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Journal of the Royal Army Medical Corps

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https://www.readbyqxmd.com/read/29151040/meningoencephalitis-in-a-royal-marine-after-skinning-reindeer-in-norway
#1
Christopher A Pollard, D S Burns, B Ho, A McD Johnston
Meningoencephalitis presenting in service personnel overseas may present a diagnostic challenge due to the broad range of potential differential diagnosis as well as the requirement for rapid assessment and treatment. A 25-year-old Royal Marine was evacuated to the Royal Centre for Defence Medicine in Birmingham, UK, with a history of rash consistent with erythema chronicum migrans, a seizure, and lymphocytic pleocytosis after skinning reindeer in Norway. Neuroborreliosis was suspected and empirical antibiotics were administered...
November 18, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29146724/commentary-nocturnal-serum-melatonin-levels-in-sulfur-mustard-exposed-patients-with-sleep-disorders
#2
EDITORIAL
Surg Cdr S A Bland
No abstract text is available yet for this article.
November 16, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29146723/nocturnal-serum-melatonin-levels-in-sulfur-mustard-exposed-patients-with-sleep-disorders
#3
Seyyedeh Soghra Mousavi, E Vahedi, M Shohrati, Y Panahi, S Parvin
BACKGROUND: Sulfur mustard (SM) exposure causes respiratory disorders, progressive deterioration in lung function and mortality in injured victims and poor sleep quality is one of the most common problems among SM-exposed patients. Since melatonin has a critical role in regulation of sleep and awareness, this study aimed to evaluate the serum melatonin levels in SM-injured subjects. METHODS: A total of 30 SM-exposed male patients and 10 controls was evaluated. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was measured by the Epworth Sleepiness Scale (ESS), and the risk of obstructive sleep apnoea was determined by the STOP-Bang questionnaire...
November 16, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29097551/retropharyngeal-course-of-the-internal-carotid-artery
#4
Stanislas Ballivet de Regloix, O Maurin
A 77-year-old male patient presented with dysphonia. Endoscopic examination demonstrated a distortion of the posterior pharyngeal wall, which was pulsatile. The axial CT showed left internal carotid artery in a retropharyngeal location. An anomalous course of the carotid artery in the retropharyngeal space is an unusual finding that poses a risk of vascular injury during pharyngeal surgery and intubation. Such an anomaly may be congenital (incomplete descent of the third aortic arch) and may be more pronounced in older patients secondary to atherosclerosis and hypertension as occurred in our case noted here...
November 2, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29079661/development-of-a-portable-blood-salvage-and-autotransfusion-technology-to-enhance-survivability-of-personnel-requiring-major-medical-interventions-in-austere-or-military-environments
#5
Terence Gourlay, C Simpson, C A Robertson
INTRODUCTION: Uncontrolled haemorrhage is the leading cause of death on the battlefield, and two-thirds of these deaths result from non-compressible haemorrhage. Blood salvage and autotransfusion represent an alternative to conventional blood transfusion techniques for austere environments, potentially providing blood to the casualty at point of injury. The aim of this paper is to describe the design, development and initial proof-of-concept testing of a portable blood salvage and autotransfusion technology to enhance survivability of personnel requiring major medical interventions in austere or military environments...
October 26, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29061762/descriptive-analysis-of-the-medical-care-performed-in-the-spanish-military-role-1-medical-treatment-facility-deployed-in-operation-inherent-resolve-iraq-2015-2016
#6
Rafael García Cañas, R Navarro Suay
INTRODUCTION: Operation 'Inherent Resolve' was approved by the United Nations in August 2014 with the objective of suppressing the Islamic State in Iraq and the Levant and increasing the region's stability. The mission of the Spanish military forces within this was to direct training missions for the Iraqi Army. The aim of this study is to analyse the medical care provided in the Spanish Role 1 deployed medical treatment facility during Operation 'Apoyo a Irak'. METHODS: A cross-sectional, descriptive and retrospective study was conducted between 15 December 2015 and 18 November 2016...
October 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29055895/the-pattern-of-paediatric-blast-injury-in-afghanistan
#7
Daniel C Thompson, R J Crooks, J C Clasper, A Lupu, S A Stapley, D J Cloke
INTRODUCTION: Between 2009 and 2015, 3746 children died, and 7904 were injured as a result of armed conflict within Afghanistan. Improvised explosive devices (IEDs) and explosive remnants of war accounted for 29% of child casualties in 2015. The aim of this study was to review the burden of paediatric blast injuries admitted to Camp Bastion, Afghanistan, and to investigate the hypothesis that children suffer proportionally more head injuries than adults. METHOD: A retrospective analysis was undertaken of prospectively collected data derived from the UK Joint Theatre Trauma Registry of ambulant paediatric (aged 2-15 years) admissions with blast injuries at the Role 3 Field Hospital, Camp Bastion from June 2006 to March 2013...
October 21, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29055894/major-incident-triage-and-the-implementation-of-a-new-triage-tool-the-mptt-24
#8
James Vassallo, J E Smith, L A Wallis
INTRODUCTION: The Modified Physiological Triage Tool (MPTT) is a recently developed primary triage tool and in comparison with existing tools demonstrates the greatest sensitivity at predicting need for life-saving intervention (LSI) within both military and civilian populations. To improve its applicability, we proposed to increase the upper respiratory rate (RR) threshold to 24 breaths per minute (bpm) to produce the MPTT-24. Our aim was to conduct a feasibility analysis of the proposed MPTT-24, comparing its performance with the existing UK Military Sieve...
October 21, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29025962/therapeutic-hypothermia-in-acute-traumatic-spinal-cord-injury
#9
James Collis
Therapeutic hypothermia is already widely acknowledged as an effective neuroprotective intervention, especially within the acute care setting in relation to conditions such as cardiac arrest and neonatal encephalopathy. Its multifactorial mechanisms of action, including lowering metabolic rate and reducing acute inflammatory cellular processes, ultimately provide protection for central nervous tissue from continuing injury following ischaemic or traumatic insult. Its clinical application within acute traumatic spinal cord injury would therefore seem very plausible, it having the potential to combat the pathophysiological secondary injury processes that can develop in the proceeding hours to days following the initial injury...
October 12, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29025961/phosphate-replacement-in-the-critically-ill-potential-implications-for-military-patients
#10
A E Coulden, L J Rickard, N Crooks, N Arora
BACKGROUND: Severe hypophosphataemia in the intensive care unit (ICU) setting has been widely associated with adverse clinical outcomes across multiple organ systems, as well as increased mortality. However, the clinical significance of mild or moderate hypophosphataemia remains uncertain. This can lead to heterogeneous phosphate replacement protocols across different institutions. The aim of this study was to assess the significance of mild and moderate hypophosphataemia on clinical outcomes across several organ systems...
October 12, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29018173/a-pilot-study-of-surgical-telementoring-for-leg-fasciotomy
#11
Max Talbot, E J Harvey, G K Berry, R Reindl, H Tien, D J Stinner, G Slobogean
INTRODUCTION: Acute extremity compartment syndrome requires rapid decompression. In remote locations, distance, weather and logistics may delay the evacuation of patients with extremity trauma beyond the desired timeline for compartment release. The aim of this study was to establish the feasibility of performing telementored surgery for leg compartment release and to identify methodological issues relevant for future research. METHODS: Three anaethetists and one critical care physician were recruited as operators...
October 10, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28993489/civilian-and-military-doctors-knowledge-of-tranexamic-acid-txa-use-in-major-trauma-a-comparison-study
#12
Jonathan Blair Thomas Herron, R French, A D Gilliam
INTRODUCTION: Tranexamic acid (TXA) administration within the recommended time of 3 hours has been demonstrated to improve outcomes following trauma. The aim of this study was to identify potential knowledge gaps in the administration of TXA in order to target further educational training in those doctors responsible for the management of acute trauma. METHODS: 104 military and 852 civilian doctors were invited to complete a four-item web-based questionnaire pertaining to the indications, dose, side effects and evidence base for TXA administration in trauma...
October 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28993488/support-needs-and-experiences-of-family-members-of-wounded-injured-or-sick-uk-service-personnel
#13
Anna Verey, M Keeling, G Thandi, S Stevelink, N Fear
INTRODUCTION: When a service person has been wounded, injured or sick (WIS), family members may provide care during their recovery in an unpaid capacity. This may occur in diverse environments including hospitals, inpatient rehabilitation centres, in the community and at home. METHOD: Thirty-seven family members of WIS personnel were interviewed regarding their support needs, family relationships and use of UK support services. Semistructured, in-depth telephone interviews were used, with data analysis undertaken using a thematic approach...
October 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28993487/managing-post-laparotomy-pain-in-a-contingency-setting-the-utility-of-rectus-sheath-catheters
#14
LETTER
William Buxton, D Hunt, P Joshi
No abstract text is available yet for this article.
October 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28993486/defence-policy-and-doctrine-on-captured-persons-cpers-further-guidance
#15
LETTER
Paddy S McKillop-Duffy, M Bricknell
No abstract text is available yet for this article.
October 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28993485/focusing-on-the-mental-health-of-treatment-seeking-veterans
#16
EDITORIAL
Dominic Murphy, W Busuttil
No abstract text is available yet for this article.
October 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28988190/the-outcome-of-patients-in-traumatic-cardiac-arrest-presenting-to-deployed-military-medical-treatment-facilities-data-from-the-uk-joint-theatre-trauma-registry
#17
Ed B G Barnard, P A F Hunt, P E H Lewis, J E Smith
BACKGROUND: The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the aim of this study was to define the epidemiology of TCA in the military population with a particular focus on survival rates and injury patterns. METHODS: A retrospective database analysis of the UK Joint Theatre Trauma Registry was undertaken...
October 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28986390/relationship-between-1-5-mile-run-time-injury-risk-and-training-outcome-in-british-army-recruits
#18
Lianne J Hall
BACKGROUND: 1.5-mile run time, as a surrogate measure of aerobic fitness, is associated with musculoskeletal injury (MSI) risk in military recruits. This study aimed to determine if 1.5-mile run times can predict injury risk and attrition rates from phase 1 (initial) training and determine if a link exists between phase 1 and 2 discharge outcomes in British Army recruits. METHOD: 1.5-mile times from week 1 of initial training and MSI reported during training were retrieved for 3446 male recruits...
October 5, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28986389/is-there-a-need-for-a-postgraduate-military-healthcare-qualification
#19
LETTER
Nicholas Newton, M Bricknell
No abstract text is available yet for this article.
October 5, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28986388/shocking-the-system-aeds-in-military-resuscitation
#20
REVIEW
Andrew M Buckley, A T Cox, P Rees
Automated external defibrillator (AED) devices have been in routine clinical use since the early 1990s to deliver life-saving shocks to appropriate patients in non-clinical environments. As expectations of survival from out-of-hospital cardiac arrest increase, and evidence incontrovertibly points to reduced timelines as the most crucial factor in achieving return of spontaneous circulation, questions regarding the availability and location of AEDs in the UK military need to be readdressed. This article explores the background of AEDs and reviews their history, life-saving potential and defines current and best practice...
October 5, 2017: Journal of the Royal Army Medical Corps
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