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1.
Mil Med Res ; 9(1): 27, 2022 06 10.
Article in English | MEDLINE | ID: covidwho-1951382

ABSTRACT

Since its establishment in 2014, Military Medical Research has come a long way in becoming a premier journal for scientific articles from various different specialties, with a special emphasis on topics with military relevance. The field of military medicine may be obscure, and may not be readily encountered by the typical clinician on a day-to-day basis. This journal aims not only to pursue excellence in military research, but also keep current with the latest advancements on general medical topics from each and every specialty. This editorial serves to recap and synthesize the existing progress, updates and future needs of military medical excellence, discussing foremostly the unique traits of literature published in this journal, and subsequently presenting the discourse regarding wartime and peacetime medicine, the role of the military in a public health emergency, as well as wound healing and organ regeneration. Special attention have been devoted to military topics to shed light on the effects of Chemical, Biological, Radiological and Explosive (CBRE) warfare, environmental medicine and military psychiatry, topics which rarely have a chance to be discussed elsewhere. The interconnectedness between military combat and soldier physical and mental well-being is intricate, and has been distorted by pandemics such as coronavirus disease 2019 (COVID-19). This journal has come a long way since its first article was published, steadily contributing to the existing knowledge pool on general medical topics with a military slant. Only with continuous research and sharing, can we build upon the work of the scientific community, with hopes for the betterment of patient care.


Subject(s)
COVID-19 , Military Medicine , Military Personnel , Humans , Pandemics , Publications
2.
Health Serv Res ; 57(4): 720-722, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1937869
3.
J Trauma Acute Care Surg ; 92(6): e140, 2022 06 01.
Article in English | MEDLINE | ID: covidwho-1886533
4.
Anaesth Crit Care Pain Med ; 41(3): 101062, 2022 06.
Article in English | MEDLINE | ID: covidwho-1881591
5.
Anesth Analg ; 134(1): 216-224, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1822236

ABSTRACT

At the outbreak of World War II (WWII), anesthesiology was struggling to establish itself as a medical specialty. The battlefield abruptly exposed this young specialty to the formidable challenge of mass casualties, with an urgent need to provide proper fluid resuscitation, airway management, mechanical ventilation, and analgesia to thousands. But while Europe was suffering under the Nazi boot, anesthesia was preparing to rise to the challenge posed by the impending war. While war brings death and destruction, it also opens the way to medical advances. The aim of this study is to measure the evolution of anesthesia owing to WWII. We conducted a retrospective observational bibliometric study involving a quantitative and statistical analysis of publications. The following 7 journals were selected to cover European and North American anesthesia-related publications: Anesthesia & Analgesia, the British Journal of Anaesthesia, Anesthesiology, Schmerz-Narkose-Anaesthesie, Surgery, La Presse Médicale, and The Military Surgeon (later Military Medicine). Attention was focused on journal volumes published between 1920 and 1965. After reviewing the literature, we selected 12 keywords representing important advances in anesthesiology since 1920: "anesthesia," "balanced anesthesia," "barbiturates," "d-tubocurarine," "endotracheal intubation," "ether," "lidocaine," "morphine," "spinal anesthesia," "thiopental," "transfusion," and "trichloroethylene." Titles of original articles from all selected journals editions between 1920 and 1965 were screened for the occurrence of 1 of the 12 keywords. A total of 26,132 original article titles were screened for the occurrence of the keywords. A total of 1815 keywords were found. Whereas Anesthesia & Analgesia had the highest keyword occurrence (493 citations), Schmerz-Narkose-Anaesthesie had the lowest (38 citations). The number of publications of the 12 keywords was significantly higher in the postwar than in the prewar period (65% and 35%, respectively; P < .001). Not surprisingly, the anesthesiology journals have a higher occurrence of keywords than those journals covering other specialties. The overall occurrence of keywords also showed peaks during other major conflicts, namely the Spanish Civil War (1936-1939), the Korean War (1950-1953), and the Vietnam War (1955-1975). For the first time, this study demonstrates statistically the impact of WWII on the progress of anesthesiology. It also offers an objective record of the chronology of the major advances in anesthesiology before and after the conflict. While the war arguably helped to enhance anesthesiology as a specialty, in return anesthesiology helped to heal the wounds of war.


Subject(s)
Anesthesiology/history , Military Medicine/history , Anesthesia/history , Bibliometrics , Europe , History, 20th Century , Humans , Military Personnel , World War II
7.
Mil Med ; 187(1-2): 9-11, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1604410

ABSTRACT

In response to the COVID pandemic, Uniformed Services University (USU) suspended clerkships. As the nation's military medical school, USU had to keep students safe while still preparing them to be military physicians. In this commentary, we, a group of USU students, explore what this experience taught us about military medicine.


Subject(s)
COVID-19 , Education, Medical , Military Medicine , Military Personnel , Students, Medical , Humans , Military Medicine/education , SARS-CoV-2 , Schools, Medical
10.
Mil Med ; 186(12 Suppl 2): 35-39, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1381028

ABSTRACT

INTRODUCTION: The global 2019 coronavirus pandemic (COVID-19) is setting unprecedented demands on the nation and the military and surgical services. Surgical demands include a large backlog of surgical cases, strain on available resources, and the need for additional measures to prevent exposure. The purpose of this project was to evaluate the feasibility, duration, adverse events, and potential gains associated with using a Turbett Sterilization Pod (TSP) for total joint replacements. MATERIALS AND METHODS: A multidisciplinary team used the Plan-Do-Study-Act model to guide this project. A time-motion study was completed in the operating room (OR) to measure the average time required to set up surgical instrumentation for total joint replacement cases that required 12 or more instrument trays. We compared the amount of time it took to complete the setting up of instrumentation using the traditional method versus the TSP method. The traditional method consisted of unwrapping each surgical tray, checking for holes in the blue wrapper, and placing the tray on the back table. In the case of the TSP, the door of the pod was opened, and the instrument trays were transferred directly to the back table. We measured the time the staff took to perform the task using each of these methods. RESULTS: When compared to the traditional method, the use of the TSP resulted in improved turnover time, decreased room setup time, reduced environmental waste, and eliminated both the effect of damage to wrappers and the time previously spent wrapping surgical trays. CONCLUSION: The TSP minimizes the time needed by the staff to set up an OR suite for a total joint replacement, therefore permitting them to focus more on direct patient care. This time improvement suggests that all surgical specialties, including those requiring greater than 12 traditional instrument sets, may experience reduced turnover time between cases. The use of the TSP is one means to help rectify the OR backlog brought on by COVID-19.


Subject(s)
COVID-19 , Military Medicine , Cost Savings , Humans , Operating Rooms , SARS-CoV-2 , Sterilization , Surgical Instruments
12.
J Empir Res Hum Res Ethics ; 16(3): 193-199, 2021 07.
Article in English | MEDLINE | ID: covidwho-1166860

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic, first reported in China, soon spread worldwide, has evolved into one of the most complex global public health crises the world has encountered in the last several decades. Conducting military medical research is vital to study the unique influences of military service conditions on soldiers' health and to improve the medical response in various emergency periods. The Israel Defense Forces (IDF) Medical Corps maintains an Institutional Review Board (IRB) which reviews clinical studies conducted within the IDF. During the COVID-19 pandemic, the IRB of the IDF had to rapidly implement procedural modifications in order to comply with expanding urgent demands for research without compromising ethical standards. The ethical dilemmas and the IDF policy and perspective are outlined in this article.


Subject(s)
COVID-19 , Clinical Trials as Topic/ethics , Military Health/ethics , Military Medicine/ethics , Pandemics , Adult , COVID-19/epidemiology , Humans , Israel/epidemiology , Military Personnel , SARS-CoV-2
13.
Br J Nurs ; 30(6): 385, 2021 Mar 25.
Article in English | MEDLINE | ID: covidwho-1159505

ABSTRACT

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the benefits of having military teams to assist and bring a fresh perspective to NHS Trusts during the pandemic.


Subject(s)
Attitude of Health Personnel , COVID-19 , Military Medicine , Nursing Staff, Hospital , State Medicine , COVID-19/prevention & control , England/epidemiology , Hospitals, University , Humans , Military Medicine/organization & administration , Nursing Staff, Hospital/psychology , State Medicine/organization & administration
15.
Mil Med ; 186(1-2): 1-2, 2021 01 30.
Article in English | MEDLINE | ID: covidwho-1121439
16.
Air Med J ; 40(1): 76-78, 2021.
Article in English | MEDLINE | ID: covidwho-1060580

ABSTRACT

This short communication highlights the US Air Force's recent success with having their aeromedical evacuation crews use the Transportation Isolation System for the first time operationally to transport patients positive for coronavirus disease 2019.


Subject(s)
Aerospace Medicine/methods , Air Ambulances , COVID-19/prevention & control , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Military Medicine/methods , Military Personnel , Aerospace Medicine/instrumentation , Aerospace Medicine/trends , COVID-19/transmission , Humans , Infection Control/instrumentation , Infection Control/trends , Military Medicine/instrumentation , Military Medicine/trends , United States
17.
Nurs Inq ; 28(1): e12389, 2021 01.
Article in English | MEDLINE | ID: covidwho-1060488

ABSTRACT

The prioritisation of scarce resources has a particular urgency within the context of the COVID-19 pandemic crisis. This paper sets out a hypothetical case of Patient X (who is a nurse) and Patient Y (who is a non-health care worker). They are both in need of a ventilator due to COVID-19 with the same clinical situation and expected outcomes. However, there is only one ventilator available. In addressing the question of who should get priority, the proposal is made that the answer may lie in how the pandemic is metaphorically described using military terms. If nursing is understood to take place at the 'frontline' in the 'battle' against COVID-19, a principle of military medical ethics-namely the principle of salvage-can offer guidance on how to prioritise access to a life-saving resource in such a situation. This principle of salvage purports a moral direction to return wounded soldiers back to duty on the battlefield. Applying this principle to the hypothetical case, this paper proposes that Patient X (who is a nurse) should get priority of access to the ventilator so that he/she can return to the 'frontline' in the fight against COVID-19.


Subject(s)
COVID-19/prevention & control , Resource Allocation/standards , Salvage Therapy/trends , COVID-19/psychology , COVID-19/transmission , Humans , Intensive Care Units/organization & administration , Intensive Care Units/trends , Military Medicine/methods , Pandemics/prevention & control , Resource Allocation/methods , Salvage Therapy/psychology , Salvage Therapy/standards , Ventilators, Mechanical/supply & distribution
18.
Mil Med Res ; 8(1): 8, 2021 01 25.
Article in English | MEDLINE | ID: covidwho-1045592

ABSTRACT

The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict. Between crowded barracks at home and trenches abroad, wartime conditions helped enable the spread of influenza in the fall of 1918 during World War I such that an estimated 20-40% of U.S. military members were infected. While the coronavirus disease 2019 (COVID-19) pandemic is unparalleled for most of today's population, it is essential to not view it as unprecedented lest the lessons of past pandemics and their effect on the American military be forgotten. This article provides a historical perspective on the effect of the most notable antecedent pandemic, the Spanish Influenza epidemic, on American forces with the goal of understanding the interrelationship of global pandemics and the military, highlighting the unique challenges of the current pandemic, and examining how the American military has fought back against pandemics both at home and abroad, both 100 years ago and today.


Subject(s)
Influenza Pandemic, 1918-1919/history , Military Medicine/history , Pandemics/history , COVID-19/epidemiology , COVID-19/therapy , History, 20th Century , History, 21st Century , Humans , Military Medicine/organization & administration , SARS-CoV-2 , United States/epidemiology , World War I
19.
J Trauma Acute Care Surg ; 89(3): e59-e63, 2020 09.
Article in English | MEDLINE | ID: covidwho-1007362

ABSTRACT

BACKGROUND: Management of critically ill patients requiring mechanical ventilation in austere environments or during disaster response is a logistic challenge. Availability of oxygen cylinders for mechanically ventilated patient may be difficult in such a context. A solution to ventilate patients requiring high fraction of inspired oxygen (FiO2) is to use a ventilator able to be supplied by a low-pressure oxygen source connected with two oxygen concentrators (OCs). We tested the Elisée 350 (ResMedBella Vista, Australia) ventilator paired with two Newlife Intensity 10 (Airsep, Ball Ground, Georgia) OCs and evaluated the delivered FiO2 across a range of minute volumes and combinations of ventilator settings. METHODS: The ventilators were attached to a test lung, OC flow was adjusted with a Certifier FA ventilator test systems from 2 to 10 L/min and injected into the oxygen inlet port of the Elisée 350. The FiO2 was measured by the analyzer integrated in the ventilator, controlled by the ventilator test system. Several combinations of ventilator settings were evaluated to determine the factors affecting the delivered FiO2. RESULTS: The Elisée 350 ventilator is a turbine ventilator able to deliver high FiO2 when functioning with two OCs. However, modifications of the ventilator settings such as an increase in minute ventilation affect delivered FiO2 even if oxygen flow is constant on the OC. CONCLUSION: The ability of two OCs to deliver high FiO2 when used with a turbine ventilator makes this method of oxygen delivery a viable alternative to cylinders to ventilate patients requiring an FiO2 of ≥80% in austere place or during disaster response. LEVEL OF EVIDENCE: Feasibility study on test bench, level V.


Subject(s)
Military Medicine/instrumentation , Oxygen Inhalation Therapy/instrumentation , Respiration, Artificial , COVID-19/therapy , Critical Illness/therapy , Equipment Design , France , Humans
20.
Soins ; 65(849): 22-27, 2020 Oct.
Article in French | MEDLINE | ID: covidwho-997629

ABSTRACT

The militaryintensive care field hospital is a new tool set up by the military medical service as part of Operation Resilience to provide medical support in the regions of France most affected by the SARS-Cov-2 pandemic. Deployed in Mulhouse and Mayotte, this hospital facility is a functional intensive care unit set up to support an existing hospital structure. The caregivers and logistics specialists are all from the military medical service, active personnel or reservists, predominantly nurses. The implementation of this intensive care field hospital in a constrained environment requires an efficient provision of care in accordance with medical guidelines, while protecting the healthcare staff and, notably, the frontline nursing staff.


Subject(s)
COVID-19 , Intensive Care Units/organization & administration , Military Medicine , Mobile Health Units/organization & administration , Critical Care , France , Humans , Military Personnel
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