Journal of the Royal Naval Medical Service
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The specialty training application process can be a challenging time, and adequate preparation is essential. With the resources available, and with appropriate guidance from colleagues, experiences gained as a General Duties Medical Officer (GDMO) can be used to produce a highly competitive application. This paper aims to to provide guidance for Medical Officers (MOs) applying for specialty training.
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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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Observational Study
Intraosseous access in the military operational setting.
In an operational military environment, circulatory access can prove difficult for a variety of reasons including profound hypovolaemia, and limited first responder experience. With many injuries that cause catastrophic haemorrhage, such as traumatic limb amputations, circulatory access is needed as quickly as possible. Since 2006, the Defence Medical Services have been using the EZ-IO and FAST1 devices as a means of obtaining circulatory access. ⋯ The devices in the study were tested for a period of time following insertion (median 32 minutes), and still the success rates mirror those found in the literature. Observed differences between sites were not found to be significant with confidence intervals overlapping. Further work is proposed to investigate the long-term complications of intraosseous devices.