Military medicine
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Army recruits conducting BCT are among the most susceptible population of military personnel to experience exertional heat illness, a concern expected to become increasingly urgent due to steadily rising temperatures. In this study, we provide an empirical analysis of wet bulb globe temperature (WBGT) index trends at U.S. Army BCT installations and quantify the magnitude of these trends. Assuming these warming trends continue, the anticipated effects of increasing temperature trends are discussed in relation to potential impacts on recruit heat illness incidence and training disruption. ⋯ Temperatures measured on the WBGT index have steadily increased at US Army basic training installations since at least 1960. In the future, adaptation to the BCT program will be required to maintain rigorous standards without incurring unacceptable risk of recruit heat illness. The analysis provided by this study can help inform medical, training, and policy implementations needed to ensure continued BCT in a warming world.
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This analysis evaluates potential reporting discrepancies of the DD2341 Form (Report of Animal Bite-Potential Rabies Exposure) submitted to a forward-deployed Rabies Advisory Board to the Theater Medical Data Store (TMDS) and Reportable Medical Event (RME) systems to identify reporting gaps that can lead to improved best practices that ensure documentation of Post Exposure Prophylaxis (PEP) of potential rabies exposures into service members (SMs) electronic medical records. ⋯ This study is the first to compare the electronic medical record data to in theater reports for potential rabies exposure in a theater of operations. The analysis suggests that some written forms generated in the USCENTCOM theater are not entered into SM Military Health System electronic medical records, indicating that electronic medical records may be a less sensitive method than in-theatre reports for rabies program surveillance in a deployed setting. There is under-reporting in electronic medical records of rabies PEP in both TMDS and RME databases. Rabies PEP is an RME according to the Armed Forces Health Surveillance Division guidelines and case definitions. There needs to be better integration of the DD2341 into the electronic medical records system.
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This column explores the inception, challenges, and prospects of robotic surgery in the military. It highlights the military's role in developing early prototypes, current utilization, training struggles, partnerships with civilian organizations, and potential future applications. The military's influence on the evolving landscape of robotic surgery is emphasized.
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Hemoptysis is a rare presenting symptom in pediatric and young adult patients with a highly variable outcome ranging from an isolated mild occurrence to severe illness and death. Exercise-induced pulmonary hemorrhage (EIPH) has several reports in adult literature but has not previously been reported in pediatric patients. A 12-year-old female with a history of trisomy X (47, XXX), obesity, depression, anxiety, and obstructive sleep apnea presented to the pediatric pulmonology clinic after several episodes of hemoptysis. ⋯ The hemoptysis evaluation is important for military providers given the range of severity in presentations, even though it is a rare occurrence. In addition to a novel presentation of EIPH, this case demonstrates the value of collaboration between pediatric and adult specialists in the Military Health System (MHS). Military care providers should be aware of this rare phenomenon in service members and trainees who are at risk during maximal aerobic effort.