Military medicine
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Absence of pre-hospital coagulation tests challenges prompt management of hemostasis after trauma. The Viscoelastic Coagulation Monitor (VCM, Entegrion, Durham, NC) is a hand-held coagulation test for point-of-care. We evaluated VCM in a translational swine polytrauma model, hypothesizing that VCM correlates with a laboratory reference method, the TEG 5000 (Haemonetics, Boston, MA), and can identify coagulopathic phenotypes relevant to trauma. Our secondary hypothesis was that pre-warming of VCM disposable test cartridges using a heating plate versus pre-warming of cartridges by carrying the cartridge in the user's pocket does not significantly alter results. ⋯ In a trauma model, VCM detected significant changes in coagulation at point-of-care in a simplified portable form factor. VCM could enable informed hemostasis management in pre-hospital settings where coagulations tests are unavailable, pending further validation in clinical trials.
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Casualty evacuation has been identified as a typical and essential single military task which every soldier should be able to perform rapidly during combat. Previous studies suggest that casualty evacuation is typically conducted by dragging and demands e.g., lean body mass and anaerobic performance. Association of physical fitness with casualty evacuation by dragging has been studied widely but previous studies lack comprehensive assessment of all physical fitness determinants. The purpose of the present study was to examine comprehensively how casualty emergency evacuation (CEE) performance associates with physical fitness and body composition. ⋯ This study examined thoroughly how different physical fitness dimensions and body composition relate to a CEE test performed by a combination of dragging while crawling and in upright position. Casualty emergency evacuation was discovered as a high-intensity military task, which demands most importantly high anaerobic performance, lean body mass, and maximal strength capabilities. Improving these dimensions of physical fitness should be considered highly important as CEE is essential and possibly one of the most demanding military tasks which every soldier should be able to conduct in combat. From operational perspective, it is relevant that soldiers are able to perform CEE during operations; therefore, further research is needed on how acute operational stress changes the nature of CEE and its physical determinants.
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Musculoskeletal injuries (MSKI) are the most common clinical condition in the military that affect medical readiness. Evaluation of MSKI burden and the effects of these injuries on readiness in large deck Navy ships is warranted. ⋯ The findings in the current study demonstrate the substantial burden of MSKI aboard large deck ships, both in homeport and while deployed. Inclusion of a physical therapist aboard LHA/LHDs, like the CVN, may help to prevent and mitigate the effects of MSKI through early access to specialized care and integral injury prevention and performance optimization methods.
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As of 2020 Holistic health and fitness (H2F) teams have been embedded into brigades to engage Soldiers in Preventative Mental, Physical, Nutritional, Spiritual, and Sleep Readiness services. This represents a change in Army culture from a focus on testing to one of wellness because of increasing sleep concerns, mental health concerns, and injury rates. Soldier awareness of H2F services, where to find them, how to use them, and command endorsement of H2F professional's services has been limited and not well studied. Most soldiers fall into the Generations Y and Z categories, and this population tends to access information primarily from social media sources. Social media platforms therefore represent potentially effective ways to reach these individuals to increase their awareness of H2F services. ⋯ The use of social media to facilitate soldier awareness and use of H2F mental and sleep readiness services is a viable option for H2F units seeking to enhance their reach in these areas. The project created very little demand on the local therapist's time or to brigade resources and may help increase Soldier accessing of H2F resources online and directly.