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Battle Injuries of the Arteries in World War II: An Analysis of 2,471 Cases
Published in Stephen M Cohn, Ara J. Feinstein, 50 Landmark Papers every Trauma Surgeon Should Know, 2019
ME DeBakey, Simeone FA. Ann Surg
DeBakey and Simeone systematically collected data on 2,471 acute arterial injuries occurring during wwii. They focused on incidence, types, location, morbidity, methods of management, and factors influencing outcomes. The authors also addressed the limitations of performing vascular surgery in the austere environment and the impact that delays in casualty evacuation had on limb salvage. Recognition of these logistic limitations has significantly impacted improvements in casualty evacuation and the distribution of surgical resources in order to reduce the time from injury to surgical care.
Military doctor
Published in Adam Staten, Combatting Burnout, 2019
Military doctors are present wherever the military is deployed. The Defence Medical Services provide medical support to operations, exercises, and adventurous training all over the world. In these varied locations, military medicine ranges from providing risk assessments and casualty evacuation plans to providing immediate pre-hospital trauma care. Of course, there is also the need for hospital medicine and long-term rehabilitation, similar to the NHS, but often this medicine is provided in a very different context. For example, on recent humanitarian assistance deployments, hospital medicine has been performed at sea and under tents. This requires doctors to be robust and able to work in resource-limited environments. Military doctors treat people in need and do not only provide care for members of the Armed Forces but also their families and often civilians.
Anaesthesia and pain management
Published in Ian Greaves, Military Medicine in Iraq and Afghanistan, 2018
The efforts and clinical advances in anaesthesia made by DMS anaesthetists during these conflicts have been remarkable. As such, this was recognised by the Royal College of Anaesthetists in 2010 and 2014, which awarded the Pask Certificate of Honour to all DMS anaesthetists who had deployed on Operations Telic and Herrick, respectively. The next conflicts are unlikely to mirror those experienced in Operations Telic and Herrick. The medical and casualty evacuation capabilities will be reduced, and this must be reflected and managed in contingency planning and training. The concept of a longer duration of casualty evacuation may become more likely, and therefore, casualty management will also change and evolve as we become accustomed to quickly mobilising a more compact medical capability to austere environments.79
Navy En-Route Care in Future Distributed Maritime Operations: A Review of Clinician Capabilities and Roles of Care
Published in Prehospital Emergency Care, 2023
Ian F. Eisenhauer, Benjamin D. Walrath, Vikhyat S. Bebarta, Matthew D. Tadlock, Jay B. Baker, Steven G. Schauer
Schauer et al. (7) recently published a framework for care across the military health system to assist nonmilitary scientists in creating easily translatable research aimed at answering difficult military health needs. This work provided an overview of the military’s role-tiered levels of care that are comparable among primarily ground-based components, however the unique aspects of maritime ERC warrant dedicated explanation for accurate illustration of shipboard challenges. We add the context of the Navy’s DMO concept to help elucidate future challenges specific to maritime medical care and to the Navy ERC system (Figure 1). We describe the capabilities of different naval assets, methods of augmentation currently used and in development, the expected progression of casualty evacuation (CASEVAC), and anticipated injury patterns for future maritime warfighters. We hope that an improved understanding of the circumstances and challenges of maritime medical care will enable civilian and non-Navy researchers to assist in the development of novel solutions to respond to the medical challenges of future DMO.
U.S. Military Medical Evacuation and Prehospital Care of Pediatric Trauma Casualties in Iraq and Afghanistan
Published in Prehospital Emergency Care, 2020
Jason F. Naylor, Michael D. April, Erick E. Thronson, Guyon J. Hill, Steven G. Schauer
We performed all statistical analysis using Microsoft Excel (version 10, Redmond, Washington) and JMP Statistical Discovery from SAS (version 13, Cary, NC). We compared study variables using a Student’s t-test for continuous variables, Wilcoxon Rank Sum test for ordinal variables, and Chi-square test for nominal variables. We performed logistic regression analyses to determine odds ratios. We defined a serious injury by body region as an Abbreviated Injury Scale of 3 or greater for the respective region (7, 20). We placed all evacuations with a dedicated medical platform into the standard category and the remaining into the casualty evacuation category (CASEVAC).
Occupational heat strain in outdoor workers: A comprehensive review and meta-analysis
Published in Temperature, 2022
Leonidas G. Ioannou, Josh Foster, Nathan B. Morris, Jacob F. Piil, George Havenith, Igor B. Mekjavic, Glen P. Kenny, Lars Nybo, Andreas D. Flouris
Occupational heat stress is a major challenge for military personnel and there is a potential, with the ongoing global warming, to escalate into an even larger threat in the years to come [227]. The problem of heat illnesses in military settings is not recent. It was described over two millennia ago, as discussed in a previous section (see “historical background”). In 1954 the first instructions on how to prevent heat illnesses in the army were issued, recommending (i) acclimatization for freshmen, (ii) special training for obese soldiers, (iii) trial of air-conditioned barracks, and (iv) adoption of a new thermal stress indicator at the time, the WBGT [47]. Even after adopting these measures, in the period from 1980 through 2002, more than five thousand soldiers were hospitalized for heat-related illnesses in the United States, of whom 37 lost their lives [228]. In early 2000s, there were 14.5 soldiers hospitalized due to heat stroke for every 100,000 troops, presenting symptoms such as dehydration, rhabdomyolysis, and acute renal failure [228]. These numbers can be increased by ~16 times among those who previously experienced mild heat injuries, as well as ~2 times among overweight and ~3 times among obese individuals [229]. On the other hand, the number of heat stroke cases can be reduced significantly when soldiers are adequately acclimatized to hot conditions. For instance, a study in Serbia showed that acclimated soldiers do not suffer any detrimental effects of exertional heat stress, in comparison to their unacclimated counterparts [230]. Similarly, a study in the British Army found that, along with body composition and insufficient briefing about casualty evacuation, inadequate time for heat acclimatization was the most frequent risk factor for experiencing heat illnesses among soldiers who perform in the heat [231]. It is important to note that, although heat acclimatization is of vital importance for soldiers who operate in the heat, literature suggests that it should not be reviewed in isolation, but instead it should be measured in the context of warfighting, considering exogenous factors such as wounding, protective equipment, dehydration, and febrile illnesses [227].