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Journal of the Royal Army Medical Corps

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https://www.readbyqxmd.com/read/30228195/vascular-access-training-for-reboa-placement-a-feasibility-study-in-a-live-tissue-simulator-hybrid-porcine-model
#1
Boudewijn L S Borger van der Burg, T M Hörer, D Eefting, T T C F van Dongen, J F Hamming, J J DuBose, M Bowyer, R Hoencamp
BACKGROUND: The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with severe haemorrhagic shock is increasing. Obtaining vascular access is a necessary prerequisite for REBOA placement in these situations. METHODS: During the EVTM workshop (September 2017, Örebro, Sweden), 21 individuals participated in this study, 16 participants and five instructors. A formalised curriculum was constructed including basic anatomy of the femoral region and basic training in access materials for REBOA placement in zone 1...
September 17, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30206102/-bastard-bush-acacia-thorn-injuries-and-management
#2
Simon Johnstone Smail, C Arthur, K Hylands, C J Stewart
This case report outlines the presentation and management of a young soldier who sustained a lower limb acacia thorn injury while on exercise in Kenya. The injury failed to heal with a subsequent ultrasound scan revealing a large retained thorn requiring surgical removal and wash out. From this case, lessons can be learnt regarding the management of thorn injuries, which are common in exercising troops in Kenya and indeed around the world. The key take-home messages are always consider a retained thorn if wounds fail to settle, use ultrasound as the imaging modality of choice, always remove identified retained thorns and if antibiotics are required use broad-spectrum antibiotics pending culture results...
September 10, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30181381/negative-pressure-temporary-abdominal-closure-without-continuous-suction-a-solution-for-damage-control-surgery-in-austere-and-far-forward-settings
#3
Edwin Robert Faulconer, A J Davidson, D Bowley, J Galante
The use of topical negative pressure dressings in temporary abdominal closure has been readily adopted worldwide; however, a method of continuous suction is typically required to provide a seal. We describe a method of temporary abdominal closure using readily available materials in the forward surgical environment which does not require continuous suction after application. This method of temporary abdominal closure provides the benefits of negative pressure temporary abdominal closure after damage control surgery without the need for continuous suction or specialised equipment...
September 4, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30139924/hepatitis-b-in-a-vaccinated-soldier-a-case-report
#4
Keri McLean, T B Elmer, D A Freshwater, L Lamb, S D Woolley
Assessing for an adequate immunological response to a pre-exposure course of hepatitis B vaccine is not routinely recommended in all vaccinated individuals. Current UK guidelines advise checking hepatitis B surface antibody titres only in those considered at high occupational risk such as healthcare and laboratory workers. We present a case of an infantry soldier who developed acute hepatitis B despite having a complete course of hepatitis B vaccinations. This case emphasises that hepatitis B is still an important differential diagnosis for all returning military personnel who present with compatible symptoms despite being vaccinated...
August 23, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30139923/epidemiological-study-of-emergency-ambulance-activation-in-the-british-eastern-sovereign-base-area-of-cyprus-september-2013-to-august-2016
#5
Sophie Jefferys, A J Martin-Bates, A Harold, R Withnall
OBJECTIVES: To record the activation and use of the Eastern Sovereign Base Area (ESBA) emergency ambulance service of British Forces Cyprus between 1 September 2013 and 31 August 2016. To reflect on these findings in light of data from 1995 to 1998 to identify current treads and areas of development. METHOD: Retrospective epidemiological study of all activations of the ESBA emergency ambulance service within the study period. RESULTS: 812 patients were treated over 3 years, an 80% increase in workload, of which 41% were entitled personnel...
August 23, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30139922/emergency-preparedness-resilience-and-response-eprr
#6
Oliver Quantick
As an organisation, locality or nation, there is a growing need to respond to a wide range of incidents and emergencies that could affect health and the care of patients. Responses to both domestic and international incidents have shown that collaboration, understanding and joint responses across organisations have improved the outcome of those affected by incidents which impact on health. Emergency response is something that is of increasing importance and has been tested on multiple occasions during recent events in the UK...
August 23, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30127069/response-to-reboa-at-role-2-afloat-resuscitative-endovascular-balloon-occlusion-of-the-aorta-as-a-bridge-to-damage-control-surgery-in-the-military-maritime-setting-by-rees-et-al
#7
https://www.readbyqxmd.com/read/30127068/for-debate-health-service-support-planning-for-large-scale-defensive-land-operations-part-1
#8
EDITORIAL
Martin Bricknell, A Finn, J Palmer
This is the first of two articles that considers the medical planning implications of large-scale defensive military operations. This paper considers the military context and planning factors that may require a medical plan that is different from that seen in recent counterinsurgency operations. The scale and complexity of the challenge is likely to require a greater level of decentralisation and a more sophisticated approach to medical planning at the strategic and operational levels.
August 19, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30127067/for-debate-health-service-support-planning-for-large-scale-defensive-land-operations-part-2
#9
EDITORIAL
Martin Bricknell, A Finn, J Palmer
This is the second of two articles that considers the medical planning implications of large-scale defensive military operations. This paper describes a unified approach to theatre level health services support planning based on four phases: collection, hospitalisation, evacuation and reception. It highlights the need for a modular and agile system of medical capability building blocks that can be grouped together for specific military medical challenges. It also reintroduces the concepts of mass casualty and the medical reserve...
August 19, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30127066/should-we-prioritise-victims-over-terrorists-in-medical-triage
#10
EDITORIAL
Zohar Lederman, T C Voo
Whether injured terrorists should receive equal consideration in medical triage as their victims is a morally and emotionally challenging issue for healthcare providers. Against the conventional approach, some commentators have argued for a 'victims-first' principle in which severely injured victims should always be prioritised over an injured terrorist even if the terrorist is worse off based on justice ideas. This paper argues that supporters of 'victims-first' fail to sufficiently justify the subversion of the equal rights of terrorists to treatment and the role and professional ethics of healthcare providers in the allocation of scarce medical resources...
August 19, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30127065/reboa-in-the-role-2-afloat-environment
#11
Mansoor Khan
No abstract text is available yet for this article.
August 19, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30093376/influence-of-rib-impact-on-thoracic-gunshot-trauma
#12
Samantha Alda Rodrigues, J Guey, T C H Plummer, A Pullen, B Shaw, D C Kieser
INTRODUCTION: The influence of rib impact on thoracic gunshot trauma remains unclear, despite its high occurrence. This study therefore investigates the effect of rib impact on a bullet's terminal properties and injury severity. METHODS: Two bullets were used: 5.56×45 mm (full charge and reduced charge) and 7.62×51 mm (full charge). For each bullet, three impact groups were tested: (1) plain 10% ballistic gelatin (control) conditioned at 4°C, (2) intercostal impact, and (3) rib impact, the latter two tested with samples of porcine thoracic walls embedded in gelatin...
August 8, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30077975/nursing-and-medical-contribution-to-defence-healthcare-engagement-initial-experiences-of-the-uk-defence-medical-services
#13
Douglas M Bowley, D Lamb, P Rumbold, P Hunt, J Kayani, A M Sukhera
INTRODUCTION: The WHO Constitution enshrines '… the highest attainable standard of health as a fundamental right of every human being .' Strengthening delivery of health services confers benefits to individuals, families and communities, and can improve national and regional stability and security. In attempting to build international healthcare capability, UK Defence Medical Services (DMS) assets can contribute to the development of healthcare within overseas nations in a process that is known as Defence Healthcare Engagement (DHE)...
August 4, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30077974/primary-blast-lung-injury-simulator-a-new-computerised-model
#14
Mainul Haque, A Das, T E Scott, D Bates, J G Hardman
Mathematical modelling and computational simulation are becoming increasingly important tools in many fields of medicine where in vivo studies are expensive, difficult or impractical. This is particularly the case with primary blast lung injury, and in this paper, we give a brief overview of mathematical models before describing how we generated our blast lung injury simulator and describe some early results of its use.
August 3, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30076199/country-wide-surveillance-of-norovirus-outbreaks-in-the-portuguese-army-2015-2017
#15
António Lopes-João, J R Mesquita, R de Sousa, M Oleastro, C Silva, C Penha-Gonçalves, M S J Nascimento
INTRODUCTION: Gastrointestinal infections are among the most common foodborne and waterborne diseases in military populations, with direct implications in operational efficiency and force readiness. Through the surveillance system of reportable acute gastrointestinal illness in the Portuguese Army, four norovirus outbreaks were identified between October 2015 and October 2017 in mainland Portugal and the Azores archipelago. The present study documents the epidemiological, clinical and laboratory investigations of these norovirus outbreaks...
August 3, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30054371/dispatches-from-the-editor-emergency-preparedness-resilience-and-response-eprr
#16
Johno Breeze, D Ross
No abstract text is available yet for this article.
July 26, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30045928/military-aid-to-the-civil-authorities-a-defence-medical-services-perspective
#17
Stuart Millar, I B F Lane
This paper describes the policy and principles for the provision of Military Aid to the Civil Authorities (MACA). It emphasises the importance of following the proscribed process in order to avoid possible political, legal, reputational and financial pitfalls. It outlines the broader military application of MACA before focusing on where the Defence Medical Services can contribute, drawn from recent experiences and identifying other capabilities that may be of utility. It draws heavily from Joint Doctrine Publication 02 and is quoted with the agreement of the Developments, Concepts and Doctrine Centre...
July 25, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30037902/response-to-howard-et-al-howard-m-bakker-dyos-j-gallagher-l-et-al-power-supplies-and-equipment-for-military-field-research-lessons-from-the-british-service-dhaulagiri-research-expedition-2016-journal-of-the-royal-army-medical-corps-2018-164-41-45
#18
https://www.readbyqxmd.com/read/30037901/dispatches-from-the-editor-emergency-preparedness-and-clinical-military-aid-to-the-civilian-authorities
#19
Andrew Hollingsworth, J Breeze
No abstract text is available yet for this article.
July 23, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/30012666/responding-to-the-marauding-terror-attack-the-police-perspective
#20
Sean Wheatley, A C Hollingsworth, I Greaves
UKpolice forces have had to adapt their tactical approach to the emerging terror threat that now faces the UK. This has led to an evolution in the training, education and conduct of authorised firearms officers and an increased capability in the provision of immediate lifesaving care to injured casualties. This article intends to describe the police response to a marauding terror attack and describes the medical capabilities authorised firearms officers possess in order to educate other emergency service responders to such an event...
July 16, 2018: Journal of the Royal Army Medical Corps
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