Abstract:
BACKGROUND:Fatigue in military operations leads to safety and operational problems due to a decrease in alertness and performance. The primary method of counteracting the effects of sleep deprivation is to increase nightly sleep time, which in operational situations is not always feasible. History has taught us that surgeons and surgical teams are finite resources that cannot operate on patients indefinitely. METHODS:A systematic review was conducted using the search terms 'sleep' and 'deprivation' examining the impact of sleep deprivation on cognitive performance in military surgical teams. Studies examining outcomes on intensive care patients and subjects with comorbidities were not addressed in this review. RESULTS:Sleep deprivation in any 'out-of-hours' surgery has a significant impact on overall morbidity and mortality. Sleep deprivation in surgeons and surgical trainees negatively impacts cognitive performance and puts their own and patients' health at risk. All published research lacks consensus when defining 'sleep deprivation' and 'rested' states. It is recognised that it would be unethical to conduct a well-designed randomised controlled trial, to determine the effects of fatigue on performance in surgery; however, there is a paucity between surrogate markers and applying simulated results to actual clinical performance. This requires further research. Recommended methods of combating fatigue include: prophylactically 'sleep-banking' prior to known periods of sleep deprivation, napping, use of stimulant or alerting substances such as modafinil, coordinated work schedules to reduce circadian desynchronisation and regular breaks with enforced rest periods. CONCLUSIONS:A forward surgical team will become combat-ineffective after 48 hours of continuous operations. This systematic review recommends implementing on-call periods of no more than 12 hours in duration, with adequate rest periods every 24 hours. Drug therapies and sleep banking may, in the short term, prevent negative effects of acute sleep deprivation.
journal_name
J R Army Med Corpsjournal_title
Journal of the Royal Army Medical Corpsauthors
Parker RS,Parker Pdoi
10.1136/jramc-2016-000640subject
Has Abstractpub_date
2017-06-01 00:00:00pages
158-163issue
3eissn
0035-8665issn
2052-0468pii
jramc-2016-000640journal_volume
163pub_type
杂志文章,评审abstract::The 2014-2015 Ebola virus disease (EVD) epidemic in West Africa was the largest in history. The three most affected countries, Guinea, Liberia and Sierra Leone, have faced enormous challenges in controlling transmission and providing clinical care for patients with EVD. The Chinese government, in response to the reque...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2015-000562
更新日期:2016-06-01 00:00:00
abstract::This historical account, based on a survey of 250 medical articles written during and immediately after World War II, reviews the immediate treatment of frostbite in the American and German ground troops in Europe from 1941 to 1945. The American management was simpler and more conservative than the elaborate treatment...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 历史文章,杂志文章
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更新日期:2011-09-01 00:00:00
abstract::This paper measures the prevalence of psychological symptoms in two British Infantry battalions, 36 months after being involved in peace keeping operations in the former Yugoslavia during November 1992-April 1993. Those deployed had a high level of post traumatic stress disorder (16%) compared to (9%) in the control g...
journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
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abstract::A multi disciplinary team furthered the collaborative study of acute encephalitis in southeastern Nepal during a major epidemic which occurred in the monsoon period of 1986. Viral studies of serum and cerebro-spinal fluid (CSF) confirmed Japanese Encephalitis Virus (JEV) as the causative agent. Analysis of epidemiolog...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
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journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
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journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-145-02-03
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journal_title:Journal of the Royal Army Medical Corps
pub_type: 社论,历史文章
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journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
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journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,多中心研究
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abstract::Myocarditis, simply defined as inflammation of the heart muscle, is a commonly encountered cardiac disease in primary and secondary care, both in the UK and on Operational deployments. In the UK Armed Forces, myocarditis results in deaths as well as the premature termination of military careers on medical grounds. The...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
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abstract:INTRODUCTION:In the Netherlands, cutaneous leishmaniasis is most commonly seen in military personnel deployed on a mission or training abroad. The treatment of two Dutch soldiers who acquired cutaneous leishmaniasis with oral miltefosine was evaluated. Adverse effects were monitored and the improvement of skin lesions ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
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journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
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doi:10.1136/jramc-138-02-08
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journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
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journal_title:Journal of the Royal Army Medical Corps
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journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
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abstract::A project sponsored by HQ AMS TA and executed by an experienced TA Commanding Officer enhanced the effectiveness of Hospital Collective Training by improving the standard of selection and documentation of the input of exercise casualties, and set up the basis of a comprehensive library of casualty cards for future use...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
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abstract::Post-traumatic stress disorder (PTSD) is an important health risk factor for military personnel deployed in modern warfare. In World War I this condition (then known as shell shock or 'neurasthenia') was such a problem that 'forward psychiatry' was begun by French doctors in 1915. Some British doctors tried general an...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 历史文章,杂志文章
doi:10.1136/jramc-158-01-07
更新日期:2012-03-01 00:00:00
abstract::The Australian Army recently adopted the British concept of hospital exercise (HOSPEX) as a means of evaluating the capabilities of its deployable NATO Role 2E hospital, the 2nd General Health Battalion. The Australian approach to HOSPEX differs from the original UK model. This article describes the reasons why the Au...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
abstract::This review outlines the present knowledge of American cutaneous leishmaniasis, a disease which, owing to the increase in international travel, is being seen with increasing frequency in Europe and North America. A knowledge of this disease is of particular importance to the military medical officer as in recent years...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
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更新日期:1983-10-01 00:00:00
abstract::This study presents epidemiological data on sports injuries in deployed British troops in Bosnia, during the first five months of Operation Resolute. A retrospective analysis was carried out of sports injuries seen in one practice in the divisional rear area during April 1996. They account for a significant morbidity ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-143-01-07
更新日期:1997-02-01 00:00:00