Military medicine
-
Air Force Critical Care Air Transport Teams (CCATTs) provide fixed-wing aeromedical evacuation for combat casualties. Multiple studies have evaluated CCATT trauma patients; however, nearly 50% of patients medically evacuated from combat theaters are for nontraumatic medical illnesses to include stroke, myocardial infarctions, overdose, and pulmonary emboli. Published data are limited regarding illness types, in-flight procedures, and adverse events. ⋯ Fifty-six percent (672) of 1,209 CCATT records that were queried were of patients with medical conditions. The most common primary diagnoses of CCATT medical patients were cardiac, pulmonary, and neurological in etiology. Mechanical ventilation and continuous medication infusions were required in approximately 20% of patients. The data provided by this study may assist in guiding future CCATT training requirements and resource allocation, as well as clinical practice guideline development.
-
Research has demonstrated the positive effects of exercise during pregnancy on maternal and fetal outcomes, but very little research has evaluated the effect of pregnancy on women's fitness or the length of time needed to recover prepregnancy fitness after delivery. These questions are important in providing anticipatory guidance to women, from elite athletes to women who just want to know how their bodies will change after pregnancy. To women in the military, postpartum fitness is critically important because failing the mandatory biannual physical fitness assessment (PFA) can severely damage or prematurely end a woman's career. Therefore, understanding the expected changes in fitness, the timeline required to regain prepregnancy fitness levels after delivery, and understanding risk factors for physical fitness testing failure is an important aspect of obstetrical care in military populations. The Navy PFA is a unique opportunity to measure the effect of pregnancy on women's ability to perform a standardized fitness assessment. The objective of this research is to use data from the Navy PFA to compare fitness levels in individual women before and after pregnancy, and to identify individuals at risk for poor fitness levels and Physical Readiness Test (PRT) failure postpartum. ⋯ At 6 months postpartum, active duty women have decreased muscular and cardiovascular fitness, and have not yet regained prepregnancy weight. These changes put women at high risk for failing the PFA. These changes resolve by the second postpartum PFA. Women above the age of 30 and those who develop gestational diabetes or anemia during pregnancy are at risk for poor postpartum fitness. The Navy should consider extending the time allowed for women to meet PFA standards postpartum and develop a program to monitor women's progress toward PFA standards and provide assistance as needed.
-
Training in literature appraisal and statistical interpretation is one of the residency training requirements outlined by the Accreditation Council for Graduate Medical Education. Frequently, a journal club format is used to teach this competency although this teaching modality is not standardized or well studied in regard to its efficacy. ⋯ Better evidence is needed to guide future educational curricula directed toward teaching the competency of medical literature review and appraisal.
-
The U.S. Army Reserve Officers' Training Corps (ROTC) is the largest commissioning source among all branches. Physical Readiness Training (PRT) is fundamental to ROTC cadet training. However, although studies have evaluated the effectiveness of PRT in cadets with prior PRT experience, no study has examined the early phase adaptations in those cadets with no prior PRT experience. ⋯ Nine months of PRT improved APFT scores of freshmen cadets while minor effects were noted in laboratory-based performance. Given the lack of improvements in strength and power, it would be advisable to provide supplemental strength and power training. Being a large commissioning resource for the Army with greater access to equipment and resources, the time spent in ROTC may be a unique opportunity to improve and educate young commissioning officers on the benefits of proper strength and power training for the use in future commands while units are considerably smaller and equipment is more accessible on university grounds.