Military medicine
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Comparative Study Clinical Trial Controlled Clinical Trial
Modified closed circuit underwater breathing apparatus LAR VII and laryngeal mask airway as adjuncts for dive buddy artificial ventilation.
This study evaluated the feasibility of using the modified semi-closed circuit underwater rebreathing system (URS) LAR VII in connection with a laryngeal mask airway (LMA) as an expedient ventilatory adjunct in an operational setting. Fourteen combat swimmers, unfamiliar with this equipment, underwent cardiopulmonary resuscitation (CPR) mannequin training using these devices. Eighteen subjects, using a standard AMBU bag for ventilation, served as controls. ⋯ After proper training, divers might use a modified URS such as the LAR VII for CPR in connection with a LMA. Lower tidal volumes might prevent gastric inflation. Chest compression should be continued during LMA insertion.
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Comparative Study
Mass casualty triage knowledge of military medical personnel.
During battlefield and mass casualty incidents, triage has been traditionally performed by many different personnel, including medics, nurses, dentists, and physicians. The objective of this study was to determine which military medical providers are most knowledgeable in mass casualty triage. The design was a prospective, written, timed, case-based examination of triage knowledge. ⋯ Statistically significant differences were noted between the highest and lowest scoring groups in each scenario. Our conclusion is that among the subject groups tested, physicians were best at mass casualty triage. Dentists, nurses, and medics scored progressively less well on our examination.
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The purpose of this study was to review whether air ambulance transportation of trauma patients to the Brooke Army Medical Center (BAMC) level I trauma center contributed to maintaining national mortality standards in the trauma care of these patients. Aeromedical transportation is considered a standard-of-care component of regional trauma systems throughout the United States. Pooled trauma database information from 792 consecutive ambulance-transported trauma patients received at BAMC during the fiscal year from October 1, 1995, to September 30, 1996, were reviewed. ⋯ The mortality rates (immediate, early, and late deaths) of both ambulance groups were compared with national mortality standards using the internationally recognized Trauma and Injury Severity Score methodology, based on the Major Trauma Outcome Study in 1986 and validated in 1992. The Z test for independent populations demonstrated no statistically significant difference between BAMC trauma mortality rates for either ambulance group compared with national trauma mortality rates. The results suggest that aeromedical evacuation of the more severely injured patients farthest from the BAMC trauma center resulted in mortality rates that met national standards.
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The purpose of the current investigation was to determine the prospective predictors of discharge in a population of individuals entering U. S. Air Force Basic Military Training (BMT). ⋯ Results suggest that women and ethnic minorities are not biased in favor of discharge and that both lifestyle and psychosocial variables are consistent predictors of discharge. Future research could potentially yield other significant predictors of success versus discharge in the U. S. military.