Military medicine
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Care of casualties in the tactical combat environment should include the use of prophylactic antibiotics for all open wounds. Cefoxitin was the antibiotic recommended in the 1996 article "Tactical Combat Casualty Care in Special Operations." The present authors recommend that oral gatifloxacin should be the antibiotic of choice because of its ease of carriage and administration, excellent spectrum of action, and relatively mild side effect profile. For those casualties unable to take oral antibiotics because of unconsciousness, penetrating abdominal trauma, or shock, cefotetan is recommended because of its longer duration of action than cefoxitin.
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Intubation is a difficult skill under normal circumstances and more so with a limited visual field such as wearing a protective mask in a chemical or biological incident. This study sought to determine whether successful intubation using the intubating laryngeal mask airway (ILMA) under protective mask conditions was equivalent to standard endotracheal intubation. ⋯ This study suggests that under simulated chemical and biological conditions using an M-40 protective mask, intubation is accomplished faster and with more success with the ILMA.
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Comparing clinical productivity is important for strategic planning and the evaluation of resource allocation in any large organization. This process of benchmarking performance allows for the comparison of groups with similar characteristics. ⋯ We demonstrate how these benchmarks allow for valid comparisons of operative service productivity among these military treatment facilities and how the data could be used in expanding or contracting operating locations. In addition, these benchmarks are compared with those derived from the use of this system in the civilian sector.