U.S. Army Medical Department journal
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Emergency airway management is a critical skill for military healthcare providers. Our goal was to describe the Emergency Department (ED) intubations at Brooke Army Medical Center (BAMC) over a 12-month period.
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The active battlefield is an environment of chaos and confusion. Depending on the scale of combat, the chaos and confusion often extend into the prehospital combat setting with multiple personnel and units involved in the chain of care of casualties. ⋯ The Department of Defense (DoD) Joint Trauma System (JTS) Prehospital Trauma Registry (PHTR) was developed in conjunction with the updated Tactical Combat Casualty Care (TCCC) card and a TCCC after action report (AAR), and currently serves as the prehospital repository and module of the DoD Trauma Registry (DoDTR). We conducted a descriptive analysis of data from the DoDTR PHTR.
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Randomized Controlled Trial
A randomized comparison between neurostimulation and ultrasound-guided lateral femoral cutaneous nerve block.
This prospective, randomized trial compared neurostimulation (NS) and ultrasound (US) guided lateral femoral cutaneous nerve (LFCN) block. We hypothesized that US would result in a shorter total anesthesia-related time (sum of performance and onset times). ⋯ Ultrasound guidance and NS provide similar success rates and total anesthesia-related times for LFCN block. The territory of the LFCN displays wide inter- and intra-individual variability.
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To determine whether mandatory psychiatric admission laboratory tests yield results that change the disposition of a patient with primary psychiatric complaint from admission to a psychiatric service to admission to a medical service. ⋯ Patients presenting to the emergency department with a psychiatric chief complaint and no physical complaints, abnormal vital signs, or abnormal physical exam findings have less than 1% probability that an abnormal laboratory study will change their disposition from a psychiatric admission to a medical admission.
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Military deployment to Southwest Asia since 2003 in support of Operations Enduring Freedom/Iraqi Freedom/New Dawn has presented unique challenges from a pulmonary perspective. Various airborne hazards in the deployed environment include suspended geologic dusts, burn pit smoke, vehicle exhaust emissions, industrial air pollution, and isolated exposure incidents. These exposures may give rise to both acute respiratory symptoms and in some instances development of chronic lung disease. ⋯ The role of smoking and related disorders has yet to be defined. This article presents the current evidence for deployment-related respiratory symptoms and ongoing Department of Defense studies. Further, it also provides general recommendations for evaluating pulmonary health in the deployed military population.