Military medicine
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Clinical Trial Controlled Clinical Trial
Sevoflurane and the 885A field anesthesia machine: clinical report.
The Ohmeda 885A field anesthesia machine is equipped with a non-agent-specific, universal vaporizer that can be used with most volatile anesthetic agents. On a recent humanitarian medical mission to Honduras, the 885A was used to administer general anesthesia to 26 patients utilizing sevoflurane, a new inhalational anesthetic with a variety of clinical benefits, including less airway irritability, making it ideal for inhalation inductions. ⋯ Calculated anesthetic concentrations were compared with measured concentrations using linear regression analysis and found to have a Pearson product moment of 0.995. We find that the use of sevoflurane in the 885A is an excellent alternative to other inhalational anesthetic agents and may have applications for use during both military conflicts and peacetime missions in remote areas.
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Military family practice residency programs produce a high percentage of graduates who provide maternity care. This study will define the scope of maternity care practice for one military family practice residency program's graduates while they were serving on active duty in the U.S. Navy. ⋯ During the past 25 years, Navy residency-trained family physicians provided a wide range of maternity care services while on active duty and felt that their Navy residency training program had prepared them well to meet this responsibility.
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Comparative Study
Combat trauma life support training versus the original advanced trauma life support course: the impact of enhanced curriculum on final student scores.
Within a military framework, the trauma course student, a young medical officer, is trained to become a trauma team leader and the first provider of medical aid. By adding battlefield medicine-related subjects to the basic Advanced Trauma Life Support (ATLS) course, as well as exercises tailored to the distinctive demands of military medicine, we could develop a special teaching unit: Combat Trauma Life Support (CTLS). The curriculum is basically the complete unchanged ATLS course of the American College of Surgeons enriched with lectures and practicums to fill the gap between the essentially civilian emergency department character of the ATLS course and the military tasks of the medical officer. ⋯ We conclude that the CTLS comprehensive curriculum provides an improved training basis for the complex task of army battlefield trauma care support.
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Field anesthesia can have special considerations because of the possibly primitive conditions. The drawover vaporizer has enjoyed increased interest because of the ability to deliver an anesthetic without electricity or compressed gases. ⋯ We found that the output of the Ohmeda PAC drawover vaporizer delivered between 0.1 and 3.6% (v/v) sevoflurane. Therefore, the drawover vaporizer should be able to deliver a sufficient concentration of sevoflurane for anesthetic maintenance; however, this concentration appears inadequate for routine inhalation induction.
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The purpose of this study was to determine the prevalence of smokeless tobacco use and clinical leukoplakia in a specific military population. Two hundred fourteen soldiers participated in this study. Each participant completed a questionnaire-type survey regarding tobacco use and received an annual-type dental examination that included extra-oral and intra-oral examination of hard and soft tissues and counseling regarding the risks associated with the use of tobacco. ⋯ Leukoplakia was seen in 4 of the current smokeless tobacco users. Difficulty in cessation was experienced by 10 of 32 smokeless tobacco users; 5 continue to use smokeless tobacco. Due to the concentration of users in the 18 to 24 age group, efforts toward detection and reduction of smokeless tobacco use should be focused on junior ranks and younger age groups.