coordinates the operations and administrative services; provides logistical functions for the hospital element and attached units, to include general and medical supplies; environmental control or training, administration, professional development, personnel accountability, safety, morale, and mentoring of all assigned Soldiers.

b. SOLDIER RECOVERY UNIT (SRU), POSITION ID 276261, CO-ADOS, O3/66H, NURSE CASE MANAGER, FORT DRUM, NY. SUMMARY OF DUTIES: Nurse Case Manager (NCM) is a registered nurse responsible for coordinating the healthcare needs of patients in the Soldier Recovery Unit (SRU). The NCM plans, facilitates, and advocates for medical services to meet the Patient’s needs, at the same time ensuring quality cost effective use of resources. Collaborates with the multidisciplinary healthcare team and Chain of Command to maintain forward progression of care. Facilitates a team approach in order to maximize care coordination efforts across the health care system. Functions as an integral part of the care triad to individualize Patients care plan.

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

a. MILPER MESSAGE 22-227, INTERSERVICE PHYSICIAN ASSISTANT PROGRAM (IPAP) ARMY SELECTION BOARD RESULTS FOR 31 MAY -3 JUNE 2022, ISSUED: [6/15/2022 10:40:32 AM]. This message provides the results of the FY 22 IPAP selection board for Regular Army (RA) component and United States Army Reserve (USAR) Component.

b. ALARACT 039/2022, 2023 CSM JACK L. CLARK, JR. U.S. ARMY BEST MEDIC COMPETITION, FORT POLK, LA, 23 - 27 JANUARY 2023 (CUI), DTG: R 141430Z JUN 22. The ABMC is intended for Active Army, U.S. Army National Guard, and U.S. Army Reserve to challenge current Expert Field Medical Badge (EFMB), Combat Medic Badge (CMB) recipients. Competitors earn points towards becoming the Army’s best medic team through successful completion of evaluated events during the testing phases. The winning team claims the title as the Army’s Best Medic Team.

c. MILPER MESSAGE 22-215, PURPLE HEART FOR PERFORATED EARDRUM, ISSUED: [6/8/2022 10:56:37 AM]. Effective immediately, the U.S. Army will recognize a perforated eardrum (ruptured tympanic membrane) as a qualifying injury for award of the PH provided all requirements listed in this message are met.

d. MILPER MESSAGE 22-208, FISCAL YEAR (FY) 2023 DISTRIBUTION CYCLE ARMY MEDICAL DEPARTMENT (AMEDD) VETERINARY NOMINATIVE COMMANDS, ISSUED: [6/3/2022 2:37:18 PM]. In accordance with EXORD 241-21, selection and slating for AMEDD Veterinary Corps Nominative Commands (VNCs) (not selected through the CSL process) will be conducted outside the assignment interactive module 2.0 (AIM2) marketplace using a talent management panel. The VNC commands are an "opt-in" command selection process.

e. MILPER MESSAGE 22-207, FISCAL YEAR (FY) 2023 ARMY MEDICAL DEPARTMENT (AMEDD) DENTAL CORPS NOMINATIVE COMMANDS, ISSUED: [6/3/2022 2:34:52 PM]. In accordance with EXORD 241-21, AMEDD Field Grade Dental Commands will be completed outside of the Army Talent Alignment Process marketplace. Selections for the Dental Corps Nominative Commands (DNC) will be conducted through a Dental Corps Talent Management Panel. The DNC commands are an "opt-in" command selection process.

f. MILPER MESSAGE 22-205, FISCAL YEAR 2024 (FY24) COLONEL (COL) ARMY MEDICAL DEPARTMENT (AMEDD) SENIOR NOMINATIVE COMMAND (SNC) SELECTION PANEL, ISSUED: [6/3/2022 2:28:28 PM]. The Army Medical Department (AMEDD) Senior Nominative Command (SNC) selection panel will convene on 15 September 2022 to consider nominations for projected Fiscal Year 2024 (FY24) SNC positions.

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

a. JTS NEWSLETTER SPRING 2022 EDITION. JTS is working with the Armed Services Blood Program to develop guidelines for pre-deployment whole blood donor screening for the Military Departments (MILDEPs) and the U.S. Marines in accordance with DoD Instruction (DODI) 6480.04 Armed Services Blood Program (ASBP), 07 Jan 2022.

b. SLOW AND RISKY TO SAFE AND BRISKLY MODERN IMPLEMENTATION OF WHOLE BLOOD. During World War I, a most important concept that Cannon and colleagues noted was the efficacy of hypotensive resuscitation. They also found that the administration of saline worsens acidosis and is harmful to the critically injured. Fraser and Cowell concluded in a separate article that the use of saline is unsatisfactory. The same group noted the benefits of fresh whole blood transfusions. This was the first time blood had been used in an appreciable amount in combat.

c. Ambulance Exchange Point (AXP) Ops in LSCO. Ambulance Exchange Points (AXPs) are quintessential to the successful, expeditious evacuation of casualties from Point of Injury (POI) throughout the continuum of care during Large Scale Combat Operations (LSCO) and Multi-Domain Operations (MDO). With our near-peer/peer competitors possessing anti-air assets, air medical evacuation (MEDEVAC) may not always be available to the maneuver unit, especially between the Forward Line of Troops (FLOT) to the nearest Role of Care.

6. FORSCOM Casualty Response and Prevention

a. BDE MEDOPS Products. I have attached a few different medical operations products that have been used during combat training center rotations at JMRC.

b. MULTIMODAL EVAC FROM S KOREA FOLKS. This document is a great read, but again it is from a top down perspective. LSCO and MDO is going to require Role 1's to train in uncomfortable environments, spending half a day to 2 days in a MSTC will not provide your medics the opportunity to improve. Every TTP you have should be rehearsed in a medically focused training, we tend to practice while supporting the maneuver folks.

c. CALL CATALOG 19-09 WET GAP CROSSING. The intent of this catalog is to provide a reference point for commanders and staff in support of wet gap crossing operations. The resources listed consist of current and historic doctrine, handbooks, academic research, after action reviews, and other publications.

d. ARMY NON-DEPLOYABLE REPORT AS OF EOM MAY 22. As of EoM May 22, ~62.6K or ~6.4% of the Total Army was considered Non-Deployable; Army Non-Deployable rate decreased by ~0.1% from Apr 22.

e. 10TH BEB MEDICAL PLATOON TACSOP UPLOADED. Never create your SOP from scratch. Check the Role 1 Casualty Response and Operations page for several examples and templates.

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

a. UKRAINE: PODCAST EPISODE 101. Dennis had the honor of interviewing Dr. John Quinn who’s on the ground working Role 1 medical operations for an NGO somewhere in Ukraine. The lessons being learned by John and others during the early days of this conflict and the past 8 years can be used to help those on the ground now and into the future. This is an amazing opportunity to stay informed of current events and prepare ourselves by narrowing expectations and tweaking training.

b. RESUSCITATIVE ADJUNCTS, IO AND IV ACCESS USING NVGS, AND VANCOMYCIN POWDER FOR OPEN PENETRATING TRAUMA FROM THE JOURNAL OF SPECIAL OPERATIONS MEDICINE PODCAST SPRING 2022. The Spring podcast is a little late, but well worth the wait! In this podcast, our experts Josh and Alex review articles from Dr. Alexander Iteen and Dr. Hossam Abdou. Guest Medic PJ Pelaez reviews the article from PA Brett TerBeek. Josh and Alex are joined by Dr. Jonathan Morrison, coauthor of the Swine Polytrauma article. Their discussion delves into the particulars of the research and adds an element of fidelity to the manuscript.

8. MEDCoE Lessons Learned and Project Warrior

a. Marine Air-Ground Task Force Warfighting Exercise 3-21. United States Marine Corps Air-Ground Task Force Warfighting Exercise. Note Page 24 Logistics in a Contested Environment. Line 884 and discussion of CASEVAC operations and use of the Forward Resuscitative Surgical System.


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.

JOIN INSTRUCTIONS: If you would like to receive messages on updates and posts to A&L NET, you must join community on milSuite. To join, click on the A&L NET Home Page link and sign in to milSuite with your CAC (signing in establishes your milSuite account if you didn’t have one). When you reach the A&L NET Home Page look on the left side of the page for the “Join A&L NET” widget and click it. Approval is automatic. All A&L NET members receive these messages. You must log on every 9 months to keep your account active.

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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