Ethics surrounding the medical evacuation of catastrophically injured individuals from an operational theatre of war.

Although prolonging life is usually in the best interests of patients, the British Medical Association states that it is not appropriate to prolong life with no regard to its quality. Medical advances both on the battlefield and within the field hospitals have resulted in the unexpected survival of a number of British personnel, and in some cases, soldiers are being repatriated with injuries categorised as 'catastrophic'. This paper considers medical ethics based on the Beauchamp and Childress Four Principles framework with regard to whether catastrophically injured individuals should be repatriated without any prior advanced directive and without evaluation of future quality of life.

The use of a thermal camera and Eulerian enhancement in the examination of pedal pulse and microvascular health.

Early detection of impaired blood flow and microvascular functioning is important to prevent ulceration in diabetic patients. This paper aims to first determine if thermal video in conjunction with Eulerian Video Magnification (EVM) can be used to find the pedal pulse rate, and reveal patterns indicative of the foot's microvascular health. Thermal video was captured of a healthy adult's foot while a Doppler ultrasound captured pedal pulse. Another thermal video was captured of a patient's heels. These videos were subjected to EVM, areas of interest were defined and the mean intensity signal was calculated temporally, within each defined area. The healthy adult signals were compared to Doppler data to determine the signal best representative of pedal pulse. The patient signals were examined for patterns. The mean intensity signals best representing pedal pulse in the healthy adult resulted from areas containing an artery close to the skin. The most significant pattern in the patient data was a large difference in signal amplitude from areas containing the left posterior tibial artery and the right; the left, colder heel had a weaker signal amplitude. These results suggest that thermal video subjected to EVM can reveal the pedal pulse rate by extracting intensity signals from areas in which arteries are close to the skin, and may reveal differences in the microvascular health of the left versus right foot. The ability to detect pedal pulse and differences in microvascular health using an inexpensive and non-intrusive thermal camera would of great value to a podiatric clinic.