Combat casualty care research at the U.S. Army Institute of Surgical Research.

The Institute of Surgical Research is the U.S. Army's lead research laboratory for improving the care of combat casualties. The Institute follows a rigorous process for analyzing patterns of injury and the burden of disease to determine where research can be conducted in order to positively impact care. These analyses led the ISR to focus research on: preventing death from bleeding; developing improved pain control techniques; developing improved vital signs analysis techniques; improving the treatment of extremity injuries; preventing burn injuries on the battlefield; and improving critical care for combat casualties. This process has resulted in numerous improvements in care on the battlefield. Highlights include development, fielding, and efficiency testing of tourniquets and improved dressings for bleeding control. Significant progress has also been made in the resuscitation of combat casualties using blood products instead of crystalloid or colloid solutions. Improvements in pain control include assessments of the effect of perioperative anaesthetics on the development of post-traumatic stress disorder [PTSD]. Novelvital signs analyses have been successful in identifying promising techniques which may improve the medic's ability to accurately triage patients. Current research in extremity injuries has focused on optimizing the use of negative pressure wound therapy for contaminated wounds. Burn research has focused on improving personnel protective equipment and implementing continuous renal replacement therapy. This research program is soldier focused and addresses care from self aid and buddy aid through all echelons of care. Many of these advances have been adopted in civilian medical centres as well, benefiting not only the military trauma patient, but also the civilian trauma patient.

Ambient ground level monitoring: a sensible control system for the industry.

Sulfur emission rules are being changed. This action and a proposed EPA Supplementary Control strategy that would allow industrial facilities to continue their operations based on emission measurements and weather conditions is a logical step. Nevertheless, other EPA requirements and limitations are not acceptable to the electric power generating industry. Effective sulfur removal processes and equipment are yet beyond the "state of the art" and thus are not cost effective capital investments while the technology is in development. Field proven ambient monitoring networks are available now to implement fuel switching which is the preferred method of the power industry. This permits remaining within ambient limits, thus fulfilling the basic requirements of the primary SQX stand"... to protect the public health.".