Military Medicine

[MedCorps]

There are some good articles in the Sept volume of Military Medicine.  Take a look if you have the chance.

Acanthamoeba Keratitis in a U.S. Army Soldier after Unauthorized Use of Contact Lenses in the Combat Theater

Bacteria Recovered from Patients Admitted to a Deployed U.S. Military Hospital in Baghdad, Iraq

Bacteriology of War Wounds at the Time of Injury

High Prevalence of Iron Deficiency and Anemia in Female Military Recruits

Humanitarian Assistance in Afghanistan: A Prospective Evaluation of Clinical Effectiveness

Job Stress, Depression, Work Performance, and Perceptions of Supervisors in Military Personnel

Noninvasive Hemodynamic Monitoring for Combat Casualties

Pelvic Pain Presenting in a Combat Environment

Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency in U.S. Army Personnel

Preventive Medicine in Task Force 1st Armored Division During Operation Iraqi Freedom

and lots of other neat stuff also...

Cheers,

MC

 

[GINge!]

This sounds like a good journal to have in the unit library. Does your unit have a subscription to it?

 

[MedCorps]

We have access via ProQuest.  Military Medicine is well worth having in my humble opinion, espcially if you are a bigger unit.  CFMGHQ has it is in the library also, and CFMSS might also. 

For a hard copy it works out to $165 USD / year. 

Here is a link for more information: http://www.amsus.org/journal/

Cheers,

MC

 

[Blackadder1916]

Members of the Association of Military Surgeons of the United States (AMSUS) receive Military Medicine  by mail as one of the benefits of their membership.  Officers of the military medical services of other nations are eligible to join.  The current regular dues are $145 USD for three years or $50 USD annually .

 

[MedCorps]

Good stuff in this month (Oct) Military Medicine also:

Canadian Forces Evaluation of the EPINATO Health Surveillance System in Bosnia-Herzegovina, from our own Ms. Wilson, Dr.  Carew, and Ms. Strauss at CFHSHQ / Force Health Protection. 

Sexually Transmitted Diseases in Operation Iraqi Freedom/Operation Enduring Freedom

The Military Physician as a Noncombatant: The Concept of Over Identification

Usefulness of Temazepam and Zaleplon to Induce Afternoon Sleep  (for forced rest pre night mission)

Lessons Learned from Indonesia: An Outline - Post Tsunami

Medical Support to Sri Lanka in the Wake of Tsunamis: Planning Considerations and Lessons Learned

Rapid Assessment of Health Needs and Medical Response after the Tsunami in Thailand, 2004-2005

And lots of other good stuff.

Cheers,

MC

 

[GINge!]

excellent - appears I can access this through DWAN free of change via ingentaconnect.

 

[RatCatcher]

Link???

Alot of good PMed Info for units without PMed (mainly in the MO)

 

[MedCorps]

I do not have a link, as the ProQuest search engine requires a password.  GINge! might have a DWAN link to the source he has found free of change via ingentaconnect.

I cannot post the articles here due to copyright issues.  But, if you want to PM me to talk about <hint hint> the concepts, or the state of science behind of one or two of the articles please feel free to drop me a line  . 

Cheers,

MC

 

[GINge!]

enjoy - it may only work through DWAN though

http://www.ingentaconnect.com/content/amsus/zmm

 

[MedCorps]

In this edition of Military Medicine... (June) that might be of interest...

A Decade after the Tokyo Sarin Attack: A Review of Neurological Follow-Up of the Victims

Comparative Sporicidal Effects of Disinfectants after Release of a Biological Agent

Effects of Heavy Load Carriage during Constant-Speed, Simulated, Road Marching

How Satisfied Are Soldiers with Their Ballistic Helmets? A Comparison of Soldiers' Opinions about the Advanced Combat Helmet and the Personal Armor System for Ground Troops Helmet

Meralgia Paresthetica Due to Body Armor Wear in U.S. Soldiers Serving in Iraq: A Case Report and Review of the Literature

Nonconventional Uses of the Rocket-Propelled Grenade and Its Consequences

Metabolic Effects of Soldier Performance on a Simulated Graded Road March while Wearing Two Functionally Equivalent Military Ensembles

Psychological Guidelines for a Medical Team Debriefing after a Stressful Event

Enjoy,

MC

 

[MedCorps]

Finally had a chance to read July... here is a list of the "good stuff" IMHO.  Let me know if you have questions. 

Application of the Mangled Extremity Severity Score in a Combat Setting

Blast Injury of the Ear: Clinical Update from the Global War on Terror

Developing an Effective Medication Soldier Readiness Process

Effects of Gender and Body Adiposity on Physiological Responses to Physical Work While Wearing Body Armor

Diagnosing Cutaneous Leishmaniasis: The Advantage of Forward Deployed Histology in Avoiding a Surgical Pitfall

Expeditionary Medicine in Africa: The French Experience

Psychiatric Medications for Deployment: An Update

Enjoy,

MC

 

[MedCorps]

It was a little bit of a "thin" month for Military Medicine, but the highlights of the Aug issue of Military Medicine include:

Comparison of M-16A2 and M-4 Wounding Potential  (M-16A2 had more tissue disruption)

Drowning Deaths of U.S. Service Personnel Associated with Motor Vehicle Accidents Occurring in Operation Iraqi Freedom and Operation Enduring Freedom, 2003-2005  (the US has had 71 of them)

Evaluation of a Combat Medic Skills Validation Test

Physiological Effects of Night Vision Goggle Counterweights on Neck Musculature of Military Helicopter Pilots

The Lessons Learned from the Canadian Forces Physiotherapy Experience during the Peacekeeping Operations in Bosnia

The Readiness Estimate and Deployability Index and Psychometric Properties in Army Reserve Nurses and Medics

Enjoy,

MC

 

[MedCorps]

Once again the September issue was a little thin.  In fact you can read all the interesting stuff in about 10 minutes.  Let me know if anyone sees anything of interest.

Dehydration in Extreme Temperatures While Conducting Stability and Support Operations in a Combat Zone

Mobile Chemical Detector (AP2C+SP4E) as an Aid for Medical Decision Making in the Battlefield

Cheers,

MC

 

[MedCorps]

Hello all...

I don't think they came out with an Oct. issue of Military Medicine (or it did not make it to my desk).  Nonetheless the Nov. supplement makes up for it. 

The Supplement is called Tactical Combat Casualty Care 2007: Evolving concepts an battlefield experience by Capt Bulter, USN (Ret) and crew.  It covers the development of TCCC, a review of the 1996, 2003, and 2006 guidelines, updated information and recommendations on metrics, phases of care, tourniquets, hemostatic agents, NPA, surgical airways, tension pneumothorax, IV/IO access, fluid resuscitation, blood products, oxygen, patient monitoring, hypothermia, battlefield analgesia, and battlefield antibiotics. There is also a section on combining good medicine with good tactics, current challenges and future issues.

Overall a fine piece of reading for all involved in the craft, with a solid set of references.  I highly recommend finding a copy of this and reading the 19-pages of goodness. 

The rest of Military Medicine this month...  meh... it is ok.  Some of the worth-while reads in IMHO are:

Fatal Road Accidents among Finnish Military Conscripts: Fatigue-Impaired Driving
Giving Care in Iraq
Hepatitis E Virus Infection in Thai Troops Deployed with U.N. Peacekeeping Force
Wartime Burn Care in Iraq: 28th Combat Support Hospital, 2003

Cheers,

MC

 

[vincent.escanlar]

There was an October edition (online, at least), it looked like this:

Volume 172, Number 10, October 2007

Postdeployment Health Reassessment - A Sustainable Method for Brigade Combat Teams

Deaths Attributed to Suicide among Enlisted U.S. Armed Forces Recruits, 1980-2004

Evaluation of Data Obtained from Military Disability Medical Administrative Databases for Service Members with Schizophrenia or Bipolar Disorder

Does Compensation Status Influence Treatment Participation and Course of Recovery from Post-Traumatic Stress Disorder?

A Comparison of Experiences of Training Emergency Care in Military Exercises and Competences among Conscript Nurses with Different Levels of Education

Too Little Time to Teach? Medical Student Education and the Resident Work-Hour Restriction

Factors Associated with Health Care Professionals' Choice of Written Asthma Management Plans

Auditing and Benchmarking of Azithromycin Utilization in Primary Care Military Clinics

Gaining Experience with Military Medical Situational Awareness and Geographic Information Systems in a Simulated Influenza Epidemic

Premilitary Tobacco Use by Male Marine Corps Recruits

A Study of Cancer in the Military Beneficiary Population

Colonoscopy by a Family Physician: A Case Series Demonstrating Health Care Savings

Influenza Vaccine Refusal in Israeli Young Adults

War-Associated Cases of Typhoid Fever Imported to Split-Dalmatia County (Croatia)

Self-Reported Incidence of Snake, Spider, and Scorpion Encounters among Deployed U.S. Military in Iraq and Afghanistan

Outbreak of Query Fever among Argentinean Special Police Unit Officers during a United Nations Mission in Prizren, South Kosovo

Successful Treatment of a Septic Aneurysm Due to Salmonella enteritidis Complicated by the Rupture of the Pelvis of the Kidney

Severe Lung Contusion and Death after High-Velocity Behind-Armor Blunt Trauma: Relation to Protection Level

Prevention of Vaccinia Infection in a Laboratory Worker

Use of Surgisis for Abdominal Wall Reconstruction/Closure in Battlefield Casualties during Operation Iraqi Freedom

The Use of Rigid Sternal Fixation for Complex Poststernotomy Wounds and a Military-Unique Fracture at an Army Medical Center

Traumatic Arteriovenous Fistula Due to an Old Gunshot Injury - A Victim from the Afghanistan War

Unfortunately my university account only lets you access after they're 3mo old.  That supplement you mentioned with the guidelines sounds like a good read though, looking forward to it.

Speaking of trauma guidelines:  does anyone have a good clinical practice guidelines/protocols guide to share/recommend?  Especially if you're away from a tertiary care centre.  I'm using the Vancouver Coastal Health (2005) one which is great, but very dependent on having specialist referral (eg ENT, Neurosurg) and CT on-site.  (Eg the Blunt Neck Vascular Injury algorithm:  blunt force trauma -> (head injury c/ GCS <13, LeFort #, basal skull #, C-spine body #, major thoracic injury) -> CTA C-spine -> neurosurg +/- vascular consult.  But where I am I can't even get past the first box!)

 

[RatCatcher]

There is a good article in regards to Malaria prophylaxis in the Dec issue, written by the CF Entomolgist. I got the article sent to me... don't know if it is on line.

 

[MedCorps]

For some reason I did not get a Dec issue... I suspect it is because Dec is normally the Winter AMSUS Newsletter... Nov was volume 172, issue 11 and Jan was volume 173, issue 1...  The article you have form the CF Ento might be a pre-release copy.  I have found from the time I submit something for publication to the time it gets published is about 6 months (or a little longer). 

In this issue, was dental heavy.  Lots and lots of stuff on military dental issues.  One article of note from the Major Groves of the CFDS (he is/was the Director Dental Svcs Pol & Programs) was on Dental Fitness Classification in the Canadian Forces. Nice to see a CFHS'er publish in such a well respected international journal.

One other short read of general interest was: The Impact of Retained Third Molars on the Deployed Airman.  It turns out 22% of all deployed dental problems in this study were from people who still had "wisdom" teeth.

We will see what is next month...

Enjoy,

MC

 

[RatCatcher]

Malaria Risk Assessment and Preventive Recommendations - A New Approach for the Canadian Military
pp. 1250-1253(4)
Authors: Schofield, Steve; Tepper, Martin; Tuck, Jeremy J. H.

It's in the 12 Dec Issue...

 

[Blackadder1916]

For some reason I did not get a Dec issue... I suspect it is because Dec is normally the Winter AMSUS Newsletter... Nov was volume 172, issue 11 and Jan was volume 173, issue 1...  The article you have form the CF Ento might be a pre-release copy.  I have found from the time I submit something for publication to the time it gets published is about 6 months (or a little longer). 

AMSUS Journal Abstracts
December 2007, Vol 172, No 12

Three-Step Emergency Cricothyroidotomy
Allan MacIntyre, DO; Mark K. Markarian, MD; Dale Carrison, DO; Jay Coates, DO; Deborah Kuhls, MD; John J. Fildes, MD

Objective: Surgical cricothyroidotomy is the airway of choice in combat. It is too dangerous for combat medics to perform orotracheal intubation, because of the time needed to complete the procedure and the light signature from the intubation equipment, which provides an easy target for the enemy. The purpose of this article was to provide a modified approach for obtaining a surgical airway in complete darkness, with night-vision goggles. Methods: At our desert surgical skills training location at Nellis Air Force Base (Las Vegas, Nevada), Air Force para-rescue personnel received training in this technique using human cadavers. This training was provided during the fall and winter months of 2003-2006. Results: Through trial and error, we developed a "quick and easy" method of obtaining a surgical airway in complete darkness, using three steps. The steps involve the traditional skin and cricothyroid membrane incisions but add the use of an elastic bougie as a guide for endotracheal tube placement. We have discovered that the bougie not only provides an excellent guide for tube placement but also eliminates the use of additional equipment, such as tracheal hooks or dilators. Furthermore, the bevel of the endotracheal tube displaces the cricothyroid membrane laterally, which allows placement of larger tubes and yields a better tracheal seal. Conclusions: Combat medics can perform the three-step surgical cricothyroidotomy quickly and efficiently in complete darkness. An elastic bougie is required to place a larger endotracheal tube. No additional surgical equipment is needed.

Malaria Risk Assessment and Preventive Recommendations: A New Approach for the Canadian Military
Steve Schofield, PhD; Martin Tepper, MD; Col Jeremy J. H. Tuck, L/RAMC

Western militaries deploying to international locations are often confronted with the threat of malaria. For the Canadian military, the consequent response has been prescriptive- any risk of malaria warrants use of personal protective measures and chemoprophylaxis. In reality, however, malaria risk is highly variable and a one-size-fits-all strategy to mitigation may not be appropriate. In line with this, the Canadian military has revised its approach to malaria risk assessment and preventive response. More effort is now spent on predictive modeling and, where risk is deemed to be low, chemoprophylaxis may not be recommended. We describe here an application of the revised methodology to the recent Canadian military deployment to Kandahar province, Afghanistan.

 

[MedCorps]

Hmm... not sure why I did not get it.  Thanks for letting me know what I missed.  Need to make a phone call.

I spoke with Steve Schofield about the article, a very good piece of work... we are very lucky to have him working for the CFHS. 

Cheers,

MC