Military medicine
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A major fire at sea is among the most devastating events that can occur while a U.S. Navy combatant vessel is underway. Since World War II, no attack on a large U.S. Navy capital ship has occurred during combat operations. However, increasing global tensions raise the threat of future peer adversary naval combat, and shipboard medical caregivers must be prepared for mass casualty events in the deployed maritime environment. To better prepare modern naval caregivers for this possibility, we reviewed mass casualty events from major fires aboard large U.S. Navy aircraft carriers from 1950 through 2020 to summarize available objective data and identify lessons learned. ⋯ Shipboard fires underway pose a significant threat to crew safety with a mortality of nearly a quarter of those injured. These fire mass casualty events immediately overwhelm shipboard medical capabilities requiring a complex response from all hands beginning with non-medical first responders. Notably, all events occurred outside of direct enemy combat, potentially underestimating the impact and number of casualties of a shipboard fire during naval combat. Advances in peer weaponry and the threat of future conflict emphasize the need for pre-deployment burn care training for all shipboard medical caregivers as well as advanced airway and resuscitation training for non-physician caregivers. This review underscores the profound impact of shipboard fires on crew safety, highlighting the critical need for enhanced preparedness and response strategies to prepare for fire-related mishaps during routine operations and naval combat.
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The French Armed Forces are deployed in French Guiana (FG) to protect national territory and ensure the security of strategically important sites. Military health support (MHS) provides medical support for missions in this tropical environment, which is hazardous and where confrontations are possible. MHS must organize tactical and strategic evacuations (Strat-AEs), so that an optimal level of care can be delivered. Overall, Strat-AE activity has been described previously but no specific data related to FG has been reported. The main objective of this study was to provide an overview of military Strat-AEs from FG. ⋯ The particularity of FG is a local health care system that provided initial care before the evacuation. To reduce the number of Strat-AEs in FG, the risk of nonbattle injury must be lessened and improvements must be made to the local health care system and to the partnership between civilian and military health services.
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The Vestibular/Ocular Motor Screening (VOMS) was created as a brief clinical screening tool for identifying vestibular and ocular motor symptoms and impairments post-concussion. It was found to have predictive validity in correctly identifying concussed athletes from healthy controls. In 2018, the Military Acute Concussion Evaluation 2 (MACE2) replaced the original Military Acute Concussion Evaluation (MACE); the most prominent change between the MACE and MACE2 was the addition of the VOMS. Despite its adoption into military medicine, it is not known if the addition of the VOMS to the MACE2 is acutely helpful, and if it provides additional information for diagnosis, prognosis, and/or management. The purposes of this systematic review were: (1) to determine the utility of the VOMS in correctly identifying concussed individuals, particularly as it pertains to military medicine; (2) to explore the extent to which the VOMS can inform concussion prognosis; and (3) to establish the value of the VOMS as a measure for monitoring the evolution of symptoms throughout a service member's course of care. ⋯ The VOMS had excellent internal consistency and moderate to good test-retest reliability; however, a false-positive rate of 21.9% was found. Most studies indicated that a positive VOMS was associated with a delayed recovery. Several studies indicated that VOMS scores improved with targeted, active interventions and/or a symptom-guided progressive return to activity. The greatest limitation was the paucity of published evidence in the military population. More research is needed on the use of the VOMS in service members.
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Although health information is widely available to the Norwegian population a lack of health literacy is still common and considered a public health challenge. However, there is limited information on the health literacy of the adolescent population in Norway. The purpose of this pilot study was to assess health literacy and self-reported health habits among soldiers in basic military training, both in field, camp, and home settings. Furthermore, we aimed to investigate which health habits characterize soldiers with inadequate health literacy. ⋯ The results from our study suggest that the conscripts in the Norwegian Armed Forces have a lower health literacy than the general population, and this is reflected in reported higher frequency of unhealthy habits in service settings than at home. The Armed Forces have an opportunity to take responsibility to optimize the health skills of their soldiers and to encourage them to make informed decisions about their own health. Improved adaptation to the national recommendations regarding nutrition, tobacco use, and oral health are areas having the potential to greatly improve the overall health habits of conscripts.
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Simulation has rapidly expanded in obstetrics and gynecology (OB/GYN) for teaching surgical skills, reinforcing medical knowledge and assessing surgical proficiency. Low-fidelity simulations are typically lower cost to produce and have been proven to be beneficial for surgical training. The aim of this study is to describe an innovative simulation competition among residency programs to develop, present, and share low-cost, low-fidelity surgical simulation. ⋯ This event succeeded in nurturing innovative, cost-effective, and readily replicable simulations in the field of OB/GYN. This event can be replicated at meetings to foster novel simulation development.