Military medicine
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The objective of this study was to use descriptive and phenomenological methods with Critical Care Air Transport Team (CCATT) nurses to identify knowledge and skills required to provide care for critically ill patients in a combat environment. Unstructured interviews, focus groups, written narratives, group interviews, participant observation, and review of in-flight documentation of care were used to obtain data from 23 registered nurses who had deployed with CCATT missions. ⋯ This information should be shared with CCATT trainers and unit personnel to better prepare them for the realities of future deployments. Future research could incorporate these data into a self-assessment scale to evaluate CCATT nurses' readiness for future deployments.
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To determine the clinical outcomes of an aggressive combined cooling technique for exertional heatstroke in Thailand. ⋯ Despite early recognition and aggressive combined cooling, exertional heatstroke remains associated with multiorgan dysfunction. However, our 7.1% in-hospital mortality rate was low compared to previous studies. Early diagnosis and prompt treatment are critical.
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The Global War on Terrorism brings significant ethical challenges for military physicians. From Abu Ghraib to Guantanamo Bay, the actions of health care providers have come under considerable scrutiny. Military providers have dual roles as military officers and medical professionals, which have the potential to come into conflict. ⋯ We review pertinent historical precedents, applicable laws, ethical guidelines, and military regulations. We also present examples of ethical challenges deployed clinicians have faced and their ethical solution. Finally, we propose a practical strategy to educate physicians on how to manage complex ethical dilemmas in war time settings.
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Comparative Study Historical Article
Wound ballistics: Minié ball vs. full metal jacketed bullets--a comparison of Civil War and Spanish-American War firearms.
The advent of the full metal jacketed bullet in the late nineteenth century was thought to cause less severe battlefield wounds. This study compares the wounding characteristics of a reproduction rifle from the American Civil War to one of the Spanish-American War using the wound profile method. ⋯ The rifled musket produced more severe wounds when compared to the Krag-Jorgenson rifle, as was clinically apparent to observers at the time of the Spanish-American War.
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The study seeks to identify demographic and health-related predictors of attrition among female Marine Corps recruits. ⋯ One-year attrition among female Marines may be reduced by more extensively screening applicants who report risk-taking behavior. Such screening can exclude applicants who are unlikely to succeed and identify others who may need additional support to complete their tour of duty.