Army Emergency Medicine: Advancing the Vison for Army Medicine.

The US Army Medical Department (AMEDD) is facing unprecedented changes brought on by legislative directives and a renewed emphasis on operational readiness. This article explores the impact of the Medical Corps (MC) survey results, media attention on military trauma readiness, and congressional mandates on military medicine. It highlights the work of emergency medicine (EM) physicians across the Army and the impact of the EM community on helping shape the future of Army medicine. Emergency Physicians at the Medical Center of Excellence are leveraging medical simulation to reduce a reliance on real-life experience, leading the development of new and increased opportunity for simulated operational medical training in order to meet the demands of deploying units. EM leadership at the Program Executive Officer for Simulation, Training and Instrumentation (PEO STRI) is helping ensure medical simulation capabilities developed meet the needs of the medical end user. The AMEDD Military-Civilian Trauma Team Training (AMCT3) partnerships developed as a line of effort under the Army Medical Skills Sustainment Program (AMSSP) are developing partnership to place military trauma teams in Level 1 civilian trauma centers to optimize real-world training. And EM physicians are serving as key leaders in the Army Ready Surgical Force Task Force tackling issues like central management of critical wartime specialties and legislative changes to lift caps on military physician bonuses to improve salary parity with the civilian sector.

Comparison of medical visits by active duty and National Guard soldiers at a forward deployed medical facility in Iraq.

STUDY OBJECTIVE: To compare differences in disease nonbattle injury data between cohorts of deployed active duty (AD) and National Guard (NG) soldiers. METHODS: This study compared AD and NG soldiers presenting for medical visits to a level I clinic in Iraq. Retrospective data were collected from the Department of Defense (DOD) electronic records system, on soldiers in two AD and two NG companies with populations of 391 and 425, respectively, regarding number of visits, age, gender, diagnosis, and evacuation for laboratory tests or X-rays (level II care) or for hospitalization or subspecialty services (level III care). Visits occurred during the 11-month period of October 1, 2006 through August 30, 2007. RESULTS: In the AD group, 180 of 391 (46%) soldiers presented for 594 visits (1.5 visits per soldier). In the NG units, 300 of 425 (71%) soldiers made 1,294 visits (3.1 visits per soldier). There were 67 AD evacuations, 54 sent for level II care and 13 for level III care as compared to 151 NG evacuations, 116 to level II and 35 to level III. The leading diagnoses for visits in both groups were musculoskeletal and dermatologic and the leading cause for evacuation was genitourinary. Gender utilization rates were 3.4 and 7.4 visits per AD and NG female compared to 1.2 and 2.8 visit per group matched male. CONCLUSION: NG soldiers presented for care and required evacuation twice as frequently as AD soldiers. NG patients were typically older. Female soldiers in both groups had higher utilization and evacuation rates than males.