Military medicine
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Considering the potential of weaponized opioids, evaluating how prophylactic countermeasures affect military-relevant performance is necessary. Naltrexone is a commercially available Food and Drug Administration-approved medication that blocks the effects of opioids with minimal side effects. However, the effects of naltrexone on the health and performance of non-substance abusing military personnel are not well described in the existing literature. ⋯ Temporary (7-day) daily use of naltrexone was safe and did not negatively affect physical performance, cognitive functioning, marksmanship ability, or sleep in a healthy cohort of U.S. Army Soldiers.
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Medical assistance to populations (MAP) is a rich and varied activity, but it is not well known, and its modalities are inconsistent and unclear, particularly in the pediatric field; they can confront the military doctor with difficult management issues. Today, a military doctor deployed in foreign operations (FOs) does not know if he will perform MAP. He does not know how it will be carried out, nor if it will include a pediatric component. Finally, he does not know what difficulties he will face and therefore cannot prepare himself effectively. The primary objective of this work is to describe the modalities of MAP in FO, with an emphasis on the pediatric activity. The secondary objective is to develop a template for a post-session MAP registry. ⋯ MAP in FO is an activity in which modalities are very variable depending on the theater. Practitioners must have a solid theoretical and practical preparation beforehand, particularly in pediatrics. Keeping a specific activity register is an essential basis for judiciously adapting human and material resources dedicated to this activity. Future studies should aim to investigate more precisely the difficulties encountered.
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Shock states that occur during, for example, profound hemorrhage can cause global tissue hypoperfusion leading to organ failure. There is an unmet need for a reliable marker of tissue perfusion during hemorrhage that can be followed longitudinally. Herein, we investigated whether longitudinal POMCO2 tracks changes in hemodynamics in a swine model of coagulopathic uncontrolled junctional hemorrhage. ⋯ Despite the logical appeal of measuring noninvasive tissue CO2 measurement as a surrogate for gastrointestinal perfusion, prior studies have only reported snapshots of this readout. The present investigation shows real-time longitudinal measurement of POMCO2 to confirm that MAP inversely correlates to POMCO2 in the face of coagulopathy. The simplicity of measuring POMCO2 in real time can provide an additional practical option for military or civilian medics to monitor trends in hypoperfusion during hemorrhagic shock.