scholarly journals Efficiency of the Damage Control Orthopedic Strategy in the Management of Military Ballistic Limb Trauma.

2020 ◽  
Author(s):  
Khalil Amri ◽  
Ahmed Tounsi ◽  
Achraf Oueslati ◽  
Mouhamed Ben Salah ◽  
Rim Dhahri ◽  
...  
Keyword(s):  
Bone Loss ◽  
External Fixation ◽  
Damage Control ◽  
Health Centre ◽  
Military Hospital ◽  
Grading System ◽  
Average Delay ◽  
Limb Trauma ◽  
The Military ◽  
Ballistic Trauma

Abstract Background: In conflicting areas, orthopaedic surgeons adopted this concept of damage control orthopaedic (DCO) to face limb fracture due to ballistic trauma because of the gravity of the hurts, the limitation of equipment, and precarious conditions of asepsis. They use external fixation as an initial treatment at the nearest health centre. They delay the definitive treatment to be realized in better conditions. Our study aims to assess the outcome of the damage control orthopaedic (DCO) strategy in military ballistic limb trauma according to the experience of the Military Hospital of Tunisia.Materials and methods: This study is a retrospective study on patients who were hospitalized for a limb ballistic fracture. It includes military patients treated urgently with primary external fixation at the nearest health centre. We adapted the Gustilo classification to describe wound opening, the Winquist and Hansen classification to define fracture comminution and the grading system for bone loss to evaluate bone loss. Then, all victims were evacuated secondary to the military hospital to receive the definitive treatments. The conversion to internal osteosynthesis had taken place according to some criteria. They were the absence of local sepsis, a haemoglobin level (> 10 g/dl), a serum protein level (> 50 g/l) and negative or falling CRP kinetics. We studied the delay of conversion from external fixation to internal osteosynthesis, bone healing time and complications.Result: Our study included 32 patients, all men, with a mean age of 31 years. The average follow-up was 33.2 months. Eighty-eight percent of trauma concerned the lower limb. The average delay for conversion from external fixation to internal osteosynthesis was 7.8 days. Bone union was achieved in 26 cases, with an average delay of 4.23 months. The observed general complications were anaemia, pulmonary embolism and rhabdomyolysis. Local complications were essentially sepsis on osteosynthesis material and pseudarthrosis. These complications were significantly associated with a type III Gustilo skin opening, a type III and IV Winquist fracture comminution, a type II and III Grading system for bone loss, and a delay in conversion from external fixation to internal osteosynthesis.Conclusion: DCO is a global strategy that involves all measures participating in the acceleration of wound healing and fighting against infection. These measures shorten the delay of conversion from external fixation into internal osteosynthesis, which constitutes a key parameter in the management of limb fracture due to ballistic trauma.

scholarly journals Efficiency of damage control orthopaedics strategy in the management of military ballistic limb trauma

2020 ◽  
Author(s):  
Amri Khalil ◽  
Tounsi Ahmed ◽  
Oueslati Achraf ◽  
Ben Salah Mouhamed ◽  
Dhahri Rim ◽  
...  
Keyword(s):  
Bone Loss ◽  
External Fixation ◽  
Damage Control ◽  
Health Centre ◽  
Military Hospital ◽  
Grading System ◽  
Average Delay ◽  
Limb Trauma ◽  
The Military ◽  
Ballistic Trauma

Abstract Background: In conflict areas, orthopaedic surgeon adopted this concept of damage control orthopaedic (DCO) to face limb fracture due to ballistic trauma because of the gravity of the hurts, the limitation of equipment, and precarious conditions of asepsis. They use external fixation as an initial treatment at the nearest health centre. And they delay the definitive treatment to be realized in better conditions. Our study aims to assess the outcome of damage control orthopaedic (DCO) strategy in military ballistic limb trauma according to the experience of the Military Hospital of Tunisia. Materials and methods: This study is a retrospective study on patients who were hospitalized for a limb ballistic fracture. It includes military patients treated urgently with primary external fixation at the nearest health centre. We adapted Gustilo classification to describe the wound opening, Winquist and Hansen classification to define the fracture comminution and Grading system for bone loss to evaluate the bone loss. Then all victims were evacuated secondary, to the Military hospital to receive the definitive treatments. The conversion to internal osteosynthesis had taken place according to some criteria. They were the absence of local sepsis, a haemoglobin level (> 10 g/dl), a serum protein level (> 50 g/l) and a negative or falling CRP kinetics. We studied the delay of conversion from external fixation to an internal osteosynthesis, bone healing time and complications. Result: Our study included 32 patients, all men, mean age was 31 years. The average follows up was 33,2 months. 88% of trauma concerned lower limb. The average delay for conversion from external fixation to internal osteosynthesis was 7,8 days. The bone union was achieved in 26 cases, with an average delay of 4.23 months. Observed general complications were anaemia, pulmonary embolism and rhabdomyolysis. Local complications were essentially sepsis on osteosynthesis material and pseudarthrosis. These complications were significantly associated with a type III of Gustilo skin opening, a type III and IV of the Winquist fracture comminutions, a type II and III of the Grading system for bone loss, and the delay for conversion from external fixation to internal osteosynthesis. Conclusion: DCO is a global strategy which involves all measures participating in the acceleration of the wound healing and fighting against the infection. These measures shorten the delay of conversion from external fixation into an internal osteosynthesis, which constitutes a key parameter in the management of limb fracture due to ballistic trauma.

Simulation of an Aircraft Accident at Brussels Airport

1986 ◽  
Vol 2 (1-4) ◽  
pp. 207-208
Author(s):  
Fr Labeeu ◽  
M de Backer ◽  
C Bellanger
Keyword(s):  
Military Hospital ◽  
University Hospitals ◽  
Disaster Plan ◽  
Code Number ◽  
Landing Point ◽  
Call Number ◽  
Aircraft Accident ◽  
The Military

The exercise held at Brussels Airport was carried out by inexperienced personnel to highlight the most common errors and shortcomings of an existing disaster plan.INCIDENT COMMUNICATIONOnce an aircraft is known to be in trouble, all the nearby fire brigades are alerted by means of the unique call number 900 and move to take up their stand-by position close to the landing point. The Military Hospital is also alerted and sends out a liaison car, with a doctor among its occupants. This car joins the stand-by position. Once the aircraft has crashed, the fire engines rush to the site and all the major university hospitals and the Military Hospital are notified by the same 900-code number. Disaster teams arrive by road.This report is almost exclusively limited to aspects of rescue, triage, on-site stabilization, and evacuation of the casualties.

scholarly journals (P1-67) Collaboration of Military and Civil EMS during Russian Georgian War 2008

2011 ◽  
Vol 26 (S1) ◽  
pp. s120-s120
Author(s):  
K. Chikhradze ◽  
T. Kereselidze ◽  
T. Zhorzholiani ◽  
D. Oshkhereli ◽  
Z. Utiashvili ◽  
...  
Keyword(s):  
Emergency Care ◽  
Medical Personnel ◽  
Disaster Medicine ◽  
Military Hospital ◽  
Emergency Medical Care ◽  
Field Hospital ◽  
Occupied Territory ◽  
Long Time ◽  
The Military ◽  
The Village

IntroductionDuring 2008 Russian Federation realized major aggression against its direct neighbor, the sovereign republic of Georgia. It was Russia's attempt to crown its long time aggressive politics by force, using military forces. EMS physicians from Tbilisi went to the Gori district on August 8 at first light, 14 brigades were sent. At noontime of August 8, their number was increased up to 40. 6 brigades of disaster medicine experts joined them as well.ResultsDestination site for the beginning was the village Tkviavi, where a military field hospital was assembled and a Military Hospital in Gori. Later 6 brigades were withdrawn towards the village Avnevi. During fighting, wounded victims were evacuated from the battlefield, where initial triage was done. Evacuated victims were brought to the military hospital where the medical triage, emergency medical care and transportation to Gori military hospital or to Tbilisi hospitals was done. A portion of the wounded was directly taken to Gori military hospital and later to different civil hospitals in Tbilisi. Corpses were transported to Gori morgue as well. On August 9, the emergency care brigades and field hospital left Tkviavi and moved to the village Karaleti, then to Gori. On August 12, the occupied territory was totally evacuated by civil and military medical personnel. Although withdrawal of wounded was done on following days. Up to 2232 military and civil persons were assisted by EMS brigades during war period (8–12 August), from them 721 patients were transported among which 120 were severely injured.ConclusionClose collaboration between military and civil EMS gave the system opportunity to work in an organized manner. On the battlefield prepared military rescuers were active taking out wounded victims to the field or front-line hospitals from which civil emergency care brigades transported them to Tbilisi hospitals. Only 3 fatalities occurred during transportation.

scholarly journals Myelodysplastic Syndromes Experience of the Laboratory of the Military Hospital Avicenna Marrakech

2019 ◽  
Vol 4 (6) ◽  
pp. 115
Author(s):  
Mouhib Hanane ◽  
Karrati Ilham ◽  
Hanane Zahir ◽  
Yahyaoui Hicham ◽  
Ait Ameur Mustapha ◽  
...  
Keyword(s):  
Myelodysplastic Syndromes ◽  
Military Hospital ◽  
The Military

Development and Testing of an External Fixation Coupling for a Damage Control Orthopedic System1

2018 ◽  
Vol 12 (1) ◽  
Author(s):  
Laura Ruhala ◽  
Dennis Beck ◽  
Richard Ruhala ◽  
Aaron Megal ◽  
Megan Perry
Keyword(s):  
External Fixation ◽  
Damage Control

Sisters of Mercy

2019 ◽  
pp. 251-257
Author(s):  
Philip Gerard
Keyword(s):  
Military Hospital ◽  
Religious Orders ◽  
Black And White ◽  
Medical Supplies ◽  
Small Band ◽  
Sisters Of Mercy ◽  
Excellent Care ◽  
The Military

In July 1862, small band of Sisters of Mercy, led by Mother Mary Madeline Tobin, arrive at Beaufort and take charge of the military hospital at the Atlantic Hotel-once a fine report, now half-derelict and spoiled by looting. They find patients badly fed, suffering with little care and no sanitation. They demand food, clothing, cleaning and medical supplies. Quickly they transform the squalid place into a clean hospital that provides excellent care for wounded and ill men of both armies. They are among some 600 women from 21 religious orders who labor among the battlefield wounded. Four of the sisters die in service. All exhibit extraordinary commitment and perseverance and earn the undying loyalty of the soldiers to whom they minister-many of whom have never before encountered a nun and are at first confounded by their black and white habits, but quickly are won over by the sisters’ gentleness and competence.

The Life of a Combat Social Worker

2020 ◽  
pp. 15-27
Author(s):  
Jeffrey S. Yarvis
Keyword(s):  
Social Work ◽  
Social Workers ◽  
Social Worker ◽  
Mental Health Treatment ◽  
Health Clinic ◽  
Military Hospital ◽  
Base Camp ◽  
The Social ◽  
The Military

Chapter 1 gives the reader a tour—a kind of ride-a-long or a kind of “see-what-I-see” experience. Much of the chapter is about the combat part of combat social work: What does social work look like outside the wire, downrange, or in combat or other hostile and dangerous battles or threats. This chapter will enable the reader to appreciate the role and experiences of combat social workers, as captured in later autobiographical chapters. However, deployments are time-limited (7–15 months, as a rule), and most of the time spent as a military social worker is in garrison (i.e., base camp with offices, often a behavioral health clinic or the social work department at a military hospital). This is where and how most members of the military receive their mental health treatment—conducted by military social workers. This is discussed in Chapter 2.

Sign in / Sign up

Export Citation Format

Share Document