Identification and Development of Leaders in the Navy Medical Department

1990 ◽  
Author(s):  
Daniel G. Dominguez
Keyword(s):  
2019 ◽  
Vol 70 (7) ◽  
pp. 2622-2626 ◽  
Author(s):  
Letitia Doina Duceac ◽  
Constantin Marcu ◽  
Daniela Luminita Ichim ◽  
Irina Mihaela Ciomaga ◽  
Elena Tarca ◽  
...  

Over the past two decades, the resistance to antibiotics, especially for Gram-negative bacteria, has increased at an alarming rate, requiring constant concern for resolving and controlling this extremely important therapeutic aspect in any medical department but in particular, in Anaesthesia and Intensive Care Units, in units of neonatology, paediatrics, neurosurgery, burned patients and immunosuppressed. Specialists note a particular concern for the resistance of Enterobacteriaceae to third-generation cephalosporins and aztreonam, with a resistance profile frequently associated with the expression of extended-spectrum �-lactamases (ESBL). The Enterobacter genus comprises 14 species, but two are of medical interest, Enterobacter aerogenes and E. cloacae, which are involved in inducing healthcare-associated infections such as urinary tract infections, pneumonia associated with mechanical ventilation, bacteremia, septicemia, etc. The purpose of the study was to highlight the antibiotic molecules in which microbial resistance of some circulating strains of enterobacteria was detected. A descriptive and retrospective study was conducted between 2012-2017, on a batch of 35 patients, admitted to the Sf. Maria Emergency Clinical Hospital for Children of Iasi, from whom various pathological products were collected to highlight the Enterobacter sp strains involved in the production of infections associated with the inpatient medical care. The antimicrobial sensitivity of each strain was determined by diffusimetric method, while the interpretation criteria were considered to be those of the laboratory standards. Most cases were reported in 2017 (31.42%). The majority were registered in new-borns (42.85%) and infants (25.71%). The Anaesthesia and Intensive Care Units and Neonatology Anaesthesia and Intensive Care Units departments were the most involved. Microbial antibacterial resistance of Enterobacter sp isolates showed that all manifested resistance to ampicillin, amoxicillin and clavulanic acid, 48.57% were resistant to Cefuroxime, 42.85% resistant to Ceftazidime and Ceftriaxone, 14.28% to ciprofloxacin, 11.42% to ertapenem, 5.71% to Meronem. Although it showed relatively few cases with infections associated with healthcare in which strains of Enterobacter sp. were isolated our study, which was carried out over a period of 5 years, provides useful indications regarding the prevalence of healthcare associated infections with Enterobacter sp in paediatric patients and guidelines for antibiotic therapy.


1966 ◽  
Author(s):  
Kenneth D. Allen ◽  
Maurice C. Archer ◽  
Vernon L. Bolton ◽  
Richard C. Boyes ◽  
Webster H. Brown ◽  
...  

2005 ◽  
Author(s):  
Bruce Nelson ◽  
Don Aldridge ◽  
Linda Nelson

2021 ◽  
Author(s):  
Diego A Vicente ◽  
Obinna Ugochukwu ◽  
Michael G Johnston ◽  
Chad Craft ◽  
Virginia Damin ◽  
...  

ABSTRACT Introduction Navy Medicine's Role 2 Light Maneuver (R2LM) Emergency Resuscitative Surgical Systems (ERSS) are austere surgical teams manned, trained, and equipped to provide life-saving damage control resuscitation and surgery in any environment on land or sea. Given the restrictions related to the COVID-19 pandemic, the previously established pre-deployment training pipeline for was modified to prepare a new R2LM team augmenting a Role 1 shipboard medical department. Methods The modified curriculum created in response to COVID-19 related restriction is compared and contrasted to the established pre-deployment R2LM ERSS curriculum. Subject Matter Experts and currently deployed R2LM members critically evaluate the two curricula. Results Both curricula included the team R2LM platform training and exposure to cadaver based team trauma skills training. The modified curriculum included didactics on shipboard resuscitation, anesthesia and surgery, shipboard COVID-19 management, and prolonged field care in austere maritime environments. Conclusions We describe Navy Medicines R2LM ERSS capability and compare and contrast the standard R2LM pre-COVID-19 curriculum to the modified curriculum. Central to both curricula, the standard R2LM platform training is important for developing and honing team dynamics, communication skills and fluid leadership; important for the successful function austere surgical teams. Several opportunities for improvement in the pre-deployment training were identified for R2LM teams augmenting shipboard Role 1 medical departments.


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