Military medicine
-
Designated a Department of Defense Team Resource Center (TRC) in 2008, Naval Medical Center Portsmouth (NMCP) currently hosts three tri-service health care teams training courses annually. Each consists of didactic learning coupled with simulation-based training exercises to provide an interactive educational experience for health care professionals. ⋯ The course is also the foundation of a research program designed to explore applications of modeling and simulation for enhanced team training in health care. The TRC has adopted two theoretical frameworks for evaluating training efficacy and outcomes, and has used these frameworks to guide a systematic reconfiguration of the infrastructure supporting health care teams training at NMCP.
-
Case Reports
A rare case of acute diffuse alveolar hemorrhage following initiation of amiodarone: a case report.
Amiodarone is effective for treating ventricular and supraventricular tachyarrhythmias, despite potential side effects which can include injury to the liver, thyroid, cornea, skin, and neuromuscular system. Acute lung toxicity is a known but rare side effect of amiodarone use, most commonly taking the form of an acute or subacute interstitial pneumonitis. ⋯ Postmortem lung histology confirmed the diagnosis of diffuse alveolar hemorrhage. The case presentation and proposed mechanisms of action will be reviewed here.
-
Iron is a micronutrient necessary for energy metabolism and for oxygen transport and delivery. Depletion of iron stores (iron deficiency [ID]) may lead to iron deficiency anemia (IDA), which affects mood, cognitive function, and physical performance. Previous studies indicated that iron status may decline during military training. ⋯ Female sex (p = 0.05) and self-reported history of anemia (p < 0.05) were associated with diminished iron status. Amenorrhea was associated with higher ferritin (p < 0.05) and hemoglobin (p < 0.05) levels. Although ID and IDA did not affect a large portion of the deployed population assessed in this study, findings suggest that risk factors including female sex, history of anemia, and regular menstruation should be considered in the assessment of iron status in military personnel.
-
We hypothesize that an anecdotally observed increase in tourniquet breakage and decrease in efficacy may be secondary to environmental exposure during military deployment. This was a study comparing efficacy and breakage of 166 Afghanistan-exposed tourniquets to 166 unexposed tourniquets. Afghanistan exposure was defined as tourniquet carriage by field staff in the operational environment for approximately 6 months. ⋯ Three turns were required for most tourniquets to be efficacious. Environmental exposure of military tourniquets is associated with decreased efficacy and increased breakage. In most cases, tourniquets require three turns to stop the distal lower extremity pulse.