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Journal of the Royal Army Medical Corps

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https://www.readbyqxmd.com/read/28794008/long-term-employment-outcomes-following-rehabilitation-for-significant-neurological-impairment-in-uk-military-personnel-a-3-year-study
#1
Sardar Bahadur, J McRann, E McGilloway
BACKGROUND: Returning to employment is a major modifiable factor affecting long-term health in brain injury which neurological and vocational rehabilitation attempts to address. In military patients, little is known about long-term employability, whether employment is sustained and how they fare in civilian roles. METHODS: A telephone review was undertaken of every military patient having undergone inpatient neurorehabilitation between 2012 and 2014. This was compared to their employment outcomes one to three years post discharge...
August 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28794007/the-future-of-resuscitative-endovascular-balloon-occlusion-in-combat-operations
#2
Shane A Smith, R Hilsden, A Beckett, V C McAlister
Damage control resuscitation and early thoracotomy have been used to increase survival after severe injury in combat. There has been a renewed interest in resuscitative endovascular balloon occlusion of the aorta (REBOA) in both civilian and military medical practices. REBOA may result in visceral and limb ischaemia that could be harmful if use of REBOA is premature or prolonged. The purpose of this paper is to align our experience of combat injuries with the known capability of REBOA to suggest an implementation strategy for the use of REBOA in combat care...
August 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28794012/surgeon-major-thomas-heazle-parke-1857-1893-irish-doctor-soldier-and-explorer
#3
EDITORIAL
Andrew Parke
Surgeon Major Thomas Heazle Parke (1857-1893) was a doctor from Drumsna, County Roscommon, who after completing his education at the Royal College of Surgeons in Ireland joined the British army as a medical officer. After several years of serving in Ireland and Egypt, he volunteered to be medical officer of the Emin Pasha Relief Expedition of 1887-1889. This was to become Henry Morton Stanley's largest, longest and most controversial African expedition. The epic journey saw Stanley, his eight European officers and 800 African porters take almost 3 years to cross the African continent from West to East via the Congo River, Southern Sudan and Uganda...
August 8, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28794011/beyond-bombs-and-bayonets-defence-engagement-and-the-defence-medical-services
#4
EDITORIAL
John Whitaker, D Bowley
No abstract text is available yet for this article.
August 8, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28794010/an-unusual-case-of-an-immersion-hand-presentation-in-a-young-signaller-operating-in-the-jungle-in-belize
#5
Kirstie E Forbes, P Foster
Belize, hosting one of the British Army's overseas training areas, provides access to challenging terrain and austere environments, which allows the delivery of training to soldiers on survival and combat within the jungle environment. A 26-year-old infanteer on exercise in Belize presented with progressive bilateral dry, painful, oedematous hands, secondary to the harsh environmental conditions of the jungle and inadequate drying of his hands resulting in his inability to perform his combat duties. The symptoms completely resolved with drying, emollient application and analgesia...
August 8, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28794009/commentary-parachute-group-o-low-titre-polo-program
#6
EDITORIAL
Paul Parker, H Doughty
No abstract text is available yet for this article.
August 8, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28739579/the-prospective-validation-of-the-modified-physiological-triage-tool-mptt-an-evidence-based-approach-to-major-incident-triage
#7
James Vassallo, S Horne, J E Smith, L A Wallis
INTRODUCTION: Triage is a key principle in the effective management of major incidents. There is limited evidence to support existing triage tools, with a number of studies demonstrating poor performance at predicting the need for a life-saving intervention. The Modified Physiological Triage Tool (MPTT) is a novel triage tool derived using logistic regression, and in retrospective data sets has shown optimum performance at predicting the need for life-saving intervention. MATERIALS AND METHODS: Physiological data and interventions were prospectively collected for consecutive adult patients with trauma (>18years) presenting to the emergency department at Camp Bastion, Afghanistan, between March and September 2011...
July 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28652316/the-modified-jo-burg-technique-for-securing-intercostal-chest-drains
#8
Daniel J Ablett, L Navaratne, D Chua, C G Streets, N R M Tai
Insertion of an intercostal chest drain (ICD) is a common intervention in the management of either blunt or penetrating thoracic trauma. It is frequently performed by junior medical personnel as an emergency procedure during the initial resuscitation period and often within a stressful environment. Approximately one-fifth of all ICD insertions are associated with complications. In a retrospective review of over 1000 ICD insertions, 7% of the complications observed were due to inadequate fixation, resulting in dislodgement...
June 26, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28596180/the-non-combatant-status-importance-and-implications-for-medical-personnel
#9
EDITORIAL
Daniel Wilkins, C Dieppe
Under the laws of armed conflict military medics are deemed non-combatants, and as such are subject to certain protections and limitations. The non-combatant status is defined in the famous Geneva Conventions, which form the basis of the international law of armed conflict. The protections afforded to medical personnel in armed conflict are a result of the need to protect and treat the sick and injured during times of hostility. This paper describes the history and legal development of the non-combatant status, and summarises the importance and implications of the contents of the Geneva Conventions that are relevant to medical personnel as non-combatants...
June 8, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28775163/highlights-of-this-edition
#10
John Breeze
No abstract text is available yet for this article.
August 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#11
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
August 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28148551/towards-research-combat-readiness-prepared-prospective-and-preapproved
#12
EDITORIAL
David N Naumann, N Eisenstein, D S Burns, S A Stapley
Research drives the advancement of medical knowledge during war, but planning and execution are too slow to enable early data acquisition. Future conflicts are likely to be shorter and more dispersed, requiring innovation to avoid missing out on the crucial early stages. To seize the initiative, we suggest that a collection of preapproved research studies be designed, stored and maintained within the medical command structure so that they are ready for immediate implementation at the onset of future conflicts, even during the most kinetic early phases of deployment...
August 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#13
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
August 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28062527/lessons-from-the-organisation-of-the-uk-medical-services-deployed-in-support-of-operation-telic-iraq-and-operation-herrick-afghanistan
#14
Martin C M Bricknell, M Nadin
This paper provides the definitive record of the UK Defence Medical Services (DMS) lessons from the organisation of medical services in support of Operation (Op) TELIC (Iraq) and Op HERRICK (Afghanistan). The analysis involved a detailed review of the published academic literature, internal post-operational tour reports and post-tour interviews. The list of lessons was reviewed through three Military Judgement Panel cycles producing the single synthesis 'the golden thread' and eight 'silver bullets' as themes to institutionalise the learning to deliver the golden thread...
August 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28432197/colonel-rtd-peter-roberts
#15
LETTER
Jeff Garner
No abstract text is available yet for this article.
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28249956/long-term-follow-up-of-two-patients-with-retained-intraosseous-sternal-needles
#16
James M Hodgetts, A Johnston, J Kendrew
Sternal intraosseous devices are widely used in both civilian and military trauma when vascular access is difficult to establish. We discuss a rare complication of intraosseous needle insertion in two patients where the needle tip remained in the sternum after the device had been removed. Neither patient had evidence of any complication of the retained intraosseous needle tip after >6 years of follow-up.
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28213615/force-health-protection-during-the-ebola-crisis-french-experience-in-guinea
#17
LETTER
Franck Berger, G Bédubourg, A Facon, S Boyavalle, H Michel, G Velut, S Duron
No abstract text is available yet for this article.
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27940985/military-personnel-sustaining-lisfranc-injuries-have-high-rates-of-disability-separation
#18
George C Balazs, M G Hanley, G J Pavey, J-Ph Rue
OBJECTIVES: Lisfranc injuries are relatively uncommon midfoot injuries disproportionately affecting young, active males. Previous studies in civilian populations have reported relatively good results with operative treatment. However, treatment results have not been specifically examined in military personnel, who may have higher physical demands than the general population. The purpose of this study was to examine rates of return to military duty following surgical treatment of isolated Lisfranc injuries...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27909067/concept-and-evaluation-of-the-german-war-surgery-course-einsatzchirurgie-kurs-der-bundeswehr
#19
David A Back, K Waldmann, T Hauer, N Huschitt, M W Bowyer, U Wesemann, A Lieber, C Willy
INTRODUCTION: Military surgeons must be prepared to care for severe and complex life-threatening injuries rarely seen in the civilian setting. Typical civilian training and practice do not provide adequate exposure to the broad set of surgical skills required. The German Bundeswehr Medical Service has developed and refined the War Surgery Course (WSC) to meet this training gap. This article describes the recent experience with this readiness curriculum. METHODS: Run annually since 1998, WSC consists nowadays of 5 days with 20 theoretical modules...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27903839/the-effect-of-brain-tomography-findings-on-mortality-in-sniper-shot-head-injuries
#20
Çağdaş Can, M Bolatkale, A Sarıhan, Y Savran, A Ç Acara, M Bulut
OBJECTIVES: Penetrating gunshot head injuries have a poor prognosis and require prompt care. Brain CT is a routine component of the standard evaluation of head wounds and suspected brain injury. We aimed to investigate the effect of brain CT findings on mortality in gunshot head injury patients who were admitted to our emergency department (ED) from the Syrian Civil War. METHODS: The study group comprised patients who were admitted to the ED with gunshot brain injury...
June 2017: Journal of the Royal Army Medical Corps
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