Military medicine
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Mental health treatment utilization among persons with posttraumatic stress disorder (PTSD) tends to be low but may be improved by aligning treatment with patient preferences. Our objective was to characterize the reasons that drive a person's selection of a specific evidence-based PTSD treatment. ⋯ By highlighting which pieces of information may be most important to detail when presenting different treatment options, these results can help guide treatment planning conversations, as well as the development of shared decision-making tools.
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Increased resource constraints secondary to a smaller medical footprint, prolonged evacuation times, or overwhelming casualty volumes all increase the challenges of effective management of traumatic brain injury (TBI) in the austere environment. Prehospital providers are responsible for the battlefield recognition and initial management of TBI. As such, targeted education is critical to efficient injury recognition, promoting both provider readiness and improved patient outcomes. ⋯ Evidence shows that the assessment, monitoring, and treatment in the first few hours and days after injury should focus on the preservation of cerebral perfusion and oxygenation. For cases where medical management is inadequate (eg, evidence of an enlarging intracranial hematoma), guidelines have been developed for the performance of cranial surgery by nonneurosurgeons. TBI management in the austere environment will continue to be a challenge, but research focused on improving evidence-based monitoring and therapeutic interventions can help to mitigate some of these challenges and improve patient outcomes.
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Evaluation and management of eye trauma is daunting to many practitioners. For general medical emergencies, the familiar ABCs mnemonic serves to both recompose the provider as well as provide a logical order for evaluation and action. We recently adapted an ABCs mnemonic to provide non-ophthalmologists with a familiar method for systematically evaluating and managing eye trauma. ⋯ Shield and ship to ophthalmology. The mnemonic was adapted to reflect current Joint Trauma Services and Tactical Combat Casualty Care practice guidelines. We believe this familiar mnemonic will serve as a useful tool in allowing non-ophthalmologists to comfortably and safely evaluate an eye for trauma.
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This study compared the relationship between height (HT), body mass (BM), and body mass index (BMI) of female trainees and active duty female soldiers and their performance on simulated common soldiering tasks (CSTs) with high physical demands. ⋯ Female trainees and soldiers who are taller and heavier with a higher BMI may demonstrate better performance on CSTs required of all soldiers. In addition to task-specific training, performance of CSTs may be enhanced in tasks requiring strength and power by recruiting and retaining taller and heavier females with a higher BMIs. Allowances should be considered for soldiers and trainees who can successfully perform soldiering tasks with high physical demands despite less desirable anthropometric measurements.
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Blast overpressure health hazard assessment is required prior to fielding of weapon systems that produce blast overpressures that pose risk of auditory and nonauditory blast lung injuries. The anthropomorphic blast test device (ABTD) offers a single device solution for collection of both auditory and nonauditory data from a single blast at anthropometrically correct locations for injury risk assessment. It also allows for better replication of personnel positioning during weapons firings. The ABTD is an update of the blast test device (BTD), the current Army standard for collection of thoracic blast loading data. Validation testing of the ABTD is required to ensure that lung injury model validated using BTD collected test data and sheep subjects is still applicable when the ABTD is used. ⋯ The ABTD was validated successfully for open field tests. For occupational blast injury assessments, ABTD can be used in place of the BTD and provide enhanced capabilities.