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https://www.readbyqxmd.com/read/28483389/battlefield-trauma-induced-hypothermia-transitioning-the-preferred-method-of-casualty-rewarming
#1
REVIEW
Brad L Bennett, John B Holcomb
For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an overview of trauma-induced hypothermia (TIH); 2) highlight the Department of Defense strategy for the implementation of a hypothermia clinical management program for battlefield (prehospital) casualties; 3) highlight the research and development of the Hypothermia Prevention and Management Kit (HPMK) as the preferred field rewarming system for battlefield TIH; and 4) emphasize how the HPMK can be easily transitioned to the civilian sector for active rewarming of both accidental and TIH patients...
May 5, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28478999/integration-of-tactical-ems-in-the-national-park-service
#2
REVIEW
William Will R Smith
The National Park Service (NPS) has domestic responsibility for emergency medical services (EMS) in remote and sometimes tactical situations in 417 units covering over 34 million hectares (84 million acres). The crossover between conflicting patient care priorities and complex medical decision making in the tactical, technical, and wilderness/remote environments often has many similarities. Patient care in these diverse locations, when compared with military settings, has slightly different variables but often similar corresponding risks to the patients and providers...
May 4, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28464968/prehospital-interventions-during-mass-casualty-events-in-afghanistan-a-case-analysis
#3
Steven G Schauer, Michael D April, Erica Simon, Joseph K Maddry, Robert Carter, Robert A Delorenzo
BACKGROUND: Mass-casualty (MASCAL) events are known to occur in the combat setting. There are very limited data at this time from the Joint Theater (Iraq and Afghanistan) wars specific to MASCAL events. The purpose of this report was to provide preliminary data for the development of prehospital planning and guidelines. METHODS: Cases were identified using the Department of Defense (DoD; Virginia USA) Trauma Registry (DoDTR) and the Prehospital Trauma Registry (PHTR)...
May 3, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28457227/nih-workshop-report-on-the-trans-agency-blood-brain-interface-workshop-2016-exploring-key-challenges-and-opportunities-associated-with-the-blood-brain-and-their-interface
#4
REVIEW
Margaret J Ochocinska, Berislav V Zlokovic, Peter C Searson, A Tamara Crowder, Richard P Kraig, Julia Y Ljubimova, Todd G Mainprize, William A Banks, Ronald Q Warren, Andrei Kindzelski, William Timmer, Christina H Liu
A trans-agency workshop on the blood-brain interface (BBI), sponsored by the National Heart, Lung and Blood Institute, the National Cancer Institute and the Combat Casualty Care Research Program at the Department of Defense, was conducted in Bethesda MD on June 7-8, 2016. The workshop was structured into four sessions: (1) blood sciences; (2) exosome therapeutics; (3) next generation in vitro blood-brain barrier (BBB) models; and (4) BBB delivery and targeting. The first day of the workshop focused on the physiology of the blood and neuro-vascular unit, blood or biofluid-based molecular markers, extracellular vesicles associated with brain injury, and how these entities can be employed to better evaluate injury states and/or deliver therapeutics...
May 1, 2017: Fluids and Barriers of the CNS
https://www.readbyqxmd.com/read/28452882/field-and-en-route-reboa-a-feasible-military-reality
#5
Viktor A Reva, Tal Hörer, Andrey I Makhnovskiy, Mikhail V Sokhranov, Igor M Samokhvalov, Joseph J DuBose
BACKGROUND: Severe non-compressible torso hemorrhage (NCTH) remains a leading cause of potentially preventable death in modern military conflicts. Resuscitative endovascular occlusion of the aorta (REBOA) has demonstrated potential as an effective adjunct to the treatment of NCTH in the civilian early hospital and even pre-hospital settings - but the application of this technology for military pre-hospital use has not been well described. We aimed to assess the feasibility of both field and en route pre-hospital REBOA in the military exercise setting simulating a modern armed conflict...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452878/inefficacy-of-standard-vital-signs-for-predicting-mortality-and-the-need-for-prehospital-life-saving-interventions-in-blunt-trauma-patients-transported-via-helicopter-a-repeated-call-for-new-measures
#6
Nehemiah T Liu, John B Holcomb, Charles E Wade, Jose Salinas
OBJECTIVE: The aim of this study was to investigate the efficacy of traditional vital signs for predicting mortality and the need for prehospital life-saving interventions (LSIs) in blunt trauma patients requiring helicopter transport to a Level I trauma center. Our hypothesis was that standard vital signs are not sufficient for identifying or determining treatment for those patients most at risk. METHODS: This study involved prehospital trauma patients suffering from blunt trauma (motor vehicle/cycle collision) and transported from the point of injury via helicopter...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422911/do-vented-chest-seals-differ-in-efficacy-an-experimental-evaluation-using-a-swine-hemopneumothorax-model
#7
Bijan S Kheirabadi, Irasema B Terrazas, Nahir Miranda, Spc Amber N Voelker, Francoise Arnaud, Harold G Klemcke, Frank F Butler, Michael A Dubick
OBJECTIVE: Hemopneumothorax (HPTX) is the second leading cause of potentially preventable death among combat casualties. We investigated the ability of five FDA-approved non-occlusive chest seals (CSs) to seal a bleeding chest wound and prevent tension HPTX in a swine model. METHODS: Following instrumentation, an open chest wound was created in the left thorax of spontaneously air-breathing anesthetized pigs (n=26, 43 Kg). Autologous fresh blood (226 mL) was then infused into the pleural cavity to produce HPTX...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28411934/tactical-combat-casualty-care-and-wilderness-medicine-advancing-trauma-care-in-austere-environments
#8
REVIEW
Frank K Butler, Brad Bennett, Colonel Ian Wedmore
Tactical Combat Casualty Care (TCCC) is a set of evidence-based, best-practice prehospital trauma care guidelines customized for use on the battlefield. Military units that have trained all of their unit members in TCCC have now documented the lowest incidence of preventable deaths in the history of modern warfare and TCCC is now the standard for battlefield trauma care in the US Military. TCCC and wilderness medicine share the goal of optimizing care for patients with trauma in austere environments that impose significant challenges in both equipment and evacuation capability...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28410014/gender-differences-in-posttraumatic-stress-disorder-among-u-s-navy-healthcare-personnel
#9
Andrew J MacGregor, Mary C Clouser, Jonathan A Mayo, Michael R Galarneau
BACKGROUND: The role of women in the U.S. military has changed markedly over the course of 20th- and 21st-century conflicts. Although women frequently occupy healthcare positions in the military, little is known about gender differences in posttraumatic stress disorder (PTSD) within this occupational subgroup. MATERIALS AND METHODS: A total of 4275 (667 women and 3608 men) U.S. Navy healthcare personnel supporting military operations in Iraq and Afghanistan were identified from electronic deployment records...
April 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28392170/translating-tactical-combat-casualty-care-lessons-learned-to-the-high-threat-civilian-setting-tactical-emergency-casualty-care-and-the-hartford-consensus
#10
REVIEW
David W Callaway
Combat operations necessitate bold thought and afford the opportunity to rapidly evolve and improve trauma care. The development and maturation of Tactical Combat Casualty Care (TCCC) is an important example of a critical process improvement strategy that reduced mortality in high-threat combat-related trauma. The Committee for Tactical Emergency Casualty Care (C-TECC) adapted the lessons of TCCC to the civilian high-threat environment and provided important all-hazards response principles for austere, dynamic, and resource-limited environments...
April 6, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28383472/battlefield-pain-management-a-view-of-17-years-in-israel-defense-forces
#11
Avi Benov, Margaux M Salas, Helit Nakar, Ben Antebi, Bader Tarif, Avraham Yitzhak, Elon Glassberg
INTRODUCTION: Pain control in trauma is an integral part of treatment in combat casualty care (CCC). More soldiers injured on the battlefield will need analgesics for pain than those who will need life-saving interventions (LSI). It has been shown that early treatment of pain improves outcomes after traumatic injury, while inadequate treatment leads to higher rates of PTSD. The purpose of this article is to report the Israel Defense Forces Medical Corps (IDF-MC) experience with point of injury (POI) use of analgesia...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28383471/clinical-practice-guideline-adherence-during-operation-inherent-resolve
#12
Timothy P Plackett, Darren C Cherry, Gerald Delk, Steven Satterly, Jared Theler, Derek McVay, Jacqueline Moore, Stacy A Shackelford
BACKGROUND: The Joint Trauma System (JTS) Clinical Practice Guidelines (CPGs) contributed to the decrease in battlefield morality over the past 15 years. However, it is unknown to what degree the guidelines are being followed in current military operations. METHODS: A retrospective review was performed of all patients treated at three separate US Army Role II facilities during the first ten months of Operation Inherent Resolve in Iraq. Charts were reviewed for patient demographics, clinical care, and outcomes...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28383466/relative-device-stability-of-anterior-vs-axillary-needle-decompression-for-tension-pneumothorax-during-casualty-movement-preliminary-analysis-of-a-human-cadaver-model
#13
Matthew L Leatherman, Jenny M Held, Laura M Fluke, Christian S McEvoy, Kenji Inaba, Daniel Grabo, Matthew J Martin, Angela S Earley, Robert L Ricca, Travis M Polk
BACKGROUND: Tension pneumothorax (tPTX) remains a significant cause of potentially preventable death in military and civilian settings. The current pre-hospital standard of care for tPTX is immediate decompression with a 14 gauge 8cm angiocatheter (14G AC); however, failure rates may be as high as 17-60%. Alternative devices, such as 10G AC, modified Veress needle (mVN) and laparoscopic trocar (LT), have shown to be potentially more effective in animal models; however, little is known about the relative insertional safety or mechanical stability during casualty movement...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28376019/combat-casualty-care-research-for-the-multi-domain-battlefield
#14
Todd E Rasmussen, David G Baer, Kyle N Remick, George V Ludwig
No abstract text is available yet for this article.
April 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28368954/u-s-army-physical-demands-study-reliability-of-simulations-of-physically-demanding-tasks-performed-by-combat-arms-soldiers
#15
Stephen A Foulis, Jan E Redmond, Peter N Frykman, Maj Bradley J Warr, Edward J Zambraski, Marilyn A Sharp
Recently, the US Army has mandated that Soldiers must successfully complete the physically demanding tasks of their job in order to graduate from their Initial Military Training. Evaluating individual Soldiers in the field is difficult; however, simulations of these tasks may aid in the assessment of Soldiers' abilities. The purpose of this study was to determine the reliability of simulated physical Soldiering tasks relevant to Combat Arms Soldiers. Three cohorts of ∼50 Soldiers repeated a subset of eight simulated tasks four times over two weeks...
March 31, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28362519/salvage-of-combat-hindfoot-fractures-in-2003-2014-uk-military
#16
Philippa M Bennett, Thomas Stevenson, Ian D Sargeant, Alistair Mountain, Jowan G Penn-Barwell
BACKGROUND: Hindfoot fractures pose a considerable challenge to military orthopaedic surgeons, as combat injuries are typically the result of energy transfers not seen in civilian practice. This study aimed to characterize the pattern of hindfoot injuries sustained by UK military casualties in recent conflicts, define the early amputation and infection rate, and identify factors associated with poor early outcomes. METHODS: The UK Joint Theatre Trauma Registry was searched for British military casualties sustaining a hindfoot fracture from Iraq and Afghanistan between 2003 and 2014...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28338467/somewhere-in-france-9-april-17-a-centenary-review-of-medical-arrangements-at-vimy-ridge
#17
Vivian McAlister
In April 1917, medical units of the 4 divisions of the Canadian Corps combined for the first time in support of a single action, the assault upon Vimy Ridge. Detailed planning, infrastructure development, information dissemination and rehearsal were features of preparations by the combat arms and medical elements of the Canadian Forces. Extraordinary coordination resulted in the rapid rescue and evacuation by Canadian medical services of 8000 casualties over 4 days. Characteristics of today's military medical services are evident in the work of the Canadian Army Medical Corps 100 years ago...
April 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28333837/leadership-lessons-learned-in-tactical-combat-casualty-care
#18
Frank K Butler
No abstract text is available yet for this article.
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333833/leadership-and-a-casualty-response-system-for-eliminating-preventable-death
#19
Russ S Kotwal, Harold R Montgomery, Ethan A Miles, Curtis C Conklin, Michael T Hall, Stanley A McChrystal
Combat casualties who die from their injuries do so primarily in the prehospital setting. Although most of these deaths result from injuries that are nonsurvivable, some are potentially survivable. Of injuries that are potentially survivable, most are from hemorrhage. Thus, military organizations should direct efforts toward prehospital care, particularly through early hemorrhage control and remote damage control resuscitation, to eliminate preventable death on the battlefield. A systems-based approach and priority of effort for institutionalizing such care was developed and maintained by medical personnel and command-directed by nonmedical combatant leaders within the 75th Ranger Regiment, U...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328685/whole-blood-transfusion-closest-to-the-point-of-injury-during-french-remote-military-operations
#20
Yann Daniel, Anne Sailliol, Thomas Pouget, Sébastien Peyrefitte, Sylvain Ausset, Christophe Martinaud
To improve the survival of combat casualties, interest in the earliest resort to whole blood (WB) transfusion on the battlefield has been emphasized. Providing volume, coagulation factors, plasma, and oxygenation capacity, WB appears actually as an ideal product severe trauma management. Whole blood can be collected in advance and stored for subsequent use, or can be drawn directly on the battlefield, once a soldier is wounded, from an uninjured companion and immediately transfused.Such concepts require a great control of risks at each step, especially regarding ABO mismatches, and transfusion-transmitted diseases...
June 2017: Journal of Trauma and Acute Care Surgery
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