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Military pre-hospital

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https://www.readbyqxmd.com/read/29170311/14%C3%A2-prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#1
Jackie Mclennan, Jason Smith, Kevin Mackway-Jones
BACKGROUND: The predominant cause of preventable death from trauma is bleeding. Many patients need resuscitation with massive blood transfusion (MBT). In some theatres of military operation there is limited blood product availability and walking donor panels can be required. This study aimed to produce a tool to predict the need for MBT using information available on patient arrival at the ED for patients sustaining battlefield trauma. METHODS: A retrospective database analysis was undertaken using the UK Joint Theatre Trauma Registry (JTTR) to provide derivation and validation datasets...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29161399/global-lessons-developing-military-trauma-care-and-lessons-for-civilian-practice
#2
T Woolley, J A Round, M Ingram
The wars in Iraq and Afghanistan have helped to shape the modern Defence Medical Services. Many lessons were learnt including the need for rapid haemorrhage control, senior decision-making and the evolution of deployed transfusion support. These changes were implemented simultaneously with a coherent, end-to-end medical plan from point of wounding through to rehabilitation. Implementation of the medical plan is harmonious with the NHS trauma pathway, and is key to ensuring effective delivery. Military anaesthetists have a long pre-deployment training pathway starting with a Certificate of Completion of Training (CCT) in anaesthesia and/or critical care, and with an emphasis on military skills related to their specific role...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29126602/the-potential-of-blended-learning-in-education-and-training-for-advanced-civilian-and-military-trauma-care
#3
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
INTRODUCTION: In the field of advanced care of the complex trauma patient, there is an emerging need for focused education and training. However, several hospitals do not support further education and training in this field, and the challenge of releasing time for physicians and nurses is well-known. Educational strategies using blended learning, which combines traditional classroom methods with modern computer-assisted methods and media, have not yet been widely used. This study analysed the educational challenges and areas for improvement, according to senior physicians and nurses, and investigated the potential use of blended learning...
November 6, 2017: Injury
https://www.readbyqxmd.com/read/29119632/the-effect-of-education-of-nurses-on-preventing-catheter-associated-urinary-tract-infections-in-patients-who-undergo-hip-fracture-surgery
#4
Ezgi Seyhan Ak, Ayfer Özbaş
AIMS AND OBJECTIVES: The aim of the study is to investigate the effect of educating nurses on preventing catheter-associated urinary tract infections in patients who undergo hip fracture surgery. BACKGROUND: Urinary tract infections after hip fracture surgery are observed at a rate of 12% to 61%, and the most important risk factor associated with urinary tract infection is considered to be the presence of urinary catheters. Nurse education about the use and management of urinary catheters is important to decrease the risk of urinary tract infections...
November 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29050174/-effects-of-modified-three-step-procedure-for-anatrophic-nephrolithotomy-in-the-treatment-of-complex-staghorn-renal-calculi
#5
C L Yang, W Wang, W E Zhou, Y P Xue, B Q Wang, H B Nie, W L Hu
Objective: To investigate the effects of modified three-step procedure for anatrophic nephrolithotomy in the treatment of complex staghorn renal calculi. Methods: A total of 22 patients with complex staghorn renal calculi between June 2013 and June 2016 at Department of Urology in Guangzhou General Hospital of Guangzhou Military Command were retrospective analyzed. There were 13 males and 9 females, ranging from 35 to 62 years old with mean age of 47 years. There were 17 patients with dull pain, and 5 patients who were found through physical examinations...
October 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28988805/prediction-of-massive-blood-transfusion-in-battlefield-trauma-development-and-validation-of-the-military-acute-severe-haemorrhage-mash-score
#6
Jacqueline V Mclennan, Kevin C Mackway-Jones, Jason E Smith
BACKGROUND: The predominant cause of preventable trauma death is bleeding, and many of these patients need resuscitation with massive blood transfusion. In resource-constrained environments, early recognition of such patients can improve planning and reduce wastage of blood products. No existing decision rule is sufficiently reliable to predict those patients requiring massive blood transfusion. This study aims to produce a decision rule for use on arrival at hospital for patients sustaining battlefield trauma...
September 28, 2017: Injury
https://www.readbyqxmd.com/read/28968286/2017-military-supplement-hemoglobin-based-oxygen-carriers-current-state-of-the-art-and-novel-molecules
#7
Anirban Sen Gupta
In blood, the primary role of RBCs is to transport oxygen via highly regulated mechanisms involving hemoglobin (Hb). Hb is a tetrameric porphyrin protein comprising of two α- and two β-polypeptide chains, each containing an iron-containing heme group capable of binding one oxygen molecule. In military as well as civilian traumatic exsanguinating hemorrhage, rapid loss of RBCs can lead to sub-optimal tissue oxygenation and subsequent morbidity and mortality. In such cases, transfusion of whole blood or RBCs can significantly improve survival...
September 29, 2017: Shock
https://www.readbyqxmd.com/read/28810956/the-reasons-for-living-scale-military-version-assessing-protective-factors-against-suicide-in-a-military-sample
#8
Anne-Marie Deutsch, R Gregory Lande
INTRODUCTION: Military suicide rates have been rising over the past decade and continue to challenge military treatment facilities. Assessing suicide risk and improving treatments are a large part of the mission for clinicians who work with uniformed service members. This study attempts to expand the toolkit of military suicide prevention by focusing on protective factors over risk factors. In 1983, Marsha Linehan published a checklist called the Reasons for Living Scale, which asked subjects to check the reasons they choose to continue living, rather than choosing suicide...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28725149/using-an-integrated-information-system-to-reduce-interruptions-and-the-number-of-non-relevant-contacts-in-the-inpatient-pharmacy-at-tertiary-hospital
#9
Saleh Binobaid, Mohammed Almeziny, Ip-Shing Fan
Patient care is provided by a multidisciplinary team of healthcare professionals intended for high-quality and safe patient care. Accordingly, the team must work synergistically and communicate efficiently. In many hospitals, nursing and pharmacy communication relies mainly on telephone calls. In fact, numerous studies have reported telephone calls as a source of interruption for both pharmacy and nursing operations; therefore, the workload increases and the chance of errors raises. This report describes the implementation of an integrated information system that possibly can reduce telephone calls through providing real-time tracking capabilities and sorting prescriptions urgency, thus significantly improving traceability of all prescriptions inside pharmacy...
July 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28697026/smartphone-based-mobile-thermal-imaging-technology-to-assess-limb-perfusion-and-tourniquet-effectiveness-under-normal-and-blackout-conditions
#10
Morgan R Barron, John P Kuckelman, John M McClellan, Michael J Derickson, Cody J Phillips, Shannon T Marko, Joshua P Smith, Matthew J Eckert, Matthew J Martin
BACKGROUND: Over the past decade there has been a resurgence of tourniquet use in civilian and military settings. Several key challenges include assessment of limb perfusion and adequacy of tourniquet placement, particularly in the austere or pre-hospital environments. We investigated the utility of thermal imaging to assess adequacy of tourniquet placement. METHODS: The FLIR ONE™ smartphone-based thermal imager was utilized. Ten swine underwent tourniquet placement with no associated hemorrhage (n=5) or with 40% hemorrhage (n=5)...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28603241/-the-treatment-of-wounds-during-world-war-i
#11
Sergio Sabbatani, Sirio Fiorino
The First World War was a huge tragedy for mankind, but, paradoxically, it represented a source of significant progress in a broad series of human activities, including medicine, since it forced physicians to improve their knowledge in the treatment of a large number of wounded soldiers. The use of heavy artillery and machine guns, as well as chemical warfare, caused very serious and life-threatening lesions and wounds. The most frequent causes of death were not mainly related to gunshot wounds, but rather to fractures, tetanus and septic complications of infectious diseases...
June 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28598455/primary-total-hip-replacement-in-the-military-hospital-in-kathmandu
#12
P Chand, S R Magar, B B Thapa, B Shrestha
INTRODUCTION: Total hip replacement is one of the most widely performed and amongst the most successful orthopedic procedures performed worldwide. Even though it is a common orthopedic procedure in developed nations, it is performed only in selected centers in Nepal. This study will review the functional outcome of total hip replacements carried out in Shree Birendra Hospital. METHODS: We reviewed the records of total hip replacements, which were carried out in Shree Birendra Hospital, Kathmandu...
January 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28573148/a-promising-tool-for-surgical-lipotransfer-a-constant-pressure-and-quantity-injection-device-in-facial-fat-grafting
#13
Mei Song, Yi Liu, Ping Liu, Xianying Zhang
BACKGROUND: The purpose of this study was to preliminarily assess a constant pressure and quantity fat granule injection device for minimal invasive properties in clinic. METHODS: A retrospective controlled study was carried out, from October 2013 to January 2015, on 76 female healthy patients aged between 26 and 53 years at the General Hospital of Lanzhou Military Command, China. To achieve small volume, high thrust, and precision requirements of facial fat grafting, an integrated handheld controller and motor design was adopted, reducing the volume and weight of the fat transplantation injection device...
2017: Burns and Trauma
https://www.readbyqxmd.com/read/28452882/field-and-en-route-reboa-a-feasible-military-reality
#14
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/28383466/relative-device-stability-of-anterior-versus-axillary-needle-decompression-for-tension-pneumothorax-during-casualty-movement-preliminary-analysis-of-a-human-cadaver-model
#15
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 prehospital standard of care for tPTX is immediate decompression with a 14-gauge 8-cm angiocatheter; however, failure rates may be as high as 17% to 60%. Alternative devices, such as 10-gauge angiocatheter, modified Veress needle, and laparoscopic trocar, 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...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28355742/-lumbosacral-nerve-bowstring-disease
#16
J G Shi, X M Xu, J C Sun, Y Wang, Y F Guo, H S Yang, Q J Kong, Y Yang, G D Shi, W Yuan, L S Jia
Objective: To define a novel disease-lumbosacral nerve bowstring disease, and propose the diagnostic criteria, while capsule surgery was performed and evaluated in the preliminary study. Methods: From June 2016 to December 2016, a total of 30 patients (22 male and 8 female; mean age of 55.1±9.7 years) with lumbosacral nerve bowstring disease were included in Department of Spine Surgery, Changzheng Hospital, the Second Military Medical University.Lumbosacral nerve bowstring disease was defined as axial hypertension of nerve root and spinal cord caused by congenital anomalies, which could be accompanied by other lesions as lumbar disc herniation, spinal cord stenosis or spondylolisthesis, or aggravated by iatrogenic lesions, resulting in neurological symptoms...
March 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28228341/doctors-and-nurses-perceptions-of-military-pre-hospital-emergency-care-when-training-becomes-reality
#17
REVIEW
Sten-Ove Andersson, Lars Lundberg, Anders Jonsson, Pia Tingström, Madeleine Abrandt Dahlgren
The aim of this study was to identify physicians' and nurses' perceptions of military pre-hospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The results after pre-deployment training can be categorised as (1) learning about military medicine and (2) taking care of the casualty. The results after an international mission can be categorised as (1) collaborating with others, (2) providing general health care and (3) improving competence in military medicine...
May 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#18
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
August 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/27959967/transfusion-80%C3%A2-c-frozen-blood-products-are-safe-and-effective-in-military-casualty-care
#19
Femke Noorman, Thijs T C F van Dongen, Marie-Christine J Plat, John F Badloe, John R Hess, Rigo Hoencamp
INTRODUCTION: The Netherlands Armed Forces use -80°C frozen red blood cells (RBCs), plasma and platelets combined with regular liquid stored RBCs, for the treatment of (military) casualties in Medical Treatment Facilities abroad. Our objective was to assess and compare the use of -80°C frozen blood products in combination with the different transfusion protocols and their effect on the outcome of trauma casualties. MATERIALS AND METHODS: Hemovigilance and combat casualties data from Afghanistan 2006-2010 for 272 (military) trauma casualties with or without massive transfusions (MT: ≥6 RBC/24hr, N = 82 and non-MT: 1-5 RBC/24hr, N = 190) were analyzed retrospectively...
2016: PloS One
https://www.readbyqxmd.com/read/27924964/frequency-of-cyp2d6-10-genotypes-in-pakistani-breast-cancer-patients-taking-adjuvant-tamoxifen
#20
Nusrat Nazir, Akbar Waheed, Kulsoom Farhat, Muhammad Ismail, Qaisar Mansoor
OBJECTIVE: To investigate the frequency of cytochrome P2D6*10 in breast cancer patients. METHODS: This retrospective study was conducted at the Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, and the Combined Military Hospital, Rawalpindi, Pakistan, and comprised medical records of breast cancer patients from January 2000 to September 2013. Pre- and post-menopausal women with diagnosed breast cancer who were advised 20mg/day of tamoxifen as adjuvant therapy were included...
December 2016: JPMA. the Journal of the Pakistan Medical Association
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