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https://www.readbyqxmd.com/read/28318991/bleeding-control-using-hemostatic-dressings-lessons-learned
#1
REVIEW
Brad L Bennett
Based on lessons learned, many military battlefield trauma advances ultimately transition to enhance civilian trauma care. However, even with major strides to enhance battlefield hemorrhage control, it is unclear how effectively these techniques and products are being translated to civilian trauma. The purpose of this brief review is to present the evidence of current hemostatic product effectiveness, determine the evidence for transitioning of this technology to prehospital civilian application, and provide recommendations about potential use in the wilderness/austere setting...
March 16, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28318990/junctional-hemorrhage-control-for-tactical-combat-casualty-care
#2
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/28316161/-to-further-strengthen-the-construction-of-emergency-medical-treatment-system-of-massive-burn
#3
C Y Jia
Although clinical medicine of our country has made great progress in recent years, the rescue of massive burn casualties is still facing enormous challenges. No matter it is the top level design, system configuration, plan preparation, training, education, or the operation process, the medical resource allocation, and the treatment efficiency, are far behind the demand of social development. Therefore, further strengthen the construction of emergency medical treatment system of massive burn is the unshirkable responsibility of burn medical workers in our country...
March 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28301969/the-internet-s-effect-on-personality-traits-an-important-casualty-of-the-internet-addiction-paradigm
#4
Elias Aboujaoude
Background and aims The "Internet addiction" paradigm has been criticized for several shortcomings, including inattention to specific online behaviors, not distinguishing the Internet from other media, insufficient focus on comorbidities, and definitions that do not take into account the constant access now possible. The paradigm's biggest casualty, however, may be that it has diverted attention away from subtle personality changes that seem to occur online, including in users who cannot be considered "addicted" under any definition...
March 17, 2017: Journal of Behavioral Addictions
https://www.readbyqxmd.com/read/28296466/road-accident-fatality-risks-for-vulnerable-versus-protected-road-users-in-northern-ghana
#5
James Damsere-Derry, Gavan Palk, Mark King
Background Road traffic injuries (RTIs) are a serious epidemic which claims more than a million lives across the globe each year. The burden of RTIs is particularly pronounced in Africa and other low and middle income countries. The unfavourable disparity of the burden of road trauma in the world is largely attributable to unsafe vehicles, lack of appropriate road infrastructure and the predominance of vulnerable road users (VRUs) in developing countries. However, little research exists in Northern Ghana to highlight the scale and risk of death among road users...
March 15, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28295590/shifting-gears-triage-and-traffic-in-urban-india
#6
Harris Solomon
While studies of triage in clinical medical literature tend to focus on the knowledge required to carry out sorting, this article details the spatial features of triage. It is based on participation observation of traffic-related injuries in a Mumbai hospital casualty ward. It pays close attention to movement, specifically to adjustments, which include moving bodies, changes in treatment priority, and interruptions in care. The article draws on several ethnographic cases of injury and its aftermath that gather and separate patients, kin, and bystanders, all while a triage medical authority is charged with sorting them out...
March 10, 2017: Medical Anthropology Quarterly
https://www.readbyqxmd.com/read/28294149/oral-health-in-relation-to-all-cause-mortality-the-ipc-cohort-study
#7
Margaux Adolph, Christelle Darnaud, Frédérique Thomas, Bruno Pannier, Nicolas Danchin, G David Batty, Philippe Bouchard
We evaluated the association between oral health and mortality. The study population comprised 76,188 subjects aged 16-89 years at recruitment. The mean follow-up time was 3.4 ± 2.4 years. Subjects with a personal medical history of cancer or cardiovascular disease and death by casualty were excluded from the analysis. A full-mouth clinical examination was performed in order to assess dental plaque, dental calculus and gingival inflammation. The number of teeth and functional masticatory units <5 were recorded...
March 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28291503/regenerative-and-antibacterial-properties-of-acellular-fish-skin-grafts-and-human-amnion-chorion-membrane-implications-for-tissue-preservation-in-combat-casualty-care
#8
Skuli Magnusson, Baldur Tumi Baldursson, Hilmar Kjartansson, Ottar Rolfsson, Gudmundur Fertram Sigurjonsson
BACKGROUND: Improvised explosive devices and new directed energy weapons are changing warfare injuries from penetrating wounds to large surface area thermal and blast injuries. Acellular fish skin is used for tissue repair and during manufacturing subjected to gentle processing compared to biologic materials derived from mammals. This is due to the absence of viral and prion disease transmission risk, preserving natural structure and composition of the fish skin graft. OBJECTIVES: The aim of this study was to assess properties of acellular fish skin relevant for severe battlefield injuries and to compare those properties with those of dehydrated human amnion/chorion membrane...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291497/variation-in-postinjury-antibiotic-prophylaxis-patterns-over-five-years-in-a-combat-zone
#9
Bradley A Lloyd, Clinton K Murray, William Bradley, Faraz Shaikh, Deepak Aggarwal, M Leigh Carson, David R Tribble
In 2008, a clinical practice guideline (CPG) was developed for the prevention of infections among combat casualties and was later revised in 2011. We evaluated utilization of antimicrobials within 48 hours following injury in the combat zone over a 5-year period (June 2009 through May 2014) with regard to number of regimens, type of antimicrobial, and adherence to the 2011 CPG. The study population consisted of 5,196 wounded military personnel. Open fractures and skin and soft-tissue injuries were the most frequent injuries...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291458/wearable-pulse-oximetry-measurements-on-the-torso-arms-and-legs-a-proof-of-concept
#10
Marcus Kramer, Aaron Lobbestael, Emily Barten, John Eian, Gregory Rausch
For decades pulse oximeters designed for use on the head, hands, or feet have provided invaluable estimates of oxygen saturation to medical personal attending to combat casualties. However, traditional placement sites are not ideal for the relatively new paradigm of continuous battlefield telemonitoring. To assess the feasibility of oximetry on nontraditional body sites, 42 healthy volunteers were enrolled, consented, and underwent an industry standard induced-hypoxia study. During the study volunteers used prototype wearable oximeters, designed for the torso, arms, and legs...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291456/anesthesia-and-postoperative-respiratory-compromise-following-major-lower-extremity-surgery-implications-for-combat-casualties
#11
Samuel M Galvagno, Jordan Brayanov, George Williams, Edward E George
Care of military casualties requires not only assessment of patient, injury, and setting, but also the consequences of care decisions on other organ systems. In contemporary conflicts, pelviperineal and lower extremity trauma are common injuries, yet the optimal perioperative anesthetic and analgesic care remains unclear. Residual anesthesia and opioids can cause respiratory depression, specifically postoperative respiratory depression and opioid-induced respiratory depression. This observational study quantified and compared the incidences of respiratory depression following general anesthesia (GA) and spinal anesthesia (SA) for lower extremity surgery...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#12
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291449/the-afghan-theater-a-review-of-military-medical-doctrine-from-2008-to-2014
#13
Ian Lane, Zsolt Stockinger, Samual Sauer, Mark Ervin, Michael Wirt, Stephen Bree, Kirby Gross, Jeffrey Bailey, Brig Timothy Hodgetts, Elizabeth Mann-Salinas
This article forms part of a series that will explore the effect that Role 2 (R2) medical treatment facilities (MTFs) had on casualty care during the military campaign in Afghanistan and how we should interpret this to inform the capabilities in, and training for future R2 MTFs. Key aspects of doctrine which influence the effectiveness of R2 MTFs include timelines to care, patient movement capabilities, and MTF capabilities. The focus of this analysis was to review allied doctrine from the United States, United Kingdom, and the North Atlantic Treaty Organization to identify similarities and differences regarding employment of R2 related medical assets in the Afghan Theater, specifically for trauma care...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290955/dynamic-insights-on-surgical-activity-in-a-new-modern-warfare-the-french-role-2-in-bangui-central-african-republic
#14
Olivier Barbier, Pierre Pasquier, Maelle Racle, Yoann Baudoin, Brice Malgras
INTRODUCTION: In December 2013, France deployed more than 2,000 soldiers in Central African Republic with two main missions, to restore security and to improve the humanitarian situation. The objectives of this article were to analyze the surgical activity of forward surgical teams in Central African Republic over 2 years and to discuss features of training for deployed surgeons. MATERIALS AND METHODS: From December 5, 2013, to September 30, 2015, we retrospectively reviewed the electronic surgical database...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290946/medical-redeployment-in-soldiers-with-and-without-medical-deployment-waivers
#15
Corey M Cronrath, Joseph Venezia, Titus J Rund, Timothy H Cho, Nicole M Solana, Jennifer A Benincasa
BACKGROUND: Historically, disease and nonbattle injuries (DNBI) have caused more casualties during military operations than enemy combatants. Recent deployments to U.S. Central Commands (USCENTCOM) area of operation (AOR) have demonstrated similar outcomes. Intuitively, appropriate medical standards for our deploying Soldiers should result in no greater redeployments rates for those Soldiers who are waived for various medical conditions. However, no formal study has been published on redeployment rates of Soldiers with medical deployment waivers...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290941/professional-stress-and-burnout-in-u-s-military-medical-personnel-deployed-to-afghanistan
#16
Amy B Adler, Amanda L Adrian, Marla Hemphill, Nicole H Scaro, Maurice L Sipos, Jeffrey L Thomas
BACKGROUND: Studies of medical staff members have consistently documented high levels of burnout compared to those in other professions. Although there are studies of burnout in military medical staff, there are gaps in understanding the experience of medical staff while they are deployed and few occupationally-related factors associated with decreased burnout have been identified in this population. PURPOSE: To assess work-related variables accounting for burnout over and above rank, post-traumatic stress disorder (PTSD) symptoms, and professional stressors in the deployed environment...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290940/effects-of-combat-deployment-on-anthropometrics-and-physiological-status-of-u-s-army-special-operations-forces-soldiers
#17
Emily K Farina, Jonathan C Taylor, Gary E Means, Kelly W Williams, Nancy E Murphy, Lee M Margolis, Stefan M Pasiakos, Harris R Lieberman, James P McClung
INTRODUCTION: U.S. Army Special Operations Forces (SOF) soldiers deploy frequently and conduct military operations through special warfare and surgical strike capabilities. Tasks required to execute these capabilities may induce physical and mental stress and have the potential to degrade soldier physiological status. No investigations have longitudinally characterized whether combat deployment alters anthropometrics or biochemical markers of physiological status in a SOF population of frequent deployers...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290930/medical-effects-of-a-transuranic-dirty-bomb
#18
Asaf Durakovic
The modern military battlefields are characterized by the use of nonconventional weapons such as encountered in the conflicts of the Gulf War I and Gulf War II. Recent warfare in Iraq, Afghanistan, and the Balkans has introduced radioactive weapons to the modern war zone scenarios. This presents the military medicine with a new area of radioactive warfare with the potential large scale contamination of military and civilian targets with the variety of radioactive isotopes further enhanced by the clandestine use of radioactive materials in the terrorist radioactive warfare...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290925/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 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/28288338/ghb-involved-crimes-among-intoxicated-patients
#20
Máté Kapitány-Fövény, Gábor Zacher, János Posta, Zsolt Demetrovics
INTRODUCTION: In recent years, the involvement of GHB in drug facilitated sexual assaults has been one of the most frequently studied aspects of GHB in both clinical and non-clinical settings. GHB-involved acquisitory crimes, however, can be mentioned as understudied research topics, as well as the poisoning severity properties of GHB. MEASURES: The medical reports of Péterfy Sándor Street Hospital Clinic and Casualty Centre's 408 GHB-intoxication cases (352 patients) were reviewed and registered...
March 10, 2017: Forensic Science International
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