ABSTRACT
BACKGROUND: The purpose of this study was to assess the feasibility of hemodynamic monitoring by bioreactance during the air evacuation of war casualties. METHODS: From June 2011 to January 2012, the French Air Force used a noninvasive bioreactance monitor during the aeromedical evacuation of patients with severe battle injury. Patients were continuously monitored from takeoff (baseline) until arrival. Cardiac index, quality, and viability of signal and fluctuations in values were assessed during the entire flight. RESULTS: Eighteen patients were included, and monitoring was possible for 16 patients. The implementation of the monitoring was found to be straightforward for both doctors and paramedics, and we observed no loss of signal or interference during the flights. Cardiac index decreased significantly during the takeoff and returned to baseline value after the 50th minute of flight. CONCLUSION: The application of noninvasive bioreactance hemodynamic monitoring is feasible and pertinent in the specific environment of aeromedical evacuation. This monitoring can be particularly useful during the strategic evacuation of patients with severe injury from field hospital to tertiary centers. LEVEL OF EVIDENCE: Care management study, level V.
Subject(s)
Air Ambulances , Hemodynamics/physiology , Military Medicine/methods , Military Personnel , Monitoring, Physiologic/methods , Wounds and Injuries/physiopathology , Adult , Feasibility Studies , Female , France/epidemiology , Humans , Incidence , Iraq War, 2003-2011 , Male , Middle Aged , Retrospective Studies , Wounds and Injuries/epidemiology , Young AdultABSTRACT
We report a case of scorpion envenomation occurring during combat in Tagab district, province of Kapisa, Afghanistan. A French soldier was stung by a yellow scorpion (suspected Androctonus australis) and sustained systemic envenomation with hemodynamic and neurological manifestations. We discuss the clinical features, prevention, and management of a scorpion sting.
Subject(s)
Military Personnel , Scorpion Stings/complications , Scorpion Stings/drug therapy , Adult , Afghan Campaign 2001- , Animals , Bradycardia/etiology , France , Humans , Hypertension/etiology , Hypotension/etiology , Male , Psychomotor Agitation/etiology , Scorpions , Tachycardia/etiologyABSTRACT
Tuberculosis remains a public-health problem in 2010 with 9 millions cases and 1,7 million deaths worldwide each year. Tuberculosis meningitis is rare (0.5 to 1%) but is associated with high mortality and disability among survivors. An early starting of treatment is crucial. Despite molecular biology methods, microbiological diagnosis remains a challenge for the biologist. We report here 2 cases of tuberculous meningitis with different clinical and biological presentations, which underline diagnosis and therapeutic difficulties encountered in the management of this disease. The first one occurred in an HIV infected patient and the second one was caused by a multidrug-resistant strain. Clinical issues were severe with important neurological residual disability and death. Biological methods available for tuberculous meningitis diagnosis are exposed.
Subject(s)
Tuberculosis, Meningeal/diagnosis , Tuberculosis, Meningeal/drug therapy , AIDS-Related Opportunistic Infections/diagnosis , Adult , Antitubercular Agents/therapeutic use , Drug Therapy, Combination , Female , Humans , Male , Tuberculosis, Multidrug-Resistant/diagnosisABSTRACT
Three patients with extensive necrotizing pneumonia due to Panton-Valentine leukocidin-positive Staphylococcus aureus strains and with aggravating factors (leukopenia count of less than 3x10(9)/liter in all three cases and hemoptysis in two cases) were successfully treated with toxin-suppressing agents introduced rapidly after hospital admission.
