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combat casualty care

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https://www.readbyqxmd.com/read/29662256/analysis-of-combat-casualties-admitted-to-the-emergency-department-during-the-negotiation-of-the-comprehensive-colombian-process-of-peace
#1
Carlos A Ordoñez, Ramiro Manzano Nunez, Michael W Parra, Juan Pablo Herrera, Maria Paula Naranjo, Sara Sofia Escobar, Marisol Badiel, Monica Morales, Cecibel Cevallos, Juan G Bayona, Alvaro Ignacio Sanchez, Juan Carlos Puyana, Alberto F García
Aim: Our objective was to describe the variations in casualties admitted to the emergency department during the period of the negotiation of the comprehensive peace agreement in Colombia between 2011 and 2016. Methods: A retrospective study of all hostile military casualties managed at a regional Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (negotiation period)...
December 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/29626144/safest-light-in-a-combat-area-while-performing-intravenous-access-in-the-dark
#2
Attila Aydin, S Bilge, M Eryilmaz
INTRODUCTION: Cannulation for the administration of intravenous fluids is integral to the prehospital management of injured military patients. However, this may be technically challenging to undertake during night-time conditions where the use of light to aid cannulation may give the tactical situation away to opponents. The aim of this study was to investigate the success and tactical safety of venepuncture under battlefield conditions with different colour light sources. METHOD: The procedure was carried out with naked eye in a bright room in the absence of a separate light source, with a naked eye in a dark room under red, white, blue and green light sources and under an infrared light source while wearing night vision goggles (NVGs)...
April 6, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29618112/critical-care-in-the-military-health-system-a-survey-based-summary-of-critical-care-services
#3
Jason J Nam, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Ferdinand Bacomo, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Introduction: Critical care is an important component of in-patient and combat casualty care, and it is a major contributor to U.S. healthcare costs. Regular exposure to critically ill and injured patients may directly contribute to wartime skills retention for military caregivers. Data describing critical care services in the Military Health System (MHS), however, is lacking. This study was undertaken to describe MHS critical care services, their resource utilization, and differences in care practices amongst military treatment facilities (MTFs)...
March 29, 2018: Military Medicine
https://www.readbyqxmd.com/read/29606685/en-route-critical-care-transfer-from-a-role-2-to-a-role-3-medical-treatment-facility-in-afghanistan
#4
Amanda M Staudt, Shelia C Savell, Kimberly A Biever, Jennifer D Trevino, Krystal K Valdez-Delgado, Mithun Suresh, Jennifer M Gurney, Stacy A Shackelford, Joseph K Maddry, Elizabeth A Mann-Salinas
BACKGROUND: En route care is the transfer of patients requiring combat casualty care within the US military evacuation system. No reports have been published about en route care of patients during transfer from a forward surgical facility (role 2) to a combat support hospital (role 3) for comprehensive care. OBJECTIVE: To describe patients transferred from a role 2 to a role 3 US military treatment facility in Afghanistan. METHODS: A retrospective review of data from the Joint Trauma System Role 2 Database was conducted...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29606684/en-route-care-provided-by-us-navy-nurses-in-iraq-and-afghanistan
#5
Virginia S Blackman, Benjamin D Walrath, Lauren K Reeves, Alejandra G Mora, Joseph K Maddry, Zsolt T Stockinger
BACKGROUND: US Navy nurses provide en route care for critically injured combat casualties without having a formal program for training, utilization, or evaluation. Little is known about missions supported by Navy nurses. OBJECTIVES: To characterize the number and types of patients transported and skill sets required by Navy nurses during 2 combat support deployments. METHODS: All interfacility casualty transfers between 2 separate facilities in Iraq and Afghanistan were assessed...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29606674/reducing-the-risk-for-pressure-injury-during-combat-evacuation
#6
Elizabeth Bridges, JoAnne D Whitney, Robert Burr, Ernesto Tolentino
BACKGROUND: Combat casualties undergoing aeromedical evacuation are at increased risk for pressure injuries. The risk factors pressure and shear are potentially modifiable via solutions appropriate for en route care. OBJECTIVES: To compare transcutaneous oxygen levels and skin temperatures in healthy participants under offloaded (side lying) and loaded (supine or supine with 30° backrest elevation) under 4 conditions: control (no intervention), Mepilex sacral and heel dressings, LiquiCell pad, and Mepilex plus LiquiCell...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29596477/using-support-vector-machines-on-photoplethysmographic-signals-to-discriminate-between-hypovolemia-and-euvolemia
#7
Natasa Reljin, Gary Zimmer, Yelena Malyuta, Kirk Shelley, Yitzhak Mendelson, David J Blehar, Chad E Darling, Ki H Chon
Identifying trauma patients at risk of imminent hemorrhagic shock is a challenging task in intraoperative and battlefield settings given the variability of traditional vital signs, such as heart rate and blood pressure, and their inability to detect blood loss at an early stage. To this end, we acquired N = 58 photoplethysmographic (PPG) recordings from both trauma patients with suspected hemorrhage admitted to the hospital, and healthy volunteers subjected to blood withdrawal of 0.9 L. We propose four features to characterize each recording: goodness of fit (r2), the slope of the trend line, percentage change, and the absolute change between amplitude estimates in the heart rate frequency range at the first and last time points...
2018: PloS One
https://www.readbyqxmd.com/read/29554046/the-evolution-of-pediatric-transfusion-practice-during-combat-operations-2001-2013
#8
Jeremy W Cannon, Lucas P Neff, Heather F Pidcoke, James K Aden, Philip C Spinella, Michael A Johnson, Andrew P Cap, Matthew A Borgman
BACKGROUND: Hemostatic resuscitation principles have significantly changed adult trauma resuscitation over the past decade. Practice patterns in pediatric resuscitation likely have changed as well; however, this evolution has not been quantified. We evaluated pediatric resuscitation practices over time within a combat trauma system. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric patients (<18 years). Patients with burns, drowning, and missing injury severity score (ISS) were excluded...
March 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29551528/challenges-of-military-health-service-support-in-mountain-warfare
#9
REVIEW
Raimund Lechner, Thomas Küpper, Markus Tannheimer
INTRODUCTION: History is full of examples of the influence of the mountain environment on warfare. The aim of this article is to identify the main environmental hazards and summarize countermeasures to mitigate the impact of this unique environment. METHODS: A selective PubMed and Internet search was conducted. Additionally, we searched bibliographies for useful supplemental literature and included the recommendations of the leading mountain medicine and wilderness medicine societies...
March 16, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29547968/biological-response-to-stress-during-battlefield-trauma-training-live-tissue-versus-high-fidelity-patient-simulator
#10
Henry T Peng, Catherine Tenn, Oshin Vartanian, Shawn G Rhind, Jerzy Jarmasz, Homer Tien, Andrew Beckett
Introduction: Tactical Combat Casualty Care (TCCC) training imposes psychophysiological stress on medics. It is unclear whether these stress levels vary with the training modalities selected. It is also unclear how stress levels could have an impact on medical performance and skill uptake. Materials and Methods: We conducted a pilot study to compare the effects of live tissue (LT) with a high-fidelity patient simulator (SIM) on the level of stress elicited, performance, and skill uptake during battlefield trauma training course in an operating room (OR) and in a simulated battlefield scenario (field)...
March 14, 2018: Military Medicine
https://www.readbyqxmd.com/read/29547887/an-evaluation-of-navy-en-route-care-training-using-a-high-fidelity-medical-simulation-scenario-of-interfacility-patient-transport
#11
Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
https://www.readbyqxmd.com/read/29533455/committee-on-tactical-combat-casualty-care-meeting-minutes-6-7-september-2017-san-antonio-tx
#12
Frank K Butler, Stephen Giebner
No abstract text is available yet for this article.
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29533448/prehospital-medicine-and-the-future-will-ecmo-ever-play-a-role
#13
David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29533446/integrating-chemical-biological-radiologic-and-nuclear-cbrn-protocols-into-tccc-introduction-of-a-conceptual-model-tccc-cbrn-marche-2
#14
Devin R DeFeo, Melissa L Givens
The authors would like to introduce TCCC [Tactical Combat Casualty Care] + CBRN [chemical, biological, radiological, and nuclear] = (MARCHE)2 as a conceptual model to frame the response to CBRN events. This model is not intended to replace existing and well-established literature on CBRNE events but rather to serve as a response tool that is an adjunct to agent specific resources.
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29533435/intramuscular-tranexamic-acid-in-tactical-and-combat-settings
#15
Erik N Vu, Wilson C Y Wan, Titus C Yeung, David W Callaway
BACKGROUND: Uncontrolled hemorrhage remains a leading cause of preventable death in tactical and combat settings. Alternate routes of delivery of tranexamic acid (TXA), an adjunct in the management of hemorrhagic shock, are being studied. A working group for the Committee for Tactical Emergency Casualty Care reviewed the available evidence on the potential role for intramuscular (IM) administration of TXA in nonhospital settings as soon as possible from the point of injury. METHODS: EMBASE and MEDLINE/PubMed databases were sequentially searched by medical librarians for evidence of TXA use in the following contexts and/or using the following keywords: prehospital, trauma, hemorrhagic shock, optimal timing, optimal dose, safe volume, incidence of venous thromboembolism (VTE), IM bioavailability...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29533432/feasibility-and-proposed-training-pathway-for-austere-application-of-resuscitative-balloon-occlusion-of-the-aorta
#16
Elliot M Ross, Theodore T Redman
BACKGROUND: Noncompressible junctional and truncal hemorrhage remains a significant cause of combat casualty death. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective treatment for many junctional and noncompressible hemorrhages. The current hospital standard for time of placement of REBOA is approximately 6 minutes. This study examined the training process and the ability of nonsurgical physicians to apply REBOA therapy in an austere field environment. METHODS: This was a skill acquisition and feasibility study...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29533426/military-prehospital-use-of-low-titer-group-o-whole-blood
#17
Nicholas Warner, Jackson Zheng, Greg Nix, Andrew D Fisher, Jeffery C Johnson, John E Williams, D Marc Northern, John S Hellums
The military's use of whole-blood transfusions is not new but has recently received new emphasis by the Tactical Combat Casualty Care Committee. US Army units are implementing a systematic approach to obtain and use whole blood on the battlefield. This case report reviews the care of the first patient to receive low titer group O whole blood (LTOWB) transfusion, using a new protocol.
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29514345/military-trauma-and-surgical-procedures-in-conflict-area-a-review-for-the-utilization-of-forward-surgical-team
#18
Yi-Ling Cai, Jin-Tao Ju, Wen-Bao Liu, Jian Zhang
Introduction: Forward surgical teams (FSTs) have been used as highly mobile surgical facilities that provide "damage control" medical support in modern wars. FST regiments differ greatly in different armed services and nations. We systemically reviewed the utilization of FSTs around the world with an emphasis on the medical conditions and workloads encountered by FSTs in modern wars. Materials and Methods: We searched for terms related to FSTs, such as "Forward Surgical Team" and "Field Surgical Team," in the PubMed, EMBASE, Web of Science, and MEDLINE databases and collected any articles that provided numerical data on the organization of medical personnel combat casualty characteristics, including the casualty composition, injury types and locations, and mechanisms of injury, and surgical procedures performed...
March 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29514336/imaging-of-combat-related-thoracic-trauma-review-of-penetrating-trauma
#19
John P Lichtenberger, Andrew M Kim, Dane Fisher, Peter S Tatum, Brian Neubauer, P Gabriel Peterson, Brett W Carter
Introduction: Combat-related thoracic trauma is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries were the most common mechanisms of trauma. Imaging plays a key role in the management of combat-related thoracic trauma casualties. This review discusses the imaging manifestations of thoracic injuries from penetrating trauma, emphasizing epidemiology and diagnostic clues seen during OEF and OIF...
March 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29509923/letter-in-response-to-kim-m-torrie-i-poisson-r-withers-n-bjarnason-s-daluz-lt-pannell-d-beckett-a-tien-hc-the-value-of-live-tissue-training-for-combat-casualty-care-a-survey-of-canadian-combat-medics-with-battlefield-experience-in-afghanistan
#20
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