Journal of the Royal Army Medical Corps
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This paper suggests that 1 g tranexamic acid should be incorporated as an intramuscular auto-injector and issued to combat troops for self- or buddy-administration in the event of suffering severe injury. Early administration of tranexamic acid has shown to be beneficial in preventing death from bleeding in trauma patients in both the military and the civilian settings. ⋯ Future conflicts may be characterised by prolonged pre-hospital times and delayed access to advanced medical care. The use of this drug is the next logical step in reducing combat trauma deaths.
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The deployed Intensive Therapy Unit (ITU) in the British military field hospital in Camp Bastion, Afghanistan, admits both adults and children. The purpose of this paper is to review the paediatric workload in the deployed ITU and to describe how the unit copes with the challenge of looking after critically injured and ill children. ⋯ With appropriate support, it is possible to provide intensive care to children in a deployed military ITU.
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Comment
The Role 1 capability review: mitigation and innovation for Op HERRICK 18 and into contingency.
The Role 1 orientated JRAMC of September 2012 was a welcome addition to the body of Role 1 literature. In particular, the Role 1 capability review by Hodgetts and Findlay detailed both current issues and future aspirations for Role 1 provision. This personal view considers issues still prevalent during Op HERRICK 18 namely the provision of primary healthcare by combat medical technicians on operations and the organisational issues that contribute to historical structural and attitudinal obstructions to the employment of combat medical technicians in firm base primary healthcare. It also considers a dynamically updating dashboard capable of displaying risk across the Role 1 network with the implied move to a model of continuous healthcare assurance.
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We report the case of successful management of a transcranial penetrating high-energy transfer injury in a 20-year-old soldier. The bullet traversed both cerebral hemispheres and lacerated the superior sagittal sinus rendering him unconscious. We detail the care received at all stages following injury from 'Buddy Aid' on the battlefield, resuscitation by a forward medical team through to prompt neurosurgery within 2 h of injury. Subsequent aeromedical evacuation and continuing aggressive critical care has allowed the patient to survive with acceptable neurological impairment after what is generally considered an unsurvivable injury.