Military medicine
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Randomized Controlled Trial
Improving combat medic learning using a personal computer-based virtual training simulator.
The new military occupational specialty for combat medics, the 91W, requires that all medics successfully pass the National Registry of Emergency Medical Technicians examination. The objective of this study was to supplement standard emergency medical technician training with a three-dimensional, computer-based, virtual training simulator and to assess whether scores and pass rates could be increased. ⋯ The findings, however, were used to construct two models of combat medic characteristics that can be used to assist in initial selection for emergency medical technician courses and subsequent counseling of soldiers on course completion. With further research, these models could be refined for Army-wide use to increase the cost-effectiveness of combat medic recruitment, training, and testing.
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To provide a physiological assessment of the U.S. Army one-handed tourniquet (OHT). ⋯ The OHT appears to effectively minimize blood flow in the arm but not in the lower extremities, and clinical assessment of blood flow disappearance by Doppler ultrasonography may underestimate the magnitude of actual blood flow to the limb.
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The objectives of this study were to describe the military experiences of Native American veterans and to explore how factors related to veteran identity influence their use of health services. Study participants completed a demographic and health questionnaire, followed by participation in a focus group session. The findings revealed that, despite their negative experiences during military service, most participants had a positive veteran identity. ⋯ Almost one-third (28.2%) used the Indian Health Service (IHS) exclusively for their health care, followed by those who used both IHS and Veterans Affairs (VA) services (23.5%), followed by VA-only users (21.2%). We conclude that Native American veterans highly identify with their military service but may turn to IHS for their medical care. The data support the current VA policy of strengthening coordination with the IHS to ensure that the medical needs of Native American veterans are addressed.
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On the battlefield, a properly applied tourniquet can be an extremely effective means of controlling severe extremity wound hemorrhage. However, a great deal of confusion exists among soldiers, medics, and military medical officers on a number of tourniquet-related issues. ⋯ Pete Beach, Florida. Here we review those issues and present a summary of the panel's recommendations.
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Because of the high prevalence of post-traumatic stress disorder (PTSD) among veteran men and the limited research on victimization in this group, we recruited 133 male veterans with combat-related PTSD from a psychiatric inpatient unit and assessed them for lifetime physical and sexual trauma. Results indicated that 96% of the sample had experienced some form of victimization over their lifetimes; 60% reported childhood physical abuse, 41% childhood sexual abuse, 93% adulthood physical assault, and 20% adulthood sexual assault. ⋯ These findings support the need for routine inquiry into the histories of noncombat victimization in this cohort. Determining the lifetime history of trauma exposure may have implications for vulnerability to subsequent development of PTSD and the risk of future violence.