Trends in Research with U.S. Military Service Member Participants: A Population-Specific ClinicalTrials.gov Review.

Background: ClinicalTrials.gov reviews have evaluated research trends for specific conditions and age groups but not for specific populations of research participants. No ClinicalTrials.

Research at the Bedside: It Makes A Difference.

Research at the bedside makes a difference for our patients, and also for our nurses. However, it is now time to broaden our focus from research on interventions or events at a narrow point in time to research that addresses care across the continuum. This continuum may start at the point of injury, such as the battlefield through en route care delivered during the 8000-mile journey home for our wounded warriors, or for critically ill patients as they move between the emergency department, operating room, and intensive care unit.

Trauma resuscitation and monitoring: military lessons learned.

Over the past 13 years, the military health care system has made improvements that are associated with an unprecedented survival rate for severely injured casualties. Monitoring for indications of deterioration as the critically injured patient moves across the continuum of care is difficult given the limitations of routinely used vital signs. Research by both military and civilian researchers is revolutionizing monitoring, with an increased focus on noninvasive, continuous, dynamic measurements to provide earlier, more sensitive indications of the patient's perfusion status.

En route care patient safety: thoughts from the field.

The purpose of this study was to describe the patient safety culture of en route care in the United States Air Force aeromedical evacuation system. Almost 100,000 patients have been transported since 2001. Safety concerns in this unique environment are complex because of the extraordinary demands of multitasking, time urgency, long duty hours, complex handoffs, and multiple stressors of flight.

Arterial pressure-based stroke volume and functional hemodynamic monitoring.

Arterial pressure-based methods are less-invasive methods used to measure stroke volume and to predict fluid responsiveness. An understanding of the assumptions of the measurements and clinical factors that affect their accuracy and ability to predict fluid responsiveness is imperative when deciding when and how to use these new technologies. Frequently asked questions about these technologies and the data provided are addressed.

Military nursing research: translation to disaster response and day-to-day critical care nursing.

Where to begin? How do you identify nursing care requirements for military operations, disaster, and humanitarian response, and how do you modify care under these unique conditions? This article presents a framework for identifying areas of critical care nursing that are performed on a day-to-day basis that may also be provided during a contingency operation, and discusses how that care may be changed by the austere conditions associated with a contingency response. Examples from various disasters, military operations, and military nursing research are used to illustrate the use of this framework. Examples are presented of how the results of this military nursing research inform disaster nursing and day-to-day critical care nursing practice.

Accuracy and precision of noninvasive temperature measurement in adult intensive care patients.

Background: Research on the accuracy and precision of noninvasive methods of measuring body temperature is equivocal.

Objectives: To determine accuracy and precision of oral, ear-based, temporal artery, and axillary temperature measurements compared with pulmonary artery temperature.

Methods: Repeated-measures design conducted for 6 months.

Comparison of three strategies for preventing hypothermia in critically injured casualties during aeromedical evacuation.

Critically injured patients are at risk for hypothermia. This study determined the efficacy of three hypothermia prevention strategies: the ChillBuster warming blanket, ChillBuster with a reflective blanket, and two wool blankets. A quasi-experimental design was used to compare changes in core temperature.

Blast injuries: from triage to critical care.

Injuries from explosions are multilayered. Although blast injuries are thought of most often in a military context, all nurses need to be prepared to care for these casualties. Awareness of the multiple levels of injuries and the need to modify care based on the underlying pathology have reduced morbidity and mortality in patients who have complex and very critical injuries.

Pulmonary artery pressure monitoring: when, how, and what else to use.

The integration of data from a pulmonary artery catheter when used as part of a goal-directed plan of care may benefit certain groups of critically ill patients. Integral to the successful use of the pulmonary artery catheter is to accurately obtain and interpret invasive pressure monitoring data. This article addresses commonly asked clinical questions and considerations for decision making under complex care conditions, such as obtaining hemodynamic measurements when the patient is prone or has marked respiratory pressure variations or increased intraabdominal pressure.

Cardiovascular aspects of septic shock: pathophysiology, monitoring, and treatment.

The care of patients with septic shock is exceedingly complex. New therapies and monitoring technologies are being rapidly developed. To create an effective plan of care that integrates these new therapies and technologies, critical care nurses must understand the underlying pathophysiology of septic shock, techniques to accurately monitor patients' status, and the rationale for care.

Care of the critically ill patient in a military unique environment: a program of research.

The goal of the Air Force Nursing Research Program at WHMC is to conduct research on topics unique to Air Force and military nursing. The nine stressors of flight and the military environment of care have been used as a conceptual model to guide the development of research studies. The studies conducted to date describe how the environment affects practice and when the environment directly affects the patient.

Preparing to respond: Joint Trauma Training Center and USAF Nursing Warskills Simulation Laboratory.

Injuries related to the events of September 11, 2001, and continuing military actions associated with Operation Enduring Freedom underscore the accurate focus of the Joint Trauma Training Center and the Warskills Simulation Laboratory. These two programs ensure that nurses are prepared to respond to diverse medical situations worldwide. Outcome measures from both initiatives attest to the effectiveness of an integrated program that facilitates critical thinking skills and clinical judgment to increase the nurses' ability to provide trauma care to severely injured military personnel.

Skin interface pressure on the NATO litter.

The NATO litter serves as a transport device and hospital bed during all types of operations. Little is known about the skin interface pressure on this litter. The purpose of this study was to determine whether various types of padding on the litter and body position affect the peak skin interface pressure and the total body area exposed to interface pressures above 30 mm Hg at different body areas.

Monitoring arterial blood pressure: what you may not know.

Hemodynamic monitoring is a costly procedure, both materially and with regard to nursing time involved to ensure proper functioning of the monitoring system and correct interpretation of the data obtained. Dynamic response testing is the ideal method of confirming the ability of a monitoring system to accurately reproduce hemodynamic waveforms. MAP is a stable hemodynamic parameter, because it is least affected by monitoring method, catheter insertion site, the dynamic response characteristics of the catheter system, and wave reflection.