The impact of symptom burden on the health status of service members with extremity trauma.

Background: Service members injured in combat undergo repeated surgeries and long recoveries following a traumatic injury that produce a myriad of physical and psychological symptoms.

Purpose: To describe the severity of pain, sleep disturbance, depression, and anxiety in service members with extremity trauma sustained during combat operations at the time of discharge from the hospital and to evaluate for differences in health status between those with and without symptom burden.

Method: Descriptive study of 130 United States Army service members.

Combining ketamine and virtual reality pain control during severe burn wound care: one military and one civilian patient.

Background: US soldiers injured in Iraq, and civilian burn trauma patients are treated at the US Army Institute of Surgical Research. Burn patients experience extreme pain during wound care, and they typically receive opioid analgesics and anxiolytics for debridement. Virtual Reality (VR) has been applied as an adjunct to opioid analgesics for procedural pain.

Caring for burn patients at the United States Institute of Surgical Research: the nurses' multifaceted roles.

Nursing plays a critical role in the comprehensive burn care delivered at the US Army Institute of Surgical Research, otherwise known as the US Army's Burn Center serving the Department of Defense. This center serves as a model for burn units nationally and internationally. It also provides a challenging and innovative work environment for military and civilian nurses.

Factors influencing cognitive functioning following mild traumatic brain injury in OIF/OEF burn patients.

Objective: To examine the relationship between mild traumatic brain injury (mTBI), psychiatric conditions, pain medications, and injury severity on cognitive functioning in service members admitted to a burn unit. We hypothesize that psychiatric co-morbidity and pain medications will have a stronger relationship with cognitive dysfunction than mTBI diagnosis in this population.

Method: Retrospective review of clinical evaluations (n=194) completed between September 2005 - October 2007 on service members with burn injuries secondary to explosive munitions.

A comparison of posttraumatic stress disorder between combat casualties and civilians treated at a military burn center.

Background: Posttraumatic stress disorder (PTSD) has been identified in 12% to 20% of noninjured veterans and in 32% of combat casualties. Eight percent of the US general population experience PTSD symptoms, whereas 25.5% of civilians with major burns have PTSD.

The relationship of intravenous midazolam and posttraumatic stress disorder development in burned soldiers.

Background: Midazolam, a short-acting benzodiazepine, is administered preoperatively and intraoperatively for amnesia and anxiolysis. Subsequently, patients often do not recall events which occurred while they were sedated. Recent studies have also reported retrograde facilitation after midazolam exposure.

Posttraumatic stress disorder in combat casualties with burns sustaining primary blast and concussive injuries.

Background: There is a heightened focus on postexplosion functional outcomes in combat casualties. Previously, we reported a high prevalence of posttraumatic stress disorder (PTSD) (32%) and mild traumatic brain injury (mTBI) (41%) in patients with explosion-related burns. We hypothesized that the prevalence of PTSD in patients with burn was associated with primary blast injuries (PBIs) and mTBI.

The effect of propranolol on posttraumatic stress disorder in burned service members.

Posttraumatic stress disorder (PTSD) is reported to affect almost one third of the civilian burn patient population. Predisposing factors for PTSD include experiencing a traumatic event. Of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) soldiers returning home after deployment without injury, 17% reported cognitive symptoms of PTSD.

Incidence of posttraumatic stress disorder and mild traumatic brain injury in burned service members: preliminary report.

Background: Although sustaining physical injury in theater increases service members' risk for posttraumatic stress disorder (PTSD), exposure to explosive munitions may increase the risk of mild traumatic brain injury (mTBI). We hypothesized a higher incidence of PTSD and mTBI in service members who sustained both burn and explosion injuries than in nonexplosion exposed service members.

Methods: A retrospective review of PTSD and mTBI assessments was completed on burned service members between September 2005 and August 2006.

The correlation between ketamine and posttraumatic stress disorder in burned service members.

Background: Predisposing factors for posttraumatic stress disorder (PTSD) include experiencing a traumatic event, threat of injury or death, and untreated pain. Ketamine, an anesthetic, is used at low doses as part of a multimodal anesthetic regimen. However, since ketamine is associated with psychosomatic effects, there is a concern that ketamine may increase the risk of developing PTSD.

The psychosocial effects of combat: the frequently unseen injury.

The psychosocial issues related to deployment and combat duty are complex. Deployment may result in psychiatric casualties that are either the result of inadequate coping with the stressors of deployment or acute stress reactions caused by the trauma of battle, that is, combat stress reactions. Combat duty is associated with traumatic events, deprivation, and exposure to war atrocities that may result in acute, delayed or chronic psychosocial issues during and afer returning from deployment.