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https://www.readbyqxmd.com/read/28328683/surgical-support-during-the-terrorist-attacks-in-paris-13-november-2015-experience-at-b%C3%A3-gin-military-teaching-hospital
#1
Olivier Barbier, Brice Malgras, Camille Choufani, Antoine Bouchard, Didier Ollat, Gilbert Versier
BACKGROUND: Recent conflicts have allowed the French Army Health Service to improve management quality for wartime-injured people during military operations. On 13 November 2015, it was in Paris that France was directly attacked and Bégin Military Teaching Hospital, like several hospitals in Paris, had to face a large number of gunshot victims. Thanks to our operational experience, injured people hospitalized in military hospitals benefited from a management based on triage and damage control (DC) principles...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28324673/a-framework-to-guide-the-assessment-of-human-machine-systems
#2
Kimberly Stowers, James Oglesby, Shirley Sonesh, Kevin Leyva, Chelsea Iwig, Eduardo Salas
OBJECTIVE: We have developed a framework for guiding measurement in human-machine systems. BACKGROUND: The assessment of safety and performance in human-machine systems often relies on direct measurement, such as tracking reaction time and accidents. However, safety and performance emerge from the combination of several variables. The assessment of precursors to safety and performance are thus an important part of predicting and improving outcomes in human-machine systems...
March 2017: Human Factors
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#3
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28318990/junctional-hemorrhage-control-for-tactical-combat-casualty-care
#4
REVIEW
Russ S Kotwal, Frank K Butler
During historic, as well as more recent, conflicts, most combat casualties who die from their injuries do so in the prehospital setting. Although many of the injuries incurred by these casualties are nonsurvivable, a number of injuries are still potentially survivable. Of those injuries that are potentially survivable, the majority are truncal, junctional, and extremity hemorrhage. Novel and effective approaches directed toward prehospital hemorrhage control have emerged in recent years, some of which can prove useful in the management of junctional hemorrhage whether in a military or civilian setting...
March 16, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28301394/effects-on-the-anti-abo-titers-of-military-blood-donors-from-a-predeployment-vaccination-program
#5
Olle Berséus
BACKGROUND: The use of blood group O as "universal blood" for emergency whole blood transfusions carries the risk for a hemolytic transfusion reaction mediated by incompatible A-/B-antibodies. This risk can be minimized by assuring that the donor has a low titer of anti-A and anti-B. The level of these naturally occurring antibodies have been shown to be increased by vaccination with most biologically derived vaccines. This boostering effect has been investigated for the new generation of vaccines...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28291501/lateral-flow-rapid-test-for-accurate-and-early-diagnosis-of-scrub-typhus-a-febrile-illness-of-historically-military-importance-in-the-pacific-rim
#6
Chien-Chung Chao, Zhiwen Zhangm, Giulia Weissenberger, Hua-Wei Chen, Wei-Mei Ching
Scrub typhus (ST) is an infection caused by Orientia tsutsugamushi. Historically, ST was ranked as the second most important arthropod-borne medical problem only behind malaria during World War II and the Vietnam War. The disease occurs mainly in Southeast Asia and has been shown to emerge and reemerge in new areas, implying the increased risk for U.S. military and civilian personnel deployed to these regions. ST can effectively be treated by doxycycline provided the diagnosis is made early, before the development of severe complications...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291498/emergency-department-wounds-managed-by-combat-medics-a-case-series
#7
Steven G Schauer, James A Pfaff
BACKGROUND: Combat medics are an integral part of their unit helping to conserve the fighting strength. Minor wounds are a common problem in the deployed settings that affect a soldier's ability to partake in operations. While the medics often manage wound care, there is very little data on the outcomes. METHODS: Cases were acquired as part of a quality assurance project providing training feedback to medics on wound management. Laceration management is delegated to the medic at the direction of the provider...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291495/an-assessment-of-national-emt-certification-among-enlisted-military-medics
#8
Stephen Harper, Remle Crowe, Melissa Bentley, Chetan Kharod, Benjamin Walrath
BACKGROUND: Navy Hospital Corpsmen (HMs) are the Navy equivalent to Emergency Medical Technicians (EMTs) both in-garrison and on the battlefield. In 2000, the Emergency Medical Services (EMS) Education Agenda for the Future highlighted the need for a single certification agency to provide consistent evaluation of entry level competence for each nationally recognized EMS provider level. Administered by the National Registry of EMTs (NREMT), National EMT Certification is currently utilized by 46 states, the District of Columbia, four territories, and six federal organizations as part of their processes for granting licensure...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291494/military-emergency-medical-service-system-assessment-application-of-the-national-park-service-needs-assessment-and-program-audit-to-objectively-evaluate-the-military-ems-system-of-okinawa-japan
#9
Elliot M Ross, Stephen A Harper, Cord Cunningham, Benjamin D Walrath, Gerard DeMers, Chetan U Kharod
INTRODUCTION: As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). METHODS: A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291221/-a-new-concept-of-organization-and-scope-of-neurosurgical-care-in-the-us-army-during-armed-conflicts-in-the-early-2000s
#10
Yu V Khrapov, D E Alekseev, D V Svistov
Military operations in various parts of the world in the early 2000s are becoming more regionalized; new warfare tactics emerge, which makes it necessary to review and modify the neurosurgical care system. The article reviews the results of original studies on this issue and summarizes the experience of the US Army medical service in Afghanistan and Iraq. The article discusses the structure of sanitary losses, organization and scope of medical and evacuation neurosurgical measures, types and techniques of surgical interventions, and the rate of complications...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28290979/orbital-cellulitis-in-a-psoriatic-patient-treated-with-adalimumab
#11
Vienna G Katana, Robert J Carpenter, John P Trafeli, Julia M Kwan
INTRODUCTION: Psoriatic patients on tumor necrosis factor alpha inhibitors (TNFi) may be at increased risk for upper respiratory tract infections, including chronic rhino-sinusitis (CRS). Rarely, CRS can progress to orbital cellulitis (OC), an emergent ophthalmic complication wherein respiratory flora from paranasal sinus disease intrude the retro-orbital space. MATERIALS AND METHODS: Single case report. RESULTS: We report the first case, to our knowledge, of an invasive sinusitis that rapidly evolved into OC in a patient receiving adalimumab treatment for plaque psoriasis and psoriatic arthritis...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290966/ultrasound-detection-of-soft-tissue-abscesses-performed-by-non-physician-u-s-army-medical-providers-na%C3%A3-ve-to-diagnostic-sonography
#12
Mike LaDuke, Jon Monti, Aaron Cronin, Bart Gillum
BACKGROUND: Patients commonly present to emergency rooms and primary care clinics with cellulitic skin infections with or without abscess formation. In military operational units, non-physician medical personnel provide most primary and initial emergency medical care. The objective of this study was to determine if, after minimal training, Army physician assistants and medics could use portable ultrasound (US) machines to detect superficial soft tissue abscesses. METHODS: This was a single-blinded, randomized, prospective observational study conducted over the course of 2 days at a military installation...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290958/comparative-assessment-of-three-approaches-of-teaching-nonmedically-trained-persons-in-the-handling-of-supraglottic-airways-a-randomized-controlled-trial
#13
Mario Hensel, Willi Schmidbauer, Michael Benker, Paula Schmieder, Thoralf Kerner
BACKGROUND: The use of supraglottic airways has been recommended in combat trauma airway management. To ensure an adequate airway management on the battlefield, suitable training concepts are sought to efficiently teach as many soldiers as possible. Our aim was to compare three approaches of teaching laypersons in the handling of supraglottic airways in a mannequin model. METHODS: In this prospective randomized blinded study, 285 military service men without any medical background were divided into three groups and trained in the use of the Laryngeal Mask Airway Supreme (LMA) and the Laryngeal Tube Disposable (LT-D)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290952/transitioning-to-patient-centered-medical-homes-associations-with-appointment-availability
#14
Todd C Leroux, Murray J Côté, Hye-Chung Kum, Alan Dabney, Rebecca Wells
INTRODUCTION: Recent implementation of the Patient-Centered Medical Home (PCMH) in military primary care has gained significant traction and attention from leadership and policy makers. The study objective was to measure the rate of change in appointment availability before and after primary care clinics were certified as a medical home. Access to care is one core tenet of the medical home and appointment availability is an important indicator of access. MATERIALS AND METHODS: This was a retrospective, longitudinal observational study involving 21 U...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290948/mortality-surveillance-for-infectious-diseases-in-the-u-s-department-of-defense-1998-2013
#15
Robert N Potter, Ladd A Tremaine, Joel C Gaydos
INTRODUCTION: The Mortality Surveillance Division (MSD) of the U.S. Armed Forces Medical Examiner System was established in 1998 to improve surveillance for all military deaths although emphasizing deaths from infectious diseases. Establishment of the MSD was part of the 1997 Department of Defense initiative to improve surveillance and response for emerging infectious diseases. Before 1998, mortality surveillance was limited to compiling information from death certificates, a system that provided limited useful information and lacked the timeliness needed to take meaningful action to address emerging infectious disease threats...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#16
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 best-practice 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 U.S. 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...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28285478/cat-on-a-hot-tin-roof-mechanical-testing-of-models-of-tourniquets-after-environmental-exposure
#17
Daniel K O'Conor, John F Kragh, James K Aden, Michael A Dubick
BACKGROUND: The purpose of the present study was to mechanically assess models of emergency tourniquet after 18 months of environmental exposure to weather to better understand risk of component damage. MATERIALS AND METHODS: An experiment was designed to test tourniquet performance on a manikin thigh. Three tourniquet models were assessed: Special Operations Forces Tactical Tourniquet Wide, Ratcheting Medical Tourniquet, and Combat Application Tourniquet. Unexposed tourniquets formed a control group stored in a laboratory; exposed tourniquets were placed outdoors on a metal roof for 18 months in San Antonio, Texas...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28282896/performance-and-challenges-of-service-oriented-architecture-for-wireless-sensor-networks
#18
Remah Alshinina, Khaled Elleithy
Wireless Sensor Networks (WSNs) have become essential components for a variety of environmental, surveillance, military, traffic control, and healthcare applications. These applications face critical challenges such as communication, security, power consumption, data aggregation, heterogeneities of sensor hardware, and Quality of Service (QoS) issues. Service-Oriented Architecture (SOA) is a software architecture that can be integrated with WSN applications to address those challenges. The SOA middleware bridges the gap between the high-level requirements of different applications and the hardware constraints of WSNs...
March 8, 2017: Sensors
https://www.readbyqxmd.com/read/28282331/multigroup-path-analysis-of-the-influence-of-healthcare-quality-by-different-health-insurance-types
#19
Yong-Rock Hong, Derek Holcomb, Michael Ballard, Laurel Schwartz
Winds of change have been blowing in the U.S. healthcare system since passage of the Affordable Care Act. Examining differences between individuals covered by different types of insurance is essential if healthcare executives are to develop new strategies in response to the emerging health insurance market. In this study, we used multigroup path analysis models to examine the moderating effects of health insurance on direct and indirect associations with general health status, satisfaction with received care, financial burden, and perceived value of the healthcare system...
March 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28257712/the-effects-of-a-36-hour-mixed-task-ultraendurance-race-on-mucosal-immunity-markers-and-pulmonary-function
#20
David Bellar, Kellie A Murphy, Ritvik Aithal, Greggory R Davis, Tim Piper
OBJECTIVE: The present study was conducted to assess the changes in mucosal immunity and pulmonary function among participants in a 36-hour mixed task ultraendurance race. METHODS: Thirteen of the 20 race participants volunteered for the investigation (age 34±5 y). The event consisted of a mixture of aerobic, strong man, and military-style exercise. Participants had a pulmonary function test and gave a finger stick capillary blood sample and unstimulated saliva samples both before the event and upon dropout or completion...
March 2017: Wilderness & Environmental Medicine
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