Abstract：
:Damage control resuscitation (DCR) is a strategy for resuscitating patients from hemorrhagic shock to rapidly restore homeostasis. Efforts are focused on blood product transfusion with whole blood or component therapy closely approximating whole blood, limited use of crystalloid to avoid dilutional coagulopathy, hypotensive resuscitation until bleeding control is achieved, empiric use of tranexamic acid, prevention of acidosis and hypothermia, and rapid definitive surgical control of bleeding. Patients receiving uncrossmatched Type O blood in the emergency department and later receiving cumulative transfusions of 10 or more red blood cell units in the initial 24-hour post-injury (massive transfusion) are widely recognized as being at increased risk of morbidity and mortality due to exsanguination. Ideally, these patients should be rapidly identified, however anticipating transfusion needs is challenging. Useful indicators of massive transfusion reviewed in this guideline include: systolic blood pressure <110 mmHg, heart rate > 105 bpm, hematocrit <32%, pH < 7.25, injury pattern (above-the-knee traumatic amputation especially if pelvic injury is present, multi-amputation, clinically obvious penetrating injury to chest or abdomen), >2 regions positive on Focused Assessment with Sonography for Trauma (FAST) scan, lactate concentration on admission >2.5, admission international normalized ratio ≥1.2-1.4, near infrared spectroscopy-derived StO2 < 75% (in practice, rarely available), BD > 6 meq/L. Unique aspects of out-of-hospital DCR (point of injury, en-route, and remote DCR) and in-hospital (Medical Treatment Facilities: Role 2b/Forward surgical teams - role 3/ combat support hospitals) are reviewed in this guideline, along with pediatric considerations.
journal_name
Mil Medjournal_title
Military medicineauthors
Cap AP,Pidcoke HF,Spinella P,Strandenes G,Borgman MA,Schreiber M,Holcomb J,Tien HC,Beckett AN,Doughty H,Woolley T,Rappold J,Ward K,Reade M,Prat N,Ausset S,Kheirabadi B,Benov A,Griffin EP,Corley JB,Simon CD,Fahiedoi
10.1093/milmed/usy112subject
Has Abstractpub_date
2018-09-01 00:00:00pages
36-43issue
suppl_2eissn
0026-4075issn
1930-613Xpii
5091142journal_volume
183pub_type
杂志文章abstract：INTRODUCTION:Repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression has been studied for over two decades. Repetitive TMS was approved by the Food and Drug Administration in 2008 for the treatment of depression after at least one failed trial of an antidepressant medication of adequate dose a...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usaa148
更新日期：2020-09-18 00:00:00
abstract：:A new technique called osseointegration was introduced recently by intimately connecting the artificial limb prosthesis to the residual bone, eliminating the problematic socket-residuum interface. The objective here is to describe the two-stage strategy for the osseointegrated reconstruction of amputated limbs and dis...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usx185
更新日期：2018-03-01 00:00:00
abstract：:The diagnosis and management of concussion can be difficult in a combat environment, especially in the absence of loss of consciousness or post-traumatic amnesia. As no validated test exists to diagnose or grade neurocognitive impairment from a concussion, the military currently employs the Military Acute Concussion E...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed-d-09-00258
更新日期：2010-07-01 00:00:00
abstract：:During Operation Desert Storm, in February 1991, Iraqi troops began burning Kuwaiti oil wells. Almost immediately there was concern about possible adverse health effects in U.S. personnel exposed to crude oil combustion products. Combustions products were predicted from the known composition of Kuwaiti crude oil. Moni...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed-d-11-00079
更新日期：2011-07-01 00:00:00
abstract：:A case is presented of a young active duty woman who experienced nonpsychotic denial of pregnancy until she precipitously delivered a healthy full-term infant. Despite the lack of prenatal care and the requirement for neonatal resuscitation, the child has apparently developed normally. The woman had no ongoing psychia...
journal_title：Military medicine
pub_type： 杂志文章,评审
doi：
更新日期：2000-07-01 00:00:00
abstract：:Military free fall or HALO (high altitude-low opening) is a distinct form of tactical parachuting used by the elite forces of the U.S. military. This study was undertaken to examine the type, location, and mechanism of injuries sustained by the military HALO parachutist during training. A retrospective study identifie...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1999-07-01 00:00:00
abstract：INTRODUCTION:Service members (SMs) who are injured on deployment are at risk for myriad long-term health problems that may be ancillary to their physical injury, including high rates of depression and posttraumatic stress disorder, and poor health behaviors (e.g., problem drinking, cigarette and tobacco use, poor sleep...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usaa242
更新日期：2020-10-02 00:00:00
abstract：INTRODUCTION:The purpose of this study is to characterize self-reported protective factors against suicide or self-harm within free-response comments from a harm-risk screening. MATERIALS AND METHODS:Veterans enrolled in Department of Veterans Affairs mental health care were administered a self-harm and suicide screen...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usz111
更新日期：2019-12-01 00:00:00
abstract：:Adherence to the Maximal Allowable Weight (MAW) standards established by regulation can be difficult for many active duty personnel. We have discovered some members of this group utilizing the potentially dangerous rapid weight loss methods that are commonly seen in patients with bulimia and anorexia nervosa. Two case...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1989-12-01 00:00:00
abstract：INTRODUCTION:Military-connected youth are at increased risk for experiencing distinct psychosocial and behavioral health vulnerabilities. Although behavioral health interventions have been developed to treat vulnerabilities in military-connected youth, little is known about the methodological quality of studies evaluat...
journal_title：Military medicine
pub_type： 杂志文章,评审
doi：10.7205/MILMED-D-17-00060
更新日期：2017-11-01 00:00:00
abstract：:This article addresses a topic that is part of the public consciousness yet is seldom explored in the public health literature: presidential promotion of health-related behaviors through words and example. The article explores the history of what some American presidents, as individuals, have conveyed to the populatio...
journal_title：Military medicine
pub_type： 历史文章,杂志文章
doi：10.7205/MILMED-D-12-00416
更新日期：2013-04-01 00:00:00
abstract：:This article describes, from the perspective of Project HOPE volunteers, the precedent-setting, military-civilian partnership in staffing the USNS Mercy as part of the rapid response of the United States to the overwhelming devastation and loss of life resulting from the tsunami off the coast of Indonesia. The article...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.171.1s.34
更新日期：2006-10-01 00:00:00
abstract：:Sarcoidosis has been associated with various demographic risk factors, yet findings may be falsely influenced by effects such as socioeconomic status. We used univariate and multiple logistic regression to compare demographic data from military sarcoidosis hospitalizations with similar data from the general military p...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：2000-08-01 00:00:00
abstract：:This study evaluated the efficacy of a brief cognitive-behavioral program in modifying causal attributions, expectancy of control, coping strategies, and psychological adjustment in a sample of Australian Army soldiers undergoing a 45-day recruit training program. Participants (N = 174) were randomly allocated within ...
journal_title：Military medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.7205/milmed.173.12.1151
更新日期：2008-12-01 00:00:00
abstract：:Sixty-two medical observers at various levels of medical training examined six patients for the presence or absence of scleral icterus in a double-blind survey. At a total serum bilirubin of 42.8 mmol/l (2.5 mg/dl) and 53.0 mmol/l (3.1 mg/dl), 58% (95% confidence interval [CI] 33-80%) and 68% (95% CI 46-85%) of examin...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1997-08-01 00:00:00
abstract：:Brief structured clinical interviews are a key component of the Department of Defense postdeployment health reassessment program. Such interviews are critical for recommending individuals for follow-up assessment and care. To standardize the interview process, U.S. Army Medical Research Unit-Europe developed a structu...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.173.5.411
更新日期：2008-05-01 00:00:00
abstract：:Advanced practice nurses (APN) who practice in the surgical subspecialty areas may have the opportunity to expand their scope of practice to include first assistant at surgery. Surgical APNs who practice as registered nurse first assistants (RNFA) should seek credentialing and apply for institutional privileges to ass...
journal_title：Military medicine
pub_type： 历史文章,杂志文章
doi：10.7205/milmed.171.9.875
更新日期：2006-09-01 00:00:00
abstract：INTRODUCTION:Deployment-related mild traumatic brain injury (mTBI) affects a significant proportion of those who served in Post-9/11 combat operations. The prevalence of head injuries, including those that lead to mTBI, is often reported quantitatively. However, service member (SM) and Veteran firsthand accounts of the...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usaa308
更新日期：2021-01-25 00:00:00
abstract：:The use of explosive armaments during Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn has resulted in a significant number of injured U.S. service members. These weapons often generate substantial extremity trauma requiring multiple surgical procedures to preserve life, limb, and restore fu...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-15-00315
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:Post-traumatic headache (PTH) is a commonly experienced symptom after mild traumatic brain injury (mTBI). Blast injury- or blunt injury-related mechanisms for mTBI in veterans can also affect musculoskeletal structures in the neck, resulting in comorbid neck pain (NP). However, it is unknown whether the pres...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usaa532
更新日期：2020-12-11 00:00:00
abstract：:This study evaluated the risk to hearing health associated with duty on the flight deck of a Nimitz class aircraft carrier. Descriptive data includes time-weighted average noise exposure and an evaluation of temporary threshold shift for a group of nonaviator flight deck personnel (FD), and a comparison of accrued per...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed.169.6.429
更新日期：2004-06-01 00:00:00
abstract：:Symptoms of vaginitis and urinary tract infections are miserable, distracting, and significantly affect women's quality of life. Among civilian women, these symptoms account for 10.5 million office visits per year. To examine the scope of the problem for military women during deployment situations, surveys were sent t...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：2003-07-01 00:00:00
abstract：:Rhabdomyolysis is a painful and potentially life-threatening injury in which muscle breaks down in response to an insult. In this case report, we describe the clinical course of a 22-year-old man who developed paraspinal muscle rhabdomyolysis and possible compartment syndrome in association with strenuous activity and...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-14-00647
更新日期：2015-07-01 00:00:00
abstract：INTRODUCTION:Obesity is prevalent among users of Veteran's Health Administration services, where it is comorbid with depression, post-traumatic stress disorder, type 2 diabetes, cardiovascular disease, colon, and breast cancer. Among obese subjects, severe obesity represents a subpopulation with the highest risk of dep...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.1093/milmed/usz475
更新日期：2020-06-08 00:00:00
abstract：BACKGROUND:Combat casualties have endured an increase in traumatic lower extremity amputations secondary to improvised explosive devices. Often surgical control of the proximal vasculature is required. We evaluate the safety profile of exploratory laparotomy (EXLAP) for proximal control (PC) in combat-injured patients....
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-15-00155
更新日期：2016-05-01 00:00:00
abstract：:Cigarette smoking disproportionately affects veterans, particularly those with psychiatric diagnoses. Chaplains working within the Department of Veterans Affairs (VA) play key roles in emotional, physical, and spiritual health care of veterans, and veterans often turn to chaplains with mental health concerns. The VA/D...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/MILMED-D-13-00380
更新日期：2014-05-01 00:00:00
abstract：:Previous studies have linked the use of caffeine, nicotine, and alcohol to health complications and have also found that the use of these substances significantly covary. Given the prevalence of health problems of older adults, it is surprising that no studies to date have examined the co-occurrent use of alcohol, caf...
journal_title：Military medicine
pub_type： 杂志文章
doi：
更新日期：1998-03-01 00:00:00
abstract：:In 1991-1992, a pelvic stress fracture incidence of 11.2% was recorded in a cohort of 143 female Australian Army recruits. An incidence of 0.1% was recorded in a cohort of male recruits trained in the 1992-1993 year using a nearly identical program. A number of preventive strategies were instituted in an attempt to re...
journal_title：Military medicine
pub_type： 临床试验,杂志文章
doi：
更新日期：1999-05-01 00:00:00
abstract：:The present review addresses the perceived stigma associated with admitting a mental health problem and seeking help for that problem in the military. Evidence regarding the public stigma associated with mental disorders is reviewed, indicating that the public generally holds negative stereotypes toward individuals wi...
journal_title：Military medicine
pub_type： 杂志文章,评审
doi：10.7205/milmed.172.2.157
更新日期：2007-02-01 00:00:00
abstract：:Spontaneous pneumomediastinum (SPM) with associated subcutaneous emphysema is an uncommon and generally benign condition. We describe an occurrence of SPM that occurred from yelling in a U.S. Marine Corps Drill Instructor. The patient describes yelling at Marine recruits the day prior when he felt a pop "behind his no...
journal_title：Military medicine
pub_type： 杂志文章
doi：10.7205/milmed-d-12-00243
更新日期：2012-11-01 00:00:00
