ABSTRACT
INTRODUCTION: The 2010-2011 withdrawal from Iraq included the closure of all fixed-facility military medical resources. Operation INHERENT RESOLVE, the United States-led counter-terrorism mission in Iraq and Syria, subsequently commenced in 2014. With increasing combat operations, the 28th Combat Support Hospital deployed to Iraq to support that mission as a limited footprint unit prototyped after the new modular Army Field Hospital. We describe the non-battle utilization of the emergency medical treatment section. METHODS: We prospectively collected data for this project as part of a performance improvement initiative to track healthcare utilization to guide emergency medical treatment section staffing. The project took place at a combat support hospital near Baghdad, Iraq from July 2016 through January 2017. RESULTS: During this time, the emergency department (ED) averaged 3.5 visits per day totaling 675 non-battle encounters. Most (84.6%) were U.S. military personnel with a median age of 32 (IQR 26-38). The most common procedure performed was point-of-care ultrasound (n = 33). Most patients (96.9%) underwent discharge from the ED. Of the 21 subjects admitted, 6 were for surgical intervention and the remaining for medical or observational indications. The most common chief complaints were musculoskeletal (31.1%, n = 210), respiratory (15.3%, n = 103), and dermatologic (12.0%, n = 81). CONCLUSIONS: Non-battle injuries and illnesses were the predominant reason for ED utilization. Most subjects were discharged back to duty with relatively low-resource utilization. Few visits required procedural interventions.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Hospitals, Military/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Adult , Afghan Campaign 2001- , Emergency Service, Hospital/classification , Emergency Service, Hospital/organization & administration , Female , Hospitals, Military/classification , Hospitals, Military/organization & administration , Humans , Iraq War, 2003-2011 , Male , Mobile Health Units/organization & administration , Mobile Health Units/statistics & numerical data , United States , Warfare/statistics & numerical dataABSTRACT
A catastrophic brain injury is defined as any brain injury that is expected to result in permanent loss of all brain function above the brain stem level. These clinical recommendations will help stabilize the patient so that they may be safely evacuated from theater. In addition to cardiovascular and hemodynamic goals, special attention must be paid to their endocrine dysfunction and its treatment-specifically steroid, insulin and thyroxin (t4) replacement while evaluating for and treating diabetes insipidus. Determining the futility of care coupled with resource management must also be made at each echelon. Logistical coordination and communication is paramount to expedite these patients to higher levels of care so that there is an increased probability of reuniting them with their family.
Subject(s)
Brain Injuries/therapy , Hospitals, Military/classification , Brain Injuries/classification , Brain Injuries/mortality , Hospitals, Military/trends , Humans , Medical Futility/psychology , Patient Transfer/methods , Resuscitation Orders/psychology , Treatment Outcome , WarfareABSTRACT
The authors provided results of the study on approaches to the classification of medical equipment sets for the medical service of the Armed Forces. A retrospective analysis of the formation and development of classifications of first aid kits, medical bags, sets of medical equipment, medical kits and kits is performed. Basic factors influencing the structure and principles of classification sets of medical equipment are detected. The authors present modern classification of sets of medical equipment and the ways of its improvement.
Subject(s)
Durable Medical Equipment/classification , Hospitals, Military/classification , Hospitals, Military/supply & distribution , Military Medicine/instrumentation , HumansABSTRACT
OBJECTIVE: To analyze casualties from firearm and explosives injuries who were admitted to the Intensive Care Unit in the Spanish ROLE-2E from December 2005 to December 2008 and to evaluate which damaging agent had produced the highest morbidity-mortality in our series using score indices with anatomical base (ISS and NISS). DESIGN: Observational and retrospective study performed between 2005 and 2008. SETTING: Polyvalent Intensive Care Unit in the Spanish Military Hospital of those deployed in Afghanistan. PATIENTS OR PARTICIPANTS: The inclusion criteria were all patients who had been wounded by firearm or by explosive devices and who had been admitted in ICU in Spanish Military Hospital in Herat (Afghanistan). INTERVENTION: The anatomic scores Injury Severity Score and the New Injury Severity Score (NISS) were applied to all the selected patients to estimate the grade of severity of their injuries. VARIABLES OF INTEREST: Independent: damaging agent, injured anatomical area, protection measures and dependent: mortality, surgical procedure applied, score severity and socio-demographics and control variables. RESULTS: Eighty-six casualties, 30 by firearm and 56 by explosive devices. Applying the NISS, 38% of the casualties had suffered severe injuries. Mean stay in the ICU was 2.8 days and mortality was 10%. Significant differences in admission to the ICU for the damaging agent were not observed (P=.142). CONCLUSIONS: No significant differences were observed in the need for admission and stay in the ICU according to the damaging agent. The importance of the strategy, care and logistics of the intensive care military physician in Intensive Medicine in the Operating Room in Afghanistan is stressed.
Subject(s)
Blast Injuries/epidemiology , Critical Care/organization & administration , Hospitals, Military/statistics & numerical data , Intensive Care Units/statistics & numerical data , Wounds, Gunshot/epidemiology , Adult , Afghanistan/epidemiology , Blast Injuries/surgery , Blast Injuries/therapy , Critical Care/statistics & numerical data , Female , Hospital Mortality , Hospitals, Military/classification , Hospitals, Military/organization & administration , Humans , Intensive Care Units/classification , Intensive Care Units/organization & administration , Length of Stay/statistics & numerical data , Male , Military Medicine/organization & administration , Military Personnel/statistics & numerical data , Patient Care Team/organization & administration , Patient Transfer/statistics & numerical data , Police/statistics & numerical data , Retrospective Studies , Spain , Surgery Department, Hospital/classification , Surgery Department, Hospital/organization & administration , Trauma Severity Indices , Warfare , Wounds, Gunshot/surgery , Wounds, Gunshot/therapy , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Hospitals, Military/classification , Hospitals, Military/ethics , 51708/classification , 51708/ethics , Military Personnel/classification , Military Personnel/psychology , Relief Work/ethics , Equipment and Supplies, Hospital/standards , Hospitals, Military/standards , Hospitals, Military , 51708/methods , 51708/policies , Military Personnel/education , Spain/ethnology , Relief Work/classification , Equipment and Supplies, Hospital/classificationABSTRACT
No disponible
Subject(s)
Humans , Hospitals, Military/classification , Hospitals, Military/standards , Societies/methods , Societies/policies , Information Systems/standards , Stem Cells/cytology , Medication Reconciliation/classification , Hospitals, Military/economics , Hospitals, Military , Societies/classification , Societies/economics , Information Systems , Stem Cells/metabolism , Medication Reconciliation/methodsABSTRACT
No disponible
Subject(s)
Humans , Military Medicine/education , Military Medicine/methods , Information Systems/classification , Hospitals, Military/classification , Hospitals, Military/standards , Primary Health Care/classification , Primary Health Care/methods , Telemedicine/methods , Military Medicine/classification , Military Medicine/standards , Information Systems/instrumentation , Hospitals, Military/economics , Hospitals, Military , Primary Health Care/standards , Primary Health Care , Telemedicine/standardsABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Military Medicine/classification , Military Medicine/education , Hospitals, Military/classification , 51708/policies , Veterinary Service, Military/organization & administration , Military Dentistry/education , Spain , Military Medicine/methods , Military Medicine/standards , Hospitals, Military , 51708/methods , Veterinary Service, Military/methods , Military Dentistry/methods , Spain/ethnologyABSTRACT
No disponible
Subject(s)
Humans , Hospitals, Military/classification , Hospitals, Military/standards , Health Policy, Planning and Management/standards , Pharmaceutical Preparations/administration & dosage , Military Medicine/classification , Military Medicine/education , Medication Reconciliation/standards , Hospitals, Military/economics , Hospitals, Military , Health Policy, Planning and Management/economics , Pharmaceutical Preparations/metabolism , Military Medicine/methods , Military Medicine/standards , Medication ReconciliationABSTRACT
No disponible
Subject(s)
Humans , Hospitals, Military/classification , Hospitals, Military/economics , Information Systems/standards , Military Medicine/education , 51708/policies , 34002 , Technology/education , Military Dentistry/education , Databases as Topic/instrumentation , Spain , Hospitals, Military/standards , Hospitals, Military , Information Systems/classification , Military Medicine/classification , 51708/classification , 51708/methods , Technology/economics , Military Dentistry/classification , Databases as Topic , Spain/ethnologyABSTRACT
No disponible
Subject(s)
Humans , Hospitals, Military/classification , Hospitals, Military/economics , Education, Continuing/methods , Societies/policies , Ambulatory Surgical Procedures/education , Urban Health Services/economics , Plan Director of Civil Defense , Hospitals, Military/standards , Hospitals, Military , Education, Continuing/standards , Societies/methods , Health of the Elderly , Ambulatory Surgical Procedures/methods , Urban Health Services/classificationABSTRACT
No disponible
Subject(s)
Humans , Hospitals, Military/standards , Plan Director of Civil Defense , Clinical Protocols/classification , Preventive Medicine/education , Preventive Medicine/methods , Hospitals, Military/classification , 34785 , Clinical Protocols/standards , Preventive Medicine/classification , Preventive Medicine/standardsABSTRACT
Este trabalho visa transmitir a experiencia inedita na literatura mundial de Interconsulta Psiquiatrica em Hospital Militar (Hospital Geral de Campo Grande-HCeGC), no periodo de marco de 1992 a marco de 1993. Pretende, ainda, comparar os dados obtidos quanto ao numero de casos atendidos, idade, sexo, estado civil, categoria e situacao militar atual, Forca Armada a que pertence, escolaridade, unidade solicitante, motivo e autor do pedido, medicacao em uso, exame neurologico, diagnostico e conduta psiquiatrica, com dados da literatura civil, propondo a expansao da Interconsulta a outras Organizacoes Militares de Saude, nao so do Comando Militar do Oeste (CMO), mas tambem de outros Comandos.
