Journal of the Royal Naval Medical Service
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Review
Optimising the management of severe Traumatic Brain Injury in the military maritime environment.
Severe Traumatic Brain Injury (sTBI) is a devastating cause of morbidity and mortality, especially among those aged less than 45 years. Advances in clinical practice continue to focus on preventing primary injury through developing ballistic head and eye protection, and through minimising secondary brain injury (secondary prevention). ⋯ Strategies for the management of sTBI in the maritime environment should be in keeping with current best evidence. Provision of specialist interventions for sTBI in military maritime environments may require alternative approaches matched to the skills of the staff and environmental restrictions.
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Blast lung injury is an increasing problem for UK forces in Afghanistan, but is not a new phenomenon, with evidence that it has been increasing in incidence over the last century. Management is conservative, but there are newer therapies that may play a role in the future management of this condition.
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The practice of clinical medicine involves performing a large number of practical procedures so that psychomotor function is of considerable importance, particularly to trainees mastering new skills. Performance of motor skills by trainees is usually assessed by faculty in a random, unorganised, subjective manner without clearly stated criteria of satisfactory performance. This review discusses objective assessment of motor skills utilising psychometric principles in anaesthesia and surgery. In addition, the role of simulators will be discussed within the context of learning new motor skills.