Beyond HOSPEX: what is the additional training value of military hospital exercises (HOSPEX)?

BACKGROUND: The use of simulation in clinical environments is a frequently used adjunct to training individuals and teams. The military uses clinical simulation to train large numbers of personnel, standardise patient pathways and sustain specific skills to ensure medical personnel are prepared to deploy in their clinical roles. METHODS: As part of a North Atlantic Treaty Organization (NATO) exercise, 256 Field Hospital (Reserves) deployed a team of clinicians to simulate a role 2 basic field hospital. This hospital exercise (HOSPEX) involved training, and a 4-day real-time exercise with casualty simulation. A retrospective survey of all clinical personnel was conducted to analyse the utility of the exercise on their understanding of their job role, the workings of the field hospital and their confidence in deploying on operations. RESULTS: 39 personnel were surveyed, with questions graded on a modified Likert scale. 41% had previous operational experience in their current job role. A significantly higher proportion of respondents graded their understanding of their job role, and the field hospital overall, as good or excellent having completed the exercise (p<0.01), and 90% felt more confident in fulfilling their operational role postexercise. 90% of respondents had previous experience of simulation, and 94% of these rated the military simulation as being more beneficial than civilian equivalents. DISCUSSION: With a shift towards simulation in medical training, opportunities have arisen within HOSPEX to develop additional skills for teams and individuals. Simulation is especially important in personnel who have not had previous operational experience, who may deploy on first time operations in senior clinical and leadership roles. CONCLUSION: HOSPEXs are perceived as being extremely useful by clinical personnel preparing for future operational deployment. HOSPEX simulation has prepared the military for varied operations since its inception, and the paradigm has potential for extension into civilian training for high intensity medical responses.

Exploiting Fluorescence Lifetime Plasticity in FLIM: Target Molecule Localization in Cells and Tissues.

The mechanisms of drug-receptor interactions and the controlled delivery of drugs via biodegradable and biocompatible nanoparticulate carriers are active research fields in nanomedicine. Many clinically used drugs target G-protein coupled receptors (GPCRs) due to the fact that signaling via GPCRs is crucial in physiological and pathological processes and thus central for the function of biological systems. In this letter, a fast and reliable ratiometric fluorescence lifetime imaging microscopy (rmFLIM) approach is described to analyze the distribution of protein-ligand complexes in the cellular context. Binding of the fluorescently labeled antagonist naloxone to the G-protein coupled µ-opioid receptor is used as an example. To show the broad applicability of the rmFLIM method, we extended this approach to investigate the distribution of polymer-based nanocarriers in histological liver sections.

The reconnaissance and siting of field hospitals.

This paper describes the reconnaissance function for the siting of deployable field hospitals. It reports two levels of reconnaissance, theatre/operational and tactical. The paper describes the factors to be considered when conducting the reconnaissance and the format of the reconnaissance report.

Improving the reproducibility of acoustic rhinometry: a customized stand giving control of height and angle.

Control and recording of the position of the acoustic rhinometer in relation to the nostrils is important for serial measurements. Several technical factors must be controlled, including the angle of the incident acoustic wave. We describe a simple, newly-designed, rhinometer stand which allows control of height and angle, and hence improves the reliability of serial measurements in clinical and physiological work.