Military medicine
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Hypothermia increases mortality in trauma populations and frequently occurs in military casualties due to the nature of combat environments. The association between hypothermia and the time of year when injured remains unclear. We sought to determine the association between seasonal changes in temperature and hypothermia among combat casualties. ⋯ We found a seasonal variation in the occurrence of hypothermia in a large cohort of trauma casualties. Despite adjustment for multiple known confounders, our findings substantiate probable ambient temperature variations to trauma-induced hypothermia. Furthermore, our findings, when taken in the context of other studies on the efficacy of current hypothermia prevention and treatment strategies, support the need for better methods to mitigate hypothermia in future cold-weather operations.
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Perioperative death is a harrowing experience that physicians often encounter while needing to continue life sustaining care for others. In this piece, an anesthesiology resident uses poetry to process the recent passing of one of his patients, highlighting the ways that it continues to impact the care that he provides.
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This analysis evaluates potential reporting discrepancies of the DD2341 Form (Report of Animal Bite-Potential Rabies Exposure) submitted to a forward-deployed Rabies Advisory Board to the Theater Medical Data Store (TMDS) and Reportable Medical Event (RME) systems to identify reporting gaps that can lead to improved best practices that ensure documentation of Post Exposure Prophylaxis (PEP) of potential rabies exposures into service members (SMs) electronic medical records. ⋯ This study is the first to compare the electronic medical record data to in theater reports for potential rabies exposure in a theater of operations. The analysis suggests that some written forms generated in the USCENTCOM theater are not entered into SM Military Health System electronic medical records, indicating that electronic medical records may be a less sensitive method than in-theatre reports for rabies program surveillance in a deployed setting. There is under-reporting in electronic medical records of rabies PEP in both TMDS and RME databases. Rabies PEP is an RME according to the Armed Forces Health Surveillance Division guidelines and case definitions. There needs to be better integration of the DD2341 into the electronic medical records system.
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The U.S. Army fell 25% short of its recruitment goal in 2022 and therefore, increasing the eligibility pool for potential recruits is of interest. Raising the body mass index (BMI) standards for eligibility presents a path to increase the recruitable population; however, there may be additional costs incurred due to attendant health risks that may be present in individuals with higher BMI. ⋯ Potential recruits from Cluster 1 have excessive health risk and may incur substantial cost to the U.S. Army if enlisted. However, potential recruits from Cluster 3 appear to add little risk and offer an opportunity to increase the pool for recruiting.
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While previous studies have analyzed military surgeon experience within military-civilian partnerships (MCPs), there has never been an assessment of how well military providers are integrated within an MCP. The Center for Sustainment of Trauma and Readiness Skills, Cincinnati supports the Critical Care Air Transport Advanced Course and maintains the clinical skills of its staff by embedding them within the University of Cincinnati Medical Center. We hypothesized that military trauma surgeons are well integrated within University of Cincinnati Medical Center and that they are exposed to a similar range of complex surgical pathophysiology as their civilian partners. ⋯ This is the first assessment of U.S. Air Force trauma surgeon integration relative to their civilian partners within an MCP. Normalized by FTE, there was no difference between the two groups' trauma experience to include patient acuity metrics and KSA-CA scores. The proportion of CPT codes that was most relevant to expeditionary surgery was similar between the military and civilian partners, thus optimizing the surgical experience for the military trauma surgeons within University of Cincinnati Medical Center. The methods used within this pilot study can be generalized to any American College of Surgeons verified Trauma Center MCP, as standard databases were used.