Military medicine
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To provide an analysis of casualties treated during medical evacuation (MEDEVAC) or/and at the Spanish Role 2 in Herat, Afghanistan, including type of weapon, injuries, and effects of protective measures. ⋯ The injury score indices of firearm casualties were higher than the explosive device casualties' injury score indices. The possible reasons for this finding are discussed.
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Designated a Department of Defense Team Resource Center (TRC) in 2008, Naval Medical Center Portsmouth (NMCP) currently hosts three tri-service health care teams training courses annually. Each consists of didactic learning coupled with simulation-based training exercises to provide an interactive educational experience for health care professionals. ⋯ The course is also the foundation of a research program designed to explore applications of modeling and simulation for enhanced team training in health care. The TRC has adopted two theoretical frameworks for evaluating training efficacy and outcomes, and has used these frameworks to guide a systematic reconfiguration of the infrastructure supporting health care teams training at NMCP.
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The effectiveness of the intraosseous (IO) route for fluid resuscitation remains uncertain. This study compares IO infusion rates and estimated volume expansion using clinically relevant infusion pressures with lactated Ringer's (LR) and hetastarch (HES). ⋯ HES flow rates are lower than LR flow rates in the sternum and tibia of swine. Sternal infusion of HES is likely to provide greater estimated intravascular volume expansion than LR despite the lower infusion rates.
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To assess factors associated with medical disability in the U.S. Marine Corps. ⋯ Continued surveillance of the disability evaluation system is needed to help develop preventive measures and to help policy makers establish evidence-based policies on accession, deployment, and retention standards over the lifecycle of service members.