Military medicine
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Advanced Trauma Life Support (ATLS) is a 2-day course on handling the acutely injured patient. It has been developed by and is directed by the American College of Surgeons, and teaches a systematic approach to the care of the injured patient. ⋯ ATLS does not address the combat casualty, nor the combat scenario. Special courses must be utilized to train military medical providers for the conflicts and casualties of the future.
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United States military medical planning must reevaluate the practices of combat casualty resuscitation, transportation, and triage to secondary echelon care. Analysis of the experiences of other medical commands, such as that of the Israeli Defense Force, offers insight into improvements in equipment and training that are achievable with minimal cost. ⋯ Today in military medicine there exists a major deficiency of expertise in trauma care, arising through a near total lack of involvement in active trauma surgery on the part of military medical training facilities. Civilian trauma centers offer an abundance of opportunity for military-like casualty management, and successful efforts at our command have integrated active duty personnel into this experience.
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In August 1988, a study was conducted to determine the etiology and risk factors associated with travelers' diarrhea among U. S. military personnel after a 5-day port visit to Alexandria, Egypt. Twenty-one percent of the 2,747 evaluated crew members of the USS John F. ⋯ Independent risk factors for the development of diarrhea included: (1) consuming any meal ashore and specifically eating meats, desserts, or a buffet meal; and (2) a recent history of travelers' diarrhea. These data indicate that even brief port visits to developing countries pose a major threat to the health of U. S. shipboard personnel.
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Comparative Study
1993 Federal Nursing Service Award recipient. Use of air-filled pads to reduce risk of intraoperatively acquired pressure ulcers.
This descriptive study utilized a two-phased retrospective review of medical records to investigate the development of pressure ulcers during cardiothoracic or vascular surgery. Using descriptive and chi-square statistics, the charts of 104 patients having surgery on standard table pads were compared with those of 124 patients having similar surgical procedures while positioned on air pads. Eight (8%) of the patients who had surgery without an air pad developed pressure ulcers, while none (0%) of the patients who were positioned on air pads developed pressure ulcers. Six (75%) of the eight patients who developed pressure ulcers were diabetic.