Surgery Presentation

[bobbyseal]

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Hi all,

I would like to give an oral presentation for surgery on militar aspects of surgery. I am curious if anyone has any point of contacts or papers that may describe results of clinical trials of military surgery.

Thanks.

 

[militarymd]

What do you mean, "military surgery"?

 

[bobbyseal]

Well, I thought it would be an interesting topic to describe improvements in surgical care for military members during combat. I am curious if there are studies that the military has performed and published which would describe improvements in trauma care for the military personnel. Thanks.

 

[militarymd]

The majority of trauma literature published out of civilian institutions. I'm not aware of much literature from military institutions....I'm talking good literature, not case reports, case series, etc.

Military physicians are sent out to civilian institutions for their trauma training.

Any advances in trauma care for military peronnel does not involve new therapy, but rather involves trying to figure out how to get 1) get injured personnel back from the front, or 2) how to get some semblance of trained personnel out to the front.

 

[Homunculus]

Originally posted by bobbyseal
Hi all,

I would like to give an oral presentation for surgery on militar aspects of surgery. I am curious if anyone has any point of contacts or papers that may describe results of clinical trials of military surgery.

Thanks.

We had a presentation at our school by CPT Mabry, who was a medic in the Battle of Mogadishu and i think was an ER resident at BAMC. He spoke of the difference between military and civilian GSW traumas, and contrasted the injuries sustained by the soldiers in Mogadishu vs. soldiers in other wars. He also followed up on the medical care received (i think three surgeons worked nonstop for something like 36 hours-- maybe more, patching people lack together). Fantastic presentation. He published a paper on it, though the title of it slips my mind.


there is also a substantial amount of information on military battlefield specific medicine in a military medicine text i read while on a rotation at Walter Reed-- it was set up in a volume-like system. i'll try to dig up what it was, you may find it interesting as well.

 

[denali]

I don't know how much of this is available in publications yet, but you may want to look at the types of wounds being seen in OEF/OIF now that we've got reliable body armor for the torso. It has certainly changed the #s vs. historical regarding extremity wounds (ortho/vascular type stuff) vs. chest & abdomen (CT/gen surg). Just a thought.

 

[bobbyseal]

Thanks a lot for that information.

I think I'm going to do my talk on fluid resuscitation in the combat patient. There have been some good examples of delay in care for soldiers in recent battles - Mogadishu and Afghanistan where soldiers were injured, but hospital treatment had to be delayed based on battle conditions.

Because of this, the military is re-evaluating its resuscitation protocols because civilian resuscitation protocols are not sufficient for the combat medic. The medic is not able to carry the amount of LR needed.

So, I think I'm going to present some of the challenges facing fluid resuscitation in military patients and then present some research on colloid solutions like Dextran saline, etc.

 

[denali]

When I first got to school here is when I first heard about the Army rethinking the issue of IV fluid resuscitation for combat trauma victims. Haven't read all of the articles, but evidently this is a volume chock full of this stuff:

J Trauma. 2003 May;54(5 Suppl)

Have fun!