Aldon Delport, Timothy Makrides, S. Delport, Hannah Makrides
{"title":"Insidious bleeding; the danger of complacency: Case Report","authors":"Aldon Delport, Timothy Makrides, S. Delport, Hannah Makrides","doi":"10.33553/JHTAM.V1I1.9","DOIUrl":"https://doi.org/10.33553/JHTAM.V1I1.9","url":null,"abstract":"Background: A recent publication in the Journal of Trauma and Acute Care Surgery reported that patients who received a tourniquet (TQ) for severe extremity bleeding had a fourfold decrease in overall shock related mortality (Scerbo et al., 2017). A systematic review conducted in the United States (US) by Beaucreux, Vivian, Miles, Sylvain, and Pasquier (2018) showed that tourniquets are an effective tool for haemorrhage control in civilian populations with low levels of associated complications. Not a lot is known about the attitudes of Australian paramedics toward TQ’s or their use thereof, but anecdotal evidence suggests that their use is contentious.\u0000\u0000\u0000Case: We present a case of severe extremity haemorrhage involving a 90-year-old male who sustained a partial amputation to the lower aspect of the left leg proximal to the ankle whilst cutting a tree branch with a 5-inch toothed garden saw.\u0000\u0000\u0000Conclusion: In this case, the paramedics who attended to this patient believed that the use of a TQ was extreme. Standard trauma management and haemorrhage control measures that included a pressure bandage, vacuum splint and warming blanket served as confounding factors in obscuring an ongoing insidious bleed. Based on the injury profile, the patients advanced age, medications for comorbidities and associated decrease in physiological reserves this patient was a candidate for early TQ application. Failure to apply a TQ may have contributed to coagulopathy and the need for postoperative transfusions.","PeriodicalId":320991,"journal":{"name":"Journal of High Threat & Austere Medicine","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132657593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Australian Tactical Medical Association and the Journal of High Threat & Austere Medicine: A joint initiative to progress a niche subspecialty of medicine","authors":"Timothy Makrides, Matthew P. J. Pepper","doi":"10.33553/JHTAM.V1I1.8","DOIUrl":"https://doi.org/10.33553/JHTAM.V1I1.8","url":null,"abstract":"This year sees the launch of the official journal of the Australian Tactical Medical Association (ATMA), the Journal of High Threat and Austere Medicine (JHTAM). This initiative is a significant achievement in the progression of high threat medicine in Australia and builds upon the success of the past 18 months. \u0000\u0000\u0000Whilst ‘Tactical Medicine’ conjures in the minds of the uninformed ideas of black-clad specialists in body armour, JHTAM and ATMA actually encompass and represent a wide range of applications of first aid and medicine. The crossover between all these applications is significant, and collaboration will only allow for a larger evidence base to draw from, as well as opening communication channels and starting conversations that enable greater and more cohesive response capacity in wilderness, expedition, prehospital, tactical, military and austere applications.","PeriodicalId":320991,"journal":{"name":"Journal of High Threat & Austere Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131055393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}