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V Vitalis, C Carfantan, A Montcriol, S Peyrefitte, A Luft, T Pouget, A Sailliol, S Ausset, E Meaudre, J Bordes
INTRODUCTION: Haemorrage is the leading cause of death after combat related injuries and bleeding management is the cornerstone of management of these casualties. French armed forces are deployed in Barkhane operation in the Sahel-Saharan Strip who represents an immense area. Since this constraint implies evacuation times beyond doctrinal timelines, an institutional decision has been made to deploy blood products on the battlefield and transfuse casualties before role 2 admission if indicated...
November 23, 2017: Injury
Stacy A Shackelford, Deborah J Del Junco, Nicole Powell-Dunford, Edward L Mazuchowski, Jeffrey T Howard, Russ S Kotwal, Jennifer Gurney, Frank K Butler, Kirby Gross, Zsolt T Stockinger
Importance: Prehospital blood product transfusion in trauma care remains controversial due to poor-quality evidence and cost. Sequential expansion of blood transfusion capability after 2012 to deployed military medical evacuation (MEDEVAC) units enabled a concurrent cohort study to focus on the timing as well as the location of the initial transfusion. Objective: To examine the association of prehospital transfusion and time to initial transfusion with injury survival...
October 24, 2017: JAMA: the Journal of the American Medical Association
Ferdinand K Hui, Amgad El Mekabaty, Jacky Schultz, Kelvin Hong, Karen Horton, Victor Urrutia, Imama Naqvi, Shawn Brast, John K Lynch, Zurab Nadareishvili
BACKGROUND AND PURPOSE: It is increasingly recognized that time is one of the key determinants in acute stroke outcome when interventional stroke therapy is applied. With increasing device efficacy and understanding of imaging triage options, reducing pre-treatment time loss may be a critical component of improving interventional stroke outcomes for the population at large. Time sensitive procedures such as organ harvest have transported physicians to the patient site to improve time to procedure...
May 2, 2017: Journal of Neurointerventional Surgery
Sharyn Toner, Derkje H Andrée Wiltens, Johannes Berg, Hector Williams, Susan Klein, Simon Marshall, Neil Nerwich, Ryan Copeland
Background: Businesses increasingly conduct operations in remote areas where medical evacuation [Medevac(s)] carries more risk. Royal Dutch Shell developed a remote healthcare strategy whereby enhanced remote healthcare is made available to the patient through use of telemedicine and telemetry. To evaluate that strategy, a review of Medevacs of Shell International employees [i.e. expatriate employees (EEs) and frequent business travellers (FBTs)] was undertaken. Method: A retrospective review of Medevac data (period 2008-12) that were similar in operational constraints and population profile was conducted...
May 1, 2017: Journal of Travel Medicine
Mathieu Boutonnet, Pierre Pasquier, Laurent Raynaud, Laurent Vitiello, Jérôme Bancarel, Sébastien Coste, Guillaume Pelée de Saint Maurice, Sylvain Ausset
OBJECTIVE: The French Military Health Service (FMHS) has developed a training program for medical evacuation (MEDEVAC) of critical care patients on fixed wing aircraft. METHODS: We conducted a 10-year retrospective analysis (2006-2015) of the data from the FMHS Academy. The number of trainees was listed according to the different courses and medical specialties. The number of MEDEVACs recorded during the period was described. RESULTS: Since 2006, the FMHS has developed training courses designed for MEDEVAC of critical care patients...
March 2017: Air Medical Journal
Shelia Savell, Alejandra G Mora, Crystal A Perez, Vikhyat S Bebarta, Maj Joseph K Maddry
OBJECTIVE: To describe and compare vascular access practices used by en route care providers during medical evacuation (MEDEVAC). DESIGN: This was a retrospective cohort study. Medical records of US military personnel injured in combat and transported by MEDEVAC teams were queried. PATIENTS: The subjects were transported by military en route care providers, in the combat theater during Operation Enduring Freedom (OEF) between January 2011 and March 2014...
2016: American Journal of Disaster Medicine
Cyril Carfantan, Yvain Goudard, Christophe Butin, Sandrine Duron-Martinaud, Jean-Philippe Even, Anthony Anselme, Erwan Dulaurent, Mélanie Géhant, Vicky Vitalis, Christian Bay, Jérôme Bancarel, Julien Bordes
INTRODUCTION: The French army has been deployed in Mali since January 2013 with the Serval Operation and since July 2014 in the Sahel-Saharan Strip (SSS) with the Barkhane Operation where the distances (up to 1100km) can be very long. French Military Medical Service deploys an inclusive chain from the point of injury (POI) to hospital in France. A patient evacuation coordination cell (PECC) has been deployed since February 2013 to organise forward medical evacuation (MEDEVAC) in the area between the POI and three forward surgical units...
January 2017: Injury
Joseph K Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
November 2016: Journal of Trauma and Acute Care Surgery
Nicole Powell-Dunford, Jose F Quesada, Kirby R Gross, Stacy A Shackelford
BACKGROUND: Identify challenges and best practices in the development of an austere air ambulance transfusion program. METHODS: A search of PubMed using combinations of the key terms 'prehospital,' 'blood product,' 'red blood cells,' 'damage control resuscitation,' 'transfusion,' 'air ambulance,' 'medical evacuation,' and 'medevac' yielded 196 articles for further analysis, with 14 articles suitable for addressing the background of prehospital transfusion within a helicopter...
August 2016: Aerospace Medicine and Human Performance
Dirk Dethleff, Nils Weinrich, Birgitt Kowald, Dorothea Hory, Rüdiger Franz, Maja Verena Nielsen, Klaus Seide, Christian Jürgens, Markus Stuhr
OBJECTIVE: Our purpose was 2-fold: 1) to show emergency-related traumatic injury and acute disease patterns and 2) to evaluate air rescue process times in a remotely located German offshore wind farm. Optimally, this will support methodologies to reduce offshore help time (time from the incoming emergency call until offshore arrival of the helicopter). METHODS: The type and severity of traumatic injuries and acute diseases were retrospectively analyzed for 39 air medevacs from August 2011 to December 2013, and the process times of air rescue missions were evaluated in detail...
July 2016: Air Medical Journal
Joseph Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide life-saving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
May 27, 2016: Journal of Trauma and Acute Care Surgery
Audra L Taylor, Jason B Corley
The Army Blood Program (ABP) is charged with the responsibility of supporting the Warfighter on the battlefield, in addition to meeting garrison hospital blood requirements on a daily basis. Blood support concepts developed in response to Operation Iraqi Freedom/Operation Enduring Freedom combat operations are the cornerstone to maintaining current capabilities and shaping future endeavors.. The ABP is actively engaged with research, advanced development of blood products and medical technology to improve blood safety and efficacy for both our conventional and operational forces...
April 2016: U.S. Army Medical Department Journal
Desmond Whalen, Chris Harty, Mohamed Ravalia, Tia Renouf, Sabrina Alani, Robert Brown, Adam Dubrowski
The relevance of simulation as a teaching tool for medical professionals working in rural and remote contexts is apparent when low-frequency, high-risk situations are considered. Simulation training has been shown to enhance learning and improve patient outcomes in urban settings. However, there are few simulation scenarios designed to teach rural trauma management during complex medical transportation. In this technical report, we present a scenario using a medevac helicopter (Replica of Sikorsky S-92 designed by Virtual Marine Technology, St...
2016: Curēus
Andrew H Lin, Jacob H Cole, John C Chin, Chirstopher Becket Mahnke
INTRODUCTION: The Health Experts onLine at Portsmouth teleconsultation system is designed to connect health providers in the Navy Medicine East Region to specialists at Naval Medical Center Portsmouth. METHODS: A review of the first year of the Health Experts onLine at Portsmouth system was performed. Data on each teleconsultation were extracted from the Health Experts onLine at Portsmouth system database and analyzed. RESULTS: From June 2014 to May 2015 there have been 585 teleconsultations...
2016: SAGE Open Medicine
A F Hamam, M H Bagis, K AlJohani, A H Tashkandi
BACKGROUND: The City of Jeddah is the major and largest city in the Western Region of the Kingdom of Saudi Arabia (KSA). Covering a total area of 748 km2. The Saudi Red Crescent Organization (SRC) makes up the major bulk of the Emergency Medical Service (EMS) system in the Kingdom. We have set out to investigate the level of public awareness of the EMS system in place in Western KSA. METHOD: This study was an observational cross-sectional study that was done by interviewing the general public in public venues...
December 2015: International Journal of Emergency Medicine
Mikael Gellerfors, Joacim Linde, Dan Gryth
Massive hemorrhage with coagulopathy is one of the leading causes of preventable death in the battlefield. The development of freeze-dried plasma (FDP) allows for early treatment with coagulation-optimizing resuscitation fluid in the prehospital setting. This report describes the first prehospital use of FDP in a patient with carotid artery injury due to a high-velocity gunshot wound (HVGSW) to the neck. It also describes in-flight constitution and administration of FDP in a Medevac Helicopter. Early administration of FDP may contribute to hemodynamic stabilization and reduction in trauma-induced coagulopathy and acidosis...
October 2015: Prehospital and Disaster Medicine
Wojciech Witkowski, Agnieszka Surowiecka-Pastewka, Magdalena Biesaga, Tomasz Gierczak
BACKGROUND: The aim of this study was to determine effectiveness of first aid dressings in extinguishing burning white phosphorous (WP), eliminating WP pieces from the surface, inhibiting re-ignition on the model (fresh bacon covered with military uniform), and preventing from late re-ignition caused by persistent WP pieces. MATERIAL AND METHODS: Burning WP was extinguished with several dressings: tactical Military Dressing (WJ10), wet gauze, 2 hydrocolloids, and 3 prototypes of hydrocolloids developed by the authors...
2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Lawrence Fulton, Bernie Kerr, James M Inglis, Matthew Brooks, Nathaniel D Bastian
In this study, we re-evaluate air ambulance requirements (rules of allocation) and planning considerations based on an Army-approved, Theater Army Analysis scenario. A previous study using workload only estimated a requirement of 0.4 to 0.6 aircraft per admission, a significant bolus over existence-based rules. In this updated study, we estimate requirements for Phase III (major combat operations) using a simulation grounded in previously published work and Phase IV (stability operations) based on four rules of allocation: unit existence rules, workload factors, theater structure (geography), and manual input...
July 2015: Military Medicine
Leonid Belyayev, Norman M Rich, Patricia McKay, Leon Nesti, Gary Wind
Vascular injuries comprised a small percentage of total injuries requiring medevac in the Iraq and Afghanistan conflicts; however, their impact cannot be overstated. This case highlights an individual who sustained a grenade blast injury leading to hemorrhage, and forearm compartment syndrome. He was initially treated with irrigation and debridement, forearm fasciotomy, and delayed primary closure. The patient developed persistent ulnar neuropathy and hypothenar atrophy despite a normal initial vascular examination...
June 2015: Military Medicine
Hapu T Msonda, Jeffrey T Laczek
BACKGROUND: Chronic abdominal pain is a frequently encountered complaint in the primary care setting. The abdominal wall is the etiology of this pain in 10 to 30% of all cases of chronic abdominal pain. Abdominal cutaneous nerve entrapment at the lateral border of the rectus abdominis muscle has been attributed as a cause of this pain. In the military health care system, patients with unexplained abdominal pain are often transferred to military treatment facilities via the Military Medical Evacuation (MEDEVAC) system...
May 2015: Military Medicine
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