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https://www.readbyqxmd.com/read/29604210/a-new-triage-method-for-burn-disasters-fast-triage-in-burns-ftb
#1
Agnieszka Surowiecka-Pastewka, Wojciech Witkowski, Marek Kawecki
BACKGROUND There are few triage methods based on patient age and extent of burn. However, in case of mass casualties, age might be hard to define. Burn segregation in mass-casualty accidents requires an easy, fast, and effective method. Triage in burns should also segregate casualties requiring treatment in burn centers. The aim of this study was to create a proprietary segregation algorithm dedicated to mass-casualty incidents. MATERIAL AND METHODS A retrospective analysis of 939 burned patients admitted to the Clinical Department of Burns, Plastic and Reconstructive Surgery, Military Institute of Medicine (MIM) in Warsaw and to the Center for the Treatment of Burns (CTB) in Siemianowice Śląskie in 2012 and 2013 was performed...
March 31, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29580352/weight-loss-and-glycemic-control-after-sleeve-gastrectomy-results-from-a-middle-eastern-center-of-excellence
#2
Khalid Al Khalifa, Ahmed Al Ansari, May Showaiter
Obesity and its associated metabolic disorders are strongly linked to both morbidity and mortality. Sleeve gastrectomy (SG) has been established as an effective means of weight loss for obese patients as well as a treatment for type 2 diabetes mellitus (T2DM). This study was designed to examine the short- and midterm outcomes of patients who underwent SG in a Middle Eastern Center of Excellence, a military training teaching hospital. The clinical outcomes of 59 patients with impaired glucose tolerance and T2DM who underwent SG between 2011 and 2014 with at least one and up to four years of follow-up were studied...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29544581/percutaneous-tracheostomy-by-physician-intensivists
#3
Asad Zaman Khan, Aslam Khan, Arshad Naseem
OBJECTIVE: To assess the safety of percutaneous tracheostomy when performed by physician intensivists. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Adult Medical ICU in the Department of Critical Care Medicine, Military Hospital, Rawalpindi, Pakistan, from September 2013 to August 2016. METHODOLOGY: Departmental record for percutaneous tracheostomies, performed by physician intensivifts, was evaluated...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29520669/the-use-of-oral-appliances-in-obstructive-sleep-apnea-a-retrospective-cohort-study-spanning-14-years-of-private-practice-experience
#4
Sylvan S Mintz, Reka Kovacs
PURPOSE: In 2005, the American Academy of Sleep Medicine stated, "Oral appliances are indicated for use in patients with mild to moderate obstructive sleep apnea (OSA) who prefer them to CPAP therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP." However, this recommendation is based upon variable results from only six studies with more than 100 participants. These studies have assessed the effectiveness of mandibular advancement devices (MADs) in specific groups (military populations, academic institutions, or hospital settings) with no large study conducted in a fee-for-service private practice where the majority of patients receive MADs for OSA...
March 8, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29502519/identifying-prognostic-factors-for-conservative-treatment-outcomes-in-servicemen-with-chronic-exertional-compartment-syndrome-treated-at-a-rehabilitation-center
#5
Mariëtte Z Meulekamp, Peter van der Wurff, Alfred van der Meer, Cees Lucas
BACKGROUND: Chronic exertional compartment syndrome (CECS) is a condition of pain induced by exercise, and it is characterized by muscle swelling and impaired muscle function in the lower leg. Given the diversity in the diagnosis and treatment of CECS, it is desirable to determine variables pertaining to prognosis and recovery. The purpose of this study is to identify prognostic factors for conservative treatment outcomes in servicemen with CECS who were treated at a Military Rehabilitation Center...
November 28, 2017: Military Medical Research
https://www.readbyqxmd.com/read/29458451/increasing-perceived-emergency-preparedness-by-participatory-policy-making-think-tanks
#6
Bruria Adini, Avi Israeli, Moran Bodas, Kobi Peleg
OBJECTIVE: The study aimed to examine impact of think-tanks designed to create policies for emerging threats on medical teams' perceptions of individual and systemic emergency preparedness. METHODS: Multi-professional think-tanks were established to design policies for potential attacks on civilian communities. In total, 59 multi-sector health care managers participated in think-tanks focused on: (a) primary care services in risk zones; (b) hospital care; (c) casualty evacuation policies; (d) medical services to special-needs populations; and (e) services in a "temporary military-closed zone...
February 20, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29457328/cognitive-performance-in-late-adolescence-and-long-term-risk-of-early-heart-failure-in-swedish-men
#7
Martin Lindgren, Peter Eriksson, Annika Rosengren, Josefina Robertson, Linus Schiöler, Maria Schaufelberger, David Åberg, Kjell Torén, Margda Waern, Maria Åberg
AIMS: Heart failure (HF) incidence appears to increase among younger individuals, raising questions of how risk factors affect the younger population. We investigated the association of cognitive performance in late adolescence with long-term risk of early HF. METHODS AND RESULTS: We followed a cohort of Swedish men enrolled in mandatory military conscription in 1968-2005 (n = 1 225 300; mean age 18.3 years) until 2014 for HF hospitalization, using data from the Swedish National Inpatient Registry...
February 19, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29447402/intraoperative-endotracheal-cuff-pressure-study-how-education-and-availability-of-manometers-help-guide-safer-pressures
#8
Gregory J Stevens, Joel W Warfel, James K Aden, Scott D Blackwell
Introduction: Endotracheal intubation is a medical procedure that is often indicated in both the perioperative and critical care environments. Cuffed endotracheal tubes (ETT) allow for safer and more efficient delivery of positive pressure ventilation, as well as create a barrier to reduce the risk of micro-aspiration and anesthetic pollution in the operating room environment. Over-inflation of the endotracheal cuff can lead to serious and harmful sequelae. This study aimed to assess if departmental education paired with ready access to a manometer to assess cuff pressure would result in an improvement in the proportion of ETT cuff pressures in the goal range...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29420761/chinese-military-evaluation-of-a-portable-near-infrared-detector-of-traumatic-intracranial-hematomas
#9
Chun-Yang Liang, Yang Yang, Chun-Sen Shen, Hai-Jiang Wang, Nai-Ming Liu, Zhi-Wen Wang, Feng-Lei Zhu, Ru-Xiang Xu
Introduction: Secondary brain injury is the main cause of mortality from traumatic brain injury (TBI). One hallmark of TBI is intracranial hemorrhage, which occurs in 40-50% of severe TBI cases. Early identification of intracranial hematomas in TBI patients allows early surgical evacuation and can reduce the case fatality rate of TBI. As pre-hospital care is the weakest part of Chinese emergency care, there is an urgent need for a capability to detect brain hematomas early. In China, in addition to preventing injuries and diseases in military staff and in enhancing the military armed forces during war, military medicine participates in actions such as emergency public health crises, natural disasters, emerging conflicts, and anti-terrorist campaigns during peacetime...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29396756/pre-hospital-management-of-pediatric-polytrauma-during-modern-conflict-experience-and-limits-of-the-french-military-health-service
#10
Victor Laville, Christophe Lebleu, Christophe Desterke, Pierre Mornand, Luc Aigle, Emmanuel Hornez
BACKGROUND: French military physicians serving in deployment are confronted with pediatric polytrauma patients (PPP) during the provision of medical aid to civilian populations. The objectives of this study were to describe the current care of PPPs during these missions, to report difficulties encountered and to evaluate the training of doctors for management of PPPs in the field. METHODS: A descriptive epidemiological study based on a questionnaire sent to physicians who had been deployed overseas...
February 2, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29386714/forward-surgical-care-emerging-issues-and-challenges
#11
Bipin Puri
War strategies have been evolving with time and battlefield casualty care services have been trying to keep pace with the changing demands. Technological advances in the field of trauma care have revolutionised the way in which erstwhile 'non-salvageable' lives and limbs are managed with more favourable outcome. The quality of Pre-Hospital Trauma Care Services will largely determine the survival statistics of battle casualties. The surgeon has to acknowledge the various resource constraints imposed upon him in the course of delivery of expert trauma care in the battlefield...
October 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29380855/single-arm-resistance-training-study-to-determine-the-relationship-between-training-outcomes-and-muscle-growth-factor-mrnas-in-older-adults-consuming-numerous-medications-and-supplements
#12
R A Dennis, K K Garner, P M Kortebein, C M Parkes, M M Bopp, S Li, K P Padala, P R Padala, D H Sullivan
OBJECTIVES: Determine if the muscle mRNA levels of three growth factors (insulin-like growth factor-1 [IGF1], ciliary neurotropic factor [CNTF], and vascular endothelial growth factor-D [VEGFD]) are correlated with muscle size and strength gains from resistance exercise while piloting a training program in older adults taking medications and supplements for age-associated problems. DESIGN: Single-arm prospective study. SETTING: US Veterans Affairs hospital...
2018: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29369076/analysis-of-pediatric-trauma-in-combat-zone-to-inform-high-fidelity-simulation-predeployment-training
#13
Patrick T Reeves, Marc M Auerbach, Tuan D Le, Nicole W Caldwell, Mary J Edwards, Elizabeth A Mann-Salinas, Jennifer M Gurney, Zsolt T Stockinger, Matthew A Borgman
OBJECTIVES: The military uses "just-in-time" training to refresh deploying medical personnel on skills necessary for medical and surgical care in the theater of operations. The burden of pediatric care at Role 2 facilities has yet to be characterized; pediatric predeployment training has been extremely limited and primarily informed by anecdotal experience. The goal of this analysis was to describe pediatric care at Role 2 facilities to enable data-driven development of high-fidelity simulation training and core knowledge concepts specific to the combat zone...
January 23, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29261592/whole-blood-and-hextend-bookends-of-modern-tactical-combat-casualty-care-field-resuscitation-and-starting-point-for-multi-functional-resuscitation-fluid-development
#14
Forest R Sheppard, Thomas A Mitchell, Antoni R Macko, Darren M Fryer, Leasha J Schaub, Kassandra M Ozuna, Jacob J Glaser
BACKGROUND: Hemorrhage is the leading cause of preventable death in traumatically injured civilian and military populations. Pre-hospital resuscitation largely relies on crystalloid and colloid intra-vascular expansion, as whole blood and component blood therapy are logistically arduous. In this experiment, we evaluated the bookends of Tactical Combat Casualty Care Guidelines recommendations of pre-hospital resuscitation with Hextend and whole blood in a controlled hemorrhagic shock model within non-human primates, as means of a multi-functional resuscitative fluid development...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29170311/14-prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#15
Jackie Mclennan, Jason Smith, Kevin Mackway-Jones
BACKGROUND: The predominant cause of preventable death from trauma is bleeding. Many patients need resuscitation with massive blood transfusion (MBT). In some theatres of military operation there is limited blood product availability and walking donor panels can be required. This study aimed to produce a tool to predict the need for MBT using information available on patient arrival at the ED for patients sustaining battlefield trauma. METHODS: A retrospective database analysis was undertaken using the UK Joint Theatre Trauma Registry (JTTR) to provide derivation and validation datasets...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29161399/global-lessons-developing-military-trauma-care-and-lessons-for-civilian-practice
#16
T Woolley, J A Round, M Ingram
The wars in Iraq and Afghanistan have helped to shape the modern Defence Medical Services. Many lessons were learnt including the need for rapid haemorrhage control, senior decision-making and the evolution of deployed transfusion support. These changes were implemented simultaneously with a coherent, end-to-end medical plan from point of wounding through to rehabilitation. Implementation of the medical plan is harmonious with the NHS trauma pathway, and is key to ensuring effective delivery. Military anaesthetists have a long pre-deployment training pathway starting with a Certificate of Completion of Training (CCT) in anaesthesia and/or critical care, and with an emphasis on military skills related to their specific role...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29126602/the-potential-of-blended-learning-in-education-and-training-for-advanced-civilian-and-military-trauma-care
#17
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
INTRODUCTION: In the field of advanced care of the complex trauma patient, there is an emerging need for focused education and training. However, several hospitals do not support further education and training in this field, and the challenge of releasing time for physicians and nurses is well-known. Educational strategies using blended learning, which combines traditional classroom methods with modern computer-assisted methods and media, have not yet been widely used. This study analysed the educational challenges and areas for improvement, according to senior physicians and nurses, and investigated the potential use of blended learning...
January 2018: Injury
https://www.readbyqxmd.com/read/29119632/the-effect-of-education-of-nurses-on-preventing-catheter-associated-urinary-tract-infections-in-patients-who-undergo-hip-fracture-surgery
#18
Ezgi Seyhan Ak, Ayfer Özbaş
AIMS AND OBJECTIVES: The aim of the study is to investigate the effect of educating nurses on preventing catheter-associated urinary tract infections in patients who undergo hip fracture surgery. BACKGROUND: Urinary tract infections after hip fracture surgery are observed at a rate of 12% to 61%, and the most important risk factor associated with urinary tract infection is considered to be the presence of urinary catheters. Nurse education about the use and management of urinary catheters is important to decrease the risk of urinary tract infections...
November 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29050174/-effects-of-modified-three-step-procedure-for-anatrophic-nephrolithotomy-in-the-treatment-of-complex-staghorn-renal-calculi
#19
C L Yang, W Wang, W E Zhou, Y P Xue, B Q Wang, H B Nie, W L Hu
Objective: To investigate the effects of modified three-step procedure for anatrophic nephrolithotomy in the treatment of complex staghorn renal calculi. Methods: A total of 22 patients with complex staghorn renal calculi between June 2013 and June 2016 at Department of Urology in Guangzhou General Hospital of Guangzhou Military Command were retrospective analyzed. There were 13 males and 9 females, ranging from 35 to 62 years old with mean age of 47 years. There were 17 patients with dull pain, and 5 patients who were found through physical examinations...
October 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28988805/prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#20
Jacqueline V Mclennan, Kevin C Mackway-Jones, Jason E Smith
BACKGROUND: The predominant cause of preventable trauma death is bleeding, and many of these patients need resuscitation with massive blood transfusion. In resource-constrained environments, early recognition of such patients can improve planning and reduce wastage of blood products. No existing decision rule is sufficiently reliable to predict those patients requiring massive blood transfusion. This study aims to produce a decision rule for use on arrival at hospital for patients sustaining battlefield trauma...
September 28, 2017: Injury
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