Military medicine
-
Field anesthesia can have special considerations because of the possibly primitive conditions. The drawover vaporizer has enjoyed increased interest because of the ability to deliver an anesthetic without electricity or compressed gases. ⋯ We found that the output of the Ohmeda PAC drawover vaporizer delivered between 0.1 and 3.6% (v/v) sevoflurane. Therefore, the drawover vaporizer should be able to deliver a sufficient concentration of sevoflurane for anesthetic maintenance; however, this concentration appears inadequate for routine inhalation induction.
-
The purpose of this study was to determine the prevalence of smokeless tobacco use and clinical leukoplakia in a specific military population. Two hundred fourteen soldiers participated in this study. Each participant completed a questionnaire-type survey regarding tobacco use and received an annual-type dental examination that included extra-oral and intra-oral examination of hard and soft tissues and counseling regarding the risks associated with the use of tobacco. ⋯ Leukoplakia was seen in 4 of the current smokeless tobacco users. Difficulty in cessation was experienced by 10 of 32 smokeless tobacco users; 5 continue to use smokeless tobacco. Due to the concentration of users in the 18 to 24 age group, efforts toward detection and reduction of smokeless tobacco use should be focused on junior ranks and younger age groups.
-
The Military Unique Curricula (MUC) was published in 1988 as a guideline for instruction at military residencies in military-specific topics. To evaluate the degree of implementation and the perceived necessity of the MUC curricula and the attitudes and logistical factors relevant to military medicine instruction in military family practice residencies, questionnaires were sent to all 18 military family practice residency directors. ⋯ The total number of topics taught was correlated (p < 0.05) with years as residency director, awareness of the MUC, and an opinion that the material would not be better taught at service-specific schools. There appears to have been little influence of the MUC on the curricula of military family practice residencies since its publication.
-
Two hundred one consecutive adult admissions to a 3-bed Special Care Unit in a 25-bed military hospital were scored using APACHE II (Acute Physiology and Chronic Health Evaluation). Outcome measures included APACHE II scores and mortality predictions; active intensive care interventions; transfers for specialized care; and mortality. ⋯ APACHE II scoring can be applied in small intensive care settings. Scoring criteria and logistic regression equations may need to be customized accordingly.
-
Biography Historical Article
Hospital ship doctrine in the United States Navy: the Halsey effect on scoop- and-sail tactics.
Although hospital ships have a long history, naval strategists have paid little attention to their tactical employment in naval and amphibious warfare. Often employed as floating ambulances, operational doctrine for hospital ships did not permit their use as floating combat surgical hospitals until the final amphibious campaigns of World War II. Based on operational archives-ships' logs, war diaries, battle plans, and other official records-this essay traces the evolution of tactical doctrine on hospital ships from Guadalcanal to Inchon. ⋯ Nimitz approved Halsey's proposal, and the battle plan at Iwo Jima combined the careful triage of casualties at the waterfront with early, forward employment of hospital ships. Despite more than 21,000 casualties at Iwo Jima, they were handled better than at any previous operation in the Pacific theater. The tactical doctrine for hospital ships suggested by Halsey has since been employed in every major amphibious operation, including Okinawa and Inchon, and has also been used in modern-era contingency and humanitarian missions.