Disaster and military medicine最新文献

{"title":"Case report: a brain abscess in a disaster zone- beyond the call of duty.","authors":"Giora Weiser,&nbsp;Joseph Mendlovic,&nbsp;David Dagan,&nbsp;Dov Albukrek,&nbsp;Manor Shpriz,&nbsp;Ofer Merin","doi":"10.1186/s40696-015-0003-2","DOIUrl":"https://doi.org/10.1186/s40696-015-0003-2","url":null,"abstract":"<p><p>We present a case of a child with a suspected brain abscess treated by a military field hospital in post-typhoon Philippines. We review our intervention and decision process both at the field hospital and following his transfer to a referral center. These interventions were critical for his successful outcome.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2015-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40696-015-0003-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secular trends in 1,192 diarrheal outbreaks in the Israel Defence Forces between 1988-2011.","authors":"Sharon Elazar,&nbsp;Yifat Zelikovich,&nbsp;Hagai Levine,&nbsp;Anat Tzurel-Ferber,&nbsp;Inbal Galor,&nbsp;Michael Hartal","doi":"10.1186/s40696-015-0004-1","DOIUrl":"https://doi.org/10.1186/s40696-015-0004-1","url":null,"abstract":"<p><strong>Background: </strong>In the military, outbreaks of infectious diarrhea pose a significant health problem. In this descriptive analysis of data collected by the IDF on all infectious diarrhea outbreaks between 1988-2011, we analysed temporal, seasonal, and unit-type trends in 1,192 diarrheal outbreaks in the Israel Defence Forces (IDF) over a 24-year period, and described the long-term trends in seasonality and the effects of strategic preventive measures on outbreak frequency among populations at risk.</p><p><strong>Results: </strong>We found two distinct phases in annual outbreak occurrence. The mean annual number of outbreaks during the period 1988-1996 was 75.8 (<i>±</i>14.50) but dropped to 34.0 (<i>±</i>8.13) during the period 1997-2011 (P < 0.0001). Overall, a downward trend continued through the 1990's, while from 2000 onwards outbreak counts fluctuated annually. A significantly higher number of outbreaks occurred during the summer season, throughout the study period. The greatest number of outbreaks occurred in deployed units, although the proportion of outbreaks in this unit type decreased over time. Accordingly, the proportion of outbreaks in training units more than doubled during the study window. When we looked at outbreak size, summer outbreaks increased in magnitude over time, and during all periods outbreaks were larger, on average, in training units than in deployed units.</p><p><strong>Conclusions: </strong>The changing patterns in diarrheal outbreaks in the Israel Defence Forces require maintenance of a higher level of vigilance than ever before. Lack of a clear peak period require the use of all available preventive measures throughout the year. This is especially true in training units, where the increased number of outbreaks coincides with increased trainee volume, regardless of season.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2015-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40696-015-0004-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dimensions of operational stress and forms of unacceptable risk taking with small arms and munitions.","authors":"Uzi Ben-Shalom","doi":"10.1186/s40696-015-0001-4","DOIUrl":"https://doi.org/10.1186/s40696-015-0001-4","url":null,"abstract":"<p><strong>Background: </strong>Accidents with small arms and munitions during deployment is a significant safety concern for leaders and safety specialists in combat units. Operational stress may lead to forms of unacceptable risk taking with small arms that may underlie some of these accidents. The present research studied the correlation between two dimensions of operational stress, two forms of risk taking with small arms among combat unit soldiers and possible mediators. The dimensions of operational threat, negative affect and personality profile from the EPQ-R-S were predictors; \"exaggerated preparedness\" and \"risky games with small arms and munitions\" were dependent variables; safety climate of the platoon served as a mediator variable. The participants were 461 compulsory service combat soldiers in 31 companies. This field study was conducted during period of top security alert.</p><p><strong>Results: </strong>The results reveal that perceived threat is indeed correlated with exaggerated operational preparedness whereas general emotional state was correlated with risky games with small arms. Safety climate mediated only the correlation between general emotional state and risky games with small arms and munitions. Preparedness and risky games were predicted by the interaction of Psychoticism and the Lie Scale from the EPQ-R-S.</p><p><strong>Conclusions: </strong>The results may enhance the efforts in reducing risk taking and prevention of accidents with small arms and munitions during and following deployment.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2015-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40696-015-0001-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and public health management of conjunctivitis in the Israel Defense Forces.","authors":"Orly Efros,&nbsp;Alon Zahavi,&nbsp;Hagai Levine,&nbsp;Michael Hartal","doi":"10.1186/s40696-015-0002-3","DOIUrl":"https://doi.org/10.1186/s40696-015-0002-3","url":null,"abstract":"<p><p>Acute conjunctivitis is a common diagnosis in the general population, and is especially prevalent among military personnel. Conjunctivitis patients are often contagious, and outbreaks of this infectious condition can cause significant morbidity and may jeopardize military readiness. Early recognition and effective management can prevent additional cases in military units. In this article we review the clinical guidelines and public health policy of the Israel Defense Forces for the management of this important medical condition.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2015-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40696-015-0002-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of the suicidal soldier in the Israeli Defense Force-a review of literature.","authors":"Leah Shelef,&nbsp;Lucian Laur,&nbsp;Eyal Fruchter","doi":"10.1186/2054-314X-1-10","DOIUrl":"https://doi.org/10.1186/2054-314X-1-10","url":null,"abstract":"<p><p>Suicide is the third leading cause of death among adolescents in most Western world countries. Similar findings have been reported among adolescents in Israel (including the Israeli army) in times of peace; nonetheless, suicide rate has decreased significantly in recent years. In Israel, IDF service is mandatory and adolescents are obligated to serve by law. Therefore, the IDF is responsible under state and moral law to care for the physical and mental health of its soldiers. Additionally, there is an understanding that the Israeli soldiers represent a mentally healthy population as prior to their enlistment they undergo a series of tests and evaluations to determine their suitability for service. The IDF is one of the few organizations in the world that is comprised of the majority of a country's healthy adolescent population. International literature defines this population (i.e., the adolescent population) as having the highest risk of suicidality. Moreover, the risk of suicide increases in the face of two additional circumstances within the context of military service: the army service as a stressor and the availability of weapons. The IDF invests significant resources in delineating the characteristics of suicidal soldiers, realizing its importance for suicide prevention during military service. This article reviews studies regarding complete suicide cases of Israeli soldiers in the aim of characterising a 'suicidal soldier's profile' to inform better screening and prevention policies.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2015-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Naval casualty management training using human patient simulators.","authors":"Itamar Netzer,&nbsp;Aviram Weiss,&nbsp;David Hoppenstein","doi":"10.1186/2054-314X-1-9","DOIUrl":"https://doi.org/10.1186/2054-314X-1-9","url":null,"abstract":"<p><strong>Background: </strong>Extended-evacuation or austere environments (e.g. naval<b>,</b> immature or depleted combat zones) are characterized by the lack of resources to facilitate medical evacuation in the \"Golden Hour\" from moment of injury. This may require the primary caregiver, often a relatively inexperienced general physician or EMT, to administer extended medical care in the field. We describe the Shipboard and Underwater Casualty Care and Sedation Simulation (SUCCeSS) program in the Israeli Navy, intended to train caregivers for extended prehospital intensive casualty care using high fidelity life-size simulation mannequins set up onboard corvettes or submarines during maneuvers, in maximally realistic conditions. Twenty two general physicians and EMTs in 12 teams were enrolled in the program in the years 2011-2013. Two to three hour long training sessions were headed by senior surgeons and anesthesiologists using flexible scripts enabling the mannequin operators to react to caregivers' actions and their consequences. Trainee evaluation was performed by the preceptors using semi-structured forms taking into account both critical treatment decisions and observation on the effects of actions taken. Trainees also completed self-report CRM (Crisis Resource Management) questionnaires before and after the sessions.</p><p><strong>Results: </strong>Success of the trainees correlated with an evaluation score above 72%. The mean overall CRM score for team leaders post exercise was 74.64%, an improvement of 10% over pre-exercise scores (p < 0.0001).</p><p><strong>Conclusion: </strong>Caregiver self-perceived competence and self-sufficiency in treating casualties at sea was improved via high fidelity simulation in theatre using realistic naval casualty care situations. We discuss the relative strengths and weaknesses of our training program for the teaching of \"NCM\", or Naval Casualty Management, as well as the emergent concepts of the military extended evacuation environment.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2015-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-hospital intra-osseous freeze dried plasma transfusion: a case report.","authors":"Misgav Rottenstreich,&nbsp;Itzik Malka,&nbsp;Elon Glassberg,&nbsp;Oren Schwartz,&nbsp;Bader Tarif","doi":"10.1186/2054-314X-1-8","DOIUrl":"https://doi.org/10.1186/2054-314X-1-8","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhage and coagulopathy are among the leading causes of death in combat and are considered the leading causes of preventable deaths. Plasma, in the form of Fresh Frozen Plasma (FFP) is considered a key component in the Damage Control Resuscitation performed within hospitals. Freeze-Dried Plasma (FDP) can be stored at room temperature and therefore is potentially useful in pre-hospital conditions. Our case report join to few cases where FDP was administered at the point of injury. It is also unique as it describes an intra- osseous administration given to pediatric patient.</p><p><strong>Case report: </strong>M.S. otherwise healthy 13 year old girl was injured due to gunshots and grenade blast. On the first triage by the IDF medical teams she suffered from: Severe hemorrhagic shock, (Blood pressure could not be measured, Heart rate 163), superficial wounds to her face, (forehead and Rt. Eye), gunshot wounds with active bleeding from her Lt. Arm and her RT. Knee (Mangled Extremity Severity Score (MESS) 8) and open fractures of left elbow and right thigh. A peripheral intravenous catheter was established and 1 g tranexamic acid in 500 ml of Hartman fluid were administered. Due to difficulties in establishing a functioning intra-venous line, an intra-osseous catheter was established and one unit of FDP (250 ml) was given in the field. She was transferred by a military medical team to a regional civilian hospital for further treatment. Upon arrival to the hospital her blood pressure and heart rate were significantly improved. After three weeks of hospitalization M.S. was discharged and she was returned to her homeland.</p><p><strong>Conclusion: </strong>We have described the successful use of FDP for pre hospital resuscitation of a 13 year old girl suffering from severe hemorrhagic shock as a result of gunshots and grenade blast. This case report demonstrates that intra-osseous FDP administration for as part pre hospital resuscitation of children has a favorable outcome.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2015-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Happiness amongst Israel Defense Force (IDF) Mental Health Officers (MHO's).","authors":"Assaf Shelef,&nbsp;Calanit Zdaka,&nbsp;Yoram Barak","doi":"10.1186/2054-314X-1-7","DOIUrl":"https://doi.org/10.1186/2054-314X-1-7","url":null,"abstract":"<p><strong>Background: </strong>Positive psychology is the scientific study of positive experiences and positive individual traits. Happy people have a better quality of life and other benefits, including better health. The Mental Health Department of the IDF employs a large cadre of Mental Health Officers (MHO's). The rate of burnout among MHO's is considered to be high. Career satisfaction has received attention recently with publications dealing with the growing discontent of healthcare system workers. High MHO's satisfaction is likely to result in good outcomes with patients. Continued state of dissatisfaction, may result in health problems. In this study we tried to assess levels of happiness and its correlates among MHO's.</p><p><strong>Methods: </strong>Survey among MHO's. Participants answered a questionnaire including the Satisfaction with Life Scale (SLS);personal details: sex, age, marital status, number of children, family income, state of healthand military details:seniority as MHO, rank, administrative executive or clinical position, unit type, army service placement.</p><p><strong>Results: </strong>In the period of the survey100 MHO's completed the questionnaire. Amongst them were 14 psychiatrists, 25 psychologists and 60 social workers. Mean age 37.37 ± 7.12 years, mean years in army service 7.83 ± 6.47. 44% of the MHO's were Captains, 44% Majors, 3% Lieutenant Colonels and 8% citizens working for the I.D.F. The SLS score was analyzed in order to identify correlations to demographic and clinical variables and Pearson coefficient correlations were calculated. The mean total SLS score was 24.29 ± 5.22. The only statistically significant association with SLS score was family income (p = 0.0109).</p><p><strong>Conclusions: </strong>MHO's reported similar levels of happiness as the mean score found in an Israeli national survey and slightly higher level of happiness compared to Israeli physicians. Family income was found to be associated to the level of happiness. Army rank and unit type were not associated with higher satisfaction with life.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2015-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparation of medical personnel for an early response humanitarian mission - lessons learned from the Israeli defense forces field hospital in the Philippines.","authors":"Tomer Erlich,&nbsp;Avi Shina,&nbsp;David Segal,&nbsp;Tal Marom,&nbsp;David Dagan,&nbsp;Elon Glassberg","doi":"10.1186/2054-314X-1-5","DOIUrl":"https://doi.org/10.1186/2054-314X-1-5","url":null,"abstract":"<p><strong>Introduction: </strong>Humanitarian aid provision and early medical response missions to areas ravaged by natural disasters are as essential nowadays as in the past, and medical personnel play a pivotal role in these delegations.</p><p><strong>Case description: </strong>In November 2013, tropical cyclone Haiyan (Yolanda) slammed the Philippines archipelago, leaving more than an estimated 6000 dead in its wake while demolishing vital infrastructure and affecting the life of an estimated 25 million locals. The Israeli Defense Forces (IDF) rapidly constructed and sent a humanitarian aid delegation which included a field hospital deployment with medical capabilities from diverse specialty fields.</p><p><strong>Discussion and evaluation: </strong>The purpose of this article is to summarize our experience in the preparation process of medical personnel before and during deployment. We offer a simple, practical and structured checklist that will assist the medical specialist in preparation for his mission.</p><p><strong>Conclusion: </strong>Preparation of medical personnel for humanitarian aid medical missions is a complex and vital task that might be better accomplished with thorough briefing and structured checklists which begin with addressing of personal safety and other daily needs of the staff.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2015-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological and cognitive military related performances after 10-kilometer march.","authors":"Ran Yanovich,&nbsp;Amir Hadid,&nbsp;Tomer Erlich,&nbsp;Daniel S Moran,&nbsp;Yuval Heled","doi":"10.1186/2054-314X-1-6","DOIUrl":"https://doi.org/10.1186/2054-314X-1-6","url":null,"abstract":"<p><strong>Background: </strong>Prior operational activities such as marching in diverse environments, with heavy backloads may cause early fatigue and reduce the unit's readiness. The purpose of this preliminary study was to evaluate the effect of 10-kilometer (km) march on selected, military oriented, physiological and cognitive performances. Eight healthy young males (age 25 ± 3 years) performed a series of cognitive and physiological tests, first without any prior physiological strain and then after a 10 km march in comfort laboratory conditions (24°C, 50%RH) consisting a 5 km/h speed and 2-6% incline with backload weighing 30% of their body weight.</p><p><strong>Results: </strong>We found that the subjects' time to exhaustion (TTE) after the march decreased by 27% with no changes in anaerobic performance. Cognitive performance showed a significant (20%) reduction in accuracy and a tendency to reduce reaction time after the march.</p><p><strong>Conclusions: </strong>We conclude that a moderate-intensity march under relatively comfort environmental conditions may differently decrease selected military related physical and cognitive abilities. This phenomenon is probably associated with the type and intensity of the pre-mission physical activity and the magnitude of the associated mental fatigue. We suggest that quantifying these effects, as was presented in this preliminary study, by adopting this practical scientific approach would assist in preserving the soldiers' performance and health during training and military operations.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2015-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}