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Combat casualty

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https://www.readbyqxmd.com/read/28967639/tissue-engineered-bone-for-treatment-of-combat-related-limb-injuries
#1
R G Vasyliev, V M Oksymets, A E Rodnichenko, A V Zlatska, O S Gubar, I M Gordiienko, D O Zubov
AIM: Based on our preliminary positive clinical results with use of cultured bone marrow-derived multipotent mesenchymal stem/stromal cells in traumatology, our aim was to develop living three-dimensional tissue-engineered bone equivalent transplantation technology for restoration of critical sized bone defects caused by combat related high energy trauma. MATERIALS AND METHODS: To fabricate bone equivalent we used devitalized allogeneic bone scaffolds (blocks and chips) seeded with cultured autologous cells: bone marrow-derived multipotent mesenchymal stem/stromal cells in mix with periosteal progenitor cells and endothelial progenitor cells...
September 2017: Experimental Oncology
https://www.readbyqxmd.com/read/28941503/management-of-high-velocity-injuries-of-the-head-and-neck
#2
REVIEW
Jacob S Majors, Joseph Brennan, G Richard Holt
Trauma centers must prepare to manage high-velocity injuries resulting from a mass casualty incidents as global terrorism becomes a greater concern and an increasing risk. The most recent conflicts in Iraq and Afghanistan have significantly improved understanding of battlefield trauma and how to appropriately address these injures. This article applies combat surgery experience to civilian situations, outlines the physiology and kinetics of high-velocity injuries, and reviews applicable triage and management strategies...
November 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28930952/military-use-of-tranexamic-acid-in-combat-trauma-does-it-matter
#3
Jeffrey T Howard, Zsolt T Stockinger, Andrew P Cap, Jeffrey A Bailey, Kirby R Gross
BACKGROUND: Tranexamic acid (TXA) has been previously reported to have a mortality benefit in civilian and combat-related trauma, and was thus added to the Joint Theater Trauma System Damage Control Resuscitation Clinical Practice Guideline. As part of ongoing system-wide performance improvement, the use of TXA has been closely monitored. The goal was to evaluate the efficacy and safety of TXA use in military casualties and provide additional guidance for continued use. METHODS: A total of 3,773 casualties were included in this retrospective, observational study of data gathered from a trauma registry...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28910488/tactical-combat-casualty-care-updates
#4
Harold R Montgomery, Frank K Butler
No abstract text is available yet for this article.
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910475/chest-seal-placement-for-penetrating-chest-wounds-by-prehospital-ground-forces-in-afghanistan
#5
Steven G Schauer, Michael D April, Jason F Naylor, Erica M Simon, Andrew D Fisher, Cord W Cunningham, Daniel M Morissette, Jessie Renee D Fernandez, Kathy L Ryan
BACKGROUND: Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device. Although the Committee on TCCC (CoTCCC) has approved numerous chest seal devices for battlefield use, few data exist regarding their use in a combat zone setting...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910471/evaluation-of-xstat%C3%A2-and-quickclot%C3%A2-combat-gauze%C3%A2-in-a-swine-model-of-lethal-junctional-hemorrhage-in-coagulopathic-swine
#6
Jennifer M Cox, Jason M Rall
BACKGROUND: Hemorrhage is associated with most potentially survivable deaths on the battlefield. Effective and field-tested products are lacking to treat junctional and noncompressible injuries. XSTAT® is a newly developed, U.S. Food and Drug Administration-approved product designed to treat junctional hemorrhage. The Committee on Tactical Combat Casualty Care has recently approved the product for use as part of its treatment guidelines, but data are lacking to assess its efficacy in different wounding patterns and physiologic states...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910469/prehospital-administration-of-tranexamic-acid-by-ground-forces-in-afghanistan-the-prehospital-trauma-registry-experience
#7
Steven G Schauer, Michael D April, Jason F Naylor, Jonathan Wiese, Kathy L Ryan, Andrew D Fisher, Cord W Cunningham, Noah Mitchell, Mark A Antonacci
BACKGROUND: Tranexamic acid (TXA) was shown to reduce overall mortality and death secondary to hemorrhage in a large prospective study. This intervention is time sensitive. As such, the Tactical Combat Casualty Care (TCCC) guidelines recommend use of this low-cost, safe intervention among patients with possible hemorrhagic shock, penetrating trauma to the thorax or trunk, or extremity amputation. OBJECTIVE: Prehospital administration of TXA by ground forces in the Afghanistan combat theater is described...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910465/combat-trousers-as-effective-improvised-pelvic-binders-a-comparative-cadaveric-study
#8
Andrew Loftus, Rhys Morris, Yasmin Friedmann, Ian Pallister, Paul Parker
BACKGROUND: Improvised explosive devices and landmines can cause pelvic fractures, which, in turn, can produce catastrophic hemorrhage. This cadaveric study compared the intrapelvic pressure changes that occurred with the application of an improvised pelvic binder adapted from the combat trousers worn by British military personnel with the commercially available trauma pelvic orthotic device (TPOD). METHODS: Six unembalmed cadavers (three male, three female) were used to simulate an unstable pelvic fracture with complete disruption of the posterior arch (AO/OTA 61-C1) by dividing the pelvic ring anteriorly and posteriorly...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910462/prehospital-cricothyrotomy-kits-used-in-combat
#9
Steven G Schauer, Michael D April, Cord W Cunningham, Adrianna N Long, Robert Carter
BACKGROUND: Surgical cricothyrotomy remains the only definitive airway management modality for the tactical setting recommended by Tactical Combat Casualty Care guidelines. Some units have fielded commercial cricothyrotomy kits to assist Combat Medics with surgical cricothyrotomy. To our knowledge, no previous publications report data on the use of these kits in combat settings. This series reports the the use of two kits in four patients in the prehospital combat setting. METHODS: Using the Department of Defense Trauma Registry and the Prehospital Trauma Registry, we identified four cases of patients who underwent prehospital cricothyrotomy with the use of commercial kits...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28886611/-mass-casualty-incident-special-features-of-threatening-situations
#10
Björn Hossfeld, Thomas Wurmb, Florent Josse, Matthias Helm
Terrorist attacks or amok runs may cause "threatening situations" for emergency medical services (EMS), fire fighters and physicians. Cooperation with the police is of paramount importance. In order to minimize the risk to rescue personnel and affected persons, emergency medical care has to follow tactical principles. So, the strategy in such "threatening situations" is "Stop the bleeding and clear the scene". The police define three areas of danger: unsafe, partly safe and secure. Medical care in these areas follows the concept of Tactical Combat Casualty Care...
September 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28885956/combat-casualties-and-severe-shock-risk-factors-for-death-at-role-3-military-facilities
#11
Michelle F Buehner, Brian J Eastridge, James K Aden, Joseph J DuBose, Lorne H Blackbourne, Ramon F Cestero
BACKGROUND: Although significant research has been conducted on combat casualties receiving blood products, there is limited data for the subpopulation presenting in shock. The purpose of this study was to evaluate combat casualties arriving to a role 3 facility with an initial systolic blood pressure (SBP) ≤ 90 in order to identify clinical characteristics and associations between presentation, transfusion therapy, and mortality outcomes. METHODS: The Department of Defense Trauma Registry was queried from 2001 to 2010 for trauma-related casualties who arrived at a role 3 combat surgical facility with a SBP ≤ 90...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885944/the-value-of-live-tissue-training-for-combat-casualty-care-a-survey-of-canadian-combat-medics-with-battlefield-experience-in-afghanistan
#12
Michael Kim, Ian Torrie, Robert Poisson, Nicholas Withers, Stephen Bjarnason, Luis Teodoro DaLuz, Dylan Pannell, Andrew Beckett, Homer C Tien
INTRODUCTION: The optimum method for training military personnel for combat casualty care is unknown. In particular, there is debate regarding the incremental benefit of live animal tissue training (LTT) over inanimate human patient simulators (HPSs). Although both LTT and HPS are currently used for predeployment training, the efficacy of these models has not been established. MATERIALS AND METHODS: Canadian Armed Forces combat medics, deployed to Afghanistan between 2006 and 2011, were surveyed retrospectively regarding their experience with combat casualty care and predeployment training...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28876574/holding-the-torch-up-high-a-medical-historical-evaluation-of-surgical-advances-during-the-great-war-1914-1918-in-memory-of-those-that-served-and-fell
#13
G Scharf
"How wide and varied is the experience of the battlefield and how fertile the blood of warriors in raising good surgeons" Sir Clifford Allbutt (1898). With these sentiments of the medical lessons learned in war and conflict, with the background of the poem of "In Flanders Field", written by a doctor who had South African War connections, reasons (the Somme and third Ypres battles) will be given that this was indeed a "GREAT WAR" as the world history, weapons, strategy, tactics and wounding patterns had changed dramatically...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28864102/presenting-hypertension-burn-injury-and-mortality-in-combat-casualties
#14
Anders J Davidson, Sarah-Ashley E Ferencz, Jonathan A Sosnov, Jeffrey T Howard, Jud C Janak, Kevin K Chung, Ian J Stewart
INTRODUCTION: The effect of presenting hypertension is poorly studied in combat casualties. We hypothesized that elevated mean arterial pressure (MAP) on presentation to combat hospitals would be associated with poor outcomes. METHODS: Data was obtained from the Department of Defense Trauma Registry and the Armed Forces Medical Examiner System. Variables analyzed included presenting vital signs to Role II-III military theater hospital, demographic variables, injury severity score (ISS), location and mechanism of injury, presence of traumatic brain injury (TBI), acute kidney injury (AKI), and mortality...
August 29, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28853121/characteristics-of-us-combat-veterans-2001-2011-who-remain-on-active-duty-after-upper-extremity-amputations
#15
Sara H Kift, Taylor J Bates, Nathan A Franklin, Anthony E Johnson
OBJECTIVES: Return to duty following traumatic amputations has been extensively studied in those with lower extremity amputation. As upper extremity amputations occur less frequently, the issue of return to duty for those with upper extremity amputations has received relatively little research. The purpose of this study was to determine the rate at which service members remain on active duty at least one year after having sustained traumatic upper extremity amputations during Operation Iraqi Freedom, Operation Enduring Freedom, and other overseas contingency operations of the Global War on Terrorism...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28846577/rotational-thromboelastometry-significantly-optimizes-transfusion-practices-for-damage-control-resuscitation-in-combat-casualties
#16
Nicolas J Prat, Andrew D Meyer, Nichole K Ingalls, Julie Trichereau, Joseph J DuBose, Andrew P Cap
BACKGROUND: Up to 40% of combat casualties with a truncal injury die of massive hemorrhage before reaching a surgeon. This hemorrhage can be prevented with damage control resuscitation (DCR) methods, which are focused on replacing shed whole blood by empirically transfusing blood components in a 1:1:1:1 ratio of platelets:fresh frozen plasma:erythrocytes:cryoprecipitate (PLT:FFP:RBC:CRYO). Measurement of hemostatic function with rotational thromboelastometry (ROTEM) may allow optimization of the type and quantity of blood products transfused...
September 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28829661/multicenter-prospective-study-of-prehospital-administration-of-analgesia-in-the-u-s-combat-theater-of-afghanistan
#17
Steven G Schauer, Alejandra G Mora, Joseph K Maddry, Vikhyat S Bebarta
BACKGROUND: Published data on prehospital medical care in combat is limited, likely due to the chaotic and unpredictable nature of care under fire and difficulty in documentation There is limited data on how often analgesic agents are administered, which drug are being used, and whether there is an association with injury patterns. METHODS: This study was a prospective, multicenter, observational study to determine which analgesic agents are being used prehospital and whether there is an association with injury patterns...
August 22, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28810969/a-review-of-the-effectiveness-of-a-combat-and-operational-stress-control-restoration-center-in-afghanistan
#18
Jason L Judkins, Devvon L Bradley
BACKGROUND: The management of Combat and Operational Stress Reactions (COSR) within an operational environment is a multidimensional process. The aim is to help prevent behavioral health problems, preserve combat power, and increase return to duty rates for combat stress related casualties. In some COSR cases, enhanced services are required and the Combat and Operational Stress Control (COSC) Clinic refers Service Members (SMs) to the Freedom Restoration Clinic (FRC). The purpose was to describe a deployed restoration center in Afghanistan and examine the long-term effectiveness of those services...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810966/the-importance-of-medical-readiness-training-exercises-maintaining-medical-readiness-in-a-low-volume-combat-casualty-flow-era
#19
Kelly C Mead, David J Tennent, Daniel J Stinner
INTRODUCTION: Ringed external fixation has demonstrated promising results in the management of severe combat-related extremity injuries. The purpose of this study was to identify and compare rates of wartime-related surgical cases at times of high and low casualty time periods, and then compare these case numbers with those performed during a 2-week Medical Readiness Training Exercise (MEDRETE) in Honduras. MATERIALS AND METHODS: A retrospective review was performed of patients treated at a single Military Treatment Facility with definitive ringed external fixators during a 2-year period of high-volume combat casualty flow (January 2009-December 2010) and a subsequent 2-year period of low-volume combat casualty flow (January 2013-December 2014)...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28657971/laryngeal-mask-airway-as-a-rescue-device-for-failed-endotracheal-intubation-during-scene-to-hospital-air-transport-of-combat-casualties
#20
Itai Shavit, Eliad Aviram, Yoav Hoffmann, Oded Biton, Elon Glassberg
BACKGROUND: Advanced airway management of combat casualties during scene-to-hospital air transport is challenging. Because of the short transport time, flight physicians of the Israeli military airborne combat evacuation unit are approved for the use of a laryngeal mask airway (LMA) in the event of failed endotracheal intubation (ETI). The aim of this study was to assess the effectiveness of LMA use during scene-to-hospital transport of combat casualties in Israel. PATIENTS AND METHODS: A retrospective cohort analysis of all combat casualties treated with ETI during scene-to-hospital transport over a 3-year period was carried out...
June 27, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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