Military medicine
-
Comparative Study
Comparison of the Effects of Motion and Environment Conditions on Accuracy of Handheld and Finger-Based Pulse Oximeters.
The most common cause of preventable death on the battlefield is significant blood loss, eventually causing decrease in tissue oxygen delivery. Pulse oximeters (POs) are widely used by the Israeli Defense Forces to obtain fast and noninvasive information about peripheral oxygen saturation (SpO2). However, POs are produced by different manufacturers and therefore include different sensors and are based on distinctive algorithms. This makes them susceptible to different errors caused by factors varying from environmental conditions to the severity of injury. The objectives of this study were to compare the reliability of different devices and their accuracy under various conditions. ⋯ Considering measurement limitations of POs used is extremely important. Use of handheld devices should be favored for use in motion conditions. Technologically advanced and/or recently developed devices should be preferred because of evolving algorithms, which decrease or eliminate the error factors. The "dirty finger" effect on the measurement error cannot be neglected and therefore the action of finger cleaning should be considered part of the treatment protocol.
-
Penetrating and perforating ocular trauma are often devastating and may lead to complete visual loss in the traumatized eye and subsequent compromise of the fellow eye. A significant proportion of traumatic injuries are complex, often requiring vitreoretinal intervention to preserve vision. A retrospective analysis at a level 1 trauma center was performed to evaluate the time course, incidence, and outcomes following pars plana vitrectomy (PPV) after traumatic ocular injury and initial globe repair. ⋯ Overall, patients requiring PPV following open globe repair generally had more severe injuries and worse 6-month postoperative visual acuity. Patients who underwent more expedited vitrectomy showed greater improvement in visual acuity as measured by ETDRS letters gained.
-
Millimeter wave directed energy in the frequency regime of 94-95 GHz has potential for use in numerous military applications including crowd control and area denial. Although proven to be very safe, millimeter wave energy has the potential, because of accidental over exposure, to produce significant injuries. Currently, the Dynamic Thermal Model (DTM), developed by Beason and colleagues, is used to calculate the temperature profile in skin undergoing (millimeter wave) heating, using an all-or-nothing threshold of injury. Risk of significant injury (RSI) is determined by product of the probability of an injury outcome on a region of the body times the probability of that the injury will occur. Thus, a threshold injury determination may over predict burn probability and fail safety requirements. This work augments the DTM, replacing the current threshold value of injury with a probabilistic risk of injury to better quantify the risk of significant injury. ⋯ The dose-response models developed in this study are shown to be an excellent predictor of burn injury for each severity. The DTM was repackaged with the probabilistic burn models to more accurately determine the risk of significant burn injury.
-
The ability to accurately detect hypotension in trauma patients at the earliest possible time is important in improving trauma outcomes. The earlier an accurate detection can be made, the more time is available to take corrective action. Currently, there is limited research on combining multiple physiological signals for an early detection of hemorrhagic shock. We studied the viability of early detection of hypotension based on multiple physiologic signals and machine learning methods. We explored proof of concept with a small (5 minutes) prediction window for application of machine learning tools and multiple physiologic signals to detecting hypotension. ⋯ In this research, we explored the viability of early detection of hypotension based on multiple signals in a preexisting animal hemorrhage dataset. The results show that a multivariate approach might be more effective than univariate approaches for this detection task.
-
Combat deployment is associated with mental and physical health disorders and functional impairment. Mental health (MH) diagnoses such as adjustment and anxiety disorders have received little research attention but may reflect important postdeployment sequelae. The purpose of this study was to investigate the association of combat exposure with the acquisition of a wide range of mental health diagnoses over 2 years. ⋯ Researchers and providers should be alerted to the impact of combat exposure and the wide range of MH conditions and diagnoses that may represent important postdeployment sequelae.