Military medicine
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The study objectives were to characterize maxillofacial injuries and assess the safety of in-theater facial fracture repair in U. S. military personnel with severe combat trauma from Iraq and Afghanistan. We performed a retrospective chart review of the Expeditionary Medical Encounter Database from 2004 to 2010. 1,345 military personnel with combat-related maxillofacial injuries were identified. ⋯ Overall, 45.6% (109/239) had at least one facial bone fracture. Of those with facial fractures, 64.2% (n = 70) underwent surgical repair. None of the service members who underwent in-theater facial fracture repair developed A. baumannii facial wound infection or implant extrusion.
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The Care Provider Support Program (CPSP) was created as a way to improve the resiliency of military health care providers. The purpose of this pilot study was to update what is currently known about the resiliency, coping, and compassion fatigue of military and civilian registered nurses, licensed practical nurses (LPNs), and medics who treat wounded Soldiers and whether these factors can be improved over a sustained period of time. ⋯ on the basis of the results of this study, CPSP training was effective in reducing burnout, which often leads to decreased compassion fatigue in a group of military and civilian registered nurses, LPNs, and medics.
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Multicenter Study Observational Study
Prehospital and en route analgesic use in the combat setting: a prospectively designed, multicenter, observational study.
Combat injuries result in acute, severe pain. Early use of analgesia after injury is known to be beneficial. Studies on prehospital analgesia in combat are limited and no prospectively designed study has reported the use of analgesics in the prehospital and en route care setting. Our objective was to describe the current use of prehospital analgesia in the combat setting. ⋯ In our prospectively designed, multicenter, observational, prehospital combat study, ketamine was the most commonly used analgesic drug. The most frequently observed combination of drugs was ketamine and morphine. The intravenous route was used for 55% of drug administrations.
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This article highlights recent advances made in U. S. Air Force Pararescue Medical Operations in relation to tactical evacuation procedures. ⋯ These improvements have only been possible because of the concerted efforts of U. S. Air Force and partner platforms operating in Afghanistan.
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To determine whether comprehensive quantitative echocardiogram could be used as a resuscitation tool in critically ill surgical patients and to assess its effect on patient care. ⋯ The FREE is feasible and alters care in the intensive care unit by providing clinical data not otherwise available at the bedside. Further studies are warranted to assess the impact of comprehensive echocardiogram-directed resuscitation on patient outcomes.