Abstract:
:The pre-hospital care of patients with suspected spinal injuries involves early immobilisation of the whole spine and the institution of measures to prevent secondary injury from hypoxia, hypoperfusion or further mechanical disruption. Early ventilation and differentiation of haemorrhagic from neurogenic shock are the key elements of pre-hospital resuscitation specific to spinal injuries. Falls from a significant height, high-impact speed road accidents, blast injuries, direct blunt or penetrating injuries near the spine and other high energy injuries should all be regarded as high risk for spinal injury but clinical examination should determine whether the patient requires full, limited or no spinal immobilisation. Although there is little conclusive evidence in the literature that supports pre-hospital clinical clearance of the spine, the similarities between pre-hospital immobilisation decisions and in-hospital radiography decisions are such that it is likely that clinical clearance will be effective for selected patients. This decision can be made at the scene provided the patient has no evidence of: Altered level of consciousness or mental status Intoxication Neurological symptoms or signs A distracting painful injury (e.g. chest injuries, long bone fracture) Midline spinal pain or tenderness. Where there is evidence to support spinal immobilisation, then the full range of devices and techniques should be considered. In the remote or operational environment where pre-hospital times are prolonged, full immobilisation, analgesia and re-assessment may allow localisation of the injury and a reduction in the degree of immobilisation. Common reasons for missing significant spinal injuries include failing to consider the possibility of spinal injuries in patients who are either unconscious, intoxicated or uncooperative (54,55). The application of the decision rule discussed here will ensure that no clinically significant spinal injuries are missed in pre-hospital care.
journal_name
J R Army Med Corpsjournal_title
Journal of the Royal Army Medical Corpsauthors
Mackenzie Rdoi
10.1136/jramc-148-02-11subject
Has Abstractpub_date
2002-06-01 00:00:00pages
163-71issue
2eissn
0035-8665issn
2052-0468journal_volume
148pub_type
杂志文章,评审abstract::The link between the Maltese islands and the Army Medical Services was forged during the Wars of Revolutionary France, 1792 to 1802. This article looks at the two-year long blockade of the French garrison in Malta, Nelson's so called "very long hiccup" (1), and at the origins of the Army Medical Services in the Maltes...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 历史文章,杂志文章
doi:10.1136/jramc-143-02-14
更新日期:1997-06-01 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
doi:10.1136/jramc-2014-000378
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:Injury Severity Score (ISS) and GCS can be retrospective markers of injury severity, but if used by clinicians to decide on the treatment of acutely brain-injured casualties at the point of injury may potentially limit interventions on people who may ultimately survive with good functional outcomes. METHO...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2014-000393
更新日期:2016-04-01 00:00:00
abstract::This article argues that there is a duty of care held by the State to military veterans who have been technologically enhanced as part of their military service. It suggests that enhancements may be permanent, persistent or protracted and demonstrates how enhancements generate additional moral responsibilities from th...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2018-001140
更新日期:2019-08-01 00:00:00
abstract::This article describes the non-operative management of five patients with ballistic abdominal solid organ injuries in a role 2E medical treatment facility. The selective non-operative management of ballistic abdominal solid organ injury is an accepted management strategy in high-volume civilian trauma centres, and app...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-156-01-04
更新日期:2010-03-01 00:00:00
abstract::The management of focal radiation burns after prolonged exposure to ionising radiation remains a relatively rare but significant therapeutic challenge. This narrative aims to highlight certain aspects of management that can be overlooked and mitigation strategies in the management of these potentially fatal injuries. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2018-000967
更新日期:2019-12-01 00:00:00
abstract::Tracheobronchomalacia is a rare cause of respiratory distress in children. An infant with tracheobronchomalacia is presented. The aetiology, pathophysiology and management are discussed. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-138-02-08
更新日期:1992-06-01 00:00:00
abstract::The Role 3 Medical Treatment Facility (Field Hospital) in Camp Bastion (R3 Bastion) is acknowledged to be one of the busiest dedicated trauma facilities in the world. Casualties typically present with severe injuries and in physiological extremis. These casualties form a unique cohort representing the most relevant po...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 社论
doi:10.1136/jramc-2014-000272
更新日期:2014-06-01 00:00:00
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
doi:10.1136/jramc-2015-000500
更新日期:2015-09-01 00:00:00
abstract:AIM:To determine the prevalence of tourniquet use in combat trauma, the contribution to lives saved and the complications of their use in this environment. POPULATION:All casualties treated at UK field hospital facilities in Iraq and Afghanistan and meeting criteria for entry into UK Joint Theatre Trauma Registry (JTT...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-153-04-19
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:The long-term effect of repetitive trauma by military parachuting on the lumbar spine is not well investigated. Therefore, the purpose of this study was to examine the development of lumbar degenerative changes during a 30-year follow-up in Japanese Ground Self Defense Forces (JGSDF) parachute infantry soldi...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2013-000149
更新日期:2014-12-01 00:00:00
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
doi:10.1136/jramc-132-01-07
更新日期:1986-02-01 00:00:00
abstract::A group of British Military Hospitals was established between 1915 and 1918 along the estuary of the River Canche on the northern French coast. Their positions, now obliterated, can be identified from a plan of the time. With the growing realisation of the importance of bacteriology in the treatment of wound infection...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 历史文章,杂志文章
doi:10.1136/jramc-142-01-09
更新日期:1996-02-01 00:00:00
abstract::Leishmaniasis is an infectious disease caused by Leishmania protozoa and occurs as a spectrum of clinical syndromes ranging from various forms of cutaneous leishmaniasis (CL) to mucosal leishmaniasis (ML) and visceral leishmaniasis (VL). CL in Afghanistan is either zoonotic (ZCL) due to L. major or anthroponotic (ACL)...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-158-03-15
更新日期:2012-09-01 00:00:00
abstract::Both flexible and rigid cysto-urethroscopy are routinely used in the surveillance of transitional cell bladder tumours. This study addressed the issue of patient selection for either rigid or flexible cystoscopy. What proportion of positive findings at flexible cystoscopy and negative findings at rigid cystoscopy are ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-145-03-08
更新日期:1999-10-01 00:00:00
abstract::We describe a novel technique to allow use of small pins in medium pin size clamps. Slipping a second 3 mm pin into the same clamp hole as the first allows the 5 mm clamp to bite securely on a 3 mm pin. This enables construction of an external fixator frame utilising 3 mm and 5 mm pins, as required to span the elbow, ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:
更新日期:2010-09-01 00:00:00
abstract::The optimal fluid for the resuscitation of critically ill and injured patients remains the subject of considerable controversy. Hypertonic crystalloid solutions such as hypertonic saline provide rapid volume expansion, have an acceptable safety profile, and are easy to store and transport. Recent meta-analyses suggest...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-150-04-03
更新日期:2004-12-01 00:00:00
abstract::We report the case of successful management of a transcranial penetrating high-energy transfer injury in a 20-year-old soldier. The bullet traversed both cerebral hemispheres and lacerated the superior sagittal sinus rendering him unconscious. We detail the care received at all stages following injury from 'Buddy Aid'...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2013-000121
更新日期:2014-09-01 00:00:00
abstract::The Defence Clinical Psychology Service (DCPS) is the professional clinical psychology service and community of clinical psychology practice within UK Ministry of Defence (MoD). The DCPS provides professional clinical care, consultation and research in support of the UK Armed Forces. Regulated by the Health and Care P...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2018-001044
更新日期:2019-04-01 00:00:00
abstract::Pneumorrhachis or intraspinal air is an increasingly encountered phenomenon in the management of severe trauma. The case of a 23-year-old soldier, who sustained a gunshot wound to the chest, is presented and the subsequent discussion illustrates that while often benign this phenomenon may indicate serious occult injur...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-156-04s-09
更新日期:2010-12-01 00:00:00
abstract::A method of comparing the quality of intestinal anastomoses performed in craft workshops is described. The equipment is readily available in any hospital, inexpensive and requires no technical construction. The apparatus accurately measures the intraluminal pressure at the first sign of anastomotic leak and a method o...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-139-03-06
更新日期:1993-10-01 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
pub_type: 杂志文章
doi:10.1136/jramc-145-01-03
更新日期:1999-02-01 00:00:00
abstract::Since World War II, more vehicles have been lost to land mines than all other threats combined. Anti-vehicular (AV) mines are capable of disabling a heavy vehicle, or completely destroying a lighter vehicle. The most common form of AV mine is the blast mine, which uses a large amount of explosive to directly damage th...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-155-04-06
更新日期:2009-12-01 00:00:00
abstract::On Friday 16 February 2001, terrorists detonated a bomb under a civilian coach travelling from Nis in Serbia to Gracanica in Kosovo. 10 people were killed at the scene. 13 casualties were treated in the British KFOR hospital (Reynolds Hospital) in Pristina. Another 8 casualties were evacuated to the American KFOR hosp...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-151-01-04
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the ai...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2017-000818
更新日期:2018-07-01 00:00:00
abstract::A modified version of the J95 morbidity reporting system, called J95a, was used in the Multinational Division South West (MND SW) during Operation Resolute 2. The broad scope of the 'Other Diseases' and 'Other Injuries' event codes were reduced, with codes being added for specific areas of interest which were 'ENT Pro...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-144-01-04
更新日期:1998-02-01 00:00:00
abstract:INTRODUCTION:Morphine auto-injectors are issued to all British soldiers on operations in Afghanistan who deploy forward of Camp Bastion, the main British base. Previous studies have reviewed the effectiveness of various pre-hospital analgesics, but there is no record of the knowledge and confidence of the relatively me...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2013-000203
更新日期:2015-03-01 00:00:00
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::We present a 26-year-old male British military nurse, deployed to Sierra Leone to treat patients with Ebola virus disease at the military-run Kerry Town Ebola Treatment Unit. Following exposure to chlorine gas during routine maintenance procedures, the patient had an episode of respiratory distress and briefly lost co...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2015-000501
更新日期:2016-06-01 00:00:00
abstract::In most conflicts there is the potential that there will be Captured Persons (CPERS) whose medical care is the responsibility of the capturing army. The standard of this care should be to the same standard as that afforded to one's own troops. However the medical practicalities of maintaining such standards can be dif...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-2013-000064
更新日期:2014-03-01 00:00:00