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https://www.readbyqxmd.com/read/29447407/the-feasibility-of-venovenous-ecmo-at-role-2-facilities-in-austere-military-environments
#1
Mohamed A T Mohamed, Tareq Maraqa, Matthew D Bacchetta, Michael McShane, Kenneth L Wilson
Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been gaining use to bridge the recovery from acute respiratory distress syndrome (ARDS) refractory to conventional treatment. However, these interventions are often limited to higher echelons of military care. We present a case of lung salvage from severe ARDS in an Afghani soldier with VV-ECMO at a Role-2 (R2) facility in an austere military environment in Afghanistan. Case: A 25-year-old Afghani soldier presented to an R2 facility with blast lung injury and multiple penetrating injuries following an explosion...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29447150/life-cycle-synchronization-is-a-viral-drug-resistance-mechanism
#2
Iulia A Neagu, Jason Olejarz, Mark Freeman, Daniel I S Rosenbloom, Martin A Nowak, Alison L Hill
Viral infections are one of the major causes of death worldwide, with HIV infection alone resulting in over 1.2 million casualties per year. Antiviral drugs are now being administered for a variety of viral infections, including HIV, hepatitis B and C, and influenza. These therapies target a specific phase of the virus's life cycle, yet their ultimate success depends on a variety of factors, such as adherence to a prescribed regimen and the emergence of viral drug resistance. The epidemiology and evolution of drug resistance have been extensively characterized, and it is generally assumed that drug resistance arises from mutations that alter the virus's susceptibility to the direct action of the drug...
February 2018: PLoS Computational Biology
https://www.readbyqxmd.com/read/29446647/management-of-multi-casualty-incidents-in-mountain-rescue-evidence-based-guidelines-of-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#3
Marc Blancher, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R Wheeler, Steven Roy, Hermann Brugger, Mike Greene, Peter Paal
Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue. High Alt Med Biol. 00:000-000, 2018. INTRODUCTION: Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas...
February 15, 2018: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/29443864/past-and-present-role-of-ecmo-in-combat-casualty-care-how-far-will-we-go
#4
Jeremy W Cannon, Phillip E Mason, Andriy I Batchinsky
Advanced extracorporeal therapies have been successfully applied in the austere environment of combat casualty care over the previous decade. In this review, we describe the historic underpinnings of extracorporeal membrane oxygenation (ECMO), review the recent experience with both partial and full lung support during combat operations, and critically assess both the current status of the Department of Defense ECMO program and the way forward to establish long-range lung rescue therapy as a routine capability for combat casualty care...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29443862/red-tides-mass-casualty-and-whole-blood-at-sea-red-tides
#5
Benjamin T Miller, Andrew H Lin, Susan C Clark, Andrew P Cap, Joseph J Dubose
BACKGROUND: The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War. METHODS: Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP)...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29440876/research-of-an-emergency-medical-system-for-mass-casualty-incidents-in-shanghai-china-a-system-dynamics-model
#6
Wenya Yu, Yipeng Lv, Chaoqun Hu, Xu Liu, Haiping Chen, Chen Xue, Lulu Zhang
Objectives: Emergency medical system for mass casualty incidents (EMS-MCIs) is a global issue. However, China lacks such studies extremely, which cannot meet the requirement of rapid decision-support system. This study aims to realize modeling EMS-MCIs in Shanghai, to improve mass casualty incident (MCI) rescue efficiency in China, and to provide a possible method of making rapid rescue decisions during MCIs. Methods: This study established a system dynamics (SD) model of EMS-MCIs using the Vensim DSS program...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29439490/chemical-sensor-systems-and-associated-algorithms-for-fire-detection-a-review
#7
REVIEW
Jordi Fonollosa, Ana Solórzano, Santiago Marco
Indoor fire detection using gas chemical sensing has been a subject of investigation since the early nineties. This approach leverages the fact that, for certain types of fire, chemical volatiles appear before smoke particles do. Hence, systems based on chemical sensing can provide faster fire alarm responses than conventional smoke-based fire detectors. Moreover, since it is known that most casualties in fires are produced from toxic emissions rather than actual burns, gas-based fire detection could provide an additional level of safety to building occupants...
February 11, 2018: Sensors
https://www.readbyqxmd.com/read/29439371/automated-triage-parameters-estimation-from-ecg
#8
Monika Simjanoska, Bojana Koteska, Ana Madevska Bogdanova, Nevena Ackovska, Vladimir Trajkovik, Magdalena Kostoska
Low-cost biosensors combined with low-cost portable devices can be very useful in time critical situations of mass casualties, when fast triage procedure must be attained. A methodology that uses ECG to derive the vital parameters (heart rate and respiratory rate) needed for the triage procedure is presented and it is aimed to leverage affordable low-cost equipment that can be easily utilized by urgent medical units or even volunteers in events of considerable number of injured civilians. The methodology relies on selected well-known and published algorithms for heart rate and respiratory rate derivation from a given ECG signal...
January 30, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29437636/outcomes-following-limb-salvage-after-combat-hindfoot-injury-are-inferior-to-delayed-amputation-at-five-years
#9
P M Bennett, T Stevenson, I D Sargeant, A Mountain, J G Penn-Barwell
OBJECTIVES: The surgical challenge with severe hindfoot injuries is one of technical feasibility, and whether the limb can be salvaged. There is an additional question of whether these injuries should be managed with limb salvage, or whether patients would achieve a greater quality of life with a transtibial amputation. This study aims to measure functional outcomes in military patients sustaining hindfoot fractures, and identify injury features associated with poor function. METHODS: Follow-up was attempted in all United Kingdom military casualties sustaining hindfoot fractures...
February 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29432664/the-impact-of-cold-ischemia-time-cit-at-the-higher-end-of-the-kdpi-spectrum-what-is-the-risk
#10
David D Lee, Hani M Wadei
On December 4, 2014, the new kidney allocation system (KAS) was implemented to reduce extreme longevity mismatches between kidney allograft and recipient life expectancy, increase the highly sensitized patients' access to transplantation through prioritization, broaden access for disadvantaged candidates by counting dialysis time towards wait-list time, and potentially increase the utilization of "marginal kidneys" through broader allocation at the local and regional level. In the first year after implementation, the early results of KAS suggested that the new policies were successful in meeting many of these goals 1 ...
February 12, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29432381/systematic-review-of-prehospital-tourniquet-use-in-civilian-limb-trauma
#11
David S Kauvar, Michael A Dubick, Thomas J Walters, John F Kragh
BACKGROUND: Military enthusiasm for limb tourniquet use in combat casualty care has resulted in acceptance by the trauma community for use in the prehospital care of civilian limb injuries. To date there has been no report synthesizing the published data on civilian tourniquet use. The objective of this systematic review was to compile and analyze the content and quality of published data on the civilian use of tourniquets in limb trauma. METHODS: The MEDLINE database was searched for studies on civilian limb tourniquet use in adults published between 2001 and 2017...
February 9, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29432043/prehospital-application-of-hemostatic-agents-in-iraq-and-afghanistan
#12
Steven G Schauer, Michael D April, Jason F Naylor, Joseph K Maddry, Allyson A Arana, Michael A Dubick, Andrew D Fisher, Cord W Cunningham, Anthony E Pusateri
INTRODUCTION: Hemorrhage is the leading cause of death on the battlefield. Development of chitosan- and kaolin-based hemostatic agents has improved hemorrhage control options. Sparse data exists on the use of these agents in the prehospital, combat setting. We describe recent use of these agents and compare patients receiving hemostatic to the baseline population. METHODS: We used a series of emergency department (ED) procedure codes to identify patients within the Department of Defense Trauma Registry (DODTR) from January 2007 to August 2016...
February 12, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29431096/introduction-of-pediatric-physiological-and-anatomical-triage-score-in-mass-casualty-incident
#13
Chiaki Toida, Takashi Muguruma, Takeru Abe, Mafumi Shinohara, Masayasu Gakumazawa, Naoki Yogo, Aya Shirasawa, Naoto Morimura
BACKGROUND: Triage has an important role in providing suitable care to the largest number of casualties in a disaster setting, but there are no secondary triage methods suitable for children. This study developed a new secondary triage method named the Pediatric Physiological and Anatomical Triage Score (PPATS) and compared its accuracy with current triage methods. METHODS: A retrospective chart review of pediatric patients under 16 years old transferred to an emergency center from 2014 to 2016 was performed...
February 12, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29428037/the-vicious-cycle-of-motorcycle-rally-casualties-a-single-center-s-experience
#14
Aaron Pinnola, Jason D Sciarretta, Stefanie Gibson, Keely Muertos, Carlos Fernandez, Andrea Romano, John Mihran Davis, Antonio Pepe
No abstract text is available yet for this article.
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29426258/validation-of-the-self-assessment-teamwork-tool-satt-in-a-cohort-of-nursing-and-medical-students
#15
Lucinda Roper, Boaz Shulruf, Christine Jorm, Jane Currie, Christopher J Gordon
INTRODUCTION: Poor teamwork has been implicated in medical error and teamwork training has been shown to improve patient care. Simulation is an effective educational method for teamwork training. Post-simulation reflection aims to promote learning and we have previously developed a self-assessment teamwork tool (SATT) for health students to measure teamwork performance. This study aimed to evaluate the psychometric properties of a revised self-assessment teamwork tool. METHODS: The tool was tested in 257 medical and nursing students after their participation in one of several mass casualty simulations...
February 9, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29425472/the-use-of-field-triage-in-disaster-and-mass-casualty-incidents-a-survey-of-current-practices-by-ems-personnel
#16
Kevin Ryan, Douglas George, James Liu, Patricia Mitchell, Kerrie Nelson, Ricky Kue
BACKGROUND: Mass casualty incident (MCI) triage and the use of triage tags to assign treatment priorities are not fully implemented despite emergency medical services (EMS) personnel training during drills and exercises. OBJECTIVES: To compare current field triage practices during both training and actual MCIs and identify any potential barriers to use. METHODS: During training sessions from November 2015 through March 2016, an anonymous survey was distributed to personnel in 3 distinct types of paid full-time EMS systems: Boston EMS (2-tiered, municipal third-service); Portland Fire Department (fire department-based ALS); and Stokes County EMS (county-based ALS) combined with Forsyth County EMS (county-based ALS)...
February 9, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29417320/bridging-the-gap-towards-awareness-detection-in-disorders-of-consciousness-an-experimental-study-on-the-mirror-neuron-system
#17
Antonino Naro, Rocco Salvatore Calabrò, Antonino Leo, Margherita Russo, Demetrio Milardi, Antonino Cannavò, Alfredo Manuli, Antonio Buda, Carmela Casella, Placido Bramanti, Alberto Cacciola, Alessia Bramanti
Advanced functional neuroimaging approaches dealing with motor imagery have disclosed covert cognitive processes in patients with disorders of consciousness (DoC). However, motor impairment and cognitive-motor dissociation can bias such approaches. Fourteen patients with post-traumatic DoC and ten healthy controls (HC) were provided with three motor tasks related to mirror neuron system (MNS) activation (movement observation, movement execution, and passive motor imagery of a movement) while recording electroencephalographic (EEG) metrics [EEG power and Granger Casualty Index (GCI)] to detect residual signs of conscious awareness...
February 7, 2018: Brain Topography
https://www.readbyqxmd.com/read/29412051/prehospital-analgesia-for-pediatric-trauma-patients-in-iraq-and-afghanistan
#18
Steven G Schauer, Allyson A Arana, Jason F Naylor, Guyon J Hill, Michael D April
BACKGROUND: Previous studies have evaluated prehospital analgesia during combat operations in Iraq and Afghanistan, but were limited to the adult population. However, a significant portion of the casualties of those conflicts were children. We describe the prehospital analgesia administered to wartime pediatric trauma patients. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients (<18 years of age) admitted to United States and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016...
February 7, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29406810/response-to-the-comments-on-cellular-therapies-for-treatment-of-radiation-injury-after-a-mass-casualty-incident-radiat-res-2017-188-242-45-by-drouet-et-al-letters-to-the-editor-radiat-res-2017-188-463
#19
R Tamarat, M Benderitter, J R Jourdain, B W Maidment, F Macchiarini, C I Rios, A L DiCarlo
No abstract text is available yet for this article.
February 6, 2018: Radiation Research
https://www.readbyqxmd.com/read/29405753/are-television-deaths-good-deaths-a-narrative-analysis-of-hospital-death-and-dying-in-popular-medical-dramas
#20
Jennifer Freytag, Srividya Ramasubramanian
This study explores death narratives in the popular international medical dramas Grey's Anatomy (USA), Casualty (UK), All Saints (Australia), and E.R. (USA). Using narrative analysis, we characterize death portrayals in terms of the number and causes of the deaths, the types of characters who die, the narrative structures of the deaths, and themes found within the death stories. We then compare characteristics actual patients, physicians, and caregivers identify as important in a death experience with the characteristics of deaths portrayed in medical dramas...
February 6, 2018: Health Communication
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