Military medicine
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The Air Force Dental Service is responsible for ensuring that airmen are dentally ready to support military operations worldwide by delivering top-tier dental care. As the military healthcare landscape undergoes significant changes, the Air Force Dental Service has explored innovative approaches to dental care delivery. One consideration involves the potential use of radiographs as the primary tool for assessing service members' dental conditions, specifically focusing on identifying nondeployable conditions and periodontal health. ⋯ The study strongly cautions against relying solely on radiographs for determining the dental health of U.S. Air Force personnel. While providers effectively ruled out the absence of certain conditions, the challenge of positively identifying DRC 3 conditions poses significant risks to oral health if such a workflow was utilized. Particularly, the high probability of false negatives would be detrimental to the operational readiness of military personnel. Therefore, results support the continued use of radiographic and clinical examinations for comprehensive dental exams.
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Competence in neonatal care is especially important for military pediatricians because military pediatricians can be asked to serve in remote duty locations with limited resources. We sought to understand how this competence is defined, developed, and assessed by military pediatric training programs. ⋯ Competence in the neonatal setting is particularly important for military pediatricians. Essential skills undergo differential assessment and current assessment methods differ from ideal assessment methods. Future work should focus on how these facets can support a unified curriculum in newborn medicine.
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Assessing the survivability of, and potential injury to, a ship's crew from underwater blast is crucial to understanding the operating capability of a military vessel following blast exposure. One form of injury that can occur and affect a crew member's ability to perform tasks is traumatic brain injury (TBI). To evaluate the risk of TBI from underwater blasts, injury metrics based on linear head acceleration have traditionally been used. Although these metrics are popular given their ease of use, they do not provide a direct measure of the tissue-level biomechanical responses that have been shown to cause neuronal injury. Tissue-based metrics of injury, on the other hand, may provide more insight into the potential risk of brain injury. Therefore, in this study, we assess the risk of TBI from underwater blasts using tissue-based measures of injury, such as tissue strain, strain rate, and intracranial pressure, in addition to the more commonly used head acceleration-based injury metrics. ⋯ In this work, we assessed the risk of brain injury from underwater blasts using an anatomically detailed subject-specific FE head model. Accurate assessment of the risk of TBI from underwater explosions is important to evaluate the potential injury risk to crew members from underwater blast events, and to guide the development of future injury mitigation strategies to maintain the safety of crew members on military ships.
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Management of the patient with moderate to severe brain injury in any environment can be time consuming and resource intensive. These challenges are magnified while forward deployed in austere or hostile environments. This Joint Trauma System Clinical Practice Guideline provides recommendations for the treatment and medical management of casualties with moderate to severe head injuries in an environment where personnel, resources, and follow-on care are limited. These guidelines have been developed by acknowledging commonly recognized recommendations for neurosurgical and neuro-critical care patients and augmenting those evaluations and interventions based on the experience of neurosurgeons, trauma surgeons, and intensivists who have delivered care during recent coalition conflicts.
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The 1996 Khobar Towers bombing, a large-scale mass casualty incident (MASCAL) at a coalition forces housing complex, resulted in 519 casualties. Key lessons learned include the importance of MASCAL exercises, self-aid and buddy care, and casualty triage, all critical to preparation for future terrorist attacks or near-peer combat operations MASCALs.