Military medicine
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In response to mass casualty events, The Hartford Consensus brought together subject matter experts across multiple disciplines in health care and public safety to create guidelines and publications intended to improve survivability in active shooter events. Among the recommendations was the earlier recognition and treatment application of life-threatening hemorrhage control. These recommendations culminated in efforts to create the Stop the Bleed Campaign, which aims to empower the layperson to render aid in a life-threatening bleeding emergency. As of February 2020, the program has held over 86,000 courses, trained over 1.4 million attendees, and over 77,000 instructors since its inception. In addition to spreading within the United States, American College of Surgeons (ACS) Stop the Bleed (StB) classes have been held in 118 different countries. This systematic narrative review aims to answer the following research question: What does the ACS StB Initiative do well, and where can it improve? ⋯ StB is an effective tool in building confidence in laypersons, which is its biggest strength. A review of the literature shows several areas where the curriculum and materials could be better developed. Research can also be further refined to better quantify the program's impact.
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Each French military orthopedic surgeon is both an orthopedic surgeon and a trauma surgeon. Their mission is to support the armed forces in France and on deployment. The aim of this study was to describe the type of orthopedic surgery performed for the armed forces in France. Our hypothesis was that scheduled surgery was more common than trauma surgery. ⋯ Military orthopedic surgeons are not just traumatologists; their activity for the armed forces is varied and mainly consists of so-called programmed interventions.
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Research indicates that military service involves stressors that may be related to depression. However, the military provides financial, educational, psychological, and social advantages that may help to mitigate the effects of service-related stressors. Because most prior research was based on cross-sectional data or small clinical samples, we explored individual-level trajectories of depression over time. ⋯ Individuals who were less depressed at year 1 of the study were more likely to enlist into the military. While both civilians and service members displayed decreasing depression over the years of the study, military members had less decrease in depression over time beginning at a lower level of depression than civilian. Taken together, the minor differences in depression between the civilian and military samples and the lower level of depression among military members at the beginning of the study suggest that military service selects against higher levels of depression at the start of service and, given the known stressors related to the military, membership in the service may be associated with resilience to depression.
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Objectively determining soldiers' fatigue levels could help prevent injuries or accidents resulting from inattention or decreased alertness. Eye-tracking technologies, such as optical eye tracking (OET) and electrooculography (EOG), are often used to monitor fatigue. Eyeblinks-especially blink frequency and blink duration-are known as easily observable and valid biomarkers of fatigue. Currently, various eye trackers (i.e., eye-tracking glasses) are available on the market using either OET or EOG technologies. These wearable eye trackers offer several advantages, including unobtrusive functionality, practicality, and low costs. However, several challenges and limitations must be considered when implementing these technologies in the field to monitor fatigue levels. This review investigates the feasibility of eye tracking in the field focusing on the practical applications in military operational environments. ⋯ Monitoring physiological and psychological readiness of soldiers, as well as other civil professionals that face higher risks when their attention is impaired or reduced, is necessary. However, improvements to eye-tracking devices' hardware, calibration method, sampling rate, and algorithm are needed in order to accurately monitor fatigue levels in the field.