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Medic Evacuation

Joseph K Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide lifesaving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
November 2016: Journal of Trauma and Acute Care Surgery
Nicola Benedetto, Carlo Gambacciani, Nicola Montemurro, Riccardo Morganti, Paolo Perrini
OBJECTIVE: To evaluate the clinical outcome of patients over 70 years old who have received surgical treatment for traumatic acute subdural haematoma (aSDH) in our Neurosurgical Department. We also disclose related surgical and medical costs. METHODS: A retrospective analysis was performed by analyzing the medical records of patients older than 70 who had undergone surgery for evacuation of traumatic aSDH between June 2011 and December 2014. Through univariate and multivariate analyses, we correlated clinical and radiological pre-operatory features with outcome at one and six months after surgery...
October 19, 2016: British Journal of Neurosurgery
Mehran Peyvasteh, Shahnam Askarpour, Nasrollah Ostadian, Mohammad-Reza Moghimi, Hazhir Javaherizadeh
Background: Hirschsprung's disease is the most common cause of pediatric intestinal obstruction. Contrast enema is used for evaluation of the patients with its diagnosis. Aim: To evaluate sensitivity, specificity, positive predictive value, and negative predictive value of radiologic findings for diagnosis of Hirschsprung in patients underwent barium enema. Methods: This cross sectional study was carried out in Imam Khomeini Hospital for one year starting from 2012, April...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Paul Vespa, Daniel Hanley, Joshua Betz, Alan Hoffer, Johnathan Engh, Robert Carter, Peter Nakaji, Chris Ogilvy, Jack Jallo, Warren Selman, Amanda Bistran-Hall, Karen Lane, Nichol McBee, Jeffery Saver, Richard E Thompson, Neil Martin
BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is a devastating disease without a proven therapy to improve long-term outcome. Considerable controversy about the role of surgery remains. Minimally invasive endoscopic surgery for ICH offers the potential of improved neurological outcome. METHODS: We tested the hypothesis that intraoperative computerized tomographic image-guided endoscopic surgery is safe and effectively removes the majority of the hematoma rapidly...
October 6, 2016: Stroke; a Journal of Cerebral Circulation
Michel Debacker, Filip Van Utterbeeck, Christophe Ullrich, Erwin Dhondt, Ives Hubloue
It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS)...
December 2016: Journal of Medical Systems
Daniel F Hanley, Richard E Thompson, John Muschelli, Michael Rosenblum, Nichol McBee, Karen Lane, Amanda J Bistran-Hall, Steven W Mayo, Penelope Keyl, Dheeraj Gandhi, Tim C Morgan, Natalie Ullman, W Andrew Mould, J Ricardo Carhuapoma, Carlos Kase, Wendy Ziai, Carol B Thompson, Gayane Yenokyan, Emily Huang, William C Broaddus, R Scott Graham, E Francois Aldrich, Robert Dodd, Cristanne Wijman, Jean-Louis Caron, Judy Huang, Paul Camarata, A David Mendelow, Barbara Gregson, Scott Janis, Paul Vespa, Neil Martin, Issam Awad, Mario Zuccarello
BACKGROUND: Craniotomy, according to the results from trials, does not improve functional outcome after intracerebral haemorrhage. Whether minimally invasive catheter evacuation followed by thrombolysis for clot removal is safe and can achieve a good functional outcome is not known. We investigated the safety and efficacy of alteplase, a recombinant tissue plasminogen activator, in combination with minimally invasive surgery (MIS) in patients with intracerebral haemorrhage. METHODS: MISTIE was an open-label, phase 2 trial that was done in 26 hospitals in the USA, Canada, the UK, and Germany...
November 2016: Lancet Neurology
Hisao Nakai, Keiko Tsukasaki, Kaoru Kyota, Tomoya Itatani, Reiko Nihonyanagi, Yasuko Shinmei, Shizuka Yasuoka
This study investigated factors affecting disaster preparedness and evacuation intentions among home-care patients dependent on electrical power for life support. Health professionals interviewed 53 home-care patients using the Kanazawa and Kochi Disaster Preparedness Checklist. About half of the participants requiring continuous artificial ventilation or aspiration indicated that they would not or could not evacuate following a disaster-even though their lives could be at risk. The availability of emergency medical equipment for use during a power outage was positively associated with the desire to evacuate...
October 2016: Journal of Community Health Nursing
Myles R McKenzie, Ernest W Parrish, Ethan A Miles, James C Spradling, Lanny F Littlejohn, Mark D Quinlan, George A Barbee, David R King
During an assault on an extremely remote target, a US Special Operations Soldier sustained multiple gunshot and fragmentation wounds to the thorax, resulting in a traumatic arrest and subsequent survival. His care, including care under fire, tactical field care, tactical evacuation care, and Role III, IV, and V care, is presented. The case is used to illustrate the complex dynamics of Special Operations care on the modern battlefield and the exceptional outcomes possible when evidence-based medicine is taken to the warfighter with effective, farforward, expeditionary medical-force projection...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
David Lidwell, Colin A Meghoo
Skeletal traction is a useful technique for managing proximal femur fractures in austere environments where fracture stabilization for this injury is difficult. We present a technique and a construct appropriate for field use that facilitates patient evacuation, and we provide guidelines for the use of this technique by an advanced medical provider managing these injuries. The objectives of this article are to enable to reader to (1) recognize the role of skeletal traction in managing proximal femur fractures in an austere environment, (2) identify the key steps in placing transfemoral skeletal traction pins, and (3) identify options and requirements for building a traction construct in resource-limited environments...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
J V Turner, S Agatonovic-Kustrn, Hrg Ward
Clinical use of drugs is approved for specified clinical indication, route of administration, dose and population group. Off-label prescribing of a registered medicine occurs outside of these parameters and may be justified by pharmacology and physiology, as well as sufficient evidence from published clinical trials and reviews. Misoprostol and mifepristone in combination have recently been registered in Australia for medical termination of pregnancy in women of child-bearing age. There is good clinical evidence for efficacy and safety of misoprostol in uterine evacuation in both miscarriage and termination of pregnancy...
December 28, 2015: Facts, Views & Vision in ObGyn
Kolsoum Deldar, Kambiz Bahaadinbeigy, Seyed Mahmood Tara
BACKGROUND: The goal of teleconsultation is to omit geographical and functional distance between two or more geographically separated health care providers. The purpose of present study is to review and analyze physician-physician teleconsultations. METHOD: The PubMed electronic database was searched. The primary search was done on January 2015 and was updated on December 2015. A fetch and tag plan was designed by the researchers using an online Zotero library. RESULTS: 174 full-text articles of 1702 records met inclusion criteria...
July 16, 2016: Acta Informatica Medica: AIM
D Resiere
Martinique was accepted as an associate member by the Council of Ministers of the Organization of Eastern Caribbean State since February 2015. This membership constitutes a major asset in bringing Martiniquais closer to the other Caribbean populations and should play a key role as it relates to regional cooperation especially in the domain of healthcare. Martinique and several Caribbean countries share common health issues such as; dengue, chikungunya virus, Zika Virus leptospirosis, snakebite, severe cardiovascular diseases (CVD), HTLV-1, sickle cell diseases and so on...
August 1, 2016: Médecine et Santé Tropicales
Kate A Shaw, Klaira Lerma
PURPOSE OF REVIEW: To review the recent literature on surgical second-trimester abortion, with specific attention to cervical preparation techniques. RECENT FINDINGS: Confirming previous studies, a recent retrospective observational cohort study, including 54 911 abortions, estimated the total abortion-related complication rate to be 0.41% for second-trimester or later procedures. Cervical preparation is known to reduce risks associated with second-trimester dilation and evacuation (D&E)...
September 28, 2016: Current Opinion in Obstetrics & Gynecology
Seon-Young Park, Duane Burton, Irene Busciglio, Deborah Eckert, Michael Camilleri
Background/Aims: After exclusion of structural diseases, chronic constipation may be associated with normal or slow transit or rectal evacuation disorders. We evaluated: (1) clinical features and anorectal function, (2) difference of regional colonic transit according to the presence or absence of evacuation disorders, and (3) association of colonic transit with gender in patients with objectively slow colonic transit. Methods: We reviewed electronic medical records of 1553 constipated patients evaluated by a single gastroenterologist from 1994-2015 at a tertiary medical center...
September 25, 2016: Journal of Neurogastroenterology and Motility
S Aleksanin
This article presents an overview of the capabilities for clinical management of radiation injuries available at the Nikiforov Russian Center of Emergency and Radiation Medicine (NRCERM) of the Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters (EMERCOM). NRCERM is a federal state budgetary institution and the Russian Federation's head organization for providing medical assistance for persons overexposed to ionizing radiation, responders to radiation emergencies and people evacuated from radiation contaminated areas...
September 2016: Radiation Protection Dosimetry
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
Gene A Grindlinger, David H Skavdahl, Robert D Ecker, Matthew R Sanborn
OBJECTIVE: To examine the clinical and neurological outcome of patients who sustained a severe non-penetrating traumatic brain injury (TBI) and underwent unilateral decompressive craniectomy (DC) for refractory intracranial hypertension. DESIGN: Single center, retrospective, observational. SETTING: Level I Trauma Center in Portland, Maine. PATIENTS: 31 patients aged 16-72 of either sex who sustained a severe, non-penetrating TBI and underwent a unilateral DC for evacuation of parenchymal or extra-axial hematoma or for failure of medical therapy to control intracranial pressure (ICP)...
2016: SpringerPlus
Tamer Hanafy Said
BACKGROUND AND OBJECTIVE: To determine the safety and sustainability of operative laparoscopy in surgical management of cornual and interstitial ectopic pregnancy using a simple and practical method. DESIGN: Case series of five consecutive cases. SETTING: Endoscopy unit in Alexandria University Hospital and Alexandria New Medical Center. PATIENTS: Between July 2013 and May 2015, five women with interstitial and cornual ectopic pregnancies were admitted for laparoscopic surgical treatment...
October 2016: Journal of Obstetrics and Gynaecology of India
Gaurav Shyam Desai, Abhishek Chandavarkar, Sriram Gopal, Ganpat Sawant, Shyam V Desai
CONTEXT: Intravaginal placement of misoprostol has been used extensively to terminate second trimester pregnancies. Intracervical misoprostol is an alternative method of termination of pregnancy for women in this period of gestation. OBJECTIVE: To assess the efficacy and safety of combined intracervical and intravaginal misoprostol in the management of mid-trimester medical termination of pregnancy and to compare it with intravaginal misoprostol. MATERIALS AND METHODS: In this IRB approved prospective study, twenty-two women (mean age 25...
October 2016: Journal of Obstetrics and Gynaecology of India
Julia Ausserer, Elizabeth Moritz, Matthias Stroehle, Hermann Brugger, Giacomo Strapazzon, Simon Rauch, Peter Mair
INTRODUCTION: In remote and mountainous areas, helicopter emergency medical systems (HEMS) are used to expedite evacuation and provide pre-hospital advanced trauma life support (ATLS) in major trauma victims. Aim of the study was to investigate feasibility of ATLS in HEMS mountain rescue missions and its influence on patient condition at hospital admission. PATIENTS: 58 major trauma victims (Injury Severity Score ≥16), evacuated by physician staffed HEMS from remote and mountainous areas in the State of Tyrol, Austria between 1...
September 8, 2016: Injury
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