Journal of the Royal Army Medical Corps
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Trauma is a leading cause of death in children. Life support courses have been developed to reduce the mortality and morbidity of children suffering trauma; differences in anatomy and physiology may produce different injury patterns to adults when children are exposed to trauma, challenging the care providers. ⋯ A significant number of paediatric patients are treated by the deployed pre-hospital team. All military pre-hospital care providers should gain training and experience in the care of the seriously injured child prior to deployment.
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Following the British Government's implementation of policies to improve quality and introduce clinical governance into healthcare delivery in the late 1990s, the British Army commissioned a study into how primary healthcare for the Regular Army should best be delivered in UK. The study recommended a unitary command structure, with more central control based upon a model of a main headquarters and seven regions. ⋯ Areas still to be developed include improving information management and benchmarking standards against the NHS, improvements in practice management, plus developments in occupational health and the nursing cadres. The forthcoming Strategic Defence and Security Review and other ongoing studies are likely to have a profound influence on how the current Army Primary Health Care Service develops.
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To determine the number of medical emergency response team (MERT) patients undergoing advanced airway management in the peri-evacuation phase and to determine the indications for airway interventions undertaken in flight. ⋯ The figure of 56 patients requiring advanced airway management is at the higher end of the range expected from the study of historical military data. This may reflect the doctrine of "intelligent tasking", that is sending this physician-led team to the most seriously injured casualties.
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The aim of this review was to assess the workload of theatres in the role 3 Multinational Field Hospital in Kandahar, Afghanistan and to identify what period of day most emergency admissions arrived. During the period 05 August 2006 to 21 December 2006, 288 operations were performed on 259 patients and comprised 393 individually quantifiable procedures. 98% of these operations were to treat acute injuries. ⋯ An analysis of emergency admissions in November 2006 showed that most occurred between 18.00 and midnight. Although theatre timetabling made provision for this, whenever possible, elective surgery was scheduled for the following morning when emergency injury admissions were at their lowest.
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Intra-abdominal hypertension and abdominal compartment syndrome are increasingly recognised as causes of serious morbidity and mortality in critically injured patients, particularly those with significant burns. Identification of at risk patients, routine monitoring of intra-abdominal pressures and appropriate, early treatment may reduce the incidence and complication rate of abdominal compartment syndrome and so improve outcomes in critically injured personnel. We present the case of an American Marine injured in an explosion while on patrol in Afghanistan, who despite the absence of significant intraabdominal injury, went on to develop abdominal compartment syndrome and required decompressive laparotomy.