Journal of the Royal Army Medical Corps
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Paediatric penetrating chest trauma is common in conflict, but rarely seen in peacetime. We describe the successful hospital management of a five year old female civilian casualty with life threatening penetrating thoracic trauma caused by a fragment from an explosive device.
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Recently published case reports, coupled with a large observational study of 1017 deployed servicemen to Iraq (January 2009), has highlighted the issue and potential concerns regarding the unregulated use of dietary and exercise supplements within the British military. Consequently, an exploratory pilot study was undertaken to assess whether the findings of the previous Iraq study were applicable to current deployed British servicemen in Afghanistan. ⋯ A significant proportion of the British servicemen employed on operations in Afghanistan who were sampled, admitted to current dietary and exercise supplement use whilst on deployment. The results of this small study suggest that their use on operations may be increasing. Smoking rates and caffeine consumption, on deployment, remain high in the British military. A larger detailed study with greater representation among soldiers deployed to forward operating bases would be helpful to fully appreciate the scale of supplement use.
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There remains a significant paediatric workload through the military hospital in Camp Bastion. In this paper the authors review and discuss particular problems with resuscitation, investigation, anaesthetic and surgical issues in dealing with children suffering from ballistic injuries. ⋯ Key questions are answered in separate paragraphs for each specialty. The information described in this paper should assist any deployed physician deal with paediatric casualties particularly if they are unaccustomed to paediatric patients in their normal practice.
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This article represents a consensus view of those TTWG members present in Birmingham and taking into account the views of the other group members via email discussion. We believe it represents clear guidance for the deployed clinician and recommend the use of selective non-operative management when appropriate.