Military medicine
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Solid metals may create a variety of injuries. White phosphorous (WP) is a metal that causes both caustic and thermal injuries. Because of its broad use in munitions and smoke screens during conflicts and wars, all military clinicians should be competent at WP injury identification and acute therapy, as well as long-term consequence recognition. ⋯ Education and management regarding WP acute injury and late sequelae is essential for acute battlefield and definitive facility care. Resource-replete and resource-limited settings may use related approaches for acute management and ignition prevention. Current burn wound management recommendations should incorporate specific WP management principles and actions for military clinicians at every level of skill and environment.
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In accordance with ADP 6-22-001 and ATP 6-22.1, counseling is the process routinely executed by Army leaders to develop, mentor, and coach subordinate Soldiers and Army civilians within their organization. When implemented effectively, the counseling process can be utilized to produce capable, resilient, and satisfied subordinates who are prepared and motivated to meet mission-essential responsibilities. Training opportunities that specifically focus on optimizing this key leader competence, particularly with non-commissioned officers, are limited. The Directorate of Prevention, Resilience and Readiness (Headquarters, Department of the Army, G-9) offers a specific training, the Counseling Enhancement Workshop, and requested an evaluation to determine the effectiveness of the current training and identify opportunities for improvement. ⋯ The Army counseling process can be utilized to produce capable, resilient, and satisfied subordinates who are prepared and motivated to meet mission-essential responsibilities. Quantitative results on the content of the CEW present opportunities for meaningful training that increases leaders' confidence in delivering counseling sessions, as well as mastering specific skills that benefit the subordinate Soldier and improve unit health. Furthermore, performance psychology professionals provided feedback on focus areas to meet the instructional objective of the training more efficiently and effectively. Ultimately, the counseling process is considered the most important tool available to current leaders to build the capacity of future leaders and an investment in the training to enhance these skills will provide great returns to the U.S. Army as a whole.
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Spontaneous renal artery dissection is a rare condition with nonspecific symptoms that can be challenging to diagnose. We present the case of a 25-year-old male presenting with left flank pain, mild leukocytosis, and a benign urinalysis found to have renal artery dissection on computed tomography angiogram. The patient's condition improved following conservative management with anticoagulants. This case demonstrates that Spontaneous renal artery dissection may be a potential cause of renal artery infarction in young, previously healthy patients.