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"Medical Readiness"

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https://www.readbyqxmd.com/read/27898553/the-aeromedical-physician-assistant
#1
Joshua Radi, Michael Brisson, Michael Line
The US Army aeromedical physician assistant (PA) serves aviation units in regards to crewmember medical readiness. All PAs are graduates of a 6-week flight surgeon course. They are responsible for conducting nearly 40% of the annual US Army flight physicals. This unique training and deployment illustrates the growing adaptability of PAs to assume a greater role in military medicine.
December 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27880039/importance-of-external-cause-coding-for-injury-surveillance-lessons-from-assessment-of-overexertion-injuries-among-u-s-army-soldiers-in-2014
#2
Michelle Canham-Chervak, Ryan A Steelman, Anna Schuh, Bruce H Jones
Injuries are a barrier to military medical readiness, and overexertion has historically been a leading mechanism of injury among active duty U.S. Army soldiers. Details are needed to inform prevention planning. The Defense Medical Surveillance System (DMSS) was queried for unique medical encounters among active duty Army soldiers consistent with the military injury definition and assigned an overexertion external cause code (ICD-9: E927.0-E927.9) in 2014 (n=21,891). Most (99.7%) were outpatient visits and 60% were attributed specifically to sudden strenuous movement...
November 2016: MSMR
https://www.readbyqxmd.com/read/27849468/establishing-a-predictable-military-global-health-engagement-funding-authority-supporting-theater-security-cooperation-objectives-and-generating-military-medical-readiness
#3
Derek Licina, Brad Cogswell, Richard Paz
No abstract text is available yet for this article.
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27613207/honey-bee-swarms-aboard-the-usns-comfort-recommendations-for-sting-prevention-swarm-removal-and-medical-readiness-on-military-ships
#4
James C Dunford, Karl C Kronmann, Luke R Peet, Jeffrey D Stancil
The article provides observations of multiple honey bee (Apis mellifera) swarms aboard the USNS Comfort (TAH-20) during the Continuing Promise 2015 mission. A brief overview of swarming biology is given along with control/removal recommendations to reduce sting exposures. The observations suggest that preventive medicine personnel should provide adequate risk communications about the potential occurrence of bee swarms aboard military ships, and medical department personnel should be prepared for the possibility of treating of multiple sting exposures, especially in the Southern Command Area of Operations where the Africanized genotype of A mellifera is common...
October 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27081410/natural-language-processing-for-cohort-discovery-in-a-discharge-prediction-model-for-the-neonatal-icu
#5
Michael W Temple, Christoph U Lehmann, Daniel Fabbri
OBJECTIVES: Discharging patients from the Neonatal Intensive Care Unit (NICU) can be delayed for non-medical reasons including the procurement of home medical equipment, parental education, and the need for children's services. We previously created a model to identify patients that will be medically ready for discharge in the subsequent 2-10 days. In this study we use Natural Language Processing to improve upon that model and discern why the model performed poorly on certain patients...
2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27053982/transfer-delays-from-the-neurologic-intensive-care-unit-a-prospective-cohort-study
#6
Nicholas A Morris, Ayush Batra, Alessandro Biffi, Adam B Cohen
INTRODUCTION: Neurocritical care beds are a scarce, valuable resource. The purpose of this pilot study was to quantify discharge delays from the neurologic intensive care unit (NICU) at a tertiary-care teaching hospital and to examine the impact on overall hospital length of stay (LOS). Secondary goals were to evaluate (1) the effect of NICU delays on patient physical/occupational therapy services and (2) the accuracy of clinician estimates of NICU discharge date and hospital LOS. METHODS: We conducted a prospective cohort study of consecutive patients discharged over 1 month from NICU...
April 2016: Neurohospitalist
https://www.readbyqxmd.com/read/26559643/structured-intervention-for-management-of-pain-following-day-surgery-in-children
#7
Søren Walther-Larsen, Gitte Bruun Aagaard, Susanne Molin Friis, Trine Petersen, Jørn Møller-Sonnergaard, Janne Rømsing
BACKGROUND: Ambulatory surgery forms a large part of pediatric surgical practice. Several studies indicate that postoperative pain is poorly managed with more than 30% of children having moderate to severe pain. In a busy outpatient clinic contact between healthcare professionals and the family is increasingly limited calling for a global and efficient pain management regime. OBJECTIVE: The aim of this prospective observational cohort study was to determine postoperative pain intensity following day surgery in children after our structured intervention for pain management...
February 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26360354/kitona-2013-a-medical-readiness-training-exercise-in-the-democratic-republic-of-the-congo-leading-to-lion-rouge
#8
Elisabeth Hesse, Edmond Amisi Okito, Kelly Mann, Michael McCullough, Emil Lesho
BACKGROUND: Health initiatives support regional stability and are a priority for US and African partners. We present data and experience from the Democratic Republic of Congo (DRC), a strategically and epidemiologically ideal location for collaborative medical engagement (CME). Our objectives included relationship building, exposure of US military medical personnel to uncommon tropical diseases, bolstering a referral hospital, and updating Congolese physicians on new treatment or preventive standards of care...
2015: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/26216319/predicting-discharge-dates-from-the-nicu-using-progress-note-data
#9
Michael W Temple, Christoph U Lehmann, Daniel Fabbri
BACKGROUND AND OBJECTIVES: Discharging patients from the NICU may be delayed for nonmedical reasons including the need for medical equipment, parental education, and children's services. We describe a method to predict which patients will be medically ready for discharge in the next 2 to 10 days, providing lead time to address nonmedical reasons for delayed discharge. METHODS: A retrospective study examined 26 features (17 extracted, 9 engineered) from daily progress notes of 4693 patients (103,206 patient-days) from the NICU of a large, academic children's hospital...
August 2015: Pediatrics
https://www.readbyqxmd.com/read/26010104/cleft-and-craniofacial-care-during-military-pediatric-plastic-surgery-humanitarian-missions
#10
Christopher Madsen, Denver Lough, Alan Lim, Raymond J Harshbarger, Anand R Kumar
BACKGROUND: Military pediatric plastic surgery humanitarian missions in the Western Hemisphere have been initiated and developed since the early 1990 s using the Medical Readiness Education and Training Exercise (MEDRETE) concept. Despite its initial training mission status, the MEDRETE has developed into the most common and advanced low level medical mission platform currently in use. The objective of this study is to report cleft- and craniofacial-related patient outcomes after initiation and evolution of a standardized treatment protocol highlighting lessons learned which apply to civilian plastic surgery missions...
June 2015: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/25941253/assessing-pharmacologic-and-nonpharmacologic-risks-in-candidates-for-kidney-transplantation
#11
REVIEW
Angela Q Maldonado, Eric M Tichy, Christin C Rogers, Maya Campara, Christopher Ensor, Christina T Doligalski, Steven Gabardi, Jillian L Descourouez, Ian C Doyle, Jennifer Trofe-Clark
PURPOSE: Pharmacotherapy concerns and other factors with a bearing on patient selection for kidney transplantation are discussed. SUMMARY: The process of selecting appropriate candidates for kidney transplantation involves multidisciplinary assessment to evaluate a patient's mental, social, physical, financial, and medical readiness for successful surgery and good posttransplantation outcomes. Transplantation pharmacists can play important roles in the recognition and stratification of pharmacologic and nonpharmacologic risks in prospective kidney transplant recipients and the identification of issues that require a mitigation strategy...
May 15, 2015: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/25755244/using-quality-improvement-to-reduce-continuous-pulse-oximetry-use-in-children-with-wheezing
#12
Amanda C Schondelmeyer, Jeffrey M Simmons, Angela M Statile, Kelsey E Hofacer, Rebecca Smith, Lori Prine, Patrick W Brady
BACKGROUND AND OBJECTIVES: Clinicians commonly use continuous pulse oximetry (CPOx) for hospitalized children with respiratory illnesses. The Choosing Wisely initiative recommended discontinuing CPOx for children on room air. We used quality improvement methods to reduce time on CPOx in patients with wheezing. METHODS: Our project took place on 1 unit of a children's hospital. We developed consensus-based criteria for CPOx discontinuation. Interventions included education, a checklist used during nurse handoff, and discontinuation criteria incorporated into order sets...
April 2015: Pediatrics
https://www.readbyqxmd.com/read/25752922/prevalence-of-and-factors-associated-with-prolonged-length-of-stay-in-older-hospitalized-medical-patients
#13
Mario Bo, Gianfranco Fonte, Federica Pivaro, Martina Bonetto, Chiara Comi, Veronica Giorgis, Lorenzo Marchese, Gianluca Isaia, Guido Maggiani, Elisabetta Furno, Yolanda Falcone, Giovanni Carlo Isaia
AIM: To characterize elderly medical patients and identify factors associated with prolonged length of stay. METHODS: The present prospective observational study evaluated consecutive patients aged ≥65 years admitted in acute geriatric and medical wards. A comprehensive assessment including demographic, clinical, functional and cognitive variables was carried out. Delayed discharge was defined when patients were discharged later than the date they were deemed medically ready for discharge by physicians...
March 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/25652104/nebulized-magnesium-for-moderate-and-severe-pediatric-asthma-a-randomized-trial
#14
RANDOMIZED CONTROLLED TRIAL
Khalid Alansari, Wessam Ahmed, Bruce L Davidson, Mohamed Alamri, Ibrahim Zakaria, Mahomud Alrifaai
BACKGROUND: Intravenous magnesium sulfate, a rescue therapy added to bronchodilator and systemic steroid therapy for moderate and severe asthma, is uncommonly administered. We hypothesized that nebulized magnesium would confer benefit without undue risk. DESIGN AND METHODS: Patients aged 2 to 14 y with moderate and severe asthma (PRAM severity score ≥ 4) admitted to infirmary/observation unit care were randomized double-blind on admission to receive 800 mg nebulized magnesium or normal saline placebo after all received intensive therapy with combined nebulized albuterol-ipratropium and intravenous methylprednisolone...
December 2015: Pediatric Pulmonology
https://www.readbyqxmd.com/read/25563780/-treatment-of-breakthrough-pain-in-cancer-patients
#15
REVIEW
Fabienne J H Magdelijns, Marieke H J van den Beuken-van Everdingen, Annemie M Courtens, Daisy J A Janssen
Pain is common in patients with cancer (33-64%) and can be divided into background and breakthrough pain (BTP). BTP is a passing, acute pain that occurs despite the use of analgesia to control background pain. BTP may arise spontaneously or be provoked by certain movements or activities. It lasts 30-60 minutes and is generally self-limiting and is often undertreated. We describe 2 patients aged 68 and 57 years with metastatic disease who were admitted for pain management. BTP was inadequately managed during their hospital stay...
2015: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/25562768/blanchfield-army-community-hospital-polypharmacy-clinic
#16
Kevin J Ridderhoff, Jessica R Hull, Sheila K Sandberg
The increased use of central nervous system depressants (CNSD) and psychotropics are one of the many factors that contribute to suicidal behavior in soldiers. U.S. Army policy requires medication screening for any soldier prescribed 4 or more medications when at least 1 of the medications is a CNSD or psychotropic. Constant deployments challenged health care provider ability to comply with required screenings, and senior leaders sought proactive intervention to reduce medication risks upon return of the 101 st Airborne Division (Air Assault) from deployment in 2011...
January 2015: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/25373040/returning-to-duty-from-temporary-disability-in-the-u-s-army-observational-data-and-commentary-for-commanders-providers-and-soldiers
#17
Richard G Malish, Anthony D Arnett, Ronald J Place
Before 2011, Army commanders were unable to achieve complete visibility of soldiers possessing temporary medical limitations. The creation of time-limited definitions and technical categorization of this group, now known as the medically not ready (MNR) population, eventually allowed its quantification. With heightened visibility of the group, leaders in the Fort Stewart community facilitated its management through soldier medical readiness councils. In this commentary, we introduce a project that identified and tracked a cohort of 2,490 MNR soldiers for a 1-year period until they either recovered or entered the medical separation process...
November 2014: Military Medicine
https://www.readbyqxmd.com/read/24402984/reliability-and-validity-of-a-test-designed-to-assess-combat-medics-readiness-to-perform-life-saving-procedures
#18
Connie C Schmitz, Jeffrey G Chipman, Ken Yoshida, Rachel Isaksson Vogel, Francois Sainfort, Gregory Beilman, Joseph Clinton, Jimmy Cooper, Troy Reihsen, Robert M Sweet
OBJECTIVES: Reducing preventable deaths because of uncontrolled hemorrhage, tension pneumothorax, and airway loss is a priority. As part of a research initiative comparing different training models, this study evaluated the reliability and validity of a test that assesses combat medic performance during a polytrauma scenario using live animal models. METHODS: Nine procedural checklists and seven global rating scales were piloted with four cohorts of soldiers (n = 94) at two U...
January 2014: Military Medicine
https://www.readbyqxmd.com/read/24146239/strategies-for-optimizing-military-physical-readiness-and-preventing-musculoskeletal-injuries-in-the-21st-century
#19
Bradley C Nindl, Thomas J Williams, Patricia A Deuster, Nikki L Butler, Bruce H Jones
With downsizing of the military services and significant budget cuts, it will be more important than ever to optimize the health and performance of individual service members. Musculoskeletal injuries (MSIs) represent a major threat to the health and fitness of Soldiers and other service members that degrade our nation's ability to project military power. This affects both financial (such as the economic burden from medical, healthcare, and disability costs) and human manpower resources (Soldiers medically unable to optimally perform their duties and to deploy)...
October 2013: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/24083933/rabies-readiness-and-role-1-medical-care
#20
Louis A Dainty, Shafid A Morgan, Michael E Parker, Ronald L Burke
As medics and doctors prepare for deployment to a combat zone, there are countless specified and implied tasks needed to prepare the medical support of an Infantry unit in theater. Appropriately, units spend the lion share of their efforts in trauma training and medical readiness (vaccinations, medication prescriptions, eye glasses, etc.) while ensuring that the sets, kits, and outfits are all fully stocked with the required items needed to execute the mission. Unfortunately, this training and preparation included little on the major challenges units currently face from rabies...
October 2013: Military Medicine
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