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https://www.readbyqxmd.com/read/29115646/a-new-perspective-on-life-saving-procedures-in-a-battlefield-setting-emergency-cricothyroidotomy-needle-thoracostomy-and-chest-tube-thoracostomy-with-night-vision-goggles
#1
Sedat Bilge, Attila Aydın, Meltem Bilge, Cemile Aydın, Erdem Çevik, Mehmet Eryılmaz
BACKGROUND: In the patients with multiple and serious trauma, early applications of life-saving procedures are related to improved survival. We tried to experimentally determine the feasibility of life-saving interventions that are performed with the aid of night vision goggles (NVG) in nighttime combat scenario. METHODS: Chest tube thoracostomy (CTT), emergency cricothyroidotomy (EC), and needle thoracostomy (NT) interventions were performed by 10 combatant medical staff...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29097176/how-shall-we-transfuse-hippolyta
#2
Brendan C Graham, Lindsey J Graham, Carl H Rose, Jeffrey L Winters
The US Department of Defense recently made the decision to open direct ground combat roles to women. Blood product transfusion is an essential component of the US Military guidelines for tactical combat casualty care and damage control resuscitation, but blood transfusion carries with it the specific side effect of alloimmunization-a uniquely significant side effect for young women who may desire subsequent pregnancies. Presently to be considered are the changes that may need to be made to blood transfusion in the setting of battlefield medicine to optimally care for combat-injured women, as a majority of the existing data regarding the risks of transfusion in the trauma setting involve predominantly men...
October 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29040202/re-examination-of-a-battlefield-trauma-golden-hour-policy
#3
Jeffrey T Howard, Russ S Kotwal, Alexis R Santos, Matthew J Martin, Zsolt T Stockinger
BACKGROUND: Most combat casualties who die, do so in the prehospital setting. Efforts directed toward alleviating prehospital combat trauma death, known as killed in action (KIA) mortality, have the greatest opportunity for eliminating preventable death. METHODS: 4,542 military casualties injured in Afghanistan from September 11, 2001 to March 31, 2014 were included in this retrospective analysis to evaluate proposed explanations for observed KIA reduction following a mandate by Secretary of Defense Robert M...
October 16, 2017: Journal of Trauma and Acute Care 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
#4
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
https://www.readbyqxmd.com/read/28941503/management-of-high-velocity-injuries-of-the-head-and-neck
#5
REVIEW
Jacob S Majors, Joseph Brennan, G Richard Holt
Trauma centers must prepare to manage high-velocity injuries resulting from a mass casualty incidents as global terrorism becomes a greater concern and an increasing risk. The most recent conflicts in Iraq and Afghanistan have significantly improved understanding of battlefield trauma and how to appropriately address these injures. This article applies combat surgery experience to civilian situations, outlines the physiology and kinetics of high-velocity injuries, and reviews applicable triage and management strategies...
November 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28930960/prehospital-administration-of-freeze-dried-plasma-is-it-the-solution-for-trauma-casualties
#6
Amir Shlaifer, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg, Avi Shina, Erez Nachum Baruch, Elon Glassberg, Avraham Yitzhak
BACKGROUND: Hemorrhage is the leading cause of possible preventable death in the battlefield. There is an increasing evidence for the effectiveness of blood component therapy in general, and plasma infusion in particular but their use is less applicable in the prehospital setting due to logistic difficulties. Israeli Defense Force has implemented the use of freeze-dried plasma (FDP) at the point of injury (POI), this adoption of FDP use entailed doubts regarding the feasibility and effectiveness of this practice...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28910475/chest-seal-placement-for-penetrating-chest-wounds-by-prehospital-ground-forces-in-afghanistan
#7
Steven G Schauer, Michael D April, Jason F Naylor, Erica M Simon, Andrew D Fisher, Cord W Cunningham, Daniel M Morissette, Jessie Renee D Fernandez, Kathy L Ryan
BACKGROUND: Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device. Although the Committee on TCCC (CoTCCC) has approved numerous chest seal devices for battlefield use, few data exist regarding their use in a combat zone setting...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910462/prehospital-cricothyrotomy-kits-used-in-combat
#8
Steven G Schauer, Michael D April, Cord W Cunningham, Adrianna N Long, Robert Carter
BACKGROUND: Surgical cricothyrotomy remains the only definitive airway management modality for the tactical setting recommended by Tactical Combat Casualty Care guidelines. Some units have fielded commercial cricothyrotomy kits to assist Combat Medics with surgical cricothyrotomy. To our knowledge, no previous publications report data on the use of these kits in combat settings. This series reports the the use of two kits in four patients in the prehospital combat setting. METHODS: Using the Department of Defense Trauma Registry and the Prehospital Trauma Registry, we identified four cases of patients who underwent prehospital cricothyrotomy with the use of commercial kits...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28903862/in-a-stable-battlefield-avoid-using-austere-surgical-units-to-meet-the-golden-hour-of-trauma-time-to-care-goal
#9
EDITORIAL
Richard Childers, Paul Parker
No abstract text is available yet for this article.
November 2017: Injury
https://www.readbyqxmd.com/read/28885944/the-value-of-live-tissue-training-for-combat-casualty-care-a-survey-of-canadian-combat-medics-with-battlefield-experience-in-afghanistan
#10
Michael Kim, Ian Torrie, Robert Poisson, Nicholas Withers, Stephen Bjarnason, Luis Teodoro DaLuz, Dylan Pannell, Andrew Beckett, Homer C Tien
INTRODUCTION: The optimum method for training military personnel for combat casualty care is unknown. In particular, there is debate regarding the incremental benefit of live animal tissue training (LTT) over inanimate human patient simulators (HPSs). Although both LTT and HPS are currently used for predeployment training, the efficacy of these models has not been established. MATERIALS AND METHODS: Canadian Armed Forces combat medics, deployed to Afghanistan between 2006 and 2011, were surveyed retrospectively regarding their experience with combat casualty care and predeployment training...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28828914/the-joint-facial-and-invasive-neck-trauma-j-faint-project-iraq-and-afghanistan-2011-2016
#11
MULTICENTER STUDY
Alexander Lanigan, Brentley Lindsey, Stephen Maturo, Joseph Brennan, Adrienne Laury
Objective Define the number and type of facial and penetrating neck injuries sustained in combat operations in Iraq and Afghanistan from 2011 to 2016. Compare recent injury trends to prior years of modern conflict. Study Design Case series with chart review. Setting Tertiary care hospital. Methods The Joint Theater Trauma Registry (JTTR) was queried for facial and neck injuries from Iraq and Afghanistan from June 2011 to May 2016. Injury patterns, severity, and patient demographics were analyzed and compared to previously published data from combat operations during January 2003 to May 2011...
October 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28807080/a-descriptive-analysis-of-traction-splint-utilization-and-iv-analgesia-by-emergency-medical-services
#12
Joshua Nackenson, Amado A Baez, Jonathan P Meizoso
Study Objectives Traction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) analgesia utilization by Emergency Medical Services (EMS) in Miami, Florida (USA). METHODS: This is a retrospective study of patients who sustained a midshaft femur fracture in the absence of multiple other severe injuries or severe physiologic derangement, as defined by an injury severity score (ISS) <20 and a triage revised trauma score (T-RTS)≥10, who presented to an urban, Level 1 trauma center between September 2008 and September 2013...
August 15, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28780253/biomechanics-of-human-parietal-pleura-in-uniaxial-extension
#13
Luis E Morales Tenorio, Kelsey J Devine, Jayme Lee, Timothy M Kowalewski, Victor H Barocas
Tension pneumothorax, a major preventable cause of battlefield death, often arises from chest trauma and is treated by needle decompression to release trapped air from the pleural cavity. Surgical simulation mannequins are often employed to train medical personnel to perform this procedure properly. Accurate reproduction of the mechanical behavior of the parietal pleura, especially in response to needle penetration, is essential to maximize the fidelity of these surgical simulators. To date, however, the design of pleura-simulating material has been largely empirical and based on subjective practitioner feel rather than on the tissue properties, which have remained unknown...
July 29, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28748419/can-we-train-military-surgeons-in-a-civilian-trauma-center
#14
H Uchino, V Y Kong, G V Oosthuizen, J L Bruce, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The objective of this study was to review the trauma workload and operative exposure in a major South African trauma center and provide a comparison with contemporary experience from major military conflict. MATERIALS AND METHODS: All patients admitted to the PMTS following trauma were identified from the HEMR. Basic demographic data including mechanism of injury and body region injured were reviewed. All operative procedures were categorized. The total operative volume was compared with those available from contemporary literature documenting experience from military conflict in Afghanistan...
July 26, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28668522/the-traumatic-bone-trauma-induced-heterotopic-ossification
#15
REVIEW
Devaveena Dey, Benjamin M Wheatley, David Cholok, Shailesh Agarwal, Paul B Yu, Benjamin Levi, Thomas A Davis
Heterotopic ossification (HO) is a common occurrence after multiple forms of extensive trauma. These include arthroplasties, traumatic brain and spinal cord injuries, extensive burns in the civilian setting, and combat-related extremity injuries in the battlefield. Irrespective of the form of trauma, heterotopic bone is typically endochondral in structure and is laid down via a cartilaginous matrix. Once formed, the heterotopic bone typically needs to be excised surgically, which may result in wound healing complications, in addition to a risk of recurrence...
August 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28610569/a-novel-tamponade-agent-for-management-of-post-partum-hemorrhage-adaptation-of-the-xstat-mini-sponge-applicator-for-obstetric-use
#16
Maria I Rodriguez, Jeffrey T Jensen, Kenton Gregory, Mary Bullard, Paul Longo, Jerry Heidel, Alison Edelman
BACKGROUND: Although uterine tamponade is an effective treatment for postpartum hemorrhage (PPH), current methods have key limitations in their use, particularly in low resource settings. The XStat™ Mini Sponge Dressing (MSD) is approved for the management of non-compressible wounds in the battlefield/trauma setting. The MSD applies highly compressed medical sponges capable of stopping high-flow arterial bleeding within seconds. The objective of our study was to adopt the MSD for use in managing PPH...
June 13, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28601213/treatment-of-thoracic-trauma-lessons-from-the-battlefield-adapted-to-all-austere-environments
#17
REVIEW
Lanny F Littlejohn
Severe thoracic trauma in the backcountry can be a formidable injury pattern to successfully treat. Traumatic open, pneumo-, and hemothoraces represent some of the most significant patterns for which advanced equipment and procedures may help leverage morbidity and mortality, particularly when evacuation is delayed and environmental conditions are extreme. This paper reviews the development of successful techniques for treating combat casualties with thoracic trauma, including the use of vented chest seals and the technique of needle thoracentesis...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601212/awake-cricothyrotomy-a-novel-approach-to-the-surgical-airway-in-the-tactical-setting
#18
REVIEW
Robert L Mabry, Chetan U Kharod, Brad L Bennett
Airway obstruction on the battlefield is most often due to maxillofacial trauma, which may include bleeding and disrupted airway anatomy. In many of these cases, surgical cricothyrotomy (SC) is the preferred airway management procedure. SC is an emergency airway procedure performed when attempts to open an airway using nasal devices, oral devices, or tracheal intubation have failed, or when the risks from intubation are unacceptably high. The aim of this overview is to describe a novel approach to the inevitably surgical airway in which SC is the first and best procedure to manage the difficult or failed airway...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#19
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28599041/quikclot%C3%A2-combat-gauze%C3%A2-use-by-ground-forces-in-afghanistan-the-prehospital-trauma-registry-experience
#20
Steven G Schauer, Michael D April, Jason F Naylor, Andrew D Fisher, Cord W Cunningham, Kathy L Ryan, Krista C Thomas, Daniel B Brillhart, Jessie Renee D Fernandez, Mark A Antonacci
BACKGROUND: QuikClot® Combat Gauze® (QCCG) was fielded in 2008 to replace previous generations of hemostatic products. To the best of our knowledge, despite nearly a decade of use, there are no published data on use among US combatant forces. We describe the use of QCCG by ground forces in Afghanistan and compare patients who received QCCG compared with the remaining population in the database who did not receive QCCG. METHODS: Data were obtained from the Prehospital Trauma Registry (PHTR)...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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