RESUMO
Recent literature on the treatment of gunshot wound (GSW) injuries is based on civilian studies from large urban areas in the United States. These studies have challenged the need to hospitalize patients suffering from minor GSW injuries. Instead, these patients are treated in an outpatient setting. The feasibility of extrapolating similar therapeutic intervention in the military is discussed. Combatants experiencing a single, minor GSW injury may require only oral antibiotic treatment on an outpatient basis. In an operational setting, this type of therapeutic intervention would preclude a costly course of intravenous antibiotic therapy with hospitalization and, more importantly, expedite the return of the combatant to his/her command.
Assuntos
Assistência Ambulatorial , Antibacterianos/uso terapêutico , Ferimentos por Arma de Fogo/tratamento farmacológico , Humanos , MilitaresRESUMO
The impact of a pharmacy officer on patient compliance and blood pressure control on a deployed nuclear-powered aircraft carrier for a 2-week at-sea period was evaluated. Before any counseling by a pharmacy officer, 43 crewmembers on chronic medications anonymously completed a compliance questionnaire. The pharmacy officer then counseled these crewmembers. A follow-up compliance questionnaire was completed 2 weeks later. After counseling, compliance had increased 58% (p < 0.0001) from compliance measured before counseling. The pharmacy officer also initiated therapeutic interventions. Among 26 crewmembers diagnosed as hypertensive, preintervention blood pressure (BP) measurements were obtained. Ten to 14 days after the initial BP measurement, BP was remeasured. After intervention, 31% (p < 0.02) more crewmembers were at BP goal compared with before intervention. A pharmacy officer, working closely with a medical officer, improved patient compliance and blood pressure control. One problem identified was that these warships require computer software that can prospectively identify drug-drug interactions.