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Battlefield traumatology

I B Maksimov, L K Brizhan', V L Astashov, D V Davydov, A A Kerimov, Iu V Arbuzov, D I Varfolomeev
Injuries of the musculoskeletal system are at 60% of all battlefield injures and take first place in modern military conflicts. The main antishock measures are: pain management, emergency bleeding control, bone fragment positioning and fracture fixation. Specialist of the centre of traumatology and orthopaedics of the Burdenko General Military Clinical Hospital in cooperation with specialists of department of battlefield surgery of Mandryka Clinical Research and Training Medical Centre analysed the most effective domestic and foreign external fixators and developed Rod field package (RFP)...
April 2014: Voenno-medit︠s︡inskiĭ Zhurnal
Andrew Beckett, Homer Tien
PURPOSE OF REVIEW: This article reviews the latest operative trauma surgery techniques and strategies, which have been published in the last 10 years. Many of the articles we reviewed come directly from combat surgery experience and may be also applied to the severely injured civilian trauma patient and in the context of terrorist attacks on civilian populations. RECENT FINDINGS: We reviewed the most important innovations in operative trauma surgery; the use of ultrasound and computed tomography in the preoperative evaluation of the penetrating trauma patient, the use of temporary vascular shunts, the current management of military wounds, the use of preperitoneal packing in pelvic fractures and the management of the multiple traumatic amputation patient...
December 2013: Current Opinion in Critical Care
Berardo Di Matteo, Vittorio Tarabella, Giuseppe Filardo, Anna Viganò, Patrizia Tomba, Maurilio Marcacci
This is a brief historical essay about the 16th century European military surgeon Hans von Gersdorff (approximately 1455 to 1529 in Strasbourg) and his epochal illustrated text, Feldbuch der Wundtartzney (Field Book of Surgery), the first manual of traumatology describing the treatment of battle injuries covering topics ranging from human anatomy to pharmacy, as a guide to field surgery, and explaining the use of surgical instruments developed by Gersdorff himself; for the first time in medical history, a precursor to scientific books for practitioners, this manual is a precious source of information, and it is illustrated by hand-colored woodcuts, attributed to distinguished German renaissance artist Hans Wechtlin; this combination of text and pictures made the Feldbuch a point of reference in the process of arriving at modern traumatology...
January 2013: Journal of Trauma and Acute Care Surgery
M Hatzinger, C Ameijenda, V Lent, M Sohn
Dominique-Jean Larrey (1766-1842) was Surgeon-in-Chief of the Grande Army under Napoleon Bonaparte (1769-1821) and personal physician of the Emperor. Against the opposition of the traditionalists he introduced the "ambulances volantes", the so-called flying ambulances. The aim was the medical treatment of the injured soldiers immediately on the battlefield. This revolutionary treatment led to a benefit not only for the own soldiers, but also for the wounded enemies. His innovation in the field of immediate assistance of wounded persons, together with Larreys' outstanding medical competence, saved thousands of soldiers lives on the battlefield of the Napoleonic wars...
December 2012: Aktuelle Urologie
Russ S Kotwal, Harold R Montgomery, Kathy K Mechler
Many combat-related deaths occur in the prehospital environment before the casualty reaches a medical treatment facility. The tenets of Tactical Combat Casualty Care (TCCC) were published in 1996 and integrated throughout the 75th Ranger Regiment in 1999. In order to validate and refine TCCC protocols and procedures, a prehospital trauma registry was developed and maintained. The application of TCCC, in conjunction with validation and refinement of TCCC through feedback from a prehospital trauma registry, has translated to an increase in survivability on the battlefield...
July 2011: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Joel Anthony Nations, Robert F Browning
Combat medical care provides unique challenges and opportunities for military medical teams. The austerity of the environment severely limits access to many diagnostic and therapeutic tools. Because of their compact size, handheld ultrasound (US) machines are increasingly being used in these constrained environments. A growing body of literature documents the diagnostic utility of handheld US for trauma encountered in the battlefield. Furthermore, US guidance may assist in the performance of some procedures performed in battlefield medical care...
September 2011: Ultrasound Quarterly
Anthony Borzotta
No abstract text is available yet for this article.
January 2011: American Surgeon
Donald Trunkey
No abstract text is available yet for this article.
January 2011: American Surgeon
Kyle N Remick, James A Dickerson, Shawn C Nessen, Robert M Rush, Greg J Beilman
The US Army has been charged to transform to meet the demands of current and anticipated near-future combat needs, covering a full spectrum of military operations. The US Army combat trauma care system was created to deliver combat casualty care in a variety of situations and has been adapted to meet the needs of such care in both Operations Enduring Freedom and Iraqi Freedom. Questions related to our current system include the use and positioning of medical evacuation assets, the type of training for our trauma care providers, the positioning of these providers in proximity to the battlefield, and the type of units most suited to the wide variety of medical operations required of today's military medical team...
July 2010: U.S. Army Medical Department Journal
Rachel Byers
Management of battlefield casualties in Iraq and Afghanistan has seen considerable development in damage control resuscitation, which aims to address the risk of haemorrhage, initially due to mechanical damage; and thereafter due to the development of life-threatening coagulopathy. Damage control resuscitation combines a variety of techniques, such as the use of the combat application tourniquet and novel haemostatics, through to ground-breaking developments in transfusion protocols. These practical aspects of the doctrine are combined with an ethos which sees consultant-led care implemented from as close to the point of wounding as is possible...
October 2010: International Emergency Nursing
Brett H Waibel, Michael F Rotondo
Damage control surgery, initially formalized <20 yrs ago, was developed to overcome the poor outcomes in exsanguinating abdominal trauma with traditional surgical approaches. The core concepts for damage control of hemorrhage and contamination control with abbreviated laparotomy followed by resuscitation before definitive repair, although simple in nature, have led to an alteration in which emergent surgery is handled among a multitude of problems, including abdominal sepsis and battlefield surgery. With the aggressive resuscitation associated with damage control surgery, understanding of abdominal compartment syndrome has expanded...
September 2010: Critical Care Medicine
Bruno M T Pereira, Mark L Ryan, Michael P Ogilvie, Juan Carlos Gomez-Rodriguez, Patrick McAndrew, George D Garcia, Kenneth G Proctor
Since the beginning of the program in 2002, 84 Forward Surgical Teams (FSTs) have rotated through the Army Trauma Training Center (ATTC) at the University of Miami/Ryder Trauma Center including all those deployed to Iraq and Afghanistan. The purpose of this study was to provide the latest updates of our experience with FSTs at the ATTC. Before deployment, each FST participates in a 2-week training rotation at the ATTC. The rotation is divided into 3 phases. Phase 1 is to refresh FST knowledge regarding the initial evaluation and management of the trauma patient...
July 2010: Journal of Craniofacial Surgery
S J Mercer, C L Whittle, P F Mahoney
Anaesthetists in the Defence Medical Services spend most of their clinical time in the National Health Service and deploy on military operations every 6-18 months. The deployed operational environment has a number of key differences particularly as there is more severe trauma than an average UK hospital and injury patterns are mainly due to blast or ballistics. Equipment may also be unfamiliar and there is an expectation to be conversant with specific standard operating procedures. Anaesthetists must be ready to arrive and work in an established team and effective non-technical skills (or human factors) are important to ensure success...
July 2010: British Journal of Anaesthesia
Dana C Covey, Mark W Richardson, Elisha T Powell, Michael T Mazurek, Steven J Morgan
Musculoskeletal wounds are the most common type of injury among survivors of combat trauma. The treatment of these wounds entails many challenges. Although methods of care are evolving, significant gaps remain as knowledge of civilian trauma is extrapolated to combat injuries. It is important to discuss issues related to the use of portable vacuum-assisted wound closure devices during transport, as well as the prevention of heterotopic ossification and the participation of civilian orthopaedic trauma experts in caring for injured service members through the Distinguished Visiting Scholar Program...
2010: Instructional Course Lectures
Brian J Eastridge, George Costanzo, Donald Jenkins, Mary Ann Spott, Charles Wade, Dominique Greydanus, Stephen Flaherty, Joseph Rappold, James Dunne, John B Holcomb, Lorne H Blackbourne
INTRODUCTION: The US military forces developed and implemented the Joint Theater Trauma System (JTTS) and Joint Theater Trauma Registry (JTTR) using US civilian trauma system models with the intent of improving outcomes after battlefield injury. METHODS: The purpose of this analysis was to elaborate the impact of the JTTS. To quantify these achievements, the JTTR captured mechanism, acute physiology, diagnostic, therapeutic, and outcome data on 23,250 injured patients admitted to deployed US military treatment facilities from July 2003 through July 2008 for analysis...
December 2009: American Journal of Surgery
Kimberly Meyer, Kathy Helmick, Selina Doncevic, Rachel Park
Our data suggests that traumatic brain injury (TBI) may account for up to one third of battle-related injuries in today's war. Although the majority of these injuries are classified as mild in severity, service members with severe or penetrating TBI can be faced with many challenges. Injuries sustained on the battlefield require a slightly different approach than the TBI care that is traditionally seen in a civilian setting. This article presents the range of care that occurs beginning on the battlefield and continuing to state-of-the-art rehabilitation within the Department of Defense and Veterans Affairs Polytrauma System of Care...
October 2008: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Marla J De Jong, Kathleen D Martin, Michele Huddleston, Mary Ann Spott, Jennifer McCoy, Julie A Black, Rose Bolenbaucher
The Joint Theater Trauma System (JTTS) is a formal system of trauma care designed to improve the medical care and outcomes for combat casualties of Operation Iraqi Freedom and Operation Enduring Freedom. This article describes the JTTS Trauma Performance Improvement Plan and how JTTS personnel use it to facilitate performance improvement across the entire continuum of combat casualty care.
October 2008: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Lorne H Blackbourne
BACKGROUND: Although the use of damage control surgery for blunt and penetrating injury has been widely reported and defined, the use of damage control surgery on the battlefield (combat damage control surgery) has not been well detailed. DISCUSSION: Damage control surgery is now well established as the standard of care for severely injured civilian patients requiring emergent laparotomy in the United States. The civilian damage control paradigm is based on a "damage control trilogy...
July 2008: Critical Care Medicine
Vance Y Sohn, Lloyd A Runser, Robert A Puntel, James A Sebesta, Alec C Beekley, Jennifer L Theis, Nancy L Merrill, Bernard J Roth, Robert M Rush
INTRODUCTION: Trauma training among nonsurgical physicians in the military is highly variable in amount and quality. However, all deployed military physicians, regardless of specialty, are expected to provide combat casualty care. The goal was to assess the effectiveness of an intense modular trauma refresher course for nonsurgical physicians deploying to a combat zone. METHODS: All graduating nonsurgical residents participated in this 2.5-day course, consisting of 4 modules: (1) didactic session; (2) simulation with interactive human surgical simulators; (3) case presentations and triage scenarios from Iraq/Afghanistan with associated skill stations; and (4) live tissue surgical procedure laboratory...
July 2007: Journal of Surgical Education
J Scott Earwood, David E Brooks
Combat health support in the Military Operations in Urban Terrain (MOUT) environment represents a common challenge on today's battlefield. We identified seven key aspects of battalion level health support which required consideration before combat operations in this type of environment. We called these the "seven P's" of combat health support: prevention, proportion, preparation, portability, proximity, protection, and projection. We developed an easy to use framework for using these principles to quickly develop combat health support plans during periods of high operations tempo...
April 2006: Military Medicine
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