Military medicine
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Neurosurgeons at David Grant Medical Center (DGMC) have had low surgeon case volumes. Meanwhile, veterans have had long waits because of inadequate neurosurgical coverage. DGMC and Department of Veteran Affairs (VA) agreed to share resources to treat an underserved VA patient population. We analyzed number of cases, admissions, relative weighted product (RWP), and outpatient visits before and after this unique military-VA agreement. ⋯ The sharing agreement resulted in 1.7-fold increase in operative cases. This military-VA venture provides military neurosurgeons with more surgical cases and provides neurosurgical care to a previously underserved patient population.
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Military personnel deployed to Iraq and Afghanistan witnessed decreased numbers of soldiers killed in action and increased numbers of soldiers wounded in action. Medical personnel attribute these changes to use of improved body armor, rapid evacuation to medical treatment facilities, and use of medical technology. ⋯ This study uses modeling and simulation (M&S) to produce combat casualties, incorporate the projected benefits of field tourniquets and bandages, and examine their effects on wounded soldiers in a realistic simulated combat setting. The results show the positive benefit of using M&S to support analysis of medical technology and to inform medical research decisions.
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During the current military engagements in Iraq and Afghanistan, establishing intravenous (IV) access for resuscitation of critically injured casualties remains a persistent challenge. Intraosseous (IO) access has emerged as a viable alternative in resuscitation. In this case report, a 19 year-old male soldier was severely wounded by a roadside bomb in Iraq. ⋯ Instead, multiple IO catheters were used to initiate fluid resuscitation prior to transfer to a combat support hospital. To our knowledge, this is the first report of such extensive usage of IO catheters. Multiple IO catheters can be placed rapidly and safely and may help solve the challenge of establishing vascular access for resuscitation of critically injured casualties.