Military medicine
-
The main goal of the North Atlantic Treaty Organization role 3 hospital located in Kabul is to provide comprehensive medical services to troops engaged in Afghanistan. Nevertheless, it also provides care for Afghan National Security Forces and for Afghan and non-Afghan civilians. ⋯ Reasons of admission to the conventional hospitalization unit were numerous. Care provided to Afghan and non-Afghan civilians represented the main activity of this unit.
-
Over half of the veterans returning from the conflicts in Iraq and Afghanistan are burdened with chronic pain. Although these young veterans may have to live with pain for the rest of their lives, little is known about the struggles this new group of veterans faces, or their perceptions of support from family, friends, and others. The purpose of this study is to understand Operation Enduring Freedom/Operation Iraqi Freedom veterans' experiences with chronic pain and social support. ⋯ Although support from friends and family is often effective, veterans and others with chronic pain are uniquely positioned to offer support to others with pain. Clinically, an approach to pain management in which veteran peers are integrated into chronic pain treatment approaches, similar to the Veterans Affairs' mental health model of care, might offer additional benefits for veterans with chronic pain.
-
Intraosseous (IO) access, enabling the rapid administration of epinephrine during cardiac arrest (CA), is crucial in promoting optimal postresuscitation outcomes in patients with poor vascular access. There is a question whether IO-administered epinephrine is equivalent to intravenously administered epinephrine during CA. ⋯ The clinician should consider using proximal IO infusion sites such as the sternum or humerus when administering advanced cardiac life support drugs to rapidly achieve maximal therapeutic concentrations. Further studies are needed to determine the differences seen when epinephrine is administered by these routes during CA.
-
Review Case Reports
Sigmoid colon penetration by an intrauterine device: a case report and literature review.
The intrauterine device (IUD) is one of the most effective contraceptive methods available today. However, IUDs can cause some serious complications, such as bleeding, uterine perforation, and bowel perforation. Migration into bowel is a rare but serious complication that requires surgical attention. ⋯ The symptoms of IUD migration can be nonspecific, requiring a high degree of suspicion. Also, cross-sectional imaging studies are recommended to rule out adjacent organ involvement if IUD migration is suspected.
-
A retrospective review of 930 combat casualties from March 2003 to September 2009 who received a massive transfusion. Mechanism was categorized as explosion (EXPL) (712), gunshot wound (GSW) (190), and blunt trauma (28). Cohorts were also categorized by fresh frozen plasma (FFP) to red blood cell (RBC) ratio: low, ≤1:1.5 and high, >1:1.5. Patient characteristics and in-hospital mortality rates were compared among groups. Propensity matching was used to control for confounding variables. ⋯ High FFP:RBC ratios are associated with improved survival in combat casualties regardless of injury mechanism.