Military medicine
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Negative-pressure pulmonary edema (NPPE) is an infrequent but known postoperative complication following endotracheal intubation and general anesthesia. We report a case of a healthy 24-year-old man requiring intensive care unit management for NPPE following a routine surgical procedure. This article discusses how rare but serious the complication of NPPE can be; it also describes the diagnosis, evaluation, and treatment from one institution's experience.
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In prior reports of active data collection, we demonstrated that early use of emergency tourniquets is associated with improved survival and only minor morbidity. To check these new and important results, we continued critical evaluation of tourniquet use for 6 more months in the current study to see if results were consistent. ⋯ We found that morbidity was minor in light of major survival benefits consistent with prior reports.
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To describe current efforts and future potential for understanding long-term health of military service members by linking the Millennium Cohort Study data to exposures and health outcomes. ⋯ In conjunction with Millennium Cohort survey data, prospective individual-level exposure and health outcome assessment is crucial to understand and quantify any long-term health outcomes potentially associated with unique military occupational exposures.
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Comparative Study
Trauma readiness training for military deployment: a comparison between a U.S. trauma center and an Air Force Theater Hospital in Balad, Iraq.
The U. S. Air Force created the Center for Sustainment of Trauma and Readiness Skills at the Shock Trauma Center (STC) where staffs rotate before deployment. ⋯ The STC's high-volume of major soft tissue debridement cases may offer the closest approximation of high energy wound care. Training at selected U. S. trauma centers may prepare military staff to care for war injuries, particularly those who do not practice in high-volume Level 1 trauma centers.
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Post-mortem preautopsy multidetector computed tomography was used to assess the placement of tibial intraosseous infusion needles in 52 cases of battlefield trauma deaths for which medical intervention included the use of the technique. In 58 (95%) of 61 needles, the tip was positioned in medullary bone. All 3 (5%) unsuccessful placements were in the left leg, and the needle was not directed perpendicular to the medial tibial cortex as recommended. Considering the nature of military trauma and the environmental conditions under which care is rendered, military medical personnel appear to be highly successful in the placement of tibial intraosseous infusion needles.