Military medicine
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Operative case volumes for military surgeons are reported to be significantly lower than civilian counterparts. Among the concern that this raises is an inability of military surgeons to achieve mastery of their craft. ⋯ Obtaining mastery of general surgery is a nearly impossible proposition given the current care models at Army MTFs. Alternative staffing and patient care models should be developed if Army surgeons are to be masters at their craft.
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Current military recommendations include the use of tourniquets (TQ) in appropriate pediatric trauma patients. Although the utility of TQs has been well documented in adult patients, the efficacy of TQ application in pediatric patients is less clear. The current study attempted to identify physical constraints for TQ use in two simulated pediatric limb models. ⋯ The current study suggests that commercial windlass TQs can be applied to upper and lower extremities of children aged 5 years and older at the 50%th percentile for limb circumference. In younger children, windlass TQ efficacy is variable. Further study is required to better understand the limitations of TQs in the youngest children, and to determine actual hemorrhage control efficacy.
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Physicians in the military often take leadership roles much earlier in their career than their civilian counterparts. Military Graduate Medical Education programs must continue to provide relevant leadership training that prepares graduates for their imminent leadership roles. The following article illustrates the experience of a junior Army Medical Corps Officer deployed shortly after residency. His case illustrates how he utilized the tools and lessons learned from the professional development and leadership training in his residency to assure the operational readiness and success of his unit.