Military medicine
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Multicenter Study Observational Study
Prehospital and en route analgesic use in the combat setting: a prospectively designed, multicenter, observational study.
Combat injuries result in acute, severe pain. Early use of analgesia after injury is known to be beneficial. Studies on prehospital analgesia in combat are limited and no prospectively designed study has reported the use of analgesics in the prehospital and en route care setting. Our objective was to describe the current use of prehospital analgesia in the combat setting. ⋯ In our prospectively designed, multicenter, observational, prehospital combat study, ketamine was the most commonly used analgesic drug. The most frequently observed combination of drugs was ketamine and morphine. The intravenous route was used for 55% of drug administrations.
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Multicenter Study Comparative Study
Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: a case series of 166 patients.
Report the successful use of stellate ganglion blocks (SGBs) in 166 active duty service members with multiple combat deployments experiencing anxiety symptoms associated with post-traumatic stress disorder (PTSD). ⋯ Selective blockade of the right cervical sympathetic chain at the C6 level is a safe and minimally invasive procedure that may provide durable relief from anxiety symptoms associated with PTSD.
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Randomized Controlled Trial Multicenter Study
Identification of barriers to adaptation of battlefield technologies into civilian trauma in California.
To characterize the adoption of routine battlefield medical techniques (tourniquets, hemostatic agents, and tactical combat casualty care into civilian prehospital trauma care and to identify the barriers to their use in the state of California through anonymous electronic survey of local emergency medical services agency (LEMSA) directors. ⋯ Tourniquets, hemostatic agents, and tactical medical care are the integral components of battlefield medicine and have been lifesaving in these settings. The barriers to this transition are multifactorial. Physicians familiar with these technologies should become advocates for their integration in civilian trauma patient care.
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Randomized Controlled Trial Multicenter Study
Ultrasound evaluation of cranial and long bone fractures in a cadaver model.
Ultrasound has been utilized in various settings for evaluation and treatment of skeletal injuries. Bone has different tissue acoustic impedance than soft tissue allowing visualization of the cortical disruption found in fractures. ⋯ Ultrasound by trained emergency medicine physicians can reliably identify fractures in the radius, tibia, frontal, and temporal bones in a very short amount of time, allowing for triage, treatment, and resource management.
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The purpose of this study was to assess the possible association between scores of >200 on U.S. Medical Licensure Examination (USMLE) step 1 and the Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training examinations and the pass rate on the American Board of Obstetrics and Gynecology (ABOG) written examination. ⋯ Program directors have used USMLE step 1 to identify trainees who are likely to perform well on the CREOG in-training examination. The CREOG in-training examination has been used to identify residents who are likely to pass the ABOG written examination. The results of this study document the strength of these associations.