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Journal of the Royal Army Medical Corps

Daniel S Burns, K A Clay, M S Bailey
Undifferentiated febrile illness in a returning soldier is a common problem encountered by serving medical officers. A 32-year-old soldier presented to Birmingham Heartlands Hospital with fever and acute kidney injury after return from Borneo. Leptospirosis was suspected and empirical antibiotics were started before subsequent confirmation by serology and PCR. Leptospirosis is common in South-East Asia, and troops exercising in jungle areas, and in the UK, are at risk. Advice, including inpatient management when appropriate, is available from the UK Role 4 Military Infectious Diseases and Tropical Medicine Service...
September 28, 2016: Journal of the Royal Army Medical Corps
Tae Kyung Kim, S G Lee, K-T Han, Y Choi, S Y Lee, E-C Park
INTRODUCTION: We investigated the effect of unmet medical need on the mental health of Republic of Korea (ROK) Armed Forces personnel, as most of the service members work in remote areas and often experience such unmet needs. METHODS: This study used secondary data from the 2014 Military Health Survey (MHS), conducted by the ROK School of Military Medicine and designed to collect military health determinants. Descriptive statistics showed the general characteristics of the study populations by variable...
September 22, 2016: Journal of the Royal Army Medical Corps
Rachael Sv Parker, P Parker
BACKGROUND: Fatigue in military operations leads to safety and operational problems due to a decrease in alertness and performance. The primary method of counteracting the effects of sleep deprivation is to increase nightly sleep time, which in operational situations is not always feasible. History has taught us that surgeons and surgical teams are finite resources that cannot operate on patients indefinitely. METHODS: A systematic review was conducted using the search terms 'sleep' and 'deprivation' examining the impact of sleep deprivation on cognitive performance in military surgical teams...
September 13, 2016: Journal of the Royal Army Medical Corps
Andrew Dickinson, S Dalal, L Beales
During Herrick 19, Main Operating Base Price Role 1 treatment facility saw one of the busiest periods of Role 1 trauma care within the British Afghanistan campaign. Within 5 months 73 trauma casualties were treated, 48 of whom were category A. This article shares the experiences of this Role 1 and its unusual context, and discusses the relevance with regard to future medical planning. The focus is on the human element; a fundamental of all military operations yet one that is often overlooked. We consider the team construct and the team members of Role 1 and suggest how this team and its leaders can be optimally prepared, supported and maintained, and then safely disassembled...
September 13, 2016: Journal of the Royal Army Medical Corps
Emily Palmer, D Murphy, L Spencer-Harper
Little is known about the experience of post-traumatic growth (PTG) within UK veterans. To address this, our study aims to understand the lived experience of PTG from the perspective of UK veterans who have received treatment for post-traumatic stress disorder. The study uses Interpretative Phenomenological Analysis to explore qualitative interviews conducted with a sample of veterans who reported experiences of PTG in a quantitative measure. The themes drawn from the interviews describe the veterans' lived experiences of growth following trauma and their understanding of how it occurred...
August 16, 2016: Journal of the Royal Army Medical Corps
Anthony LaPorta, A W Kirkpatrick, J L Mckee, D J Roberts, H Tien, A Beckett, C G Ball, I Mckee, D Louw, J B Holcomb
BACKGROUND: In a care under fire situation, a first line response to haemorrhage is to apply a tourniquet and return fire. However, there is little understanding of how tourniquets and other haemorrhage control devices impact marksmanship. METHODS: We compared the impact of the iTClamp and the Combat Application Tourniquet (CAT) on marksmanship. Following randomisation (iTClamp or CAT), trained marksmen fired an AR15 at a scaled silhouette target in prone unsupported position (shooting task)...
August 16, 2016: Journal of the Royal Army Medical Corps
Yann Daniel, S Habas, L Malan, J Escarment, J-S David, S Peyrefitte
BACKGROUND: Despite the early uses of tourniquets and haemostatic dressings, blood loss still accounts for the vast majority of preventable deaths on the battlefield. Over the last few years, progress has been made in the management of such injuries, especially with the use of damage control resuscitation concepts. The early application of these procedures, on the field, may constitute the best opportunity to improve survival from combat injury during remote operations. DATA SOURCES: Currently available literature relating to trauma-induced coagulopathy treatment and far-forward transfusion was identified by searches of electronic databases...
August 16, 2016: Journal of the Royal Army Medical Corps
Amila Sanjiva Ratnayake, B Samarasinghe, M Bala
PURPOSE: The objective of this study was to characterise the spectrum of peripheral venous injury in the Sri Lankan war theatres, including categorisation of anatomic patterns, mechanism and management of casualties, including short-term results of surgical repair of traumatic venous injuries versus ligation. In addition, the effects and outcome of combined arterial and venous injuries versus arterial injury alone are compared. METHODS: All adults with extremity vascular injuries admitted to a military base hospital during an 8-month period were prospectively recorded and those with a venous injury were analysed...
August 11, 2016: Journal of the Royal Army Medical Corps
Johno Breeze, Jeff Garner
No abstract text is available yet for this article.
October 2016: Journal of the Royal Army Medical Corps
Damian Douglas Keene, J G Penn-Barwell, P R Wood, N Hunt, R Delaney, J Clasper, R J Russell, P F Mahoney
OBJECTIVES: Combat casualty care is a complex system involving multiple clinicians, medical interventions and casualty transfers. Improving the performance of this system requires examination of potential weaknesses. This study reviewed the cause and timing of death of casualties deemed to have died from their injuries after arriving at a medical treatment facility during the recent conflicts in Iraq and Afghanistan, in order to identify potential areas for improving outcomes. METHODS: This was a retrospective review of all casualties who reached medical treatment facilities alive, but subsequently died from injuries sustained during combat operations in Afghanistan and Iraq...
October 2016: Journal of the Royal Army Medical Corps
Johno Breeze, J Garner
No abstract text is available yet for this article.
August 2016: Journal of the Royal Army Medical Corps
Peter C Wever, A J Hodges
Sydney Domville Rowland was a bacteriologist and staff member at the Lister Institute of Preventive Medicine when the First World War broke out in 1914. Following a request to the Director of the Lister Institute to staff and equip a mobile field laboratory as quickly as possible, Rowland was appointed to take charge of No. 1 Mobile Laboratory and took up a temporary commission at the rank of Lieutenant in the Royal Army Medical Corps. On 9 October 1914, Rowland set out for the European mainland and was subsequently attached to General Headquarters in Saint-Omer, France (October 1914-June 1915), No...
August 2016: Journal of the Royal Army Medical Corps
Robert Staruch, G E Glass, P E M Butler
No abstract text is available yet for this article.
August 2016: Journal of the Royal Army Medical Corps
Mark S Bailey, G W Davies, D A Freshwater, A C Timperley
No abstract text is available yet for this article.
August 2016: Journal of the Royal Army Medical Corps
Danny Epstein, M Furman, A Borohovitz, Z Iversen, S Shapira, Y Yanir, D Ofir
BACKGROUND: There is a positive correlation between the volume of physical activity performed and the incidence of lower extremity overuse injuries. Difficulty in evaluating the amount of activity in which highly specialised military units are engaged has prevented the implementation of a strict training programme designed to minimise overuse injuries. PURPOSE: To quantify the ambulatory physical activity performed by trainees during the initial training phase in a Naval Commando Unit, with a view to developing more exact physical performance guidelines for the unit and the Israel Defense Forces, in general...
August 2016: Journal of the Royal Army Medical Corps
Alexander James Martin-Bates, S E Jefferys
The return to contingency after Operation HERRICK (2002-2014 Afghanistan conflict) has seen an emerging trend for small-scale rapidly developing expeditionary operations. The associated small, remote medical footprint for such operations, often within a coalition construct, reliant on host nation support is in direct conflict with the General Medical Council (GMC) guidelines for junior doctor supervision in an 'approved practice setting'. If a General Duties Medical Officer (GDMO) is nominated to support future operations, the provision of assured patient care and supervision within GMC guidelines, while ensuring career progression and ongoing education, may prove a challenge...
August 2016: Journal of the Royal Army Medical Corps
John Breeze, E A Lewis, R Fryer, A E Hepper, Peter F Mahoney, Jon C Clasper
INTRODUCTION: Body armour is a type of equipment worn by military personnel that aims to prevent or reduce the damage caused by ballistic projectiles to structures within the thorax and abdomen. Such injuries remain the leading cause of potentially survivable deaths on the modern battlefield. Recent developments in computer modelling in conjunction with a programme to procure the next generation of UK military body armour has provided the impetus to re-evaluate the optimal anatomical coverage provided by military body armour against high energy projectiles...
August 2016: Journal of the Royal Army Medical Corps
David O'Reilly, J Lordan, C Streets, M Midwinter, D Mirza
The closure of the Medical Treatment facility in Camp BASTION and the return to contingency operations presents a new challenge in training and maintaining the skills of military surgeons. Multivisceral organ retrieval presents a unique opportunity to practice some of the more unusual techniques required in military surgery in the National Health Service. This article details the experience that organ retrieval offers and matches this to the needs of military surgeons. National Organ Retrieval Service teams need skilled surgeons, and a mutually beneficial partnership is in prospect...
August 2016: Journal of the Royal Army Medical Corps
Gareth H Jones, C R Pearson
INTRODUCTION: Noise-induced hearing loss is a significant cause of morbidity among serving soldiers despite provision of a range of personal hearing protection (PHP) and education and training. It appears that soldiers are choosing to forego PHP. This audit aimed to evaluate the effect of health promotion activity on the use of hearing protection in hostile territory. METHOD: 46 dismounted infantry soldiers operating out of a forward operating base in Afghanistan during Op HERRICK 17 were directly observed in order to determine the rate of wearing PHP before and after health promotion activity...
August 2016: Journal of the Royal Army Medical Corps
Konstantinos Havenetidis
INTRODUCTION: Creatine is considered an effective nutritional ergogenic aid to enhance exercise performance. In spite of the publication of several reviews in the last decade on the topic of exercise performance/sports and creatine there is a need for an update related to the military given the lack of information in this area. The aim of this study was to critically assess original research addressing the use of creatine supplements in the military. METHODS: A search of the electronic databases PubMed and SPORTDiscus, for the following key words: military personnel, trainees, recruit, soldier, physical fitness, physical conditioning, creatine supplementation, creatine ingestion, nutritional supplements to identify surveys and randomised clinical trials from journal articles and technical reports investigating the effect of creatine supplementation on military populations...
August 2016: Journal of the Royal Army Medical Corps
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