Military medicine
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Challenges with surgical cricothyroidotomy on the battlefield can be attributed to limited frequency of use, procedure unfamiliarity, and limited knowledge base of anatomical landmarks of which is further heighten in the tactical environment. The objective was to identify ways to enhance the cricothyroidotomy training to minimize potential preventable procedural errors. ⋯ An ad hoc Working Group team identified five specific gap areas in the cricothyroidotomy training: (1) limited gross airway anatomy review; (2) lack of "hands-on" human laryngeal anatomy; (3) nonstandardized step-by-step surgical incision skill procedure; (4) inferior standards for anatomically correct cricothyroid mannequins; (5) lack of standardized refresher training frequency. Specific training enhancements are recommended across each day in the classroom, simulation laboratory, and field exercise.
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The purpose of this study is to report the device lessons learned from an emergency tourniquet program and, in particular, to emphasize analysis of discarded devices recovered after clinical use. ⋯ Correct user actions (e.g., following the instructions to remove slack before twisting) led to device effectiveness, but misuse did not. Users often assumed that optimal use required more force, but this was associated with misuse. Training should include tourniquet pearls and pitfalls.
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Current Topics in Military Tropical Medicine is a Continuing Medical Education series, which updates military medical personnel on questions related to clinical practice while deployed. This issue is Part II of a two-part series on the approach to decision to test, testing and management of latent tuberculosis infection. A representative case is explored in both parts to highlight how to approach service members and their units with regard to latent tuberculosis infection screening and intervention.
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Laboratory-based surveillance for diarrheal and respiratory illness was conducted at the 2009 Republic of the Philippines-United States Balikatan exercise to determine the presence of specific pathogens endemic in the locations where the military exercises were conducted. Ten stool and 6 respiratory specimens were obtained from individuals meeting case definitions for diarrhea or respiratory illness. Stool specimens were frozen in dry ice and remotely tested using enzyme-linked immunosorbent assay for Rotavirus, Astrovirus, Adenovirus, Entamoeba histolytica, Giardia, and Cryptosporidium and polymerase chain reaction for enterotoxigenic Escherichia coli, Campylobacter, Shigella, Vibrio, Salmonella, and Norovirus. ⋯ MassTag polymerase chain reaction for influenza A and B, respiratory syncytial virus groups A and B, human coronavirus-229E and human coronavirus-OC43, human metapneumovirus, enterovirus, human parainfluenza viruses 2,3, and 4a, human adenovirus, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, Legionella pneumonia, and Mycoplasma pneumonia was done on respiratory specimens. Out of 6 samples, 3 tested positive for H. influenzae; 1 tested positive for both H. influenzae and human parainfluenza virus 3; and 2 tested negative. Laboratory-based surveillance can be useful in determining etiologies of diarrheal and respiratory illness of deployed military personnel.
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This study examines non-battle injuries among U. S. Air Force members deployed during Operations Iraqi and Enduring Freedom. ⋯ The most common non-battle injuries were sprains and strains (53%) followed by open wounds (27%). Guard and Reserve members tended to have a lower rate of orthopedic non-battle injuries than Active Duty members in crude analyses and after adjustment for age, previous deployment, sex, race/ethnicity, and occupation (IRR = 0.95; 95% CI = 0.89-1.02 and IRR = 0.85; 95% CI = 0.77-0.93). Results from this study are intended to facilitate further research of potential differences between Air Force components to reduce non-battle injuries in a deployed environment.