Bmj Military Health最新文献

{"title":"UK military infection referral service: a review of activity 2018-2024.","authors":"Nicola Reece, M Jw Kain, L Swithenbank","doi":"10.1136/military-2025-003089","DOIUrl":"10.1136/military-2025-003089","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"377-378"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of proprietary and improvised pelvic binders: time to application and displacement during casualty evacuation.","authors":"Thomas John Howe, H Claireaux, G Morgan, L McMenemy, S D Masouros, A Ramasamy","doi":"10.1136/military-2024-002865","DOIUrl":"10.1136/military-2024-002865","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic injuries resulting from high-energy trauma have an approximately 10% mortality rate. Suspected pelvic injuries are treated with pelvic binders to stabilise fractured bones and promote tamponade until surgical treatment. The effectiveness of pelvic binders in reducing mortality risk depends on accurate positioning of the binder. This study quantifies the ability of proprietary and improvised pelvic binders to maintain their positioning during a simulated casualty evacuation.</p><p><strong>Methods: </strong>One improvised and three proprietary pelvic binders were tested in their ability to maintain their initial placement. Combat Medical Technicians applied binders to healthy subjects and then performed a simulated casualty evacuation. The time taken to apply each binder was measured. The evacuation consisted of: 20 m casualty drag, transfer onto a soft stretcher, 100 m evacuation on a soft stretcher, transfer onto a rigid stretcher and transfer into a field ambulance. Binder placement was measured using bony landmarks after the initial positioning and after each phase of the simulated casualty evacuation.</p><p><strong>Results: </strong>The field-expedient pelvic splint (FEPS), SAM Pelvic Sling II (SAM) and T-POD Pelvic Stabilisation Device (TPOD) all remained within 45 mm of vertical displacement from their initial placement, which is considered an acceptable range for optimal binder functionality. The Prometheus Pelvic Splint (PROM) fell within this range in 83% of trials. The SAM was the fastest binder to apply, followed by the TPOD, and then the FEPS and PROM which took similar times to apply.</p><p><strong>Conclusions: </strong>Binders were mostly able to maintain their positioning during the simulated casualty evacuations carried out in this study but differed in their application times. The improvised binder (FEPS) performed comparably to the proprietary binders tested, and its low cost and weight make it a good alternative to proprietary binders in the austere environment.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"348-352"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major Joseph Cardis RAMC: an ordinary man in an extraordinary world.","authors":"Oliver O'Sullivan","doi":"10.1136/military-2025-003143","DOIUrl":"10.1136/military-2025-003143","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"374-375"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicine in the drone age: prehospital emergency care under the threat of enemy UAS.","authors":"Conor Spilsbury, J Miles, A Hamer, D Ferraby","doi":"10.1136/military-2025-002969","DOIUrl":"10.1136/military-2025-002969","url":null,"abstract":"<p><p>The Ukraine-Russia conflict has seen unprecedented use of uncrewed aircraft system (UAS), leading to significant changes in injury patterns and medical evacuation constraints. This article examines the mechanisms of injury caused by UAS, the epidemiology of these injuries and the challenges faced by medical teams in evacuating and treating casualties. The prevalence of UAS has resulted in a higher incidence of head, neck and acoustic injuries, necessitating minimally invasive surgeries and advanced imaging techniques. The ability of Russian forces to sustain long-range UAS operations has severely restricted casualty movement and increased the risk to medical providers. This article highlights the need for enhanced force protection measures, including the use of counter-UAS technology, improved personal protective equipment and innovative evacuation strategies such as uncrewed ground vehicles. The findings underscore the importance of adapting medical practices to the evolving threat landscape and ensuring the safety and effectiveness of medical teams operating in high-risk environments.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"292-295"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomous ground vehicles for MEDEVAC: capability assessment based on agent-based modelling.","authors":"Dalibor Procházka, V Šedivcová, J Melichar, A Tesař, H Schvach","doi":"10.1136/military-2024-002885","DOIUrl":"10.1136/military-2024-002885","url":null,"abstract":"<p><strong>Introduction: </strong>Medical evacuation (MEDEVAC) is a crucial component of military healthcare, and the time during which evacuation of the wounded, injured and ill individuals happens is one of the most critical factors. The article focuses on the initial phase of ground evacuation from the Point of Injury to the casualty collection point (CCP). Casualty transport is the combat unit's task, triggered by a 9-liner MEDEVAC request. Two variants are considered: evacuation by means of one armoured vehicle per CCP according to the actual doctrine and potential evacuation using a fleet of autonomous unmanned vehicles.</p><p><strong>Methods: </strong>The analysis and comparison are based on data (injury time and position) obtained from computer-assisted exercises, and a simulation combining agent-based modelling and discrete events simulation methods is applied to compare two approaches.</p><p><strong>Results: </strong>The simulation results show that using distributed transport capability, represented by unmanned ground vehicles (UGVs), is more effective because it allows for prioritising casualties based on the injury category. The evacuation effectiveness is quantified in relation to the number of UGVs used.</p><p><strong>Conclusions: </strong>The use of UGVs can improve the care of the wounded, assuming the involvement of advanced technologies, including artificial intelligence. Information about the time and place of casualties is the key for decision makers to achieve the benefit, which should be ensured through potential monitoring of the physical condition of the wounded (body sensors and data transmission in case of injury).</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":"336-341"},"PeriodicalIF":1.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injury patterns, diagnostic approaches and management of survivors of a naval torpedo attack: a maritime mass-casualty incident.","authors":"R P Abeywickrama, J P M Kumarasinghe, Shanuka Kommalage, S D U M Ranga, R W Seneviratne","doi":"10.1136/military-2026-003383","DOIUrl":"https://doi.org/10.1136/military-2026-003383","url":null,"abstract":"<p><strong>Introduction: </strong>The sinking of the warship <i>IRIS Dena</i> by a torpedo attack on 4 March 2026 represents a rare maritime mass-casualty event. Because such events are relatively uncommon, the clinical outcomes of torpedo-related trauma remain poorly documented. This study describes the injury patterns among surviving crew members of a ship following a torpedo attack.</p><p><strong>Method: </strong>A retrospective study was conducted including all 32 survivors admitted to the National Hospital Galle, Sri Lanka. Data regarding patient demographics, injury characteristics, initial investigations and management were extracted from medical records and analysed.</p><p><strong>Results: </strong>All 32 survivors were male, with a mean age of 31.7 years. Eighteen patients (56.2%) reported only mild pain requiring standard analgesia. The remaining 14 patients (43.8%) sustained a total of 18 major traumatic injuries. Of these injuries, 10 (55.6%) were vertebral compression wedge fractures. Most vertebral fractures were concentrated at the thoracolumbar junction, with 6 (60%) involving T11 and L1 vertebrae. Five (27.8%) limb fractures were reported, including two scaphoid fractures, one femur fracture and two ankle fractures involving the lateral malleolus. One patient sustained severe chest trauma complicated with haemopneumothorax. The most used radiological imaging modality was spinal X-rays (n=15, 46.9%).</p><p><strong>Conclusion: </strong>Injuries among survivors of a torpedo attack predominantly consisted of thoracolumbar vertebral compression fractures. This specific injury pattern is likely attributable to the violent upward displacement of the ship, known as the \"deck-slap\" effect. Clinicians should use spinal immobilisation and subsequent spinal imaging in survivors of maritime explosions.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling up a new method to record injuries during military training: a prospective study among 1521 young Norwegian conscripts.","authors":"Matthieu Clauss, Joakim Seljevoll, John Bjørneboe, Kaare Midtgaard, André Ringdal, Thomas André Valnes, Kristine Vejrup","doi":"10.1136/military-2026-003321","DOIUrl":"https://doi.org/10.1136/military-2026-003321","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal injuries are a major concern in military populations, particularly during basic training, when up to one in four soldiers require medical attention. Traditional surveillance systems based on medical records underestimate the true burden as many injuries go unreported. Self-reporting tools, such as the validated Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2), provide a more comprehensive overview by capturing injuries of all severities. This study evaluated the feasibility of implementing a large-scale self-reporting injury surveillance system using the OSTRC-H2 across basic training schools in different branches and locations of the Norwegian Armed Forces.</p><p><strong>Method: </strong>A total of 1521 conscripts from the Norwegian Army, the Royal Norwegian Navy and the Royal Norwegian Air Force completed weekly questionnaires over 6 weeks during military training in basic training schools, using a modified version of the OSTRC-H2. Participants reported all injuries, regardless of medical attention, along with information on injury type, anatomical location and severity. Weekly prevalence and incidence rates were calculated.</p><p><strong>Results: </strong>The mean weekly response rate was 54%, with variation across weeks and platoons. 796 injuries were reported, corresponding to an annualised incidence of 5.1 injuries per recruit, including 4.1 overuse and 1.0 acute injuries per recruit per year. The average weekly injury prevalence was 17%, including 9% with substantial injuries, moderately or severely restricting military activity and/or performance. Most injuries involved the lower limbs (71%), and the average time loss per injury was 1.2 days.</p><p><strong>Conclusion: </strong>Implementation of a self-report injury surveillance system using the OSTRC-H2 across basic training schools in multiple branches and locations of the Norwegian Armed Forces proved feasible, with consistent participation and the ability to capture detailed injury patterns across units. This approach provides a robust foundation for monitoring and comparing injury burden and supports targeted prevention efforts within military training environments.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolation as a long-term force multiplier: impact of isolation following three adenovirus outbreaks in UK military training establishments, 2024.","authors":"Hannah Taylor, Adam Mcdonald, Mark Andrew Dermont","doi":"10.1136/military-2026-003391","DOIUrl":"https://doi.org/10.1136/military-2026-003391","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between sleep, fatigue and performance during sub-Arctic operations: data from a winter military field exercise in Finland.","authors":"Giorgio Varesco, Tommi Ojanen, Jani P Vaara, Antonio Martin, Jeroen van Cutsem, François Haman, Nathalie Pattyn, Guido Simonelli","doi":"10.1136/military-2026-003283","DOIUrl":"https://doi.org/10.1136/military-2026-003283","url":null,"abstract":"<p><strong>Introduction: </strong>Military operations in cold environments impose significant physiological and psychological stress, resulting in fatigue and impaired cognitive and physical performance. Sleep, a critical factor for recovery, is often disrupted in field conditions, yet its relationship with fatigue and task performance under different operational roles and living conditions remains understudied.</p><p><strong>Methods: </strong>This study investigated perceived fatigue (10 cm Visual Analogue Scale), physical performance (standing long jump), sustained attention (20-minute psychomotor vigilance task (PVT)) and sleep (actigraphy) in first-year and second-year cadets during a winter military exercise in Finland. Cadets were assigned roles reflecting combat (first-year) or officer duties (supervision, coordination; second-year) and housed in either heated tents or barracks. Training workload and environmental conditions including temperature and air quality were recorded across two training blocks differing in intensity.</p><p><strong>Results: </strong>First-year cadets accumulated significantly more physical activity (p=0.005) and obtained less total sleep per night compared with second-year cadets, with more second-year cadets achieving >5 hours of sleep (p=0.017). No significant difference was found in the number of cadets obtaining >7 hours of continuous sleep. Perceived fatigue increased post-first training block only in first-year cadets (p=0.003). First-year cadets demonstrated a notable decline in PVT reaction time (p<0.001) and jump performance (p=0.001), with no recovery after the second block. Second-year cadets also showed a PVT decline (p<0.001) but exhibited partial recovery (p=0.001). Increased fatigue correlated negatively with PVT performance (all p<0.043). Accommodation in tents showed large temperature fluctuations (~30 °C) and elevated particulate matter (PM10); barracks experiencing increased CO₂ proportional to occupancy.</p><p><strong>Conclusions: </strong>A challenging sleep environment combined with high training loads impairs fatigue resistance and performance during cold-environment military training. Sleep continuity is crucial for fatigue and in turn sustained attention. Long (~20 min) sustained tasks might serve as sensitive fatigue monitoring tools. Improvements to sleep environment such as increased temperature comfort might improve sleep, reducing fatigue.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of <i>Cryptosporidium hominis</i> by clinical metagenomics in stool samples from an outbreak of diarrhoea among British military personnel in Kenya.","authors":"Carl Halford, Romeo Toriro, Emily Rowlands, Thanh Le Viet, Stephanie Schaap, Matthew K O'Shea, Thomas Fletcher, Nicholas J Beeching, Stephen Woolley, Roman Lukaszewski, Matthew Gilmour, Simon A Weller","doi":"10.1136/military-2026-003248","DOIUrl":"https://doi.org/10.1136/military-2026-003248","url":null,"abstract":"<p><strong>Introduction: </strong>Traveller's diarrhoea is a common complaint among deployed military personnel. Maintaining sample integrity prior to diagnostic testing is a key challenge in resource-limited environments. We report the comparison of three long-term ambient temperature stool sample stabilisation matrices for the detection of <i>Cryptosporidium hominis</i> from samples collected during an outbreak among British military personnel stationed in Kenya.</p><p><strong>Methods: </strong>A retrospective cohort of stool samples, each stabilised for more than 12 months at ambient temperatures using Flinders Technical Associate (FTA) cards, OMNIgene GUT tubes and DNA Shield faecal collection tubes, were analysed by Nanopore-based clinical metagenomic (CMgs) DNA sequencing and quantitative real-time PCR (qPCR) in the UK. The results were compared with BioFire FilmArray Gastrointestinal Panel testing carried out at the point of sampling in Kenya.</p><p><strong>Results: </strong><i>Cryptosporidium</i> DNA was detected in 13/24 (54.2%) OMNIgene GUT samples by CMg following long-term storage, compared with 9/24 (37.5%) of DNA Shield samples. Samples stored on FTA cards did not identify <i>Cryptosporidium</i> DNA by CMg in any sample. OMNIgene GUT samples also had the highest rate of detection of <i>C. hominis</i> DNA by qPCR, with 23/24 samples testing positive, compared with 21/24 and 17/20 of DNA Shield and FTA samples, respectively.</p><p><strong>Conclusions: </strong>Samples stored in OMNIgene GUT tubes retained detectable levels of <i>Cryptosporidium</i> DNA in a higher proportion of samples following long-term storage. This study demonstrates the importance of selecting the optimal sample collection and stabilisation matrix for CMg and qPCR based diagnostic testing in austere environments.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}