Military medicine
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Randomized Controlled Trial
Cardiopulmonary resuscitation in the combat hospital and forward operating base: use of automated external defibrillators.
Time to defibrillation (t(defib)) directly correlates with survival from cardiac arrest. We investigated whether automated external defibrillators (AED) in a combat setting would improve this crucial variable. ⋯ In simulated cardiac arrest, the AED model demonstrated significantly improved t(defib) compared to the standard response for both training and combat settings.
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Randomized Controlled Trial
Effect of a probiotics supplementation on respiratory infections and immune and hormonal parameters during intense military training.
This study examined the effect of a probiotics supplementation on respiratory tract infection (RTI) and immune and hormonal changes during the French Commando training (3-week training followed by a 5-day combat course). Cadets (21 +/- 0.4 years) received either a probiotics (n = 24) or a placebo (n = 23) supplementation over the training period. ⋯ A greater increase in dehydroepiandrostane sulfate was observed in the probiotics group after the combat course (p < 0.05). This study suggested that the benefits of a probiotics supplementation in a multistressor environment relied mainly on its capacity to prevent the infection to spread throughout the respiratory tract.
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Randomized Controlled Trial Comparative Study
Dolasetron versus ondansetron as single-agent prophylaxis for patients at increased risk for postoperative nausea and vomiting: a prospective, double-blind, randomized trial.
This study identified 100 ambulatory surgery patients receiving general anesthesia who were at increased risk for postoperative nausea and vomiting (PONV) and randomly assigned them to receive single-agent prophylaxis (12.5 mg of dolasetron or 4 mg of ondansetron) 15 to 30 minutes before the end of surgery. Data were collected in the postanesthesia care unit, and patients completed a questionnaire 24 hours after surgery. ⋯ No statistically significant difference existed in satisfaction with the overall surgical experience (dolasetron, 87.9 of 100 mm; ondansetron, 85.3 of 100 mm; p = 0.36). Costminimization strategies should be considered without fear of substandard care or increased patient dissatisfaction.
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Randomized Controlled Trial
Improving combat medic learning using a personal computer-based virtual training simulator.
The new military occupational specialty for combat medics, the 91W, requires that all medics successfully pass the National Registry of Emergency Medical Technicians examination. The objective of this study was to supplement standard emergency medical technician training with a three-dimensional, computer-based, virtual training simulator and to assess whether scores and pass rates could be increased. ⋯ The findings, however, were used to construct two models of combat medic characteristics that can be used to assist in initial selection for emergency medical technician courses and subsequent counseling of soldiers on course completion. With further research, these models could be refined for Army-wide use to increase the cost-effectiveness of combat medic recruitment, training, and testing.
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Randomized Controlled Trial Clinical Trial
Axillary brachial plexus blockade: an evaluation of three techniques.
Surgical procedures to the distal humerus, elbow, and proximal forearm are ideally suited to regional anesthetic techniques. Selection of the preferred approach is determined by the innervation of the surgical site, the risks of regional anesthesia-related complications, and the preference and experience of the anesthesiologist. The axillary approach to the brachial plexus is the most commonly used because of its ease of performance, patient acceptance, safety, and reliability, particularly for hand and forearm surgery. ⋯ Axillary blockade performed using the combined technique had higher a success rate than blockade performed with the transarterial and Winnie techniques. Our results suggest that all three techniques are reliable for axillary blockade. But the onset, complete blockade time, and quality of analgesia were better with the combined technique than with the transarterial and Winnie techniques.