Journal of the Royal Army Medical Corps
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Post-traumatic hypothermia often occurs as a direct consequence of haemorrhage and shock. Environmental exposure in austere environments may also contribute to its pathogenesis. In those casualties that present in cardiac arrest following injury, coexisting hypothermia may be the primary cause of the arrest, or a marker of the severity of shock. A case of a 25-year-old combat casualty is presented, illustrating some of the technical challenges faced by clinicians while resuscitating hypothermic trauma patients in cardiac arrest.
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Defence Primary Health Care (DPHC) as an organisation has the responsibility for the provision of a basic level of sexual health service that every patient can access, regardless of their geographical location. The Military Advice and Sexual Health/HIV service (MASHH), based in Birmingham, provides nationally validated sexual health training and accreditation. Training was delivered to an isolated DPHC region to allow as many doctors and nurses to attend and minimised associated travel and accommodation costs. This training initiative enabled military personnel to access sexual health services within their own medical centres and reduced the number of potential referrals to local services. To assess compliance with the relevant standards, MASHH audited the DPHC region 2 months following completion of training. This was to ensure that the level 1 sexual health service provided by the DPHC region met with current British Association of Sexual Health and HIV (BASHH) Standards. ⋯ Overall, this programme demonstrates a potential model for the cost-effective roll-out of accredited sexual health training and resultant service provision for other DPHC regions, but some changes are needed to ensure national standards are met.
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Over the past 10 years the UK Defence Medical Services has deployed healthcare personnel to a variety of operational areas in support of UK Operations. The unique nature of every operational deployment, in conjunction with the wide variety of roles which healthcare staff undertake, necessitates bespoke educational preparation of the military healthcare force. This paper explores the creation and development of one of the four modules which comprise the BSc (Hons) in Defence Health Care studies, entitled 'The Diverse Nature of Defence Healthcare'. It demonstrates the unique contribution that the Defence School of Healthcare Education makes towards Generation and Preparation of the Force for deployment.
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Considerable evidence has discussed the significant workload and advances in clinical care by UK Defence Medical Services (DMS) during recent conflicts in Iraq and Afghanistan. Although the DMS is not doctrinally staffed to deal with children on operations, severely ill and injured paediatric casualties continue to present to military medical facilities; therefore, staff must be competent to deliver the appropriate level of care. This paper reports the paediatric presentations to the emergency department (ED), at the Role 3 Medical Treatment Facility (MTF) in Camp Bastion, Afghanistan, over a 21-month period. The aim was to provide quantitative, statistical data of paediatric presentations seen by deployed ED nurses, to identify whether the current training was appropriate and to make recommendations for further training requirements for DMS ED nurses. ⋯ Although the exposure to paediatric polytrauma during the conflicts in Afghanistan and Iraq is not replicated in peace time roles, it is likely that wherever emergency nurses are deployed the treatment of children will continue. Analysis of the service evaluation has led to the recommendations for specific skills that emergency nurses could develop during the pre-deployment phase to better prepare for caring for such patients. These include recognition of the sick child/triage, paediatric drug calculations, awareness of the massive transfusion requirements for children and skills to gain intravenous/intraosseous access in a child.