Medical journal (Fort Sam Houston, Tex.)最新文献

{"title":"Epidemiology of Vascular Injury Within the U.S. Department of Defense Trauma Registry From 2007-2023.","authors":"Branson D Taheri, Daniel S Saks, Garrett L Healy, Rafael D Malgor, Mark R Nehler, Julie A Rizzo, Vikhyat S Bebarta, Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Background: Since WWII, the incidence of vascular trauma in U.S. military casualties has steadily risen, with the highest rates having been reported from the recent conflicts in Iraq and Afghanistan. Within civilian populations, the incidence of vascular trauma is lower, but with disproportionately higher rates of mortality, morbidity, and resource use for these injuries. Analyses of trauma databases have informed technological advances that best help our U.S. Military Health System (MHS) manage vascular injuries. We sought to perform a retrospective cohort analysis in military casualties with and without vascular injuries alongside an updated descriptive assessment of vascular injuries by anatomic location seen within deployed Military Treatment Facilities (MTF). Study Design and Methods: This is a secondary analysis of a dataset from the Department of Defense Trauma Registry from 2007 to 2023. Vascular injuries were identified using clinical diagnostic codes, looking for vascular injury to a named blood vessel. Serious injuries were defined by us as an abbreviated injury scale by body region of ≥3. Results: From 2007 to 2023, our dataset included 48,301 casualties, of which 2,765 (6%) had at least one major vascular injury. Of these 2,765 casualties with a vascular injury, 34% were U.S. servicemembers and 33% were humanitarian casualties. There were 184 pediatric casualties: 17 (1%) were <4 years, 51 (2%) were 5-9 years, 80 (3%) were 10-14 years, and 36 (1%) were 15-17 years. Most vascular casualties were caused by an explosive mechanism (53%), followed by firearms (41%), motor vehicles (3%), and falls at (1%). Casualties involving a vascular injury had a higher composite injury severity score (median of 17 versus 5) with a higher percentage of serious injuries in each AIS region when compared to casualties without vascular injuries. The most common types of major vascular injury on a per-1000 basis were those involving the superficial femoral artery (8.6), radial artery (7.7), jugular vein (7.4), femoral vein (7.3), or popliteal artery (6.2). Among those with any major vascular injury, the median 24-hour blood product volume was 9 units (interquartile range 1-29). Both 24-hour survival and survival to discharge were lower for casualties with a vascular injury. Conclusions: Among military casualties who survived long enough to reach a military treatment facility with surgical capabilities, the incidence of vascular injuries was high, and these injuries were severe. Our findings support the need for adequate pre-deployment vascular training for deploying surgeons. Moreover, with future conflicts having the potential for delayed evacuation, preparing for the prolonged management of pre-hospital vascular injury in a pre-hospital setting is paramount.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"60-66"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842053","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":"An Analysis of Trauma Patient Deaths in the Emergency Department - an Opportunity for Performance Improvement Initiatives.","authors":"Nikki L Greenspan, Kyle Smiley, Daniel K O'Conor, Brit J Long, Julie A Rizzo, Andrew D Fisher, Michael D April, Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Introduction: Trauma is a leading cause of presentation to the emergency department (ED). Improving outcomes requires identification of areas for potential improvement, as well as identifying factors of patients with non-survivable injuries that will unnecessarily consume resources. We sought to analyze the presentations of trauma patients who expired while still in the ED. Methods: We analyzed data from patients in the Trauma Quality Improvement Program (TQIP) registry whose death time was less than their ED length of stay to a maximum of 3 hours. We used descriptive statistics. Results: From 2020-2022, there were 3,575,106 encounters in the TQIP database, of which, 33,525 (0.93801%) met inclusion for this analysis. The median time from arrival to death was 11 minutes (IQR 4-26). Of the deaths, 20% (6617) had signs of life on arrival and 62% (20835) had no signs of life on arrival with the remainder lacking arrival vitals documentation. The maximum number of deaths in one facility was 174, 177, and 212, respectively. The median age was 36, and 79% were male. Of the pediatric patients, the 15 to 17 years age group comprised the largest proportion at 3%. Collisions and firearms were predominant injury mechanisms overall. The median composite injury severity score was 21 (IQR 9-30). Overall, serious injuries to the thorax accounted for the largest proportion at 50%. Of those that arrived with signs of life, serious injuries to the head/neck accounted for the largest proportion at 57%. Of those that arrived with no signs of life, serious injuries to the thorax comprised the large portion at 52%. Across all the groups, most deaths occurred at a Level I trauma center. Conclusions: Deaths in the ED setting relating to trauma were rare occurrences but often happened quickly after arrival. Substantial resources were consumed by the patients that rapidly died suggesting that we need better methods to predict those with a poor outcome. Moreover, our findings highlight areas for performance improvement and potential implementation at trauma centers within the Military Health System. Our findings are consistent with previous reports on causes of early death.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841727","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":"Prehospital Tranexamic Acid Administration in Deployed Military Settings: A Review of the Department of Defense Trauma Registry.","authors":"Courtney D Wham, Matthew A Tovar, Eric J Koch, Ian Eisenhauer, Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Introduction: Trauma is the leading cause of death worldwide, with up to 40% of trauma fatalities resulting from massive hemorrhage. Tranexamic Acid (TXA) helps control massive bleeding by stabilizing clot formation and was added to the Tactical Combat Casualty Care (TCCC) guidelines in 2011. In 2020, the Committee on TCCC updated the dosing recommendation to a 2g IV slow push to simplify administration in combat settings. Despite this change, little is known about the characteristics of prehospital TXA administration in deployed combat settings, prompting the present investigation. Materials and Methods: This was a retrospective review of the Department of Defense Trauma Registry (DoDTR) dataset spanning 2007 to 2023. We identified casualties who received any dose of TXA (per-administration) as well as every patient who received TXA once or more (per-casualty). Results: From 2007 to 2023, there were 45,124 total DoDTR encounters within our dataset that met inclusion criteria, including 698 TXA administrations given to 671 casualties. The median time from injury to administration was 44 minutes (IQR 30-77 minutes). The median dose administered was 1000 mg (IQR 1000-1000, max 3000). 6% received a 2000 mg dose, and <1% received a 3000 mg dose. Intravenous administration was the most common route of delivery (64%), followed by intraosseous (11%), and intramuscular (<1%) delivery. A total of 46% of patients received TXA at the point-of-injury followed by administration en route to a higher level of care (38%) with the remainder having no location documented. Of those who received TXA at the point of injury and en route to the higher level of care, 55% and 29% went on to receive ≥3 and ≥10 units of whole blood or red blood cells, respectively. Conclusions: Frequent reliance on IO and IM use underscores the need for field-friendly solutions that allow for rapid, easy delivery via multiple routes. Future research should focus on evaluating intramuscular TXA and developing material solutions to streamline battlefield execution.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"89-95"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842257","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":"A Prospective Trial of Low-Dose, High Frequency Training.","authors":"Elizabeth Olson, Priscilla Garza-Quintero, Darren Hyams, Sarah Goss, Allyson A Mireles, Julliette Conte, Joseph K Maddry","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Abstract: &lt;/strong&gt;Introduction: The San Antonio Uniformed Services Health Education Consortium (SAUSHEC) Emergency Medicine (EM) Graduate Medical Education (GME) educational cur riculum previously focused almost exclusively on standard civilian trauma and pathology, resulting in military emer gency physicians receiving combat casualty care-focused training as needed prior to deployment. Previously, military EM GME graduates expressed disappointment with the lack of deployment and en route care training provided during their residency and discomfort while providing care during deployments. The constant evolution of the practice of Tactical Combat Casualty Care (TCCC), and the fact that most combat-related deaths occur in the prehospital environ ment, necessitates ongoing training of military EM physi cians. To combat this identified knowledge and skills deficit, we incorporated brief, frequent episodes of military unique EM curriculum into the standard GME over the course of the academic year. We hypothesized that this low dose, high frequency (LDHF) training model would improve knowledge and skill retention through short simulation and case-based scenarios over an extended time frame. Materials and Methods: SAUSHEC EM residents in all PGY levels were provided TCCC and deployment medicine-focused lectures and simulation scenarios during standard EM training sessions. Following selected training sessions, each resident was asked to complete 1) a ques tionnaire to rate their self-assessed operational medicine and leadership skills and 2) a multiple-choice test of TCCC topics. Over the academic year, residents were asked to repeat the questionnaire and multiple-choice test. Paired t-tests were used to compare consecutive scores on the self - reported skill and knowledge assessments. McNamar's test for paired proportions was used to compare the proportions of residents rating themselves as \"acceptable\" or better on the self-assessed skill questionnaire over consecutive surveys. Results: We analyzed data from 48 participants from September 2020 to May 2022. All participants completed 2 to 5 questionnaires, with a median of 16 weeks between them. Participants also completed at least 2 TCCC tests, with either ~6 months or ~1 year between tests. On their first self-assessment, participants on average rated their operational skills as 4.0/10 which significantly increased to 5.6/10 (p &lt; 0.0001) by their second self-assessment. Similarly, the LDHF training model significantly improved participants' self-assessed medical director/leadership skills, with the average increasing from 2.9/10 to 4.6/10 (p &lt; 0.0001) from their first to second survey. Participants also saw a sig nificant increase in their scores on the TCCC multiple choice test between their first and second exam (49% correct to 57% correct, p = 0.0009). Conclusions: The LDHF curriculum for operational med icine training significantly improved clinician confidence and operational medicin","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842408","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":"Success Rate of Identifying Dental Pulp Stem Cells in Intact Extracted Third Molars.","authors":"Brandi Gervais, Matthew Rehmel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Purpose: The purpose of this study is to determine the success rate of identifying Dental Pulp Stem Cells (DPSCs) from intact extracted human third molars. Materials and Methods: The dental pulp of six intact extracted third molars were harvested and frozen fresh. The tissues samples were then characterized for the presence of stem cells markers by direct immunofluorescence staining using CD29, CD73, CD90, and CD105. Results: Stems cells were identified in 5/6 (83.3%) of samples tested. Stem cell markers CD90 and CD105 displayed the highest positivity rate with 6/6 samples demonstrating positive immunofluorescence. Stem cell markers CD29 and CD73 displayed moderate positivity with 5/6 samples demonstrating positive immunofluorescence. Conclusion: This benchtop study suggests that dental pulp stem cells are expressed in third molars and can be identified in simple harvesting and fresh frozen techniques. Considering that third molar removal is a routine dental procedure, extracted third molars can be a suitable stem cell source for cell based regenerative procedures.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"11-18"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842312","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":"A Narrative Review of the Use of Thrombopoietin and Thrombopoietin Analogues in Trauma and Critical Illness.","authors":"Christian L Morzinski, David A Sorensen, Julie A Rizzo, Michael D April, Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Introduction: Studies exploring the use of thrombopoietin (TPO) in trauma and hemorrhage-associated thrombocytopenia are limited. Transfusion of platelets, whether as part of whole blood or component therapy, is a cornerstone of survival in trauma patients. Adjuncts to transfusion may prove useful in the pre-hospital setting or in other settings where the logistics or risks of transfusion may not prove feasible. The purpose of this review is to evaluate the literature for the applications of TPO in critical illness and trauma. Methods: We conducted a review of relevant literature to provide a comprehensive summary of the use of TPO in critically ill patients with thrombocytopenia secondary to a variety of etiologies. We used PubMed and EBSCO Discovery Services to identify relevant literature. Results: The review identified eleven studies exploring the use of thrombopoietin in critically ill patients from 2014-2025. The most frequent studies cited were retrospective cohort studies (n=3) and prospective cohort studies (n=3), followed by case reports and case series (n=2), randomized controlled trials (RCT) (n=2), and a systematic review with meta-analysis (n=1). The papers came from journals and registries worldwide to provide an accurate representation of many settings. Conclusions: There are few studies on the use of TPO for critical care and trauma. However, the limited data suggests that TPO may confer benefit in critically ill patients with thrombocytopenia. Further studies are needed to determine how TPO could be used within these populations.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842372","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":"Epidemiology, risk factors, and outcomes associated with pediatric acute respiratory distress syndrome in the Trauma Quality Improvement Program database.","authors":"Colby E Walton, Hannah L Gale, Ashley E Sam, Julie A Rizzo, Matthew A Borgman, Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Introduction: Acute respiratory distress syndrome (ARDS) occurs in the setting of trauma through multiple mechanisms. Previous systematic reviews have demonstrated a 4% pediatric ARDS (pARDS) incidence in trauma patients in intensive care units and that pARDS is associated with five-fold higher mortality rates compared to those without pARDS. However, most studies do not include recent data. We sought to describe the recent incidence, risk factors, and outcomes of pARDS in the pediatric trauma population. Methods: We analyzed data from the 2017-2023 Trauma Quality Improvement Program (TQIP) dataset for children <18 years of age. ARDS is captured as a core quality metric. We used descriptive, inferential, and multivariable logistic regression (MVLR) analyses. Results: From 2017 to 2023, there were 867,586 that met inclusion, of whom, 589 were documented to have pARDS. The overall incidence was 7 per 10,000 children. By age groups ≤4, 5-9, 10-14, and 15-17, the incidence was 4, 3, 6, 15 per 10,000 children, respectively. Among those with pARDS, the most common mechanism of injury was collisions (70%) followed by firearms (17%). Median composite injury severity scores were higher among those with pARDS (27 [19-38] versus 4 [4-9], p<0.001). The most common injured body regions were the head/neck (70% versus 27%), thorax (71% versus 11%), and skin (75% versus 50%, all p<0.001). Survival was lower among those with pARDS (76% versus 99%, p<0.001). Injuries to the head and neck (OR 4.07, 3.26-5.08) and thorax (OR 7.18, 6.21-9.83) were more commonly associated with a diagnosis of pARDS. In-hospital events such as cardiac arrest (9.44, 7.20-12.36), pulmonary embolism (3.55, 1.80-7.01), acute kidney injury (3.52, 2.13-5.82), sepsis (10.22, 6.12-17.05), and ventilator-associated pneumonia (21.54, 16.37-28.36) were associated with a diagnosis of pARDS. Conclusions: The overall incidence of pARDS in pediatric trauma patients was low, however pARDS was associated with increased in-hospital events, such as cardiac arrest, pulmonary embolism, acute kidney injury, ventilator associated pneumonia, and increased mortality when compared to those without pARDS. The overall low pARDS incidence compared to previous reports suggests that under-detection or under-coding is occurring with current TQIP data. Expanded data collection in the TQIP database is needed to better characterize pARDS and improve care for pediatric trauma patients.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"83-88"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842159","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":"A Scoping Review of Cold-Stored Apheresis Platelets for Hemorrhage.","authors":"Cayla Guerra, Nepal Nirajan, Joshua J Oliver, Andrew D Fisher, Michael A Meledeo, Kristin Reddoch-Cardenas, Jonathan D Stallings, Julie A Rizzo, Jason B Corley, Steven G Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Introduction: Room-temperature stored platelets (RTSP) have been the standard in component-based resuscitation. Its use in the austere deployed setting though is challenging for deployed and austere supply chains due to its limited shelf-life, need for constant agitation, and strict temperature parameters. More recent scientific advancements have enabled the re-implementation of apheresis cold-stored platelets (CSP) which would greatly improve the ability to deliver this lifesaving intervention across the battlespace. We conducted a scoping review to describe the current state of the art with apheresis CSP which were developed, in part, by the US military for deployed combat use. Methods: We conducted a scoping review using the PRISMA-ScR checklist. We used PubMed and Google Scholar to identify relevant literature from 2000 to 2025. Studies were eligible if they reported on the use of CSP and focused on trauma, surgical, or transfusion-related contexts in human subjects as well as addressing feasibility, safety, function, storage duration, or clinical outcomes. Results: We identified 7 studies that met inclusion criteria. Study designs included randomized controlled trials, crossover trials, and retrospective cohort studies. Populations ranged from healthy volunteers to patients with traumatic injuries, traumatic brain injury, or those undergoing surgery. Storage temperatures were between 1°C and 6°C for CSP against the control of RTSP at 22°C, with storage durations ranging from 5 to 20 days. Key outcomes assessed included platelet function, clot strength, safety, in vivo recovery, and clinical endpoints such as survival, need for neurosurgical intervention, and bleeding control. Overall, apheresis CSP demonstrated preserved or enhanced hemostatic function compared to RTSP with favorable outcomes. Conclusions: There is a limited yet growing body of literature on CSP use to enable wide implementation across the current and future battlespace.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"19-25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841662","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":"Nationwide transport by police to trauma centers - An analysis from the Trauma Quality Improvement Program (TQIP) registry.","authors":"Spencer Knierim, Ian Hudson, David Wampler, Rachel Ely, Julie Rizzo, Andrew Fisher, Michael April, Steven Schauer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>Introduction: Timely access to definitive care is critical for trauma outcomes. In several U.S. cities, police transport of penetrating trauma patients has increased. While some studies suggest police transport may offer survival advantages, outcomes vary widely. Despite growing use, limited nationwide data exist on the epidemiological characteristics of patients transported by police, highlighting the need for a better understanding of this atypical transport modality. Methods: We analyzed TQIP registry data from 2017 to 2023 for all encounters with documented arrival by police. De-identified facility codes were used to assess the number of trauma centers associated with this practice. Results: From 2017 to 2023, there were 8,014,737 total encounters, of which, 24,499 (<1%) arrived by police. Of the total police arrivals, 15% had an ISS>15. There were 1331 who were pediatric in age (<18 years). Among the pediatric patients, 19% had an ISS>15. There were 656 documented as interfacility transfers. Blunt trauma accounted for 57% of patient transports whereas penetrating trauma accounted for 36%, the remaining 8% were classified as \"other\". The most common mechanisms were collisions (42%) followed by firearms (25%). The number of facilities with a documented encounter arriving by police increased throughout the study period from 452 to 520 each year. The median number of encounters arriving by police among facilities with reported police arrivals remained steady at 3. The percentage of facilities by year with at least one encounter arriving by police ranged from 60% to 63%. Throughout the study period, the top 10 facilities had between 258 and 3856 total encounters and accounted for 8,693 of the total police arrival encounters. The top two facilities accounted for the most at 3,856 and 1,585, with the number 3 facility having 787. Conclusions: Arrival by police was rare, however, when it did occur most of the time it was for blunt mechanisms and survival was high. A small number of centers saw the majority of police transported patients; typically involving more penetrating mechanisms. This pattern shows that while police transport is not widespread, it plays a notable role in certain regions and deserves more focused study. The use of civilian data for prehospital lessons learned could help enable military use of atypical transport methods.</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"26-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842317","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":"En Route Care: Advancing Trauma Care through Handoffs (E-CATCH): MIST Report Components Associated with Need for Life Saving Interventions and Transfer to the Operating Room.","authors":"Shannon N Thompson, Rachel Ely, Dylan C Rodriguez, Kimberly L Medellin, Allyson A Araña, Darren S Baldwin, Joseph K Maddry","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Abstract: </strong>OBJECTIVES: The MIST report (Mechanism of injury/Medical complaint and history, Injuries head to toe, vital Signs, Treatments) has been used by emergency medical services (EMS) for patient handoff communication and is based on expert opinion. We sought to determine if the region-wide standardization of the EMS patient handoff utilizing the MIST report would result in the communication of information that would predict the need for life-saving intervention (LSI) or transport to the operating room (OR).</p>","PeriodicalId":74148,"journal":{"name":"Medical journal (Fort Sam Houston, Tex.)","volume":"107 4","pages":"67-73"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841871","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}