Military medicine
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Case Reports
Buprenorphine/naloxone therapy for opioid refractory neuropathic pain following traumatic amputation: a case series.
Phantom limb pain is a common consequence of limb amputation and is prevalent among the service members sustaining traumatic battlefield limb injuries during the conflicts in Iraq and Afghanistan. Current treatment to relieve phantom limb pain consists of physical, behavioral, and medical modalities including opioids and adjunct medications. ⋯ This case series describes four previously healthy service members who developed phantom limb pain following traumatic amputation successfully treated with buprenorphine/naloxone after failing traditional treatment. This is the first reported case series of patients expressing improved pain control with decreased frequency of phantom limb pain with the use of buprenorphine/naloxone instead of traditional opioid agonists.
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U. S. Army flight medics performed a process improvement initiative of 15 blood product transfusions on select Category A (Urgent) helicopter evacuation casualties meeting approved clinical indications for transfusion. ⋯ All casualties within a 10-minute flight time who met clinical indications were transfused. Utilization of a standard operating procedure with strict handling and administration parameters, a rigorous training and qualification program, an elaborate cold chain system, and redundant documentation of blood product units ensured that flight medic initiated transfusions were safe and effective. Research study is needed to refine the indications for prehospital blood transfusion and to determine the effect on outcomes in severely injured trauma patients.
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The Army Selected Reserve Dental Readiness System (ASDRS) is a key dental program directed by the Assistant Secretary of the Army (Manpower & Reserve Affairs) starting in fiscal year 09. The Army National Guard and Army Reserve have steadily implemented ASDRS over the past 3 years as a means to improve the historically abysmal dental readiness of the Army Reserve Component (RC). ⋯ S. territories, at home station before alert, and if necessary after alert (throughout the Army force generation cycle). This article examines the status of ASDRS implementation, assesses its effectiveness in improving Army RC Dental Readiness, and provides Army leadership recommendations regarding the following focus areas: (1) command emphasis, (2) program execution, and (3) synergy with the Military Health System and Department of Veterans Affairs.
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Randomized Controlled Trial Comparative Study
Re-evaluating the field tourniquet for the Canadian Forces.
To determine the best field tourniquet for Medical Technician (Med Tech) use in the Canadian Forces (CF). ⋯ When tested on a group of CF Med Techs, the C-A-T remained the CF field tourniquet of choice, based on the assessed criteria. Although there is inherent bias in the approach of this study, it reflects the process required to determine if a new piece of kit is superior to what is already considered the standard to a trained and equipped military.
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During public health emergencies, the Military Health System experiences challenges similar to those across the U.S. public and private health systems. This study explored how 1 such event, the 2009/2010 influenza (H1N1) pandemic, impacted health care utilization and associated costs in the Military Health System. ⋯ Annual trend analysis of costs and health care utilization would be helpful to plan and resource emerging influenza pandemics and to identify subgroups at greatest risk for contracting influenza.