Infections complicating the care of combat casualties during operations Iraqi Freedom and Enduring Freedom.

Background: Continued assessment of casualty complications, such as infections, enables the development of evidence-based guidelines to mitigate excess morbidity and mortality. We examine the Joint Theater Trauma Registry (JTTR) for infections and potential risk factors, such as transfusions, among Iraq and Afghanistan trauma patients.

Methods: JTTR entries from deployment-related injuries with completed records between March 19, 2003, and April 13, 2009, were evaluated using International Classification of Diseases-9 codes for infections defined by anatomic/clinical syndromes and/or type of infecting organisms.

Infections in combat casualties during Operations Iraqi and Enduring Freedom.

Background: Infections are a common acute and chronic complication of combat-related injuries; however, no systematic attempt to assess infections associated with US combat-related injuries occurring in Iraq and Afghanistan has been conducted. The Joint Theater Trauma Registry (JTTR) has been established to collect injury specific medical data from casualties in Iraq and Afghanistan.

Methods: We reviewed the JTTR for the identification of infectious complications (IC) using International Classification of Diseases, 9th Revision (ICD-9) coding during two phases of the wars, before and after the end of the major ground operations in Iraq (19 March-May 31, 2003 and June 1, 2003-December 31, 2006).

Assessment of cardiovascular regulation after burns by nonlinear analysis of the electrocardiogram.

Critical illness and hypovolemia are associated with loss of complexity of the R-to-R interval (RRI) of the electrocardiogram, whereas recovery is characterized by restoration thereof. Our goal was to investigate the dynamics of RRI complexity in burn patients. We hypothesized that the postburn period is associated with a state of low RRI complexity, and that successful resuscitation restores it.

Creating a healing environment for critical care.

Creating a healing environment for critical care requires an organizational as well as personal commitment. An organizational model for health and healing integrates five key elements: common value for the mind-body-spirit approach to wellness and health; patient/family centered relationships; an organizational culture that promotes personal growth; the availability of CAT as well as conventional therapy; and a physical environment that supports healing. CAT strategies to support a physical environment for spirituality and healing were outlined, followed by a discussion of strategies for building capacity for EI to alleviate the emotional labor of nursing and facilitate family centered care.