Type 2 diabetes: New anti-diabetics and therapeutic strategy for military pilots and planes, combat vehicles and warship crews

The training of combat, transport or helicopter pilots and flight, combat vehicles and warship crews imply a big effort in terms of economic resources, time and logistics for our Armed Forces (FAS). Therefore, it is the responsibility of the Military Health Service to maintain the aptitudes and the skills of our personnel in the best possible conditions for the longest period of time, thus procuring the maximum operating capacity required for the accomplishment of their missions. In this paper it is reviewed and proposed anti-diabetic drugs that may be safely used by pilots, flight, combat vehicles and warship crews, appreciating those that do not produce hypoglycemia neither cause side effects that can compromise the operating capacity. It is recommended and encouraged personnel with pre-diabetic condition to modify their life style and to initiate treatment with metformin, in order to delay or to avoid the onset of diabetes and extend their operating life. It is also encouraged the use of those anti-diabetic agents that best preserve the function of the pancreatic beta cell, therefore delaying the need for insulin based therapy

la formación de un piloto de combate, transporte o helicóptero, tripulaciones de vuelo y vehículos de combate y dotaciones de buques de guerra, supone un gran esfuerzo en cuestión de recursos económicos, de tiempo y medios logísticos para nuestras Fuerzas Armadas (FAS). Por tanto, es responsabilidad de la Sanidad Militar velar por mantener en las mejores condiciones y durante el mayor tiempo posible las aptitudes y capacidades de nuestro personal de vuelo, vehículos de combate y embarcado, procurando así la máxima operatividad para el cumplimiento de las misiones que el mando pudiera requerir. En este artículo se hace una revisión y propuesta de aquellos fármacos antidiabéticos susceptibles de ser utilizados con seguridad por pilotos, tripulaciones de aeronaves y vehículos de combate y dotaciones de buques de guerra, valorando que no produzcan hipoglucemias ni causen efectos secundarios que comprometan la operatividad. Se recomienda y estimula a aquellos que presenten un estado prediabético a modificar su estilo de vida y tratamiento con metformina para retrasar o evitar la aparición de una diabetes prolongando su vida operativa. Se estimula a quienes presenten una diabetes tipo 2 la utilización de aquellos antidiabéticos que mejor preserven la función de la célula beta para retrasar la necesidad de tratamiento insulínico

Audibility of patient clinical alarms to hospital nursing personnel.

The audibility of patient clinical alarms to nursing personnel was tested during the first shift on a medical/surgical in-patient ward at William Beaumont Army Medical Center. This study was conducted during normal hospital operations, and we tested the Joint Commission on Accreditation of Healthcare Organizations 2004 National Patient Safety Goal, Section 6b to determine whether patient alarms could sufficiently compete against environmental background noises. Patient clinical alarms were audible at distances of > or = 95 feet with room doors open but were not sufficiently audible to hospital staff members when room doors were closed or during floor-buffing activities. This study suggests that, under these circumstances, hospitals may not meet Joint Commission on Accreditation of Healthcare Organizations 2004 National Patient Safety Goal, Section 6b. Because the audibility of patient clinical alarms directly affects patient safety, satisfaction, and quality of care, we provide recommendations for engineering controls and modifications to work routines.

Do cadet force units need a dedicated medical pack?

There are over 38,000 army cadets in the United Kingdom of whom about 20,000 attend a two week annual camp each summer. In response to criticisms from the medical staff attached to cadet units about the suitability of the routinely issued medical pack, a national questionnaire survey of all serving Army Cadet Force medical personnel has been performed, along with an analysis of patient attendances at annual camp between 1989 and 1992 in one East Midlands County Force. In particular the appropriateness of the Medical Treatment Pack Training Camp Large as currently issued to cadet units has been examined. The findings suggest that, on its own, the pack is unsuitable to treat about 40% of cadets who attend for medical treatment during annual camp; medical staff on average rate its suitability for cadets as very low. Moreover, there is objective evidence that most cadet units need to obtain extra medical supplies, particularly bronchodilators, modern antibiotics and modern dressings; many do so via private purchases from civilian sources. The study highlights a situation in urgent need of review.