Burns management in the military and humanitarian setting.

Burns are an unpredictable element of the modern battlespace and humanitarian operations. Most military burns are small and may not be a significant challenge for deployed healthcare assets but usually render the individual combat ineffective until healed. However, larger burns represent a more significant challenge because of the demand for fluid resuscitation therapy, early surgical intervention and regular wound management that can rapidly deplete surgical capabilities.

Generational and occupational differences in human factors knowledge and awareness: a comparison study.

Introduction: Increasing healthcare sector litigation, accountability and governance has resulted in the identification of human factors (HF) as a common source of error. Both NHS and military doctors must have awareness of HF to enhance safety and productivity. There is limited published evidence examining knowledge of HF in these two healthcare professional groups.

Coronavirus antibody positive tests and continued use of personal protective equipment throughout the pandemic.

The COVID-19 pandemic has thrust not only a novel virus onto the world, but new challenges resulting in novel approaches. Governments have reduced regulation in order to facilitate timely advances to combat the disease. Antibody testing has rapidly been deployed but it is creating challenges for staff and patients.

A Comparison of Improvised and Commercially Available Point-of-Wounding Tourniquets in Simulated Traumatic Amputation with Catastrophic Hemorrhage.

Introduction: Catastrophic hemorrhage is the leading cause of preventable trauma deaths in the military and civilian populations. The use of tourniquets by first responders (medical and nonmedically trained) is supported and has the potential to save lives if applied correctly.

Aims: We sought to examine the use of 5 tourniquets: 1 improvised and 4 commercially available tourniquets to investigate the time taken to stop simulated bleeding and to secure the device; evidence of rebleeding when the "blood pressure" was restored and to gain qualitative feedback on their application.

Specialist infantry and defence engagement.

In 2015, the UK government published the National Strategic Defence and Security Review (SDSR) 2015, which laid out their vision for the future roles and structure of the UK Armed Forces. SDSR 2015 envisaged making broader use of the Armed Forces to support missions other than warfighting. One element of this would be to increase the scale and scope of defence engagement (DE) activities that the UK conducts overseas.

Reducing medical error during a pandemic.

On 30 January 2020, the WHO declared the coronavirus disease 2019 (COVID-19) a public health emergency of international concern. By 11 March 2020, it was designated a pandemic owing to its rapid worldwide spread. In this short article we provide some information that might be useful and help equip colleagues to reduce medical error during a pandemic.

Do theatre staff use face masks in accordance with the manufacturers' guidelines of use?

Aim: Surgical face masks are worn by theatre staff to protect the surgical site from airborne contamination and the wearer from bodily fluid splash. This observational/audit aimed to assess whether theatre staff wear masks in accordance with manufacturers'/Centers for Disease Control and Prevention (CDC) guidelines of use.

Methods: A total of 1034 surgically scrubbed staff were assessed on their technique of applying surgical face masks, compared to the CDC guidelines as manufacturers' guidelines were not available as per Health and Safety Executive guidelines.

The British Army's contribution to tropical medicine.

Infectious disease has burdened European armies since the Crusades. Beginning in the 18th century, therefore, the British Army has instituted novel methods for the diagnosis, prevention and treatment of tropical diseases. Many of the diseases that are humanity's biggest killers were characterised by medical officers and the acceptance of germ theory heralded a golden era of discovery and development.

Subduing the killer - sepsis; through simulation.

Few pathophysiological processes have a higher morbidity and mortality than sepsis. Implementing effective strategies to improve these poor outcomes remains a challenge. Previous work has shown improvements using single and multifaceted approaches, many with inclusion of sepsis training for doctors and nurses.

Extended operating times are more efficient, save money and maintain a high staff and patient satisfaction.

Current public sector austerity measures necessitate efficiency savings throughout the NHS. Performance targets have resulted in activity being performed in the private sector, waiting list initiative lists and requests for staff to work overtime. This has resulted in staff fatigue and additional agency costs.

X-Bolt unforeseen placement complication: case report.

With the introduction of the World Hip Trauma Evaluation Four clinical trial, fixation of pertrochanteric neck of femur fractures is becoming a hot topic. In this trial, the novel X-Bolt expanding bolt implant is being compared with the current gold standard of a sliding hip screw. We present a previously undescribed complication when inserting the bolt into the femoral head, where the expandable wings penetrate the femoral neck due to misplacement of the bone crusher or the X-Bolt prosthesis.

Civilian and military doctors' knowledge of tranexamic acid (TXA) use in major trauma: a comparison study.

Introduction: Tranexamic acid (TXA) administration within the recommended time of 3 hours has been demonstrated to improve outcomes following trauma. The aim of this study was to identify potential knowledge gaps in the administration of TXA in order to target further educational training in those doctors responsible for the management of acute trauma.

Methods: 104 military and 852 civilian doctors were invited to complete a four-item web-based questionnaire pertaining to the indications, dose, side effects and evidence base for TXA administration in trauma.