Installation Management Command's COVID-19 Pandemic Efforts Rely on Multiple Collaborative Partnerships.

The Installation Management Command (IMCOM) delivers quality base support from the strategic support area, enabling readiness for a globally responsive Army. IMCOM has more than 75 installations, covering more than 13 million acres, in 17 time zones, 12 countries and 58 services. In early March 2020, the COVID-19 pandemic required IMCOM to shift focus in ensuring health protection measures were implemented early and quickly, which relied on medical expertise. The IMCOM Surgeon and the Deputy Surgeon serve as the command's key advisors for all matters related to health care and medical readiness. During the COVID-19 pandemic, the IMCOM Surgeon and the Deputy Surgeon were critical in the consolidation of various information from multiple organizations. They promoted the integration of force health protection principles during COVID-19 operations. All of the military members at IMCOM headquarters (HQ) were considered mission essential while other personnel were identified on a phasing structure in the early stages of the pandemic, which meant civilian personnel were instructed to telework.

Prehospital medical documentation in the Joint Theater Trauma Registry: a retrospective study.

BACKGROUND: Prehospital care of combat casualties is a critical phase of emergency medical practice on the battlefield. The Joint Theater Trauma Registry (JTTR) was developed to standardize a system of data collection for combat casualty care; however, the degree of population and granularity of prehospital data were unknown. METHODS: This is a retrospective comparative study of all US military personnel who sustained battle injuries in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). The JTTR was queried for all US military battle casualties from OIF and OEF entered between January 2002 and July 2009 containing any data entered into the prefacility fields. Data were separated based on origination, OIF, or OEF. A comparative analysis was performed. RESULTS: During the period studied, 13,080 (66%) entries into the JTTR were recorded in the category of "Battle Injury" and met study inclusion criteria; 3,187 (24%) battle injury entries contained prehospital data (n = 3,187). The percentage of casualty records containing prehospital data were 18.6% for OEF and 25.4% for OIF (p < 0.01). CONCLUSION: Both poor population of data points and poor granularity of prehospital data entered into the JTTR were observed. It appears that the volume and quality of reporting of role-I data were better for OIF than OEF for this study period. Further investigations into the obstacles to free flow of role-I casualty clinical data, and the means to mitigate this situation, are warranted.

"March fractures" on a female military recruit.

Stress fractures are caused by repetitive low-impact activities. It is important to have a high index of suspicion in diagnosing and treating stress fractures early for remodeling to occur. This is a case report of a 19-year-old female military recruit with stress fractures of the right foot. The patient had an extended non-weight-bearing treatment that eventually had a successful outcome after allowing the fracture to heal by starting the patient on weight-bearing activities and a "walk-to-run" program. Treatment points in managing stress fractures including female-specific issues are also discussed.

Magnetic resonance diagnosis of tarsal tunnel syndrome due to flexor digitorum accessorius longus and peroneocalcaneus internus muscles.

Anomalous muscles of the ankle are common. Although they are often asymptomatic, they can sometimes cause tarsal tunnel syndrome. We report a case of tarsal tunnel syndrome due to flexor digitorum accessorius longus and peroneocalcaneus internus muscles diagnosed on magnetic resonance imaging. Recognition of the most common accessory muscles of the ankle on magnetic resonance imaging and tarsal tunnel syndrome are also reviewed.