Military medicine
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Respiratory rate (RR) is a crucial vital sign in patient monitoring and is often the best marker of the deterioration of a sick patient. It can be used to help diagnose numerous medical conditions and has been demonstrated to be an independent predictor of patient outcomes in various critical care settings and is incorporated in many clinical early warning scores. Here, we report on the performance of depth-camera-based system for the noncontact monitoring of RR during a ramped RR protocol. The ramped breathing protocol was developed specifically to test the relatively rapid changes in rates, which include clinically important low and high ranges of RRs. ⋯ The technology performed well, exhibiting an RMSD accuracy well within our target of 3 breaths/min, both across the whole range and across each individual subrange. In summary, our results indicate the potential viability of continuous noncontact monitoring for the determination of RR over a clinically relevant range.
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Providing quality care and maintaining exceptional medical providers are important priorities for military medicine. The present study examines the association between retention sentiments and voluntary separation from army service among Army Medical Corps and Nurse Corps Officers. Retention sentiments are derived from the Department of the Army Career Engagement Survey, a voluntary survey that Active Duty Soldiers complete annually. ⋯ The current study highlights unique retention concerns among army medical providers in the Medical Corps and Nurse Corps. Additionally, this study ties medical provider sentiments to subsequent voluntary separation from the army. These findings can help army senior leaders evaluate, draft, and revise policy aimed at increasing retention among army medical providers, and increasing access to quality healthcare for service members and their families.
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This study investigated the influence of stimulus color wavelength on cognitive performance in a virtual reality (VR) Go/No-Go task by assessing participant's reaction time and accuracy. Previous research has indicated that color has a variety of cognitive, physiological, and behavioral effects on individuals, differentiating their performance. However, there is a gap in understanding the influence of color on performance on VR cognitive tasks. An understanding of how stimulus color wavelength influences human performance could enhance the control over the design and interpretation of assessment and training outcomes in VR. ⋯ Shorter color wavelengths were associated with higher accuracy in a VR Go/No-Go task. These findings support the importance of color selection in VR tasks and trainings, especially in scenarios that include decision-making and require accuracy. Realistic colors encountered in real-life military operations into VR training environments may better prepare individuals for real-world challenges. Future research in this area could explore color effects in additional tasks and incorporate realistic color-based cues in VR training scenarios.
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Prolonged Casualty Care (PCC) is a military adaptation aimed at providing pre-hospital care in austere settings when evacuation is delayed or even impossible. Current lack of standardized medical equipment and size/weight restrictions of military packs during dismounted operations hinder effective PCC. We sought to design a standardized, practical, and effective prolonged field care kit (PFAK) to enable widespread implementation of PCC. ⋯ Given the changing battlefield environment, efficient and effective PCC will play an increasingly important role in the management of combat trauma. The PFAK can meet this need by providing a practical and standardized resuscitation kit generated by expert military and trauma personnel consensus, carried conveniently in the LMR.
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Inhaled nitric oxide (INO) is a selective pulmonary vasodilator delivered from compressed gas cylinders filled to 2,200 psig (137.8 bar) with 800 ppm of NO in a balance of nitrogen. NO is currently FDA-approved for use in term or near-term infants with hypoxemia and signs of pulmonary hypertension in the absence of cardiac disease. INO has also been shown to improve oxygenation in adults with refractory hypoxemia. Current doctrine precludes the use of NO during military aeromedical transport owing to the requirement for large compressed gas cylinders. We performed a bench evaluation of 2 delivery systems that create NO from room air without the need for pressurized cylinders. ⋯ Both devices delivered a reliable INO dose at ground level. Altitude significantly affected INO delivery accuracy at 14,000 ft (4,267 meter) (P < 0.01) with both devices and at 8,000 ft (2,437 meter) (P < 0.01) with LungFit. Differences in INO dosage were not statistically significant with the Odic device at 8,000 ft (2,437 meter)(P > 0.05) although there were large variations with selected ventilator settings. With careful monitoring, devices creating INO from room air without cylinders could be used during aeromedical transport without the need for pressurized cylinders.