Journal of the Royal Army Medical Corps
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The aim of this study was to determine if a set of performance indicators for command and control (C2) primarily developed for civilian use could be applied also to a military training context as well. ⋯ Measurable performance indicators for prehospital command and control were to some extent found to be applicable also to a military environment. Future developments may make it possible for the concept of measuring results using civilian performance indicators to become a quality control tool in a military setting.
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To determine which QOF clinical indicators are applicable for BFG HS primary care. ⋯ This study shows that several but not all QOF clinical indicators are applicable in BFG HS. Therefore QOF cannot be directly transferred to BFH HS and an adapted quality framework is required.
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The nature of trauma care on the modern battlefield is changing quickly. Leading figures in UK field trauma care spoke at a recent meeting of the Haywood Club. The challenge of modern warfare, the evolving evacuation chain and the command and governance of field trauma care were explored.
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The effectiveness of the command and control of medical evacuation by helicopter (MEDEVAC) of casualties sustained in southern Afghanistan each month from 1 May to 31 July 2007 was audited. In this period 762 casualties of all categories were evacuated to International Security Assistance Force (ISAF) field hospital facilities under the direction of Operations and medical staff of NATO Regional Command (South) (RC-S). The criterion for the audit was the time taken from notification in the RC-S Combined Joint Operations Centre (CJOC) until the helicopter landed ("Wheels Down") at the destination field hospital's helicopter landing site. The standard to be met was 90 minutes for all "9-liner" Category A (URGENT) and Category B (URGENT - surgical) cases (in hospital within 2 hours of wounding) allowing for time from injury to first notification in the CJOC, and time from landing to transfer to the Emergency Department (30 minutes together) at the designated destination hospital. Those that did not meet this target were assessed in order to review their outcome and to identify means for improving performance. ⋯ Regular audit of MEDEVAC response should be routine for Medical Operations staff, in order to ensure the optimal casualty care pathway from point of wounding to field hospital.