Military medicine
-
Case Reports
Intracranial insertion of a nasopharyngeal airway in a patient with craniofacial trauma.
Intracranial insertion of a nasopharyngeal airway is an unusual and catastrophic complication of airway management in the patient with a severe closed head injury. We present an unfortunate 43-year-old patient with intracranial insertion of a nasopharyngeal airway during trauma resuscitation. The nasopharyngeal airway was removed. ⋯ Oropharyngeal airways may be used to assist with ventilation. However, it is preferable to definitively secure the airway through inline endotracheal intubation or with surgical techniques in this patient population. Should violation of the skull base occur, removal is accomplished in the controlled environment of the operating room.
-
The Department of Defense (DoD) has engaged in West Nile virus (WNV) surveillance and response since 1999. In 2002, the three Services continued their cooperative, multidisciplinary approach to the WNV outbreak. Activities included a doubling of mosquito surveillance and vector control responses, extension of and doubling of bird and nonhuman mammal surveillance to all four continental United States regions, expanded diagnostic testing by DoD laboratories, and installation environmental clean up and personnel protection campaigns. ⋯ The surveillance detected WNV on 44 DoD installations. It led directly to vector control and prevention activities, and there were no confirmed cases of WNV reported in the DoD force. This multi-Service effort is a surveillance template for future outbreaks that threaten DoD force health.
-
Advances in medical technology provide the modern day field anesthetist with the extra edge to meet the challenges faced in the harsh environment of the battlefield and enhance the survivability of casualties. The tasks of triage, resuscitation, and administration of anesthesia can be facilitated with the use of new airway devices, portable ventilators, and monitoring devices. Before such equipment is used in the field, the anesthetist must carefully weigh the advantages and disadvantages and must be cognizant of the limitations of individual devices in different environmental settings. These devices should ideally be portable, lightweight, rugged in construction, durable, easy to use (requiring minimal training and supervision), readily replaceable, and cost-effective.
-
We analyzed the causes of deaths among the members of the 4th Guardian Brigade (GB) of the Croatian Army during the war in Croatia from 1991 to 1995: the site of the lethal injuries, the type of wounds, and estimated the severity of injuries with lethal outcome according to the Abbreviated Injury Scale. ⋯ During the war in Croatia, the leading causes of death were mines and explosions, and, in a minor proportion, gunshot wounds.
-
Comparative Study
Evaluation of oral or rectal midazolam as conscious sedation for pediatric patients in oral surgery.
This study was undertaken with a view to determine the acceptance and treatment possibilities of midazolam, depending upon its oral and rectal application for pediatric patients requiring an oral surgery procedure (tooth extraction) and having a pretreatment behavioral score of 1 or 2 according to the Frankl Scale. Oral (0.5 mg/kg) and rectal (0.35 mg/kg) midazolam was compared in view of acceptance of the mode of treatment and local anesthesia, level of amnesia, and adverse effects. Although oral or rectal midazolam application has similar characteristics in respect to ease of working, the oral midazolam application should generally be preferred because it is more easily accepted by pediatric patients.