Current surgery
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Far forward life-saving surgical care is the mission of an army forward surgical team (FST). Trauma skill maintenance is necessary to complete that mission. A new program has been developed for FST training using the resources of a Level 1 trauma center. ⋯ CONCLUSIONS:The volume of trauma surgical cases at MAMC during 1999 was 3 times that seen in the 1-month rotation at Ben Taub. General surgeons performed more trauma and abdominal surgery at MAMC with significantly more direct involvement in patient care and operative procedures. The experience of the 250th FST does not justify trauma sustainment deployments for surgeons from military trauma centers.
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PURPOSE:Patients admitted with the diagnosis of gastrointestinal bleeding at our institution typically undergo diagnostic/therapeutic endoscopy. Surgery is consulted and operative intervention considered when the patient has reached a 6-unit transfusion requirement for resuscitation. The purpose of this study is to examine the association between number of units transfused and clinical outcome in patients admitted for gastrointestinal hemorrhage. ⋯ Seven deaths (20%) occurred among the 35 patients, 3 of whom had received more than 6 units of blood. Patients admitted with gastrointestinal hemorrhage who require less than 6 units of blood may have a lower chance of dying (15%) than do patients requiring more than 6 units of blood (38%). Emergent surgical intervention, even in high-risk patients, can be safely performed.
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Description of a black widow spider (Latrodectus mactans) envenomation in a term pregnancy. Case report conducted at an Air Force tertiary care hospital of a 27-year-old primigravida at 38 1/7 weeks pregnancy. Latrodectus mactans antivenin can be given to treat symptoms of black widow envenomation. ⋯ If latrodectism is considered to be the underlying origin for these symptoms, appropriate treatment should be administered. In cases of pregnancy, treatment should include L. mactans antivenin if believed to be clinically indicated. There is no current evidence that this antivenin is contraindicated in pregnancy. (Curr Surg 57:346-348)