Tag Archives: #CombatMedicine

Emergency General Surgery in Deployed Settings



A discussion about the JTS Emergency General Surgery CPG with CDR Jacob Glazer, MD, a Navy Trauma & Critical Care Surgeon and Maj Andrew Hall, MD from USAF CSTARS.    

Not all casualties are trauma patients on the battlefield. Listen to this podcast about the considerations for emergency surgery in the deployed setting that may seem like routine surgery but requires unique decisions.

The following topics are discussed:

  • Overall need and purpose for a emergency general surgery
  • Surgical decision-making in the deployed environment
  • Common non-trauma conditions requiring emergency surgery
  • Various surgical patient populations in the deployed setting
  • Approaches to surgical decision-making with limitations on diagnostics and reliance on physical exams
  • Decision matrix in the CPG
  • Identification of emergent versus urgent surgical patients
  • Decisions based on follow-on care needs
  • Integrating surgical decision-making with command and mission requirements
  • Post-surgical and evacuation decision-making

Listen on Deployed Medicine at:   https://deployedmedicine.com/market/29/content/552

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Always find the latest on Combat Casualty Care at: www/deployedmedicine.com or download the mobile app “Deployed Medicine”.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.


Orthopedic Trauma: Extremity Fracture Clinical Practice Guideline



Listen to COL Mark Pallis, Orthopedic Surgery Consultant for the US Army Surgeon General, discuss the Orthopedic Trauma Extremity Fracture Clinical Practice Guideline (CPG).

Upwards of 70-80% of combat injuries involve extremity fractures.  The podcast discusses the importance of fracture management for all providers in the deployed environment.  With protective equipment worn on today’s battlefield, the survivability of wounding patterns increases the likelihood of fracture management.  In austere environments, assessment equipment can be limited, and evacuation routes can be lengthy in time.  The following topics are discussed by COL Pallis:

  • Treatment of the casualty with awareness of austere constraints
  • Treatment options in far-forward environments before evacuation
  • Initial management of extremity fractures
  • Options for stabilizing fractures before and during evacuation
  • Fracture management in sequence of care for multi-injury casualties
  • Antibiotics in early fracture management
  • Documentation and marking of splints
  • External versus internal fixation in the austere environment
  • External fixator resources for the austere environment
  • Considerations for the external fixator frame placement
  • Splints versus fixator considerations
  • Differences between management of upper and lower extremity fractures
  • Factors to consider in austere scenarios

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.


Battle and Non-Battle Injury Documentation



In this podcast, Col Stacy Shackelford, USAF, MC, Chief of Performance Improvement with the Joint Trauma System, discusses the Battle and Non-Battle Injury Documentation Clinical Practice Guideline (CPG). Listen to Col Shackelford as she explains the documentation process for the Trauma Resuscitation Record.

  • Importance of documentation
  • Documentation referenced in this CPG is specific to Role 2 and Role 3 levels of care
  • Documentation requirements for trauma patients
  • Continuity of the resuscitation record as the patient transitions to different levels of care
  • Uploading records into the Theater Medical Data Store (TMDS)
  • Documentation requirements in addition to the Trauma Resuscitation Record
  • Determining which patients require a Trauma Resuscitation Record
  • Steps to ensure records are transmitted to the Trauma Registry
  • Where can providers find the Trauma Resuscitation Record template?

 

Always find the latest on Combat Casualty Care at: www/deployedmedicine.com or download the mobile app “Deployed Medicine”.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.

 


Hyperkalemia and Dialysis in a Deployed Setting



Listen to LtCol Ian Stewart, USAF, MC, Associate Professor of Medicine at the Uniformed Services University of the Health Sciences and a practicing Nephrologist at the David Grant United Airforce Medical Center explain the “Hyperkalemia and Dialysis in a Deployed Setting” Clinical Practice Guideline (CPG).  The following topics are discussed by LtCol Stewart in this podcast:

  • Primary causes of Acute Kidney Injury (AKI) & Hyperkalemia in the deployed setting
  • Risk factors for AKI and Hyperkalemia in combat casualties
  • Rhabdomyolysis
  • Use of Renal Replacement Therapy prior to transport to a higher echelon of care
  • Monitoring practices in casualties with AKI
  • Criteria for transfer to a higher echelon of care for casualties with AKI
  • Current Research on AKI
  • Initial Treatments for AKI and hyperkalemia
  • Acute Peritoneal Dialysis
  • Methods available for Renal Replacement Therapy at different echelons of care
  • NxStage® System One TM Renal Replacement Therapy system
  • Catheter placement
  • Replacement fluids and rates
  • UltraFiltration
  • Difference between NxStage® System One TM and peritoneal dialysis
  • Performance improvement monitoring

 

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.  For more information, please visit https://creativecommons.org/.


REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) CPG



This podcast is a discussion with Lt Col Jason Paisley MD, USAF, the director of Physician Education at the Center for Sustainment of Trauma and Readiness Skills (CSTARS). The podcast reviews the updated Clinical Practice Guideline (CPG) on REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) for advanced providers. Specifically, it addresses the newer equipment that allows for easier insertion and talks about the way REBOA is being used in various clinical scenarios that may have otherwise required more invasive methods.

Always find the latest on Combat Casualty Care at: www/deployedmedicine.com or download the mobile app “Deployed Medicine”.