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Journal of the Royal Army Medical Corps

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https://www.readbyqxmd.com/read/28652316/the-modified-jo-burg-technique-for-securing-intercostal-chest-drains
#1
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
#2
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/28500141/chronic-obstructive-pulmonary-disease-in-scottish-military-veterans
#3
Beverly P Bergman, D F Mackay, J P Pell
INTRODUCTION: Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). Serving military personnel have previously been shown to be more likely to smoke, and to smoke more heavily, than civilians, but there is no clear consensus as to whether in later life, as veterans, they experience a higher prevalence and mortality from COPD than do non-veterans. We examined the risk of COPD in Scottish veterans and assessed the impact of changes in military smoking. METHODS: Retrospective 30-year cohort study of 56 205 veterans born 1945-1985, and 172 741 people with no record of military service, matched for age, sex and area of residence, using Cox proportional hazard models to examine the association between veteran status, birth cohort, length of service and risk of COPD resulting in hospitalisation or death...
May 12, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28495952/deep-and-profound-hypothermia-in-haemorrhagic-shock-friend-or-foe-a-systematic-review
#4
REVIEW
Samuel E Moffatt, S J B Mitchell, J L Walke
INTRODUCTION: Survival in exsanguinating cardiac arrest patients is poor, as is neurological outcome in survivors. Hypothermia has traditionally been seen as harmful to trauma patients and associated with increased mortality; however, there has been speculation that cooling to very low temperatures (≤20°C) could be used to treat haemorrhagic trauma patients by the induction of a suspended animation period through extreme cooling, which improves survival and preserves neurological function...
May 11, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28495951/biochemical-analysis-of-cerebrospinal-fluid-in-the-laboratories-of-deployed-medical-treatment-facilities-are-multistix-10-sg-strip-and-istat-useful
#5
Bertrand Lefrere, J Plantamura, C Renard, F Ceppa, H Delacour
INTRODUCTION: During military deployment, the diagnosis and the management of acute bacterial meningitis can be problematic, as deployed Medical Treatment Facilities (MTFs) often have a limited laboratory diagnostic capability. However, French Role 2 and 3 MTFs have point-of-care (POC) testing to perform urinary (Multistix 10 SG strip) and blood (iSTAT handheld analyser) biochemical testing mentioned in AMedP8.5. The purpose of this study was to compare the accuracy of this urine test strip and of the iSTAT CHEM8 and CG4 cartridges with a standard hospital bench top analyser in order to determine if these POC devices have a potential role in the biochemical analysis of cerebrospinal fluid (CSF protein, CSF glucose and CSF lactate, respectively)...
May 10, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28432197/colonel-rtd-peter-roberts
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27903838/european-military-mental-health-research-benefits-of-collaboration
#12
EDITORIAL
Hubertus Himmerich, G D Willmund, U Wesemann, N Jones, N T Fear
Despite joint participation in international military operations, few collaborative military mental health research projects have been undertaken by European countries. From a common perspective of military mental health researchers from Germany and the UK, the lack of shared research might be related not only to the use of different languages but also the different ways in which the two militaries provide mental health and medical support to operations and differences in military institutions. One area that is suitable for military health research collaboration within UK and German forces is mental health and well-being among military personnel...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27879473/an-unusual-cause-of-tinnitus-essential-palatal-myoclonus
#13
Stanislas Ballivet de Régloix, A Marhic, Y Pons
No abstract text is available yet for this article.
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27811196/diagnosis-of-arrhythmias-in-athletes-wearing-heart-rate-monitors
#14
David Hunt, P Tanto
No abstract text is available yet for this article.
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27811195/injury-representation-against-ballistic-threats-using-three-novel-numerical-models
#15
Johno Breeze, R Fryer, D Pope, J Clasper
Injury modelling of ballistic threats is a valuable tool for informing policy on personal protective equipment and other injury mitigation methods. Currently, the Ministry of Defence (MoD) and Centre for Protection of National Infrastructure (CPNI) are focusing on the development of three interlinking numerical models, each of a different fidelity, to answer specific questions on current threats. High-fidelity models simulate the physical events most realistically, and will be used in the future to test the medical effectiveness of personal armour systems...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27780841/-a-band-of-brothers-an-exploration-of-the-range-of-medical-ethical-issues-faced-by-british-senior-military-clinicians-on-deployment-to-afghanistan-a-qualitative-study
#16
Elizabeth M Bernthal, H J A Draper, J Henning, J C Kelly
AIMS: To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. METHOD: A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27660285/the-association-between-perceived-unmet-medical-need-and-mental-health-among-the-republic-of-korea-armed-forces
#17
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...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27625370/the-impact-of-sleep-deprivation-in-military-surgical-teams-a-systematic-review
#18
REVIEW
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...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27531661/experience-of-post-traumatic-growth-in-uk-veterans-with-ptsd-a-qualitative-study
#19
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...
June 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27531660/randomised-controlled-trial-comparing-marksmanship-following-application-of-a-tourniquet-or-haemostatic-clamp-in-healthy-volunteers
#20
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)...
June 2017: Journal of the Royal Army Medical Corps
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