Disaster and military medicine最新文献

{"title":"Evaluating new types of tourniquets by the Israeli Naval special warfare unit.","authors":"Eitan Heldenberg,&nbsp;Shahar Aharony,&nbsp;Tamir Wolf,&nbsp;Tali Vishne","doi":"10.1186/2054-314X-1-1","DOIUrl":"https://doi.org/10.1186/2054-314X-1-1","url":null,"abstract":"<p><strong>Background: </strong>Extremity injuries, which accounts for 20% of all battlefield injuries, result in 7-9% of deaths during military activity. Silicone tourniquets were used, by the Israeli Defense Force (IDF) soldiers, for upper extremity and calf injuries, while thigh injuries were treated by an improvised \"Russian\" tourniquet (IRT). This is the first study, performed in the IDF, comparing the IRT with Combat Application Tourniquets (CAT) and Special Operations Force Tactical Tourniquets (SOFTT). 23 operators from the Israeli Naval Unit (Shayetet 13) were divided into two groups according to their medical training (11 operators trained as first-responders; 12 operators as medics). Repetitive applications of the three tourniquets over the thigh and upper arm, and self-application of the CAT and SOFTT over the dominant extremity were performed using dry and wet tourniquets (828 individual placements) with efficacy recorded. Cessation of distal arterial flow (palpation; Doppler ultrasound) confirmed success, while failure was considered in the advent of arterial flow or tourniquet instability. Satisfaction questionnaires were filled by the operators.</p><p><strong>Results: </strong>CAT and SOFTT were found to be superior to the IRT, in occluding arterial blood flow to the extremities (22%, 23% and 38%, respectively, failure rate). The application was quicker for the CAT and SOFTT as compared to the IRT (18, 26, 52 seconds, respectively). Wet tourniquets neither prolonged application nor did they increase failure rates. Similarly, medics didn't have any advantage over non-medic operators. No findings indicated superiority of CAT and SOFTT over one another, despite operators' preference of CAT.</p><p><strong>Conclusions: </strong>CAT and SOFTT offer an effective alternative to the IRT in stopping blood flow to extremities. No difference was observed between medics and non-medic operators. Thus, the CAT was elected as the preferred tourniquet by our unit and it is being used by all the operators.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2015-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34786998","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":"Primary gastric lymphoma in a soldier presenting as acute gastrointestinal bleeding.","authors":"Ishay Ostfeld,&nbsp;Roei Hod Feins,&nbsp;Ory Rouvio,&nbsp;Lev Dorfman,&nbsp;Jacob Moran-Gilad","doi":"10.1186/2054-314X-1-4","DOIUrl":"https://doi.org/10.1186/2054-314X-1-4","url":null,"abstract":"<p><p>Acute epigastric pain is commonly encountered among young adults undergoing military training. Gastric malignancy usually affects older individuals and may occasionally masquerade as peptic disease. We report a case of primary gastric lymphoma (PGL) in a young soldier, presenting as an acute upper gastrointestinal tract bleeding. The case is presented along with a review of the relevant literature. Primary care physicians should bear in mind that although highly unusual in this age group, primary gastric lymphoma may occasionally afflict young adults and military recruits as demonstrated by the case under discussion. Nevertheless, referral for investigation of suspected peptic disease should follow standard guidelines.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2015-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787001","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":"Cardiovascular and bone health of former elite infantry soldiers at middle life.","authors":"Yael Milgrom,&nbsp;Charles Milgrom,&nbsp;Naama Constantini,&nbsp;David Lavi,&nbsp;Victor Novak,&nbsp;Aharon Finestone","doi":"10.1186/2054-314X-1-3","DOIUrl":"https://doi.org/10.1186/2054-314X-1-3","url":null,"abstract":"<p><strong>Background: </strong>The long term implications of elite infantry service on cardiovascular health and cortical bone width at middle age has not been studied. The purpose of this study was to compare the cardiovascular health and cortical bone thickness of former elite infantry soldiers at middle life with a sedentary population of religious scholars using seven factors associated with cardiovascular risk and QCT tibial cross sections 8 cm above the ankle joint.</p><p><strong>Results: </strong>Torah scholars had a higher 5 year risk for a fatal or non fatal cardiovascular event (p = 0.008) than former elite infantry soldiers. The former elite infantry soldiers had wider tibia cortices than Torah scholar (p = 0.003).</p><p><strong>Conclusions: </strong>This study shows that former elite infantry soldiers who performed strenuous physical activity during their military service and continued physical activity in their subsequent life, had stronger tibias based on increased cortical width and a modest decrease in cardiovascular risk at middle life compared to sedentary Torah scholars.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2015-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34787000","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":"\"Mass casualty management (Rana Plaza Tragedy) in secondary military hospital-anesthesiologist experience: case study\".","authors":"Hasan Murshed,&nbsp;Rokshana Sultana","doi":"10.1186/2054-314X-1-2","DOIUrl":"https://doi.org/10.1186/2054-314X-1-2","url":null,"abstract":"<p><p>Major challenges in the management of mass casualty have been identified as lack of human resources, lack of material resources, lack of communication and co-ordination. Our hospital has limited resources of manpower and disposable items. The Departments of Anaesthesiology and Intensive Care have been seriously disrupted by the influx of 155 severely injured patients following the collapse of a nine storey building. Such a large, instantaneous influx of injured citizens would overwhelm even the most well resourced health care system. A multidisciplinary team approach was planned to manage the casualties. Senior anaesthesiologists took responsibility for the organisation of different staff members into medical triage team, an immediate care team, an urgent care team, a non-urgent care team and a clerical team. Different teams have accomplished casualty management by addressing four principal issues (the assessment of available resources; ensuring critical but limited care; stocking up on medicine and equipment for the patient surge; and tough rationing of decisions). Assessments of available resources were done by emphasising three #8216;S's - staff (human resources), stuff (material resources) and structure. Additional human resources (anaesthesiologists, orthopaedic surgeons etc.) and material resources (#8216;H' type oxygen cylinders, intravenous fluid etc.) were reinforced from nearby hospitals. Additional influxes of critical patients were supported in the postoperative ward and recovery rooms without any monitoring devices. A surgical dressing room without any basic monitoring device was used as an operating room. To do the greatest good for the greatest number of patients, we restricted ourselves to providing \"essential rather than limitless critical care\". \"Stocking up on medicine and equipment resources\" on assessment of the constraints in managing the patient surge, was the next essential step in the management of the casualty load. Patients with life-limiting illnesses were excluded from receiving scarce critical care resources. Thus \"Tough rationing of decision\" was also an important element. Although the patients that were managed were not large in number, a consideration of the setup with a limited workforce and modern equipment and management experience of a mass casualty addressing the four principal issues in our department, might also help other departments in managing such events.</p>","PeriodicalId":91863,"journal":{"name":"Disaster and military medicine","volume":"1 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2015-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/2054-314X-1-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34786999","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}