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The Expanding Role of the U.S. Army Paramedic.
Mil Med
January 2025
Combat Paramedic Program, U.S. Army MedCoE, JBSA Fort Sam Houston, TX 78234, USA.
The combat medic (68W) will play a critical role in medical operations in the event of future large-scale combat operations (LSCOs). However, the combat medic is largely not prepared for LSCOs. The revised Medical Education and Demonstration of Individual Competence (TC 8-800) state 68Ws much be able to provide advanced airway and trauma management, medication administration, and advanced casualty movement.
View Article and Find Full Text PDFRecent Orthopedic Trauma Volume in the United States Military Health System.
Mil Med
January 2025
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
Introduction: As illustrated by the "Walker Dip," there is growing concern regarding the lack of combat casualty care during peacetime. Surgical volume and case complexity are paramount for training and skill sustainment. We sought to quantify the recent orthopedic trauma surgical case load of all military orthopedic surgeons across the Military Health System (MHS).
View Article and Find Full Text PDFDevelopment of a Stringent Ex Vivo-Burned Porcine Skin Wound Model to Screen Topical Antimicrobial Agents.
Antibiotics (Basel)
December 2024
Combat Wound Care Group, CRT 4, United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX 78234, USA.
: Due to rising antibiotic-resistant microorganisms, there is a pressing need to screen approved drugs for repurposing and to develop new antibiotics for controlling infections. Current in vitro and ex vivo models have mostly been unsuccessful in establishing in vivo relevance. In this study, we developed a stringent ex vivo-burned porcine skin model with high in vivo relevance to screen topical antimicrobials.
View Article and Find Full Text PDFTiMON: a real-time integrated monitor for improving the placement and wear of emergency tourniquets.
BMC Emerg Med
January 2025
Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, CNY149, 13th St, Charlestown, 02129, MA, USA.
Background: The use of emergency tourniquets among military personnel has helped to dramatically reduce battlefield deaths and has recently gained popularity in the civilian sector. Yet, even well-trained individuals can find it difficult to assess proper tourniquet application. Emergency tourniquets are typically deemed sufficiently tightened through cursory visual confirmation or pulse assessment.
View Article and Find Full Text PDFThe inability to predict futility in hemorrhaging trauma patients using 4-hour transfusion volumes and rates.
J Trauma Acute Care Surg
January 2025
From the Department of Surgery (J.-M.V., T.W.C., B.A.C.), McGovern Medical School, University of Texas Health Science Center, Houston, Texas; Department of Epidemiology (B.L.R.-R., S.R.W.) and Department of Surgery (J.W.C.), University of Pennsylvania, Philadelphia, Pennsylvania; Donald D. Trunkey Center for Civilian and Combat Casualty Care (M.A.S.), Oregon Health & Science University, Portland, Oregon; Department of Surgery, Ernest E. Moore Shock Trauma Center at Denver Health (E.E.M.), University of Colorado Health Sciences Center, Denver, Colorado; Department of Surgery (N.N.), University of Miami/Jackson Memorial Hospital, Miami, Florida; and Department of Surgery (J.L.S.), Trauma and Transfusion Medicine Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Background: Blood shortages and utilization stewardship have motivated the trauma community to evaluate futility cutoffs during massive transfusions (MTs). Recent single-center studies have confirmed meaningful survival in ultra-MT (≥20 U) and super-MT (≥50 U), while others advocate for earlier futility cut points. We sought to evaluate whether transfusion volume and intensity cut points could predict 100% mortality in a multicenter analysis.
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