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1.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 38(10): 794-796, 2020 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-33142392

RESUMO

Low back pain (LBP) is a common occupational disease among naval officers and soldiers. This article reviewed the incidence of LBP in naval personnel in different positions in recent years, and analyzed the causes combined with the operating environment and occupational characteristics of personnel in different positions in order to clarify the causes of LBP in naval officers and soldiers in different positions and improve their awareness of the disease. Moreover, this study aims to help naval officers and soldiers to take protective measures in training life to reduce the incidence of LBP.


Assuntos
Dor Lombar , Militares , Doenças Profissionais , Humanos , Incidência , Dor Lombar/epidemiologia , Dor Lombar/prevenção & controle , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle
3.
Rev Sci Tech ; 39(2): 513-521, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33046924

RESUMO

Those involved in emergency response and recovery, including the military, require an acute level of awareness of livelihoods that rely on livestock and their associated implications for human security. Emergencies cause injury and death and devastate livestock-based livelihoods, a key characteristic of the lives of many of the world's rural poor. The role for military forces in emergency management is expanding, and this can cause friction during an emergency due to competing agendas and objectives. Opportunities exist to make greater use of the military, such as providing support to livestock-based livelihoods, but there are challenges and barriers that must be overcome. A common framework for civil-military interaction may help to coordinate response efforts and enhance local and international responses to emergencies. The Livestock Emergency Guidelines and Standards and the proposed livelihood security model are constructs that can help to develop a shared understanding of the security environment during a livestock emergency response. Examples from the Philippines' response to Typhoons Sarika and Haima and Sri Lankan military agricultural engagements provide context for a proposed common operational framework.


Assuntos
Militares , Socorro em Desastres , Agricultura , Animais , Emergências/veterinária , Humanos
4.
PLoS One ; 15(10): e0239749, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027278

RESUMO

BACKGROUND: Anxiety could be felt even in objectively peaceful situations, but a vision of conflict could result in increased stress levels. In this article, we aimed to identify hidden patterns of mental conditions and create male profiles to illustrate the different subgroups as well as determinants of anxiety levels among them in accordance with proximity to a possibility of direct exposure to military action. METHODS: A sample of Ukrainian males, in duty as conscripts to military service (n = 392, M±SD = 22.1±5.3) participated in a survey. We used the 36-Item Short Form Health Survey, and State-Trait Anxiety Inventory. In addition to psychological indices, social-demographic data were collected. To discover the number of clusters, the k-means algorithm was used, the optimal number of clusters was found by the elbow algorithm. For validation of the model and its use for further prediction, the random forest machine-learning algorithm, was used. RESULTS: By performing k-means cluster analyses, 3 subgroups were identified. High values of psychological indices dominated in Subgroup 2, while lowest values dominated in Subgroup 3. Subgroup 1 showed a more even distribution among the indices. The strength of the relevance and main determinants of the prediction of the presented model mostly consisted of mental qualities, while socio-demographic data were slightly significant. CONCLUSIONS: There is no clear relevance between proximity or even the experience of military actions and anxiety levels. Other factors, mostly subjective feelings about mental conditions, are crucial determinants of feeling anxiety.


Assuntos
Transtornos de Ansiedade/psicologia , Ansiedade/psicologia , Militares/psicologia , Adulto , Alcaloides de Berberina , Depressão/psicologia , Humanos , Aprendizado de Máquina , Masculino , Saúde Mental , Fenantridinas , Adulto Jovem
5.
Can J Surg ; 63(5): E409-E411, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009895

RESUMO

SUMMARY: There is currently no consensus on the appropriate sports and occupational restrictions for military service members with a joint replacement. Data from the United States show that 14% of military patients complete an operational deployment after the index surgery. No published data are available on arthroplasty in the militaries of other North Atlantic Treaty Organization countries. Research is needed to determine the appropriate medical employment limitations for Canadian Armed Forces members with a knee or hip replacement. Service members wanting to continue military service should be carefully screened to ensure that their duties do not compromise the longevity of the implant and that the risk of mission-threatening complications is minimal.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Medicina Militar/normas , Militares/estatística & dados numéricos , Falha de Prótese , Canadá , Consenso , Teste de Esforço/normas , Humanos , Medicina Militar/estatística & dados numéricos , Aptidão Física , Guias de Prática Clínica como Assunto , Estados Unidos , Avaliação da Capacidade de Trabalho
6.
Artigo em Inglês | MEDLINE | ID: mdl-33114116

RESUMO

The pandemic caused by the SARS-CoV-2 coronavirus, which produces COVID-19 disease, has revealed to political and social circles a series of needs that have not yet been met. The workers of the State Security Forces and the Armed Forces have done an extraordinary job to try to alleviate the effects that the pandemic has had on the population and to return stability to the citizenry as much as possible. In this context, the following investigation is developed based on two objectives: (PO1) to know the level of anxiety in the face of death in these professionals; (PO2) to determine the predictive variables in the above-mentioned phenomenon. Professionals from all over Spain have participated in the study (n = 2079). From a quantitative perspective, a questionnaire was developed from the Collet-Lester death anxiety scale. The results show a total level of 69.2% in the scale, as well as some higher levels about the fear of death of others (82.1%) and the fear of the process of dying of others (78.2%). On the other hand, from the binary logistic regressions, four variables are evidenced that condition the risk of suffering death anxiety: (a) certainty of needing psychological treatment in the future; (b) absence of Individual Protection Equipment (PPE); (c) high levels of Emotional Exhaustion; (d) high levels of depersonalization-these last two come from the Maslach and Jackson Burnout scale. These data show a need for training and intervention in the emotional and psychological demands of the professionals of the Armed Forces and State Security Forces, as well as the obligation to develop a continuous dialogue with the institutions they represent to foster the feeling of belonging to them. It is essential, regardless of the serious consequences that the virus has caused, to understand the psychosocial and emotional demands of enforcement agents and to improve their occupational health.


Assuntos
Ansiedade , Esgotamento Profissional , Infecções por Coronavirus , Morte , Militares , Pandemias , Pneumonia Viral , Ansiedade/epidemiologia , Betacoronavirus , Esgotamento Profissional/epidemiologia , Humanos , Militares/psicologia , Espanha/epidemiologia
7.
Medicine (Baltimore) ; 99(42): e22836, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080764

RESUMO

The performance of electrocardiographic (ECG) voltage criteria to identify left and right ventricular hypertrophy (LVH and RVH) in young Asian female adults have not been clarified so far.In a sample of 255 military young female adults, aged 25.2 years on average, echocardiographic LVH was respectively defined as the left ventricular mass (LVM) indexed by body surface area (BSA) (≥88 g/m) and by height (≥41 g/m), and RVH was defined as anterior right ventricular wall thickness >5.2 mm. The performance of ECG voltage criteria for the echocardiographic LVH and RVH were assessed by area under curve (AUC) of receiver operating characteristic (ROC) curve to estimate sensitivity and specificity.For the Sokolow-Lyon (the maximum of SV1 or SV2 + RV5 or RV6) and Cornell (RaVL + SV3) voltage criteria with the LVM/BSA ≥88 g/m, the AUC of ROC curves were 0.66 (95% confidence intervals [CI]: 0.52-0.81, P = .039) and 0.61 (95% CI: 0.44-0.77, P = .18), respectively. For these 2 ECG voltage criteria with the LVM/height ≥41 g/m, the AUC of ROC curves were 0.64 (95% CI: 0.52-0.75, P = 0.11) and 0.73 (95% CI: 0.61-0.85, P = 0.0074), respectively. The best cut-off points selected for the Sokolow-Lyon and Cornell voltage criteria with echocardiographic LVH in young Asian females were 26 mm and 6 mm, respectively. In contrast, all the AUC of ROC curves were less than 0.60 and not significant according to the Sokolow-Lyon (the maximum of RV1 + SV5 or V6) and Myers' voltage criteria (eg, the voltage of R wave in V1 and the ratios of R/S in V1, V5 and V6) with echocardiographic RVH.There was a suggestion that the ECG voltage criteria to screen the presence of LVH should be adjusted for the young Asian female adults, and with regard to RVH, the ECG voltage criteria were found ineffective.


Assuntos
Eletrocardiografia , Hipertrofia Ventricular Esquerda/diagnóstico , Hipertrofia Ventricular Direita/diagnóstico , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático , Ecocardiografia , Feminino , Humanos , Militares , Sensibilidade e Especificidade , Taiwan , Adulto Jovem
8.
Nat Commun ; 11(1): 4366, 2020 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-32868764

RESUMO

Armed forces often rely on strict hierarchical organization, where people are required to follow orders. In two cross-sectional studies, we investigate whether or not working in a military context influences the sense of agency and outcome processing, and how different durations (junior cadets vs senior cadets) and types (cadets vs privates) of military experience may modulate these effects. Participants could administer painful electrical shocks to a 'victim' in exchange for money, either by their own free choice, or following orders of the experimenter. Results indicate that working in a strictly hierarchical structure may have a generalized negative impact on one's own sense of agency and outcome processing by reducing it, even when participants could freely decide their action. However, trained officers showed an enhanced sense of agency and outcome processing. This study offers insights on the potential for training the sense of agency and outcome processing.


Assuntos
Militares/psicologia , Estudos Transversais , Humanos , Masculino , Psicologia Militar , Desempenho Psicomotor/fisiologia , Adulto Jovem
9.
J Spec Oper Med ; 20(3): 103-108, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969012

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARSCov- 2) is hypothesized to have originated from a spillover event from an animal reservoir. This has raised many questions, with an important one being whether the widely disseminated coronavirus disease 2019 (COVID-19) is transmissible to other animal species. SARS-CoV-2 is primarily transmitted person to person. K9-to-human transmission, although theoretically possible via fomites, is considered minimal, if at all, and there have been no reported cases of K9-to-human transmission. Human-to-K9 transmission, although rare, seems more likely; however, in only one case has a K9 been suspected to have displayed symptoms of COVID-19. Preparation, decontamination, hand hygiene, and distancing remain the key factors in reducing transmission of the virus. The information presented is applicable to personnel operating within the military conventional and Special Operation Forces as well as civilian Tactical Emergency Medical Services communities who may have the responsibility of supporting an operational K9.


Assuntos
Infecções por Coronavirus/transmissão , Infecções por Coronavirus/veterinária , Cães/virologia , Militares , Pandemias/veterinária , Pneumonia Viral/transmissão , Pneumonia Viral/veterinária , Animais , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
11.
Urologiia ; (4): 171-174, 2020 Sep.
Artigo em Russo | MEDLINE | ID: mdl-32897033

RESUMO

The article reveals the formation and work of the Department of Urology during the Grear Patriotic War (1941-1945) based on the memories of its first head, professor A.I. Vasiliev.


Assuntos
Medicina Militar , Militares , Urologia , História do Século XX , Humanos
12.
JMIR Mhealth Uhealth ; 8(9): e22079, 2020 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-32955456

RESUMO

BACKGROUND: A necessary shift from in-person to remote delivery of psychotherapy (eg, teletherapy, eHealth, videoconferencing) has occurred because of the COVID-19 pandemic. A corollary benefit is a potential fit in terms of the need for equitable and timely access to mental health services in remote and rural locations. Owing to COVID-19, there may be an increase in the demand for timely, virtual delivery of services among trauma-affected populations, including public safety personnel (PSP; eg, paramedics, police, fire, correctional officers), military members, and veterans. There is a lack of evidence on the question of whether digital delivery of trauma-therapies for military members, veterans, and PSP leads to similar outcomes to in-person delivery. Information on barriers and facilitators and recommendations regarding digital-delivery is also scarce. OBJECTIVE: This study aims to evaluate the scope and quality of peer-reviewed literature on psychotherapeutic digital health interventions delivered remotely to military members, veterans, and PSP and synthesize the knowledge of needs, gaps, barriers to, and facilitators for virtual assessment of and virtual interventions for posttraumatic stress injury. METHODS: Relevant studies were identified using MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica dataBASE), APA (American Psychological Association) PsycINFO, CINAHL (Cumulative Index of Nursing and Allied Health Literature) Plus with Full Text, and Military & Government Collection. For collation, analysis, summarizing, and reporting of results, we used the CASP (Critical Skills Appraisal Program) qualitative checklist, PEDro (Physiotherapy Evidence Database) scale, level of evidence hierarchy, PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), and narrative synthesis. RESULTS: A total of 38 studies were included in this review. Evidence for the effectiveness of digital delivery of prolonged exposure therapy, cognitive processing therapy, behavioral activation treatment with therapeutic exposure to military members, veterans, and PSP was rated level 1a, whereas evidence for cognitive behavioral therapy was conflicting. The narrative synthesis indicated that virtual delivery of these therapies can be as effective as in-person delivery but may reduce stigma and cost while increasing access to therapy. Issues of risk, safety, potential harm (ie, suicidality, enabling avoidance), privacy, security, and the match among the therapist, modality, and patient warrant further consideration. There is a lack of studies on the influences of gender, racial, and cultural factors that may result in differential outcomes, preferences, and/or needs. An investigation into other therapies that may be suitable for digital delivery is needed. CONCLUSIONS: Digital delivery of trauma therapies for military members, veterans, and PSP is a critical area for further research. Although promising evidence exists regarding the effectiveness of digital health within these populations, many questions remain, and a cautious approach to more widespread implementation is warranted.


Assuntos
Socorristas/psicologia , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Telemedicina , Veteranos/psicologia , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
13.
Viruses ; 12(9)2020 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-32867108

RESUMO

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compromises the ability of military forces to fulfill missions. At the beginning of May 2020, 22 out of 70 Belgian soldiers deployed to a military education and training center in Maradi, Niger, developed mild COVID-19 compatible symptoms. Immediately upon their return to Belgium, and two weeks later, all seventy soldiers were tested for SARS-CoV-2 RNA (RT-qPCR) and antibodies (two immunoassays). Nine soldiers had at least one positive COVID-19 diagnostic test result. Five of them exhibited COVID-19 symptoms (mainly anosmia, ageusia, and fever), while four were asymptomatic. In four soldiers, SARS-CoV-2 viral load was detected and the genomes were sequenced. Conventional and genomic epidemiological data suggest that these genomes have an African most recent common ancestor and that the Belgian military service men were infected through contact with locals. The medical military command implemented testing of all Belgian soldiers for SARS-CoV-2 viral load and antibodies, two to three days before their departure on a mission abroad or on the high seas, and for specific missions immediately upon their return in Belgium. Some military operational settings (e.g., training camps in austere environments and ships) were also equipped with mobile infectious disease (COVID-19) testing capacity.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Militares/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Bélgica/epidemiologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Surtos de Doenças , Humanos , Masculino , Epidemiologia Molecular , Níger/epidemiologia , Pandemias , Pneumonia Viral/diagnóstico , Reação em Cadeia da Polimerase em Tempo Real/métodos , Testes Sorológicos , Carga Viral , Adulto Jovem
14.
Georgian Med News ; (304-305): 74-79, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32965253

RESUMO

The problem of studying, diagnosing and correcting stress-associated disorders resulting from exposure to psychogenic factors, the sources of which are various traumatic events, is one of the most relevant.; The purpose of the work is to create a psychological portrait of a combat participant for the subsequent development of preventive measures for stress-associated disorders. To study the psychological characteristics and psycho-emotional state, a comprehensive clinical and psychological examination of 147 military personnel was carried out after mostly mine-blast injuries received while performing official duties in the ATO zone.; The state of mental functions, and the emotional-volitional sphere and personality traits were evaluated. The points and characteristics of the test methods were analyzed, the total number of points was calculated separately on each scale.; A generalization of the results of the study allowed us to determine the main aspects of the psychological portrait of a military man. The essence of the portrait consists in harmonious restructuring from conscious to unconscious psychological attitudes and vice versa, in changing the subjective hierarchy of values and also to note that the character of the traumatic situation is not important in the portrait of the ATO participant, but the personal attitude of the participant and his environment.


Assuntos
Traumatismos por Explosões , Militares , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Humanos , Masculino , Saúde Mental , Fatores de Risco
16.
PLoS One ; 15(9): e0239437, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32960918

RESUMO

OBJECTIVE: This study sought to determine the incidence rates of cancer, overall and by site, among active component U.S. Air Force fighter pilots, and to compare the rates with those in other active component Air Force officers. METHODS: Using a matched retrospective cohort design, U.S. Air Force fighter pilots were compared with other commissioned officers who entered active component service between 1 January 1986 and 31 December 2006. The cohort was followed for cancer diagnoses in TRICARE and the Veterans Health Administration from 1 October 1995 through 31 December 2017. Fighter pilots and non-fighter pilot officers were compared after matching on sex, age at first observation (15 age groups), and age at last observation (15 age groups). Sex-stratified overall and site-specific cancer rates were compared with matched Poisson regression to determine incidence rate ratios with 95% confidence intervals. RESULTS: During 1,412,590 person-years of follow-up, among the study population of 88,432 service members (4,949 fighter pilots and 83,483 matched officers), 977 incident cancer cases were diagnosed (86 in fighter pilots and 891 in matched officers). Male fighter pilots and matched officers had similar rates of all malignant cancers (RR = 1.04; 95% CI: 0.83-1.31) and of each cancer site. Female fighter pilots and matched officers also had similar rates of all malignant cancers (RR = 0.99; 95% CI: 0.25-4.04). DISCUSSION: In the active component U.S. Air Force, fighter pilots and their officer peers had similar overall and site-specific cancer rates.


Assuntos
Neoplasias/epidemiologia , Adulto , Aeronaves , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Militares , Neoplasias/diagnóstico , Pilotos , Estudos Retrospectivos , Risco , Classe Social , Estados Unidos/epidemiologia
17.
PLoS One ; 15(9): e0239194, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966320

RESUMO

BACKGROUND: Aircrew members are required to attend hypoxia awareness training regularly to strengthen their memory of their personal hypoxia symptoms by undergoing training inside a hypobaric chamber. The aim of this study was to examine the association between hypoxia symptoms experienced during two training sessions that were 4 years apart. METHODS: This was a crossover study to compare hypoxia symptoms and self-reported physiological effects of trapped gas between a previous training session and a current training session in an altitude chamber. The subjects were military crew members who undertook a 25,000-feet refresher training course in 2018. We used a structured questionnaire to obtain the target information before and during hypoxia exposure. Data were analyzed using SPSS software. RESULTS: A total of 341 trainees participated in this survey and completely filled out the questionnaire. Gastrointestinal tract discomfort caused by the expansion of trapped gas was the main physiological reaction during the previous and current training sessions. Frequently reported symptoms were poor concentration (30.5%), impaired cognitive function (20.5%), visual disturbances (16.4%), hot flashes (15.8%), and paresthesia (12.6%) during both exposures. However, the proportions of participants reporting poor concentration (P = 0.378) and visual disturbances (P = 0.594) were not significantly different between the recalled and current training sessions. The five most common symptoms among the subjects with less than 1,000 flight hours were poor concentration (29.8%), visual disturbance (27.3%), impaired cognitive function (14.9%), dizziness/lightheadedness (11.6%), and hot flashes (9.9%), which overlapped substantially with the symptoms reported by other subjects. The occurrence of those five most common symptoms in the group with more than 1,000 flight hours did not significantly differ between the recalled training session and the current training session. CONCLUSIONS: The most common hypoxia symptoms reported were similar between the recalled and current training sessions in an environment with a low oxygen concentration. This finding was also clearly affected by the duration of flight experience. Moreover, GI effects of the expansion of trapped gas were commonly observed at low atmospheric pressure.


Assuntos
Hipóxia , Rememoração Mental , Adulto , Medicina Aeroespacial , Altitude , Pressão Atmosférica , Estudos Cross-Over , Feminino , Humanos , Hipóxia/fisiopatologia , Hipóxia/psicologia , Masculino , Pessoa de Meia-Idade , Militares , Inquéritos e Questionários
18.
J Spec Oper Med ; 20(3): 62-66, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969005

RESUMO

INTRODUCTION: Airway compromise is the second leading cause of potentially survivable death on the battlefield. Studies show that airway management is a challenge in prehospital combat care with high error and missed opportunity rates. Lacking is user information on the perceived reasons for the challenges. The US military uses several performance improvement and field feedback systems to solicit feedback regarding deployed experiences. We seek to review feedback and after-action reviews (AARs) from end-users with specific regard to airway challenges noted. METHODS: We queried the Center for Army Lessons Learned (CALL), the Army Medical Department Lessons Learned (AMEDDLL), and the Joint Lessons Learned Information System (JLLIS).Our queries comprised a series of search terms with a focus on airway management. Three military emergency medicine expert reviewers performed the primary analysis for lessons learned specific to deployment and predeployment training lessons learned. Upon narrowing the scope of entries to those relevant to deployment and predeployment training, a panel of eight experts performed reviews. The varied nature of the sources lent itself to an unstructured qualitative approach with results tabulated into thematic categories. RESULTS: Our initial search yielded 611 nonduplicate entries. The primary reviewers then analyzed these entries to determine relevance to the project-this resulted in 70 deployment- based lessons learned and four training-based lessons learned. The panel of eight experts then reviewed the 74 lessons learned. We categorized 37 AARs as equipment challenges/malfunctions, 28 as training/education challenges, and 9 as other. Several lessons learned specifically stated that units failed to prioritize medic training; multiple comments suggested that units should consider sending their medics to civilian training centers. Other comments highlighted equipment shortages and equipment malfunctions specific to certain mission types (e.g., pediatric casualties, extreme weather). CONCLUSIONS: In this review of military lessons learned systems, most of the feedback referenced equipment malfunctions and gaps in initial and maintenance training.This review of AARs provides guidance for targeted research efforts based the needs of the end-users.


Assuntos
Manuseio das Vias Aéreas , Medicina Militar , Serviço Hospitalar de Emergência , Humanos , Militares
19.
J Spec Oper Med ; 20(3): 71-75, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969007

RESUMO

BACKGROUND: Ultrasound, due to recent advances in portability and versatility, has become a valuable clinical adjunct in austere, resource-limited settings and is well demonstrated to be an accurate/efficient means to detect pneumothorax. The purpose of this study was to evaluate the impact of hands-on ultrasound training on ultrasound-naive US Army combat medics' ability to detect sonographic findings of pneumothorax with portable ultrasound in a cadaver model. METHODS: Ultrasound-naive US Army combat medics assigned to conventional military units were recruited from a single US Army installation and randomized to receive either didactic training only, or "blended" (didactic and hands-on) training on ultrasound detection of pneumothorax. Blinded participants were asked to perform a thoracic ultrasound exam on ventilated human cadaver models. Primary outcome measured was sensitivity and specificity of detecting sonographic findings of pneumothorax between cohorts. RESULTS: Forty-three participants examined a total of 258 hemithoraces. The didactic-only cohort (n = 24) detected sonographic findings of pneumothorax with a sensitivity of 68% and specificity of 57%. The blended cohort (n = 19) detected sonographic findings of pneumothorax with an overall sensitivity of 91% and specificity of 80%. Detection sensitivities were similar between B-mode versus M-mode use. CONCLUSION: US Army combat medics can use portable U/S to detect sonographic findings of pneumothorax in a human cadaver model with high sensitivity after a brief, blended (didactic and hands-on) training intervention.


Assuntos
Militares , Pneumotórax , Cadáver , Humanos , Pneumotórax/diagnóstico por imagem , Sensibilidade e Especificidade , Ultrassonografia
20.
J Spec Oper Med ; 20(3): 76-80, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32969008

RESUMO

BACKGROUND: The United States (US) military utilizes combat wound medication packs (CWMP) to provide analgesia and wound prophylaxis in casualties who are still able to fight. We compared characteristics of combat casualties receiving CWMP to those not receiving CWMP. We also describe the proportions of casualties with injury patterns consistent with Tactical Combat Casualty Care (TCCC) guideline indications for CWMP use who received this intervention. METHODS: This is a secondary analysis of Department of a Defense Trauma Registry (DODTR) dataset of US military personnel from January 2007 to August 2016. We searched for all subjects with documented use of at least one medication from the CWMP (acetaminophen, meloxicam, moxifloxacin). RESULTS: Within our dataset, 11,665 casualties were US military Servicemembers. Overall, <1% (84) of our study population received the CWMP. The median age and mechanism of injuries were similar between CWMP nonrecipients versus recipients. Median composite injury scores were higher for nonrecipients than recipients (6 versus 4, P < .001). Proportions of casualties with injury patterns meeting TCCC guideline CWMP indications who received this intervention were low: gunshot wound, <1% (14 of 1805), tourniquet applied, <1% (11 of 1912), major amputation, <1% (5 of 803), and open fracture, <1% (10 of 2425). Based on serious injuries by body region, we had similar findings for the thorax (<1%; 3 of 1122), abdomen (<1%; 1 of 736), and extremities (<1%; 11 of 2699). CONCLUSIONS: Subjects receiving the CWMP were less severely injured compared to those who did not receive this intervention. The CWMP had very infrequent use among those casualties with injury patterns meeting indications specified in the TCCC Guidelines for use of this intervention.


Assuntos
Serviços Médicos de Emergência , Medicina Militar , Militares , Ferimentos por Arma de Fogo , Campanha Afegã de 2001- , Afeganistão/epidemiologia , Humanos , Iraque/epidemiologia , Guerra do Iraque 2003-2011 , Sistema de Registros , Estados Unidos/epidemiologia
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