Military medicine
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Randomized Controlled Trial
Impact of a 4-hour Introductory eFAST Training Intervention Among Ultrasound-Naïve U.S. Military Medics.
Advances in the portability of ultrasound have allowed it to be increasingly employed at the point of care in austere settings. Battlefield constraints often limit the availability of medical officers throughout the operational environment, leading to increased interest in whether highly portable ultrasound devices can be employed by military medics to enhance their provision of combat casualty care. Data evaluating optimal training for effective medic employment of ultrasound is limited however. This prospective observational cohort study's primary objective was to assess the impact of a 4-hour introductory training intervention on ultrasound-naïve military medic participants' knowledge/performance of the eFAST application. ⋯ A 4-hour introductory eFAST training intervention can effectively train conventional military medics to perform the eFAST exam. Online, asynchronously available platforms may effectively mitigate some of the resource requirement burden associated with point-of-care ultrasound training. Future studies evaluating medic eFAST performance on real-world battlefield trauma patients are needed. Skill and knowledge retention must also be assessed for this degradable skill to determine frequency of refresher training when not regularly performed.
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The majority of the published literature on contemporary military medicine contradicts the concept of austere. Operational medicine is part of every armed conflict around the world, while armed forces of most countries internationally have limited medical resources especially in the front line. The aim of this review is to identify the particularities of a truly austere environment and present a short guide of preparation and action for military medical personnel internationally. ⋯ The military surgeon must be specially trained and prepared to use a wide range of skills in truly austere environments in contemporary conflicts.
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Although numerous efforts have aimed to reduce suicides in the U.S. Army, completion rates have remained elevated. Army leaders play an important role in supporting soldiers at risk of suicide, but existing suicide-prevention tools tailored to leaders are limited and not empirically validated. The purpose of this article is to describe the process used to develop the Behavioral Health Readiness and Suicide Risk Reduction Review (R4) tools for Army leaders that are currently undergoing empirical validation with two U.S. Army divisions. ⋯ The R4 development process entailed the simultaneous integration of leadership feedback with evidence-based predictors of suicide risk and design considerations. Thus, the development of these tools builds upon previous Army leadership tools by specifically tailoring elements of those tools to accommodate leader preferences, accounting for potential implementation barriers (eg, institutional factors), and empirically evaluating the implementation of those tools. Future studies should consider utilizing a similar process to develop empirically based resources that are more likely to be incorporated into the routine practice of leaders supporting soldiers at risk of suicide, very often located at the company level and below.
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Diplopia and strabismus are known complications after corneal refractive surgery (CRS). Within the U.S. Armed Forces, refractive surgery is used to improve the operational readiness of the service member, and these complications could cause significant degradation to their capability. This study was performed in order to identify the incidence of strabismus and diplopia following CRS within the U.S. Military Health System. ⋯ Diplopia and strabismus are rare complications after CRS in the U.S. military population. These procedures continue to increase the operational readiness of our service members with minimal risk of these potentially debilitating complications. Overall, this study provides support for the continued use of PRK and LASIK despite study limitations related to the use of large databases for retrospective review. Future prospective studies using delineated preoperative and postoperative examinations with sensorimotor testing included may be able to resolve the limitations of this study.
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Post-traumatic stress disorder (PTSD) is associated with an increased risk of cardiovascular and metabolic diseases and physical inactivity. Cardiorespiratory fitness (CRF), which is modifiable by physical activity, is a strong independent predictor of cardiometabolic health. However, the relationship between CRF and cardiometabolic health in veterans with PTSD is unknown. Thus, this study aimed to explore the cross-sectional relationships among CRF, indices of cardiometabolic health (ie, HbA1c, blood lipids, blood pressure, waist-hip ratio, and body mass index), and PTSD severity in veterans with PTSD. ⋯ These preliminary findings suggest that CRF and by proxy physical activity may be important factors in understanding the increased risk of cardiovascular and metabolic disease associated with PTSD.