Abstract:
INTRODUCTION:The U.S. Air Force utilizes specialized Critical Care Air Transport Teams (CCATT) for transporting "stabilized" patients. Given the drawdown of military forces from various areas of operation, recent CCATT operations have increasingly involved the evacuation of unstable and incompletely resuscitated patients from far forward, austere locations. This brief report describes unique cases representative of the evolving CCATT mission and provides future direction for changes in doctrine and educational requirements in preparation for en route combat casualty care. METHODS AND MATERIALS:This case series describes three patients who required significant resuscitation during CCATT transport from austere locations between April and November 2017. Approval for this project was received from the US Air Force 59th Medical Wing Institutional Review Board as non-research. RESULTS:Case 1: CCATT was dispatched to transport patient 1 who was reported to have a head injury after a fall. Upon evaluation of the patient onboard the aircraft, it was discovered that the patient was in cardiac arrest. Cardiopulmonary resuscitation was performed during tactical takeoff with frequent combat maneuvers. The patient developed a palpable pulse after three rounds of CPR, three doses of epinephrine, and one unit of packed red blood cells. Point of care laboratory analysis demonstrated a profoundly elevated lactate level. Cyanide poisoning was a concern but there was no antidote available in the available equipment set. After delivery to a medical facility, blood samples were positive for cyanide. Over the next 2 weeks, the patient improved and was discharged home, neurologically intact. Case 2: Patient 2 sustained complex blast injuries and bilateral lower extremity amputations. He required early transport for continuous renal replacement therapy (CRRT). The patient received 200 units of blood products in the 24 hours prior to transport and developed renal failure, pulmonary edema, and elevated ICP. During the 7 hour flight, Patient 2 received frequent adjustments of vasopressor medications, multiple Dakins solution soaks and flushes, and 1 unit of fresh frozen plasma. He remained alive 2 months later. Case 3: The team was notified to collect an urgent patient with a blast lung injury and bilateral lower extremity amputations. The ground team encountered difficulty ventilating the patient. Patient 3 arrived in the back of a pickup truck accompanied by medics and being bag valve mask ventilated with a pulse oximetry reading of 65%. He was secured to the floor of the aircraft which departed within 5 minutes of arrival. An ultrasound of the lungs showed no pneumothorax. By the end of the flight, the patient's oxygen saturation had risen to 95% and he was delivered to the emergency department in stable condition. He later passed away in the operating room due to severe blast lung and cardiac contusion. CONCLUSION:This brief report demonstrates the need of CCATT in the transport of unstable patients from forward deployed locations. The Air Force has adapted and is continuing to adapt CCATT training, equipment, onboard diagnostics and therapies, and team members' clinical skills to meet en route care combat casualty needs.
journal_name
Mil Medjournal_title
Military medicineauthors
Maddry JK,Ball EM,Cox DB,Flarity KM,Bebarta VSdoi
10.1093/milmed/usy371subject
Has Abstractpub_date
2019-05-01 00:00:00pages
e172-e176issue
5-6eissn
0026-4075issn
1930-613Xpii
5233900journal_volume
184pub_type
杂志文章abstract::Typical military tasks include load carriage, digging, and lifting loads. To avoid accumulation of fatigue, it is important to know the energy expenditure of soldiers during such tasks. The purpose of this study was to measure cardiorespiratory responses during military tasks in field conditions. Unloaded (M1) and loa...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-13-00299
更新日期:2014-02-01 00:00:00
abstract::The authors describe the case of a giant osteochondroma emanating from the L5 vertebral body and extending into the retroperitoneum of a 40-year-old man, causing low back pain. Osteochondromas are benign bony tumors that typically occur within the appendicular skeleton, although in the sporadic form, up to 4% occur in...
journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/MILMED-D-14-00239
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:Noise exposure is an occupational health concern for certain professions, especially military servicemembers and those using power tools on a regular basis. The purpose of this study was to quantify noise exposure during total hip arthroplasty (THA) and total knee arthroplasty (TKA) cases compared to the r...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa102
更新日期:2020-09-18 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.173.2.210
更新日期:2008-02-01 00:00:00
abstract::The results from a study undertaken to assess the smoking behavior of Greek warship personnel found that of the 274 participants, ages 19 to 38 years, 59.5% were current smokers who started the habit between the ages of 15 and 21 years. However, 33.1% of these current smokers started smoking after entering the Greek N...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2003-11-01 00:00:00
abstract::From 1976 to 1993 we inserted 160 chronic peritoneal dialysis catheters for renal failure patients. Three of these patients developed sudden onset of penile and scrotal edema after the catheter had been in place for several months. The first patient was diagnosed by instilling technetium sulfur colloid in the peritone...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract::Mindfulness meditation training has been shown to reduce stress and improve short-term memory for military personnel. However, no studies have investigated the effects of in-person and virtual world (VW) mindfulness training on Post-Traumatic Stress Disorder (PTSD) or Attention Deficit Hyperactivity Disorder (ADHD) sy...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usx227
更新日期:2018-03-01 00:00:00
abstract::The Assessment of Recruit Motivation and Strength (ARMS) project evaluated whether active duty Army enlistees who exceeded weight and body-fat standards but were able to pass the ARMS physical fitness test were at elevated risk of early attrition relative to the traditional recruit population. Attrition among 1146 ove...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-02-7508
更新日期:2009-07-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-12-00538
更新日期:2013-10-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz172
更新日期:2020-02-12 00:00:00
abstract::The objective of this case report is to present an interesting case of a mixed malaria infection of Plasmodium falciparum and Plasmodium vivax in a U.S. service member deployed in support of Operation Enduring Freedom in Afghanistan and the use of rapid malaria tests with microscopy for the diagnosis of malaria and th...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-10-00034
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Deployed service members exposed to burn pit smoke can experience a multitude of symptoms. Respiratory symptoms after burn pit smoke exposure are well recognized, but neurologic symptoms are less well recognized. There are reports of migraines triggered by odors but no specific reports of new onset migraines...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-16-00200
更新日期:2017-05-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::Suicide is currently the second leading cause of death in the U.S. military. Little recent research has been done on a well-defined cohort at high risk for death by suicide, which consist of military patients who attempt suicide or are admitted for suicidal ideation. As a pilot investigation based on a literature revi...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2003-03-01 00:00:00
abstract::Successful rehabilitation of female service members suffering traumatic injuries to the maxillofacial region is both a physiological and a psychological issue. A clinical evaluation to determine if an association exists between sex hormone levels and dental implant success was undertaken. Endosseous dental implants we...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1997-09-01 00:00:00
abstract::Appropriate and consistent use of condom remains an effective approach to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) intervention. We analyzed the baseline data gathered for a situationally based HIV/AIDS intervention to assess the potential predictors of condom use among the Uniforme...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.171.10.1027
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:The study establishes the functional outcomes of service personnel injured in current conflicts by correlating data on initial injury to the findings of medical boards after trauma and reconstructive treatment. Data comprehensively include all casualties of the Royal Navy and Royal Marines and all functional...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-13-00180
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:This study examined soldier attitudes about postdeployment mental health screening, treatment, barriers to care, strategies for overcoming barriers, and settings, personnel and timing for conducting postdeployment mental health screening. METHODS:Deploying soldiers participated in a voluntary anonymous surve...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.173.6.563
更新日期:2008-06-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章,评审
doi:
更新日期:1998-05-01 00:00:00
abstract::Seasonal aeroallergens commonly cause allergic conjunctivitis, rhinorrhea, sinusitis, and cough in sensitized individuals. These clinical symptoms are the result of IgE-mediated type I hypersensitivity reactions, which trigger the degranulaton of mast cells and basophils. In contrast, aeroallergens are not common prec...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usz106
更新日期:2019-12-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-17-00031
更新日期:2017-09-01 00:00:00
abstract::The Clinical Breast Care Project (CBCP) is a congressionally mandated program that began in the year 2000. The military-civilian collaboration was founded on five pillars: (1) center of excellence in clinical care, (2) risk reduction for women at risk for developing breast cancer, (3) tissue banking to develop and mai...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-10-00052
更新日期:2010-07-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-16-00049
更新日期:2017-03-01 00:00:00
abstract:INTRODUCTION:In 2017, over 75,000 cataract surgeries were performed within the Veterans Health Administration System (VHA). Previous reports of outcomes of cataract surgery in veterans include patients with pre-existing ocular disease, which can affect vision. To exclude the confounding factor of pre-existing ocular co...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy375
更新日期:2019-07-01 00:00:00
abstract::Camp Bullis, Texas, is an active training facility for the U.S. Army and Air Force with a storied history dating back to the late 19th century. In the early 1940s, an epidemic of a seasonal tick-borne rickettsial-like illness occurred at Camp Bullis; the last case was reported in 1947. To date, the etiology of this di...
journal_title:Military medicine
pub_type: 历史文章,杂志文章
doi:10.7205/milmed.169.11.863
更新日期:2004-11-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-11-00246
更新日期:2011-12-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章,评审
doi:10.7205/milmed-d-11-00067
更新日期:2011-11-01 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:INTRODUCTION:Computer-aided design/computer-aided manufacturing (CAD/CAM) has gained increasing popularity since the first commercially viable dental system was introduced in the mid-1980s. Digitally milled dental restorations can be fabricated chairside in the course of one dental appointment, reducing time, cost, and...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usy260
更新日期:2019-05-01 00:00:00