Military Medicine

https://academic.oup.com/milmed

List of Papers (Total 1,497)

Update: Efficacy of Military Fluid Intake Guidance

Fluid intake during military training is prescribed based on the interactions among work rates, environmental conditions, and uniform configurations. The efficacy of this guidance has not been empirically assessed in over a decade. To determine the acceptability of the fluid intake guidance, sweat losses were measured in a variety of conditions with modern uniform/body armor...

Expeditionary Force Health Protection for Global Health Engagement: Lessons Learned from Continuing Promise 2017

Global health engagement (GHE) is an important priority for the Military Health Service as such activities strengthen the health capabilities of partner nations and improve interoperability. By their very nature, GHE activities are predominantly conducted in low-resource areas with limited infrastructure and substantial humanitarian need. The Department of Defense is evaluating...

Taking Charge: Moving from Peer to Supervisor

Leadership transitions occur frequently, and these times can be challenging for the individual and those they lead. Leaders must develop new knowledge and skills required of the position. Leaders also assume a new formal leadership role over prior peers. This can be a difficult task for junior leaders. The following article illustrates an example case faced by a junior Navy...

Two-Stage Osseointegrated Reconstruction of Post-traumatic Unilateral Transfemoral Amputees

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 discuss the clinical outcomes of the procedure. This is a...

An Innovative Advance in Non-invasive Wound Closure: A New Paradigm

Injury is the leading health and readiness threat to the armed forces, with two million instances per year; therefore, innovating wound care solutions can help improve readiness. The DermaClip Skin Closure Device is a new, non-invasive, painless, and easy-to-apply wound closure device that does not require either needles or painful anesthesia injections or create additional...

Antibiotic Treatment – What Can Be Learned from Point of Injury Experience?

Early antibiotic administration after trauma reduces infection rates of open wounds. A clinical practice guideline (CPG) was created to ensure that wounded personnel who are not expected to arrive at the hospital within an hour receive antibiotic treatment in the field. This study evaluated how well-advanced life saver (ALS) providers complied with Israeli Defense Force (IDF) CPG.

Ocular Manifestations of Mosquito-Transmitted Diseases

Of the 3,548 known mosquito species, about 100 transmit human diseases. Mosquitoes are distributed globally throughout tropical and temperate regions where standing water sources are available for egg laying and the maturation of larva. Female mosquitoes require blood meals for egg production. This is the main pathway for disease transmission. Mosquitoes carry several pathogenic...

A Family’s Affair: Caring for Veterans with Penetrating Traumatic Brain Injury

Approximately 1.1 million family members are primary caregivers to post 9/11 veterans. These military caregivers assume a role that requires a long-term commitment that may affect their own health status; however, the impact on health among military caregivers is underestimated and underrepresented. As part of a larger retrospective cohort study that aimed to assess the health...

Army Combat Medic Resilience: The Process of Forging Loyalty

This study presents a grounded theory analysis of in-depth interviews of United States Army Combat Medics (CMs) who had served in Iraq and/or Afghanistan. The study explores how 17 CMs nominated by their peers as resilient cope with military stressors in order to identify the factors that enable them to thrive amidst harsh conditions. Four distinct categories of characteristics...

Olfactory Testing Informs the Decision Process to Obtain Advanced Neuroimaging in Traumatic Brain Injury

The purpose of this article is to examine the usefulness of olfactory testing as a tool for the evaluation or stratification of traumatic brain injury (TBI) patients. Olfactory dysfunction is more likely to be overlooked by both the patient and the provider, especially in the acute setting, in contrast to deficits in other senses like vision or hearing. This is a retrospective...

Combat Helmet Suspension System Stiffness Influences Linear Head Acceleration and White Matter Tissue Strains: Implications for Future Helmet Design

Combat helmets are expected to protect the warfighter from a variety of blunt, blast, and ballistic threats. Their blunt impact performance is evaluated by measuring linear headform acceleration in drop tower tests, which may be indicative of skull fracture, but not necessarily brain injury. The current study leverages a blunt impact biomechanics model consisting of a head, neck...

Comparison of Intubation Using Personal Protective Equipment and Standard Uniform in Simulated Cadaveric Models

The use of personal protection equipment (PPE) for patient care can have an impact on the delivery of effective patient care. The purpose of this study is to examine the effects of basic PPE on intubation times and corresponding success rates in cadaver models.

Surfactant Dysfunction in ARDS and Bronchiolitis is Repaired with Cyclodextrins

Acute respiratory distress syndrome (ARDS) is caused by many factors including inhalation of toxicants, acute barotrauma, acid aspiration, and burns. Surfactant function is impaired in ARDS and acute airway injury resulting in high surface tension with alveolar and small airway collapse, edema, hypoxemia, and death. In this study, we explore the mechanisms whereby surfactant...

A Step Toward Identifying Sources of Medical Errors: Modeling Standards of Care Deviations for Different Disease States

To examine the feasibility of utilizing electronic health records (EHR) to determine a metric for identifying physician diagnostic and treatment deviations in standards of care for different disease states.

Videoconferenced Telebehavioral Health Referral Process Adherence

In 2015, the Army mandated 100% digital storage of telehealth consent forms (DA4700) in the Health Artifact and Image Management Solution (HAIMS) system, and a telebehavioral health (TBH) hub clinic set an aim to accomplish this by improving adherence to referral procedures essential to expanding patient access to videoconferenced (VC) behavioral health care.

Risk Factors for Training-Related Injuries During U.S. Army Basic Combat Training

Injuries during basic combat training (BCT) impact military health and readiness in the U.S. Army. Identifying risk factors is crucial for injury prevention, but few Army-wide studies to identify risk factors for injury during BCT have been completed to date. This study examines associations between individual and training-related characteristics and injuries during Army BCT.

Validation of Visual Objective Biomarkers for Acute Concussion

Despite an increase in the awareness and diagnosis of mild traumatic brain injury (mTBI), there remains a paucity of data examining the comparative efficacy of available assessments. This study aims to validate visual functions as potential biomarkers for mTBI.