Journal of the Royal Army Medical Corps
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Historical Article
Military intensive care part 1. A historical review.
ICU is a product of clinical developments, technological advances, social changes and history. Military ICU reflects all of these as well as deployed operational experience. Having considered how military ICU got to where it is, the next article will consider current practice.
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Military trauma produces predominantly blast and fragmentation injury, commonly resulting in haemorrhagic shock. Injury patterns to limbs are such that the conventional sites for venous cannulation may be unsuitable. The EZ-IO (Vidacare, San Antonio) system is one of a number of novel products designed for intraosseous (IO) access in adults or children. ⋯ A total of 32 needles were inserted, with 97% effective function. IO needles were used to administer fluid (crystalloid, packed red cells and fresh frozen plasma) and drugs (analgesics, cardiac arrest drugs, antibiotics, drugs for both rapid sequence induction and maintenance of anaesthesia). No complication of infection was noted, but pain was observed in responsive patients with the pain of infusion exceeding that of the underlying injuries in 3 cases.