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https://www.readbyqxmd.com/read/29463357/point-of-care-ultrasound-for-pulmonary-concerns-in-remote-spaceflight-triage-environments
#1
Benjamin D Johansen, Rebecca S Blue, Tarah L Castleberry, Erik L Antonsen, James M Vanderploeg
INTRODUCTION: With the development of the commercial space industry, growing numbers of spaceflight participants will engage in activities with a risk for pulmonary injuries, including pneumothorax, ebullism, and decompression sickness, as well as other concomitant trauma. Medical triage capabilities for mishaps involving pulmonary conditions have not been systematically reviewed. Recent studies have advocated the use of point-of-care ultrasound to screen for lung injury or illness. The operational utility of portable ultrasound systems in disaster relief and other austere settings may be relevant to commercial spaceflight...
February 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29447407/the-feasibility-of-venovenous-ecmo-at-role-2-facilities-in-austere-military-environments
#2
Mohamed A T Mohamed, Tareq Maraqa, Matthew D Bacchetta, Michael McShane, Kenneth L Wilson
Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been gaining use to bridge the recovery from acute respiratory distress syndrome (ARDS) refractory to conventional treatment. However, these interventions are often limited to higher echelons of military care. We present a case of lung salvage from severe ARDS in an Afghani soldier with VV-ECMO at a Role-2 (R2) facility in an austere military environment in Afghanistan. Case: A 25-year-old Afghani soldier presented to an R2 facility with blast lung injury and multiple penetrating injuries following an explosion...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29443864/past-and-present-role-of-ecmo-in-combat-casualty-care-how-far-will-we-go
#3
Jeremy W Cannon, Phillip E Mason, Andriy I Batchinsky
Advanced extracorporeal therapies have been successfully applied in the austere environment of combat casualty care over the previous decade. In this review, we describe the historic underpinnings of extracorporeal membrane oxygenation (ECMO), review the recent experience with both partial and full lung support during combat operations, and critically assess both the current status of the Department of Defense ECMO program and the way forward to establish long-range lung rescue therapy as a routine capability for combat casualty care...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29440467/fentanyl-lozenge-story-part-2-from-military-procurement-to-package
#4
REVIEW
Edward Rogers, C Wright, P King
This paper describes the selection of fentanyl as a replacement for morphine as the United Kingdom Ministry of Defence's first-line battlefield analgesic agent. It is a detailed review of the 6 year journey from selection to eventual roll-out in October 2017. It concentrates on the procurement and governance process of the deployment of fentanyl for individual issue and self-use. It highlights the significant differences in military and civilian legislation, the specialist environment we work in and the safety concerns surrounding controlled drugs in the austere environment...
February 12, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29420812/expeditionary-force-health-protection-for-global-health-engagement-lessons-learned-from-continuing-promise-2017
#5
Lucas A Johnson, Robert P Lennon
Background: Global health engagement (GHE) is an important priority for the Military Health Service as such activities strengthen the health capabilities of partner nations and improve interoperability. By their very nature, GHE activities are predominantly conducted in low-resource areas with limited infrastructure and substantial humanitarian need. The Department of Defense is evaluating leaner, flexible force packages to accomplish GHE missions and better prepare uniformed medical providers to provide care in austere environments...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29420777/management-of-acute-upper-gastrointestinal-disease-while-at-sea
#6
Matthew J Carr, Christopher Oxner, Eric A Elster, Eric M Ritter, Diego Vicente
Management of complex acute surgical pathology in austere environments necessitates rapid evaluation and resource appropriate management to avoid time-associated morbidity and potentially mortality. Obstructive upper gastrointestinal (UGI) pathologies can be particularly challenging and associated with significant morbidity. Herein, we present six patients with UGI obstructions encountered over the course of an 8-mo deployment onboard a US Navy Aircraft Carrier. Each patient presented to our medical department with signs and symptoms of obstructive UGI pathology including one gastric volvulus requiring operative management at sea, one with a new diagnosis of achalasia requiring transportation and continental United States outpatient evaluation, and four patients with food impaction requiring urgent endoscopic management...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29408681/housing-environment-influences-stress-related-hippocampal-substrates-and-depression-like-behavior
#7
Archana Ashokan, Akshaya Nagrajan Hegde, Anushanthy Balasingham, Rupshi Mitra
Rats are widely used animal models for biological psychiatry and neuroscience. Laboratory rats are typically housed in impoverished sensory environments. The lack of species-typical sensory environment might radically change the response of individual animals to stressful and/or threatening episodes. In this report, we demonstrate that behavioral and neural sequelae of chronic stress were modified by sensory environment of adult male rats. This includes effects of stress on the density of spines on CA3 hippocampal neurons, hippocampal neurogenesis and abundance of glucocorticoid or mineralocorticoid receptors...
February 1, 2018: Brain Research
https://www.readbyqxmd.com/read/29394283/lyophilized-plasma-attenuates-vascular-permeability-inflammation-and-lung-injury-in-hemorrhagic-shock
#8
Shibani Pati, Zhanglong Peng, Katherine Wataha, Byron Miyazawa, Daniel R Potter, Rosemary A Kozar
In severe trauma and hemorrhage the early and empiric use of fresh frozen plasma (FFP) is associated with decreased morbidity and mortality. However, utilization of FFP comes with the significant burden of shipping and storage of frozen blood products. Dried or lyophilized plasma (LP) can be stored at room temperature, transported easily, reconstituted rapidly with ready availability in remote and austere environments. We have previously demonstrated that FFP mitigates the endothelial injury that ensues after hemorrhagic shock (HS)...
2018: PloS One
https://www.readbyqxmd.com/read/29373217/an-effective-treatment-in-the-austere-environment-a-critical-appraisal-into-the-use-of-intra-articular-local-anesthetic-to-facilitate-reduction-in-acute-shoulder-dislocation
#9
REVIEW
Fraser John Gould
Acute shoulder dislocation is a common injury in the outdoor environment. The objective of this systematic review of the literature was to determine if intra-articular local anesthetic (IAL) is an effective treatment that could have prehospital application. A methodical search of MEDLINE, PubMed, and EMBASE databases targeted publications from January 1, 1990 until January 1, 2017. Eligible articles compared IAL with other analgesic techniques in patients 16 years or older experiencing acute glenohumeral dislocation...
January 16, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29352825/safety-of-electro-medical-equipment-in-floods-in-austere-environment
#10
Zubair Ahmed Khan, Ahsin M Bhatti, Faisal Akhtar
Pakistan is prone to floods. In 2010, floods in North-Western Pakistan caused devastation in wide areas. Electro-medical equipment is very expensive and without proper equipment adequate surgery is not possible. We retrospectively analyzed how expensive electro-medical equipment got damaged during floods of 2010 at a district-level hospital in North-Western Pakistan and how we could have saved this equipment or reduced the damage to the minimum. The article provides the lessons learned and recommendations aimed to prevent or minimize damage to the valuable and expensive equipment in the areas prone to floods...
January 21, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29279321/power-supplies-and-equipment-for-military-field-research-lessons-from-the-british-service-dhaulagiri-research-expedition-2016
#11
Matt Howard, J Bakker-Dyos, L Gallagher, J P O'Hara, D Woods, A Mellor
INTRODUCTION: The British Service Dhaulagiri Research Expedition (BSDMRE) took place from 27 March to 31 May 2016. The expedition involved 129 personnel, with voluntary participation in nine different study protocols. Studies were conducted in three research camps established at 3600, 4600 and 5140 m and involved taking and storing blood samples, cardiac echocardiography and investigations involving a balance plate. Research in this remote environment requires careful planning in order to provide a robust and resilient power plan...
December 25, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29193130/evaluation-of-a-lateral-flow-based-technology-card-for-blood-typing-using-a-simplified-protocol-in-a-model-of-extreme-blood-sampling-conditions
#12
Benoît Clavier, Thomas Pouget, Anne Sailliol
BACKGROUND: Life-threatening situations requiring blood transfusion under extreme conditions or in remote and austere locations, such as the battlefield or in traffic accidents, would benefit from reliable blood typing practices that are easily understood by a nonscientist or nonlaboratory technician and provide quick results. STUDY DESIGN AND METHODS: A simplified protocol was developed for the lateral flow-based device MDmulticard ABO-D-Rh subgroups-K. Its performance was compared to a reference method (PK7300, Beckman Coulter) in native blood samples from donors...
November 29, 2017: Transfusion
https://www.readbyqxmd.com/read/29155246/relatively-enriched-housing-conditions-delay-binge-onset-but-do-not-attenuate-binge-size
#13
Kerry E Preston, Rebecca L Corwin, Julia O Bader, Stephen L Crimmins
Housing and enrichment conditions are essential factors to consider when using animal models of behavior, as they can alter the behavior that is under investigation. The goal of this study was to determine the impact of the relatively enriched environment recommended by current animal care guidelines on development and maintenance of binge-type behavior in rats, using the limited access (LA) binge model. Non-food-deprived rats were divided into two groups, enriched and nonenriched, with all rats housed in shoebox cages...
November 15, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/29079661/development-of-a-portable-blood-salvage-and-autotransfusion-technology-to-enhance-survivability-of-personnel-requiring-major-medical-interventions-in-austere-or-military-environments
#14
Terence Gourlay, C Simpson, C A Robertson
INTRODUCTION: Uncontrolled haemorrhage is the leading cause of death on the battlefield, and two-thirds of these deaths result from non-compressible haemorrhage. Blood salvage and autotransfusion represent an alternative to conventional blood transfusion techniques for austere environments, potentially providing blood to the casualty at point of injury. The aim of this paper is to describe the design, development and initial proof-of-concept testing of a portable blood salvage and autotransfusion technology to enhance survivability of personnel requiring major medical interventions in austere or military environments...
October 26, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29072190/employment-insecurity-mental-health-and-suicide
#15
K N Fountoulakis
With the economic crisis an increase in suicidality has been reported across Europe but especially in Greece. Τhese reports hit the mass media headlines and were also included in the debate among political parties. The literature suggests that during periods of deep economic crisis, there is an increase specifically in suicides but causality remains unclear. The prevailing picture both in the scientific literature and in the mass media is that the economic crisis acts as a more or less generic risk factor on the entire population putting at risk literally anybody...
July 2017: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/29018173/a-pilot-study-of-surgical-telementoring-for-leg-fasciotomy
#16
Max Talbot, E J Harvey, G K Berry, R Reindl, H Tien, D J Stinner, G Slobogean
INTRODUCTION: Acute extremity compartment syndrome requires rapid decompression. In remote locations, distance, weather and logistics may delay the evacuation of patients with extremity trauma beyond the desired timeline for compartment release. The aim of this study was to establish the feasibility of performing telementored surgery for leg compartment release and to identify methodological issues relevant for future research. METHODS: Three anaethetists and one critical care physician were recruited as operators...
October 10, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28982709/the-british-services-dhaulagiri-medical-research-expedition-2016-a-unique-military-and-civilian-research-collaboration
#17
Adrian Mellor, J Bakker-Dyos, M Howard, C Boos, M Cooke, E Vincent, P Scott, J O'Hara, S B Clarke, M Barlow, J Matu, K Deighton, N Hill, C Newman, R Cruttenden, D Holdsworth, D Woods
INTRODUCTION: High-altitude environments lead to a significant physiological challenge and disease processes which can be life threatening; operational effectiveness at high altitude can be severely compromised. The UK military research is investigating ways of mitigating the physiological effects of high altitude. METHODS: The British Service Dhaulagiri Research Expedition took place from March to May 2016, and the military personnel were invited to consent to a variety of study protocols investigating adaptation to high altitudes and diagnosis of high-altitude illness...
October 5, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28960477/real-time-ultrasound-assessment-of-astronaut-spinal-anatomy-and-disorders-on-the-international-space-station
#18
Kathleen M Garcia, Michael F Harrison, Ashot E Sargsyan, Douglas Ebert, Scott A Dulchavsky
OBJECTIVES: Back pain is one of the most common conditions of astronauts during spaceflight and is hypothesized to be attributed to pathologic anatomic changes. Ultrasound (US) represents the only available imaging modality on the International Space Station, but a formal US protocol for imaging the structures of the spinal column does not exist. This investigation developed a method of acquiring diagnostic-quality images of the anterior lumbar and cervical regions of the spine during long-duration spaceflight...
September 29, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28910474/atropine-eye-drops-a-proposed-field-expedient-substitute-in-the-absence-of-atropine-autoinjectors
#19
Christopher J Calvano, Robert W Enzenauer, Derek L Eisnor, Robert A Mazzoli
Nerve agents are a threat to military and civilian health. The antidote, atropine sulfate, is delivered by autoinjector, which is a limited resource. We propose the use of 1% atropine ophthalmic solution (supplied commercially in 5mL or 15 mL bottles) via oral, ocular, and intranasal administration as an expedient substitute in austere environments.
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910473/optimization-of-simulation-and-moulage-in-military-related-medical-training
#20
Christopher Petersen, Stephen C Rush, Isabelle Gallo, Bryan Dalere, Brian Staak, Litt Moore, Win Kerr, Matthew Chandler, Will Smith
Preparation of Special Operations Forces (SOF) Medics as first responders for the battle space and austere environments is critical to optimize survival and quality of life for our Operators who may sustain serious and complex wounding patterns and illnesses. In the absence of constant clinical exposure for these medics, it is necessary to maximize all available training opportunities. The incorporation of scenario-based training helps weave together teamwork and the ability to practice treatment protocols in a tactical, controlled training environment to reproduce, to some degree, the environment in and stressors under which care will need to be delivered...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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