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https://www.readbyqxmd.com/read/27890137/the-identification-of-combat-survivability-tasks-associated-with-naval-vessel-damage-in-maritime-environments
#1
Kane J Middleton, Amelia J Carr
Effective Navy personnel have the physical ability to perform combat survivability tasks commensurate with their unique physical requirements due to the distinctive characteristics of naval platforms. The aim of this investigation was to identify the physically demanding whole-of-ship tasks that are performed by Navy personnel while at sea. A mixed method design was used to identify tasks, inclusive of focus groups and field observations. From a series of ten focus groups, nine tasks were deemed to be physically demanding whole-of-ship tasks...
March 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/27865269/the-immunopathogenesis-of-staphylococcal-skin-infections-a-review
#2
P B Hill, A Imai
Staphylococcus aureus and S. pseudintermedius are the major causes of bacterial skin disease in humans and dogs. These organisms can exist as commensals on the skin, but they can also cause severe or even devastating infections. The immune system has evolved mechanisms to deal with pathogenic microorganisms and has strategies to combat bacteria of this type. What emerges is a delicate "peace" between the opposing sides, but this balance can be disrupted leading to a full blown "war". In the ferocious battle that ensues, both sides attempt to get the upper hand, using strategies that are comparable to those used by modern day armies...
December 2016: Comparative Immunology, Microbiology and Infectious Diseases
https://www.readbyqxmd.com/read/27855132/extremity-war-injuries-xi-maintaining-force-readiness-during-an-era-of-military-transition
#3
Col Jeffrey N Davila, Andrew H Schmidt
The symposium Extremity War Injuries XI focused on issues related to the transitions in medical care that are occurring as the focus of the war on terror changes. Titled "Maintaining Force Readiness During an Era of Military Transition," this year's symposium highlighted the results of Department of Defense-funded research in musculoskeletal injury, the evolution of combat casualty care, and the readiness of the fighting force. The issues highlighted related to the force readiness of both troops and their medical support as well as the maintenance of the combat care expertise that has been developed during the last decade of conflict...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27816610/forward-psychiatry%C3%A2-%C3%A2-early-intervention-for-mental-health-problems-among-uk-armed-forces-in-afghanistan
#4
N Jones, N T Fear, S Wessely, G Thandi, N Greenberg
BACKGROUND: This observational study examined return to duty (RTD) rates following receipt of early mental health interventions delivered by deployed mental health practitioners. METHOD: In-depth clinical interviews were conducted among 975 UK military personnel referred for mental health assessment whilst deployed in Afghanistan. Socio-demographic, military, operational, clinical and therapy outcomes were recorded in an electronic health record database. Rates and predictors of EVAC were the main outcomes examined using adjusted binary logistic regression analyses...
November 3, 2016: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/27798535/urinary-biomarkers-are-associated-with-severity-and-mechanism-of-injury
#5
Jud C Janak, Ian J Stewart, Jonathan A Sosnov, Jeffrey T Howard, Edward D Siew, Mallory M Chan, Nancy Wickersham, T Alp Ikizler, Kevin K Chung
Combat-related blast trauma results in massive tissue injury and tends to involve multiple systems. Further, an acute measure of injury severity based on underlying biological mechanisms may be important for the triage and treatment of these types of patients. We hypothesized that urinary biomarkers (UBs) would reflect severity of injury and that they would be elevated for blast injuries compared to gunshot wounds (GSW) in a cohort of combat casualties. We also postulated that UBs would be higher in patients with burns compared to patients with non-burn trauma in a civilian cohort...
October 26, 2016: Shock
https://www.readbyqxmd.com/read/27787435/assessment-of-key-plasma-metabolites-in-combat-casualties
#6
Elizabeth R Lusczek, Sydne L Muratore, Michael A Dubick, Greg J Beilman
BACKGROUND: Previous studies have indicated that hemorrhagic shock and injury cause significant early changes in metabolism. Recently, global changes in metabolism have been described using metabolomics in animal models and civilian trauma. We evaluated metabolic changes associated with combat injury to identify early biomarkers and aid in triage. METHODS: Plasma obtained at Emergency Department (ED) presentation and intervals thereafter from patients injured during combat operations in Iraq (n=78) were compared to healthy control subjects (n=40)...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27779578/does-small-volume-resuscitation-with-crystalloids-or-colloids-influence-hemostasis-and-survival-of-rabbits-subjected-to-lethal-uncontrolled-hemorrhage
#7
Bijan S Kheirabadi, Nahir Miranda, Irasema B Terrazas, Mary D Gonzales, Rose C Grimm, Michael A Dubick
INTRODUCTION: Prehospital, small-volume resuscitation of combat casualties with a synthetic colloid [6% hydroxyethyl starch (HES) 670/0.75] has been recommended when blood or blood components are unavailable. We studied hemostatic effects of a newer synthetic colloid (6% HES 130/0.4,) compared to either a natural colloid (albumin) or to crystalloids in an uncontrolled hemorrhage model. METHODS: Spontaneously breathing NZW rabbits (3.4±0.1 kg) were anesthetized, instrumented and subjected to a splenic injury with uncontrolled bleeding...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27768663/incidence-risk-factors-and-mortality-associated-with-acute-respiratory-distress-syndrome-in-combat-casualty-care
#8
Pauline K Park, Jeremy W Cannon, Wen Ye, Lorne H Blackbourne, John B Holcomb, William Beninati, Lena M Napolitano
BACKGROUND: The overall incidence and mortality of acute respiratory distress syndrome (ARDS) in civilian trauma settings have decreased over the past four decades; however, the epidemiology and impact of ARDS on modern combat casualty care are unknown. We sought to determine the incidence, risk factors, resource utilization, and mortality associated with ARDS in current combat casualty care. METHODS: This was a retrospective review of mechanically ventilated US combat casualties within the Department of Defense Trauma Registry (formerly the Joint Theater Trauma Registry) during Operation Iraqi Freedom/Enduring Freedom (October 2001 to August 2008) for ARDS development, resource utilization, and mortality...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27753568/compatibility-of-hydroxyethyl-starch-and-tranexamic-acid-for-battlefield-co-administration
#9
Nicholas M Studer, Ahmad H Yassin, Donald E Keen
INTRODUCTION: The current Tactical Combat Casualty Care Guidelines recommend tranexamic acid (TXA) administration for casualties in whom massive blood transfusion is anticipated. However, despite Hextend being the recommended resuscitation fluid, the guidelines recommend against using TXA with Hextend. This appears to be due to a concern about pharmaceutical compatibility, despite the absence of a direct study of compatibility in the literature. METHODS: Two solutions of Hextend and TXA were examined for compatibility...
October 2016: Military Medicine
https://www.readbyqxmd.com/read/27743751/use-of-a-dermal-regeneration-template-wound-dressing-in-the-treatment-of-combat-related-upper-extremity-soft-tissue-injuries
#10
Ian L Valerio, Zachary Masters, Jonathan G Seavey, George C Balazs, Derek Ipsen, Scott M Tintle
PURPOSE: To assess the outcomes of treatment with a dermal regeneration template (DRT) in a cohort of combat casualties with severe upper extremity injuries. METHODS: Records of all active duty military patients treated with DRT at our institution between November 2009 and July 2013 were screened. Inclusion criteria were upper extremity open wounds sustained during combat, requiring split-thickness or full-thickness skin grafting for closure. The primary outcome measure was wound healing after the first attempt at definitive treatment (defined as the first application of split-thickness or full-thickness skin graft)...
October 12, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27734441/evaluation-of-two-junctional-tourniquets-used-on-the-battlefield-combat-ready-clamp%C3%A2-versus-sam%C3%A2-junctional-tourniquet
#11
Jean-Guillaume Meusnier, Charles Dewar, Erti Mavrovi, Frederic Caremil, Pierre-Francois Wey, Jean-Yves Martinez
BACKGROUND: Junctional hemorrhage (i.e., between the trunk and limbs) are too proximal for a tourniquet and difficult to compress. These hemorrhages are responsible for 20% of preventable deaths by bleeding on the battlefield. The majority of these involve the groin area. Devices allowing a proximal compression for arterial axes have been recently developed. OBJECTIVE: The purpose of this study was to compare the use of two junctional- tourniquet models, the Combat Ready Clamp (CRoC®) and the SAM® Junctional Tourniquet (SJT), in simulated out-of-hospital trauma care when tourniquets were ineffective to stop the arterial flow...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27724088/advances-in-military-resuscitation
#12
Sharon Edwards, Jason Smith
Trauma is a leading cause of death and disability worldwide, in civilian environments and on the battlefield. Trauma-induced haemorrhage is the principal cause of potentially preventable death, which is generally attributable to a combination of vascular injury and coagulopathy. Survival rates following severe traumatic injury have increased due to advanced trauma management initiatives and treatment protocols, influenced by lessons learned from recent conflicts in Iraq and Afghanistan. The use of tourniquets and intraosseous needles, early blood and blood product transfusion, administration of tranexamic acid in pre-hospital settings, and consultant-led damage control resuscitation incorporating damage control surgery have all played their part...
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27689383/committee-on-tactical-combat-casualty-care-meeting-2-3-february-2016-atlanta-georgia-meeting-minutes
#13
Anonymous Anonymous
No abstract text is available yet for this article.
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27689382/tactical-combat-casualty-care-top-lessons-for-civilian-ems-systems-from-14-years-of-war
#14
Frank K Butler
No abstract text is available yet for this article.
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27679752/plastic-surgery-challenges-in-war-wounded-ii-regenerative-medicine
#15
Ian L Valerio, Jennifer M Sabino, Christopher L Dearth
Background: A large volume of service members have sustained complex injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). These injuries are complicated by contamination with particulate and foreign materials, have high rates of bacterial and/or fungal infections, are often composite-type defects with massive soft tissue wounds, and usually have multisystem involvement. While traditional treatment modalities remain a mainstay for optimal wound care, traditional reconstruction approaches alone may be inadequate to fully address the scope and magnitude of such massive complex wounds...
September 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27679751/plastic-surgery-challenges-in-war-wounded-i-flap-based-extremity-reconstruction
#16
Jennifer M Sabino, Julia Slater, Ian L Valerio
Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases...
September 1, 2016: Advances in Wound Care
https://www.readbyqxmd.com/read/27661423/infection-after-orthopaedic-trauma-prevention-and-treatment
#17
Heather C Yun, Clinton K Murray, Kenneth J Nelson, Michael J Bosse
Trauma to the extremities is disproportionately represented in casualties of recent conflicts, accounting for >50% of injuries sustained during operations in Iraq and Afghanistan. Infectious complications have been reported in >25% of those evacuated for trauma, and 50% of such patients were treated in the intensive care unit (ICU). Osteomyelitis has been reported in 9% (14% of intensive care unit patients), and deep-wound infection in 27% of type III open-tibia fractures. Infections complicating extremity trauma are frequently caused by multidrug-resistant bacteria and have been demonstrated to lead to failure of limb salvage, unplanned operative take-backs, late amputations, and decreased likelihood of returning to duty...
October 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27639602/early-traumatic-brain-injury-screen-in-6594-inpatient-combat-casualties
#18
Christopher Connelly, Kathleen Martin, Joel Elterman, Jean A Orman, David Zonies
INTRODUCTION: The purpose of this study was to review the inpatient traumatic brain injury (TBI) screening program at a Role IV regional resource trauma center. TBI has been coined the "signature wound" during current U.S. combat operations. All patients injured in Iraq or Afghanistan who transit through Landstuhl Regional Medical Center (LRMC) undergo an initial TBI screen regardless of anatomic injury. The incidence and factors associated with positive screening for concussion (physical event+alteration of consciousness (AOC)) and TBI diagnoses were examined...
September 7, 2016: Injury
https://www.readbyqxmd.com/read/27612378/pelvic-floor-reconstruction-utilizing-a-residual-hamstring-rotational-flap-following-traumatically-induced-subtotal-hemipelvectomy-in-a-combat-blast-casualty-a-case-report
#19
Richard L Purcell, John P Cody, Mary O'Donnell, Romney Andersen, Carlos J Rodriguez, Scott Tintle
OBJECTIVE: There are several options for soft tissue coverage following external hemipelvectomy; however, in cases of war-related blast trauma, standard flaps are not always available as a result of the extensive soft tissue damage. METHODS: We detail a novel closure technique following a subtotal hemipelvectomy with exposed abdominal viscera using a residual hamstring myofascial cutaneous flap. RESULTS: This flap allowed for fascial tissue to fill the pelvic defect and provided excellent soft tissue coverage for future prosthetic wear...
September 2016: Military Medicine
https://www.readbyqxmd.com/read/27609650/the-surgical-management-of-facial-trauma-in-british-soldiers-during-combat-operations-in-afghanistan
#20
Matthew Wordsworth, Rachael Thomas, John Breeze, Demetrius Evriviades, James Baden, Shehan Hettiaratchy
INTRODUCTION: The recent Afghanistan conflict caused a higher proportion of casualties with facial injuries due to both the increasing effectiveness of combat body armour and the insurgent use of the improvised explosive device (IED). The aim of this study was to describe all injuries to the face sustained by UK service personnel from blast or gunshot wounds during the highest intensity period of combat operations in Afghanistan. METHODS: Hospital records and Joint Theatre Trauma Registry data were collected for all UK service personnel killed or wounded by blast and gunshot wounds in Afghanistan between 01 April 2006 and 01 March 2013...
August 20, 2016: Injury
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