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https://www.readbyqxmd.com/read/27852461/the-development-of-intensive-care-in-the-military-environment
#1
REVIEW
Matthew J Roberts
If the history of critical care is to be addressed, the starting point must be the fundamental and defining qualities of intensive care units. These are the concentration of the sickest patients in a defined area of the hospital, staffed by the personnel most able to care for them (by virtue of specialist training), and the application of the most advanced monitoring or therapeutic techniques available at the time. In the military environment, the ability to provide critical care to ill or injured servicemen has developed in tandem with the civilian experience, but the pressures of the austere environment of the battlefield have, at times, held back military medical services from providing the highest level of care that servicemen might deserve and, indeed, expect in civilian life...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27848415/learning-lessons-from-war-to-treat-people-with-trauma
#2
(no author information available yet)
Trauma is a leading cause of death and disability in civilian environments, and on the battlefield, and trauma-induced haemorrhage is the main cause of potentially preventable death.
November 9, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27768657/genitourinary-injuries-and-extremity-amputation-in-operations-enduring-freedom-and-iraqi-freedom-early-findings-from-the-trauma-outcomes-and-urogenital-health-tough-project
#3
Nina S Nnamani, Judson C Janak, Steven J Hudak, Jessica C Rivera, Eluned A Lewis, Douglas W Soderdahl, Jean A Orman
BACKGROUND: In Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), genitourinary (GU) wounds have occurred in unprecedented numbers. Severe concomitant injuries, including extremity amputations, are common. The epidemiology of GU injury and extremity amputation in OEF/OIF has not been described. MATERIALS AND METHODS: The Department of Defense Trauma Registry was queried from October 2001 through August 2013 to identify all surviving US male service members with GU injuries sustained in OEF/OIF...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27734441/evaluation-of-two-junctional-tourniquets-used-on-the-battlefield-combat-ready-clamp%C3%A2-versus-sam%C3%A2-junctional-tourniquet
#4
Jean-Guillaume Meusnier, Charles Dewar, Erti Mavrovi, Frederic Caremil, Pierre-Francois Wey, Jean-Yves Martinez
BACKGROUND: Junctional hemorrhage (i.e., between the trunk and limbs) are too proximal for a tourniquet and difficult to compress. These hemorrhages are responsible for 20% of preventable deaths by bleeding on the battlefield. The majority of these involve the groin area. Devices allowing a proximal compression for arterial axes have been recently developed. OBJECTIVE: The purpose of this study was to compare the use of two junctional- tourniquet models, the Combat Ready Clamp (CRoC®) and the SAM® Junctional Tourniquet (SJT), in simulated out-of-hospital trauma care when tourniquets were ineffective to stop the arterial flow...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27724088/advances-in-military-resuscitation
#5
Sharon Edwards, Jason Smith
Trauma is a leading cause of death and disability worldwide, in civilian environments and on the battlefield. Trauma-induced haemorrhage is the principal cause of potentially preventable death, which is generally attributable to a combination of vascular injury and coagulopathy. Survival rates following severe traumatic injury have increased due to advanced trauma management initiatives and treatment protocols, influenced by lessons learned from recent conflicts in Iraq and Afghanistan. The use of tourniquets and intraosseous needles, early blood and blood product transfusion, administration of tranexamic acid in pre-hospital settings, and consultant-led damage control resuscitation incorporating damage control surgery have all played their part...
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27661422/resuscitation-and-treatment-of-shock
#6
Michael J Beltran, Tyson E Becker, Richard K Hurley, Jennifer M Gurney, Roman A Hayda
Hemorrhage continues to be the most common cause of death among service members wounded in combat. Injuries that were previously nonsurvivable in previous wars are now routinely seen by combat surgeons in forward surgical units, the result of improvements in body armor, the universal use of field tourniquets to control extremity hemorrhage at the point of injury, and rapid air evacuation strategies. Combat orthopaedic surgeons remain a vital aspect of the forward surgical unit, tasked with assisting general surgical colleagues in the resuscitation of patients in hemorrhagic shock while also addressing traumatic amputations, open and closed long bone fractures, and mechanically unstable pelvic trauma...
October 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27648400/management-of-battlefield-injuries-to-the-skull-base
#7
REVIEW
Jayne R Stevens, Joseph Brennan
High velocity skull base injuries on the battlefield are unique in comparison to most civilian sector trauma. With more than 43,000 United States military personnel injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF), the most recent conflicts in Iraq and Afghanistan have significantly expanded the understanding of the physiology of modern battlefield trauma and how to appropriately address these injuries. The acute care principles of effective triage, airway management, and hemorrhage control in these injuries can be life saving and are reviewed here...
October 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27602905/analysis-of-injury-patterns-and-roles-of-care-in-us-and-israel-militaries-during-recent-conflicts-two-are-better-than-one
#8
Ben Antebi, Avi Benov, Elizabeth A Mann-Salinas, Tuan D Le, Leopoldo C Cancio, Joseph C Wenke, Haim Paran, Avraham Yitzhak, Bader Tarif, Kirby R Gross, David Dagan, Elon Glassberg
BACKGROUND: As new conflicts emerge and enemies evolve, military medical organizations worldwide must adopt the "lessons learned." In this study, we describe roles of care (ROCs) deployed and injuries sustained by both US and Israeli militaries during recent conflicts. The purpose of this collaborative work is facilitate exchange of medical data among allied forces in order to advance military medicine and facilitate strategic readiness for future military engagements that may involve less predictable situations of evacuation and care, such as prolonged field care...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27531659/tactical-damage-control-resuscitation-in-austere-military-environments
#9
REVIEW
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...
December 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27456289/advances-in-the-diagnosis-of-shock-its-assessment-and-resuscitation-during-the-great-war
#10
A G P Bullingham
The Great War of 1914-1918 ushered in a new era of technology on the battlefield resulting in casualties on an unprecedented scale. There had been progress in many related areas of medicine before the outbreak of hostilities but these had not been applied or fully developed in clinical practice. This is particularly true for the management of haemorrhagic shock and resuscitation. This article discusses the history and development of medical treatment of shock and trauma patients during the conflict.
July 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27405067/tactical-study-of-care-originating-in-the-prehospital-environment-tacscope-acute-traumatic-coagulopathy-on-the-contemporary-battlefield
#11
Robert T Gerhardt, Elon Glassberg, John B Holcomb, Robert L Mabry, Martin B Schreiber, Philip C Spinella
BACKGROUND: Uncontrolled major hemorrhage and delayed evacuation remain substantial contributors to potentially survivable combat death, along with mission, environment, terrain, logistics, and hostile action. Life-saving interventions and the onset of acute traumatic coagulopathy (ATC) may also contribute. OBJECTIVE: Analyze US casualty records from the DoD Trauma Registry, using International Normalized Ratio (INR) of 1.5 for onset of ATC. METHODS: Retrospective cohort study from September 2007 to June 2011, inclusive...
September 2016: Shock
https://www.readbyqxmd.com/read/27366860/management-and-reconstruction-of-blast-wounds-of-the-head-and-neck
#12
Jayne R Stevens, Joseph Brennan
PURPOSE OF REVIEW: The purpose of this review is to highlight recent literature related to the initial management and reconstruction of blast injuries to the head and neck. RECENT FINDINGS: An increasing percentage of combat-related injuries are caused by blast trauma. Management of blast trauma over the last 10 years has improved understanding of the unique nature of these injuries and the importance of thoughtful management and reconstruction. Blast trauma is associated with an increased need for definitive airway management...
October 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27318022/total-phallic-reconstruction-using-the-radial-artery-based-forearm-free-flap-after-traumatic-penile-amputation
#13
Marco Falcone, Giulio Garaffa, Amr Raheem, Nim A Christopher, David J Ralph
INTRODUCTION: Although genital injuries in civilian centers are rare, the scenario is completely different in the battlefield. If the penile distal stump is not adequate for primary reimplantation or it cannot be found, then delayed penile reconstruction needs to be considered. AIM: To report a single-center experience with total phallic reconstruction using radial artery based forearm free flap (RAFFF) after penile traumatic loss. METHODS: We retrospectively reviewed the clinical records of 10 patients who underwent total phallic reconstruction with the use of the RAFFF from September 2001 through August 2015 after traumatic amputation of the penis...
July 2016: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/27280938/genitourinary-injuries-and-extremity-amputation-in-operations-enduring-and-iraqi-freedom-early-findings-from-the-trauma-outcomes-and-urogenital-health-tough-project
#14
Nina S Nnamani, Judson C Janak, Steven J Hudak, Jessica C Rivera, Eluned A Lewis, Douglas W Soderdahl, Jean A Orman
BACKGROUND: In Operations Enduring Freedom and Iraqi Freedom (OEF/OIF), genitourinary (GU) wounds have occurred in unprecedented numbers. Severe concomitant injuries, including extremity amputations, are common. The epidemiology of GU injury and extremity amputation in OEF/OIF has not been described. MATERIALS AND METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from October 2001 through August 2013 to identify all surviving US male service members with GU injuries sustained in OEF/OIF...
June 8, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27273615/the-success-of-battlefield-surgical-airway-insertion-in-severely-injured-military-patients-a-uk-perspective
#15
Tony Kyle, S le Clerc, A Thomas, I Greaves, V Whittaker, J E Smith
BACKGROUND: The insertion of a surgical airway in the presence of severe airway compromise is an uncommon occurrence in everyday civilian practice. In conflict, the requirement for insertion of a surgical airway is more common. Recent military operations in Afghanistan resulted in large numbers of severely injured patients, and a significant proportion required definitive airway management through the insertion of a surgical airway. OBJECTIVE: To examine the procedural success and survival rate to discharge from a military hospital over an 8-year period...
December 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27238996/vascular-injuries-in-combat-specific-soldiers-during-operation-iraqi-freedom-and-operation-enduring-freedom
#16
John C Dunn, Nicholas Kusnezov, Andrew J Schoenfeld, Justin D Orr, Patrick J Cook, Philip J Belmont
BACKGROUND: This study sought to identify vascular injury patterns among combat-specific cavalry scout personnel within the Iraq and Afghanistan Wars. METHODS: The Armed Forces Medical Examiner System and Joint Theater Trauma Registry were queried for all injuries with the cavalry scout designation from 2003 to 2011, including those both wounded in action (WIA) and killed in action (KIA). A description of vascular injury, combat causality care statistics, mechanism of injury, and demographic data were recorded...
August 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27218055/overview-of-agents-used-for-emergency-hemostasis
#17
REVIEW
Hadi Khoshmohabat, Shahram Paydar, Hossein Mohammad Kazemi, Behnam Dalfardi
CONTEXT: In today's modern world, despite the multiple advances made in the field of medicine, hemorrhagic shock is still the main cause of battlefield mortality and the second most prevalent cause of mortality in civilian trauma. Hemostatic agents can play a key role in establishing hemostasis in prehospital situations and preventing hemorrhage-associated death. In this respect, this article aims to review different aspects of known hemostatic agents. EVIDENCE ACQUISITION: A comprehensive search of the academic scientific databases for relevant keywords was conducted; relevant articles were compiled and assessed...
February 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27215891/surgical-and-resuscitation-capabilities-for-the-next-war-based-on-lessons-learned-from-this-war
#18
David Freel, Bradley J Warr
The Army gleaned many lessons regarding the provision of medical care to casualties during the past 14 years of combat. Using these lessons learned in the Joint Capabilities and Integration Development process and through the analysis of an integrated process action team, the Army recently approved 3 changes to medical organizations that are intended to provide trauma management farther forward on the battlefield. These changes include the substitution of an emergency medicine trained physician and emergency medicine physician assistant (PA) in lieu of a general medical officer and primary care PA within the brigade combat team; reorganization of the forward surgical team into a forward surgical and resuscitative team; and the modularization of the traditional 248 bed combat support hospital...
April 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27215873/battlefield-documentation-of-tactical-combat-casualty-care-in-afghanistan
#19
John B Robinson, Michael P Smith, Kirby R Gross, Samual W Sauer, James J Geracci, Charlie D Day, Russ S Kotwal
Performance improvement is reliant on information and data, as you cannot improve what you do not measure. The US military went to war in 2001 without an integrated trauma care system to collect and analyze combat casualty care data. By 2006, the conflict in Afghanistan began appreciating the capture and consolidation of hospital care documentation into the Department of Defense Trauma Registry. In contrast, a paucity of documentation has existed for prehospital or tactical combat casualty care (TCCC). Using the 75th Ranger casualty documentation model established in 2005, the Joint Trauma System developed a casualty data collection system for prehospital care using the TCCC Card, the TCCC After Action Report (AAR), and the Prehospital Trauma Registry...
April 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27215869/advances-in-anesthesia-delivery-in-the-deployed-setting
#20
John E Wilson, William P Barras
Lessons learned over the past decade and a half of combat casualty management has brought about numerous advances in trauma anesthesia practice. In the post-Vietnam era, deployable anesthesia equipment centered on the capability to provide a balanced anesthetic technique, utilizing a combination of volatile gas and intravenous anesthetic adjuncts. The evolution of the modern battlefield has forced anesthesia providers across the military to adapt to mission requirements that often dictate a surgical capability that is more rapidly mobile and less reliant on logistical support...
April 2016: U.S. Army Medical Department Journal
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