scholarly journals En Route Critical Care Transfer From a Role 2 to a Role 3 Medical Treatment Facility in Afghanistan

2018 ◽  
Vol 38 (2) ◽  
pp. e7-e15 ◽  
Author(s):  
Amanda M. Staudt ◽  
Shelia C. Savell ◽  
Kimberly A. Biever ◽  
Jennifer D. Trevino ◽  
Krystal K. Valdez-Delgado ◽  
...  
Keyword(s):  
Trauma System ◽  
Patient Characteristics ◽  
International Normalized Ratio ◽  
Medical Attendant ◽  
Treatment Facility ◽  
Medical Evacuation ◽  
Medical Treatment Facility ◽  
Us Military ◽  
Combat Casualty ◽  
Joint Trauma

BACKGROUND En route care is the transfer of patients requiring combat casualty care within the US military evacuation system. No reports have been published about en route care of patients during transfer from a forward surgical facility (role 2) to a combat support hospital (role 3) for comprehensive care. OBJECTIVE To describe patients transferred from a role 2 to a role 3 US military treatment facility in Afghanistan. METHODS A retrospective review of data from the Joint Trauma System Role 2 Database was conducted. Patient characteristics were described by en route care medical attendants. RESULTS More than one-fourth of patients were intubated at transfer (26.9%), although at transfer fewer than 10% of patients had a base deficit of more than 5 (3.5%), a pH of less than 7.3 (5.2%), an international normalized ratio of more than 2 (0.8%), or temporary abdominal or chest closure (7.4%). The en route care medical attendant was most often a nurse (35.5%), followed by technicians (14.1%) and physicians (10.0%). Most patients (75.3%) were transported by medical evacuation (on rotary-wing aircraft). CONCLUSION This is the first comprehensive review of patients transported from a forward surgical facility to a more robust combat support hospital in Afghanistan. Understanding the epidemiology of these patients will inform provider training and the appropriate skill mix for the transfer of postsurgical patients within a combat setting.

Deployed ophthalmic workload in support of US and NATO operations in Afghanistan

2020 ◽  
pp. bmjmilitary-2019-001379 ◽  
Author(s):  
Richard J Blanch ◽  
M T Kerber ◽  
W G Gensheimer
Keyword(s):  
Medical Treatment ◽  
Active Duty ◽  
Treatment Facility ◽  
Aeromedical Evacuation ◽  
Medical Treatment Facility ◽  
Us Military ◽  
Active Duty Military ◽  
Ophthalmic Pathology ◽  
Treatment Facilities ◽  
Ophthalmic Disease

PurposeThe extent and types of ophthalmic disease and non-battle injury (DNBI) seen by expeditionary ophthalmologists at deployed military medical treatment facilities have not previously been reported. We aim to characterise the extent and type of ophthalmic pathology including DNBI at a US military medical treatment facility in Afghanistan.MethodsWe conducted a retrospective non-interventional cohort study of all patients seen by ophthalmologists at Craig Joint Theater Hospital at Bagram Airfield (BAF), Afghanistan, between 1 October 2018 and 31 August 2019.ResultsThere were 281 patients seen in 540 separate encounters, of which 146 patients seen were active duty military stationed at BAF with DNBI, of a population at risk of 6000 personnel. Diagnoses managed included open and closed globe injury, bacterial and herpetic keratitis and retinal detachment, with the most common being dry eye, corneal abrasion/foreign body, blepharitis, chalazion and uveitis. Thirteen patients (5%) required aeromedical evacuation out of theatre and 39 patients were aeromedically transferred within theatre for assessment. Expert consensus estimated that 89 patients (36%) would be likely to require aeromedical evacuation out of theatre without ophthalmic input.ConclusionsThe rate of ophthalmic DNBI among deployed US, UK and coalition forces at BAF was 2.65% per year, of whom 97% were returned to duty (95% of all patients). We estimate that evacuation and loss to unit would increase from 5% to 36% without an ophthalmologist present. The low number of within-theatre aeromedical transfers suggests that the local presence of an ophthalmologist at a patient’s deployed medical treatment facility affects access to deployed ophthalmic care.

scholarly journals The Joint Trauma System Teams Dedicated to Optimizing Combat Casualty Care

2018 ◽  
Vol 183 (suppl_2) ◽  
pp. 190-192
Author(s):  
Mary Ann Spott ◽  
Cynthia R Kurkowski
Keyword(s):  
Trauma System ◽  
Combat Casualty ◽  
Joint Trauma ◽  
Combat Casualty Care

scholarly journals Use of Combat Casualty Care Data to Assess the US Military Trauma System During the Afghanistan and Iraq Conflicts, 2001-2017

JAMA Surgery ◽  
2019 ◽  
Vol 154 (7) ◽  
pp. 600 ◽  
Author(s):  
Jeffrey T. Howard ◽  
Russ S. Kotwal ◽  
Caryn A. Stern ◽  
Jud C. Janak ◽  
Edward L. Mazuchowski ◽  
...  
Keyword(s):  
Trauma System ◽  
Us Military ◽  
Combat Casualty ◽  
Military Trauma ◽  
The Us ◽  
Combat Casualty Care

Saving Lives on the Battlefield: A Joint Trauma System Review of Pre-Hospital Trauma Care in Combined Joint Operating Area - Afghanistan (CJOA-A)

2013 ◽  
Author(s):  
Russ S. Kotwal ◽  
Frank K. Butler ◽  
Erin P. Edgar ◽  
Stacy A. Shackelford ◽  
Donald R. Bennett ◽  
...  
Keyword(s):  
Trauma Care ◽  
Trauma System ◽  
System Review ◽  
Joint Trauma

scholarly journals Joint Trauma System, Defense Committee on Trauma, and Armed Services Blood Program consensus statement on whole blood

Transfusion ◽  
2021 ◽  
Vol 61 (S1) ◽  
Author(s):  
Stacy A. Shackelford ◽  
Jennifer M. Gurney ◽  
Audra L. Taylor ◽  
Sean Keenan ◽  
Jason B. Corley ◽  
...  
Keyword(s):  
Whole Blood ◽  
Consensus Statement ◽  
Trauma System ◽  
Armed Services ◽  
Joint Trauma

scholarly journals Penetrating Neck Injuries Treated at a U.S. Role 3 Medical Treatment Facility in Afghanistan During Operation Resolute Support

2020 ◽  
Author(s):  
John Breeze ◽  
William G Gensheimer ◽  
Joseph J DuBose
Keyword(s):  
Medical Treatment ◽  
Emergency Room ◽  
Neck Region ◽  
Neck Injuries ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
Trauma Registries ◽  
Neck Wound ◽  
Major Injury ◽  
High Negative Predictive Value

ABSTRACT Introduction Military trauma registries can identify broad epidemiological trends from neck wounds but cannot reliably demonstrate temporal casualty from clinical interventions or differentiate penetrating neck injuries (PNI) from those that do not breach platysma. Materials and Methods All casualties presenting with a neck wound to a Role 3 Medical Treatment Facility in Afghanistan between January 1, 2016 and September 15, 2019 were retrospectively identified using the Emergency Room database. These were matched to records from the Operating Room database, and computed tomography (CT) scans reviewed to determine damage to the neck region. Results During this period, 78 casualties presented to the Emergency Room with a neck wound. Forty-one casualties underwent surgery for a neck wound, all of whom had a CT scan. Of these, 35/41 (85%) were deep to platysma (PNI). Casualties with PNI underwent neck exploration in 71% of casualties (25/35), with 8/25 (32%) having surgical exploration at Role 2 where CT is not present. Exploration was more likely in Zones 1 and 2 (8/10, 80% and 18/22, 82%, respectively) compared to Zone 3 (2/8, 25%). Conclusion Hemodynamically unstable patients in Zones 1 and 2 generally underwent surgery before CT, confirming that the low threshold for exploration in such patients remains. Only 25% (2/8) of Zone 3 PNI were explored, with the high negative predictive value of CT angiography providing confidence that it was capable of excluding major injury in the majority of cases. No deaths from PNI that survived to treatment at Role 3 were identified, lending evidence to the current management protocols being utilized in Afghanistan.

scholarly journals Analysis of cases managed by dermatological service in the Chinese peacekeeping level 1+ medical treatment facility in Lebanon, 2018–2019

2020 ◽  
pp. jramc-2019-001315
Author(s):  
Xingwang Wang ◽  
H Yang ◽  
Yuqing Wang ◽  
Jin Yuan ◽  
Qinghua Yu
Keyword(s):  
Medical Treatment ◽  
Skin Diseases ◽  
Acne Vulgaris ◽  
Treatment Facility ◽  
Medical Treatment Facility ◽  
Common Category ◽  
Medical Facilities ◽  
Different Types ◽  
Level 1 ◽  
Basic Medical

IntroductionTo accomplish the peacekeeping mission in Lebanon, China has deployed a level 1+ (CHN L1+) medical treatment facility (MTF) as per the new memorandum. The aim of this study was to review and analyse the skin diseases managed by Chinese dermatological service so as to gain the latest prevalence of different types of skin diseases in this mission area.MethodsAll patients assessed and treated by the dermatological service of CHN L1+ MTF from January 2018 to May 2019 were included. A comparative analysis was made between this study and data published by other peacekeeping medical facilities.ResultsA total of 549 patients were included (87.4% men, with an average age of 35 years old), consisting of 399 military personnel and 150 civilians. Dermatitis and eczema (27.1%) were the most common category of skin diseases, followed by cutaneous mycoses (13.3%) and disorders of skin appendages (10.6%). Among these categories, unspecified dermatitis (9.3%), acne vulgaris (6.6%), tinea corporis (5.3%), folliculitis (5.1%) and tinea pedis (4.7%) were the top five most common reasons for dermatological consultation.ConclusionsTo get a clearer understanding of the disease-type profile in this mission area was beneficial for peacekeeping doctors to make more accurate diagnosis, as well as to prepare more comprehensive medicines during the predeployment period. As dermatological service was lacking in basic medical troops, we would recommend the use of telemedicine to promote dermatological consultations when a specialist was not deployed.

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