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Every Knox County Sheriff’s Office patrol deputy will soon be carrying an item that can save his or her life just as easily it can help an injured citizen.

It is a combat tournique, that can be easily self-applied by an injured deputy, or applied by a deputy to a fellow officer or other party, to stem the bleeding from a traumatic injury to an arm or leg.

Sheriff Jimmy “J.J.” Jones announced on Monday that the tourniquets have been acquired through a $4,400 grant from the Spirit of Blue Foundation, a nonprofit charity dedicated to improving the safety of law enforcement officers.

Additionally, the police equipment company Blue Force Gear has donated special traps designed for attaching the tourniquets to duty gear. ​

KCSO credits such a tourniquet with saving the life of Sgt. Mike Ledbetter, who was struck in the leg by a ricochet from friendly fire on June 20, 2013, during a situation involving an armed and barricaded suspect.

At the time, the tourniquet was standard issue only for KCSO’s swat team, of which Ledbetter was a member.

The Knox County Sheriff's department received a $4,404 grant from The Spirit of Blue Foundation to purchase 100 Combat Applications Tourniquets and 125 Tourniquet Now Straps for use by officers in the event of a traumatic extremity injury. The grant was made possible by a gift from Blue Force Gear. (J. MILES CARY/NEWS SENTINEL)

The Knox County Sheriff's department received a $4,404 grant from The Spirit of Blue Foundation to purchase 100 Combat Applications Tourniquets and 125 Tourniquet Now Straps for use by officers in the event of a traumatic extremity injury. The grant was made possible by a gift from Blue Force Gear. (J. MILES CARY/NEWS SENTINEL)

In a prepared statement released at Monday’s news conference, Ledbetter said: “I know the reason I am alive today is because one of the SWAT team members had a combat tourniquet, and two others members knew how to use it. The tourniquet saved me, and could save other officers as well.”

Without the tourniquet, “He could easily have bled out,” Deputy Chief Clyde Cowen said.

The benefits of having such a tourniquet handy “became obvious to everyone,” Cowen said.

The “Combat Application Tourniquet” is manufactured by North American Rescue and has proved effective by the U.S. Army’s Institute of Surgical Research.

The Spirit of Blue Foundation, based in Chicago, works to raise money and find other sources of revenue and contributions to pay for safety equipment for law enforcement agencies. It often partners with other nonprofits, retailers and manufacturers to achieve that goal.

“We try to match agencies up with their specific needs,” said Spirit of Blue board member Andrew Heltsley, who was in Knoxville for the grant announcement.

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The Uniformed Services University (USU) is partnering with the Armed Services to develop and implement the Enlisted to Medical Degree Preparatory Program (EMDP2). The EMDP2 is 24-month program that will enable highly-qualified enlisted service members to complete the preparatory coursework for application to medical school while maintaining an active duty status. EMDP2 candidates will include service members who demonstrate integrity, are passionate about service in harm's way, and are dedicated to becoming future clinicians, leaders and scholars of the nation's medical force. Candidates will reflect the diversity of our Armed Forces.

Criteria/Admission Requirements: Candidates must possess a baccalaureate degree from an accredited academic institution with a minimum of a 3.2 grade point average (GPA) and meet Service requirements for commissioning.

Criteria/Admission Requirements

Armed services will provide additional admission requirements. The projected start date for the first cohort of EMDP2 candidates is July 2014. Please see Frequently Asked Questions for more information.

Program components will include full-time coursework in a traditional classroom setting (in the Washington DC area), structured pre-health advising, formal Medical College Admission Test (MCAT) preparation, dedicated faculty and peer mentoring at USU, and integrated clinical exposure. Upon completion of the program, the successful student should be a competitive applicant to medical school.

Members must apply and be selected through their respective armed service.

For more information please contact:

Althea Green Dixon, 301-295-3198 or
NaShieka Knight 301-295-3103 or

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Click here for more information - World's First Prehospital REBOA Performed in UK.


The compensatory reserve index can predict when a patient will go into shock from internal injuries. U.S. Army Institute of Surgical Research photo.

Battlefield medics and emergency responders have seen it before: a patient with no visible wounds suddenly goes into shock from internal bleeding.

At that point, no matter how fast medical personnel respond, "the patient can still die," said Lt. Col. Will Smith, an emergency medicine physician in the Army Reserve. By the time a patient "crashes," or goes into shock, the body has difficulty keeping the brain and heart functioning. Early recognition and treatment of shock is paramount to saving the life of a patient with internal injuries, he said.

It's tough to predict shock before it happens, but that could be about to change. Researchers at the U.S. Army Institute of Surgical Research, in collaboration with colleagues at the University of Colorado, Children's Hospital Colorado and Flashback Technologies, Inc., have developed software that can predict when a patient will go into shock.

Clinical trials have been completed on the software, called a compensatory reserve index, and the results will be submitted to Food and Drug Administration within the next couple of months along with a request for approval of the software as a medical device.

Among the first people to try out the prototype has been Army Surgeon General Patricia Horoho, who called it a "game changer" during a visit to the Army Institute of Surgical Research in San Antonio last year.

"It could revolutionize how we take care of patients in both the pre-hospital as well as the hospital setting," agreed Smith, who heard about the device in March and immediately asked for a prototype. "If this device can be validated and receive clinical approval, then it has an amazing potential to save lives."

Smith, who is now deployed in the Middle East, is eager to try out the device, which combines the software with a common medical device called a pulse oximeter, a small portable instrument that measures heart rate and the level of oxygen in the blood.

A tool like the compensatory reserve index "would be very helpful" to predict which patients need to be flown to a Level 1 trauma center, he said.

Victor Convertino, the researcher at the institute whose work was instrumental in the development of the software, can barely contain his excitement. His enthusiasm is matched by others. Convertino received an award from the Journal of Emergency Medical Services earlier this year as a top innovator in the field.

The index will be important for triage, Convertino said, because battlefield conditions - lots of noise, lots of adrenaline and not much equipment -- make diagnosis especially hard.

"Combat medics feel for a pulse, talk to the patient. [But the patient has] a big rush of adrenaline. They'll say, 'I'm fine. I'm doing OK, don't worry about me.' The medic is getting all these signals that a casualty is OK. Then all of a sudden they go out."

A collaborative research effort between the Army Institute of Surgical Research and the Department of Obstetrics at San Antonio Military Medical Center will provide an opportunity to test how well the compensatory reserve index tracks blood loss during childbirth. Convertino says postpartum hemorrhage is a major cause of maternal death, especially in the developing world.

"Obstetricians often have difficulty recognizing the actual amount of bleeding and predicting how well the mother will compensate. With this tool, we believe we're going to save the lives of mothers," he said.

The index tracks arterial waveforms, waves of blood pressure created as the heart pumps blood into the vessels. Within 30 seconds, it determines the rate at which the patient is using up his "compensatory reserve"- the body's ability to compensate for blood loss by directing blood flow to the heart and brain.

The body's compensatory reserve is like the gas that fuels a car's performance, Convertino said. The compensatory reserve index "is the gas gauge."

A small screen on the prototype uses green, yellow and red to denote how much of a patient's reserve has been used. Green indicates the patient is still strong, yellow that he is weakening, and red that he is in imminent danger of crashing.

After "training" the software to recognize the patterns in a patient's vital signs that precede shock, researchers analyzed old medical data from actual patients to see whether it could successfully predict shock. The software was so accurate that in one case it could have saved a patient by warning doctors well before she actually died.

"She was in the red [zone] hours before they lost her," Convertino said. "Remember the story of Korey Stringer?" he asked. Stringer was an offensive tackle for the Minnesota Vikings football team who died of heatstroke during training in 2001. "This would have given fair warning that they had to get him off the field."

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​Army device developed in San Antonio could save lives in combat...

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Dr. Donald H. Jenkins, a retired colonel (U.S. Air Force trauma surgeon ) and currently the director of the trauma center at the Mayo Clinic (Rochester, MN), who pioneered innovative ways to stop battlefield bleeding was presented the highest honor that The American Legion can bestow, the Distinguished Service Medal, at the 96th National Convention on Aug. 26, 2014.

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​I was asked by Colonel Kevin O’Connor, MD who is on the National Security Staff and is the physician to the vice president to meet with Vice President Biden.  The subject of the meeting was increasing survival from mass casualty events.  There is considerable and increasing concern especially with the events both in the Middle East and in Missouri that the country needs to increase its preparedness for mass casualty shooting or explosion events.  The Vice President had been briefed by National Security Staff on the activities of the Hartford Consensus and the work that had been done here at Hartford Hospital to teach the administrative, clinical, and non-clinical staff in the use of tourniquets in hemorrhage control.  He was also aware of the placement of bleeding control bags in public places beside Automatic External Defibrillators.  He commented that this work had been nationally recognized and that he commended the leadership for implementing these activities.
A chronology of the events leading up to this briefing is as follows:
  • Hartford Consensus I and II developed and implemented in April 2013 and July 2013 with representatives from a select group of public safety organizations including law enforcement, fire, prehospital care, trauma care, and the military.. 
  • Development and implementation of a national policy by the U.S. Fire Administration, Homeland Security, and FEMA to implement the Hartford Consensus recommendations.  September 2013.
  • Mass Casualty Shooting: Saving the Patients. The Hartford Consensus, Annual Meeting at the American College of Surgeons, Washington DC.  October 2013.
  • Conference for Federal and National Stakeholders regarding Improving Survivability in Intentional Explosive Devices and Active Shooter Incidents. Washington, DC. February, 2014.
  • Formal briefing to the National Security Council at the White House.  This included General Woodson, the Commander responsible for all military medicine for the United States.   March 31, 2014.
  • Presentation to the Tactical Casualty Care Committee of the United States Military at their meeting in Atlanta, GA on August 6, 2014.  This included representation from all branches of the military: Army, Navy, Air Force, Marines, and Special Services.  There was special interest in how the Hartford Consensus was developed and implemented.
  • 12,000 FBI agents trained in hemorrhage control with dissemination of hemorrhage control kits
  • 80,000 police officers trained nationwide,
  • Training has been initiated for 1,200 Connecticut State Troopers.
  • Embedding bleeding control devices every 5 miles at the Boston Marathon, 2014.  
Over 200 runners with bleeding control kits were interspersed with the runners in the Marathon.
  • Tourniquet training and bleeding control bags placed in public places at Hartford Hospital beside automatic external defibrillators.
We are significantly increasing the preparedness of the nation to be ready to improve survival in the event that there is a major explosion or mass casualty event in a public place in the United States.
Lenworth M. Jacobs, MD, MPH, DSc(Hon), FACS, FWACS (Hon)
Vice President of Academic Affairs and Chief Academic Officer
Chairman, The Trauma Institute
Hartford Hospital
Professor of Surgery
Professor and Chairman
Department of Traumatology and Emergency Medicine
Assistant Dean, Academic Affairs
University of Connecticut Health Center

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​On September 30, the Centers for Disease Control and Prevention (CDC) confirmed, through laboratory tests, the first case of Ebola to be diagnosed in the United States in a person who had traveled to Dallas, TX from Liberia.  CDC and the Office of the Assistant Secretary for Preparedness and Response have been anticipating and preparing for a case of Ebola in the United States. CDC and ASPR aim to increase understanding of the Ebola virus disease (EVD) and encourage widespread preparation for managing patients with EVD and other infectious diseases.  At the request of Dr. Nicole Lurie, the Assistant Secretary for Preparedness and Response, we are sending you the attached links to guidance that you may find useful and request that you share this information as widely as possible. 

Although the risk of an Ebola outbreak in the United States is very low, it is important for healthcare providers, facilities, and coalitions to remain vigilant and take steps to be as prepared as possible to protect our communities and our nation from emerging infectious diseases such as EVD.  CDC has numerous published resources and references to help you prepare and guidance posted on these resources may change as experts learn more about EVD.  You should frequently monitor the CDC’s Ebola website for up-to-date information.


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​Clic​k here to read more about a US Marine who survived headshot in Afghanistann.

A New Turn for Tourniquets-Outdated fears about tourniquet use need to be put to rest.
Wartime advances in trauma care are coming back to help civilians

​FDA Approves Disruptive Medical Device​​ - an aide to stop bleeding out.

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