Journal of the Royal Army Medical Corps
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The medical facility at Camp Bastion continues to evolve as a consequence of the increased throughput of battlefield trauma patients. There is a requirement for rapid and accurate diagnosis of haemodynamic instability and continued haemodynamic monitoring throughout the peri-operative period. ⋯ The old proverb: 'There are none so blind as those who cannot see' (Jeremiah 5:21) is applicable to this topic, in that TOE is proven to be a rapid, portable, safe and effective tool in the assessment of the haemodynamically unstable patient. This paper explores the application of TOE for the assessment of the major causes of haemodynamic instability in the trauma population.
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This paper describes the author's experience of the paediatric patient load on the U. K. medical services in Afghanistan. ⋯ Some of the issues of paediatric anaesthesia in this environment are discussed including paediatric equipment, resuscitation for paediatric massive haemorrhage and regional anaesthesia. The need to formally recognise the problem in training and equipping deployed medical personnel to deal with this challenge is examined.