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Front Neurol 2019 7;10:144. Epub 2019 Mar 7.

Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) - CISSS de Laval, and School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.

Driving an automobile is an important activity for the social participation of individuals with traumatic brain injury (TBI). Return to safe driving is usually addressed during rehabilitation, but we know little about driving behaviors in the years following TBI rehabilitation. To explore self-reported and objective (official driving records) post-rehabilitation driving behaviors and offenses in individuals with TBI: (a) having passed a driving evaluation, (b) who did not undergo a driving evaluation, and (c) non-injured controls. Read More

Burns 2019 Mar 5. Epub 2019 Mar 5.

Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Massachusetts General Hospital, Shriners Hospitals for Children-Boston, Harvard Medical School, United States. Electronic address:

Introduction: There is limited understanding of how burn injuries at different ages are associated with normal growth and development as well as the burn recovery process. This study provides new useful insights by comparing social participation outcomes among burn survivors injured in childhood compared with injuries sustained in middle age, and older adulthood.

Methods: Items from the development of the LIBRE profile were administered to 601 adult burn survivors with ≥5% TBSA burned or burns to critical areas (hands, feet, face, or genitals). Read More

Scand J Trauma Resusc Emerg Med 2018 Jun 27;26(1):52. Epub 2018 Jun 27.

Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.

Background: Globally, armed conflict is a major contributor to mortality and morbidity. The treatment of war-associated injuries is largely experience-based. Evidence is weak due to difficulty in conducting medical research in war settings. Read More

J Spec Oper Med Summer 2018;18(2):42-48

Background: We sought to assess the rehabilitation process, training, performance, and injury rates among those participating and not participating in the Tactical Human Optimization, Rapid Rehabilitation, and Reconditioning (THOR3) program and determine injury risk factors.

Methods: A survey inquiring about personal characteristics, injuries, physical performance, and THOR3 participation during the previous 12 months was administered to Army Special Operations Forces (SOF) Soldiers. Based on responses to physical training, Soldiers were categorized into three groups: a traditional physical training (TPT) group, a cross-training (CT) group, and a THOR3 group. Read More

Mil Med 2018 11;183(11-12):e555-e563

Department of Psychiatry, University of Texas Health Science Center at San Antonio, 7550 Interstate Highway 10 West, Suite 1325, San Antonio, TX.

Introduction: Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are two of the signature injuries in military service members who have been exposed to explosive blasts during deployments to Iraq and Afghanistan. Acute stress disorder (ASD), which occurs within 2-30 d after trauma exposure, is a more immediate psychological reaction predictive of the later development of PTSD. Most previous studies have evaluated service members after their return from deployment, which is often months or years after the initial blast exposure. Read More

Curr Rheumatol Rev 2019 ;15(1):50-58

Medical Centre & Rehabilitation Department, Defence Primary Healthcare, Infantry Training Centre Catterick Garrison, DL9 3PS, United Kingdom.

Background: Musculoskeletal Injury (MSKI), a common problem in both military and physically active civilian populations, has been suggested to result from both extrinsic and intrinsic factors.

Objective: To investigate prospectively whether gait biomechanics, aerobic fitness levels and smoking status as well as entry military selection test variables can be used to predict MSKI development during recruit training.

Methods: British infantry male recruits (n = 562) were selected for the study. Read More

Crit Care Nurse 2018 Apr;38(2):e1-e6

CDR Virginia S. Blackman, NC, USN, is an assistant professor at the Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Background: US Navy nurses provide en route care for critically injured combat casualties without having a formal program for training, utilization, or evaluation. Little is known about missions supported by Navy nurses.

Objectives: To characterize the number and types of patients transported and skill sets required by Navy nurses during 2 combat support deployments. Read More

Ergonomics 2018 Aug 8;61(8):1094-1101. Epub 2018 Mar 8.

b Department of Industrial and Operations Engineering , University of Michigan , Ann Arbor , MI , USA.

This study aimed to compare the activity of four shoulder muscles in individuals with low back pain (LBP), spinal cord injuries (SCI) and a control group, during one-handed load transfer trials. Nine individuals with minimum one-year of LBP, eleven with thoracic/lumbar SCI and nine healthy controls participated in this study. The activations of anterior deltoid, upper trapezius, infraspinatus and pectoralis major were recorded by surface EMG during one-handed transferring of a cylinder from a home shelve to six spatially distributed target shelves. Read More

Health Phys 2018 03;114(3):373-378

*Idaho State University, College of Science and Engineering, 921 S. 8th Avenue, Stop 8065, Pocatello, ID 83209-8065.

Depleted uranium (DU) munitions were initially used by the United States (U.S.) military during the first Persian Gulf War in 1991 in order to penetrate heavily armored vehicles. Read More

Technol Health Care 2018 ;26(2):249-261

Military Academy, "General Mihailo Apostolski", Skopje, University "Goce Delcev", Stip, Macedonia.

Background And Objectives: Categorization of the casualties in accordance with medical care priorities is crucial in a military environment. Automation of the triage process is still a challenging task. The goal of the paper is to propose a novel algorithm for automation of medical emergency protocol in the military environment by the creation of classifiers that can provide accurate prioritization of injured soldier cases. Read More

J Athl Train 2017 Dec 11;52(12):1153-1160. Epub 2017 Dec 11.

Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, Lexington.

Context:   Seventy-seven percent of musculoskeletal injuries sustained by United States Army Special Forces Operators are preventable. Identification of predictive characteristics will promote the development of screening methods to augment injury-prevention programs.

Objective:   To determine physical and performance characteristics that predict musculoskeletal injuries. Read More

Arch Phys Med Rehabil 2017 Nov 26. Epub 2017 Nov 26.

Massachusetts General Hospital, Shriners Hospitals for Children-Boston, Harvard Medical School, Boston, MA.

Objective: To examine differences in long-term social reintegration outcomes for burn survivors with and without work-related injuries.

Design: Cross-sectional survey.

Setting: Community-dwelling burn survivors. Read More

BMJ Open 2017 Nov 16;7(11):e017390. Epub 2017 Nov 16.

Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

Objectives: Few studies examine the influence of early predictors of work absence beyond 12 months following injury or the time-dependent relative importance of these factors. This study aimed to identify the most important sociodemographic, occupational, health, lifestyle and injury predictors of work absence at 12 and 24 months following injury and to examine changes in the relative importance of these over time.

Design: Prospective cohort study. Read More

Neurology 2017 Nov 13;89(19):2010-2016. Epub 2017 Oct 13.

From the University of Tennessee Health Science Center (J.W.T.); Children's Foundation Research Center (J.W.T.), Le Bonheur Children's Hospital, Memphis, TN; Uniformed Services University of the Health Sciences (J.W.T., F.J.H., P.F.P.); Walter Reed National Military Medical Center (L.A.S., M.R., R.S.H., B.N.P., P.F.P., M.W., C.E.T., K.S.), Bethesda, MD; Naval Medical Center San Diego (R.L.), CA; Naval Medical Center Portsmouth (S.L.); Neuroscience Consultants, PLC (E.F.), Reston; and Information Innovators, Inc (A.H.C.), Springfield, VA.

Objective: To examine whether blast exposure alone and blast-associated concussion result in similar neurologic and mental health symptoms.

Methods: A 14-item questionnaire was administered to male US Marines on their return from deployment in Iraq and/or Afghanistan.

Results: A total of 2,612 Marines (median age 22 years) completed the survey. Read More

Mil Med 2017 09;182(9):e1864-e1870

Department of Surgery, Alrijne Hospital, Simon Smitweg 1, 2353 GA Leiderdorp, Leiden, The Netherlands.

Background: An important factor within the military medical logistical chain is the capability of expeditious evacuation from point of injury, through a Medical Treatment Facility, to the country of residence where highest level of care can be provided. Although many factors can relate to patient outcome, the evaluation of the medical evacuation chain related to long-term patient outcome can be important for investigating possibilities for performance improvement in this domain. This article aims to provide a means to evaluate the quality of care of the medical evacuation chain. Read More

Mil Med 2017 07;182(7):e1862-e1868

U.S. Army-Baylor University Doctoral Program in Physical Therapy, 3630 Stanley Road, Building 2841, Suite 1301, Joint Base San Antonio-Fort Sam Houston, TX 78234.

Background: Musculoskeletal injuries present a significant challenge to military readiness accounting for over 29% of ambulatory medical visits and 25 million limited duty days across the U.S. Army. Read More

Arch Phys Med Rehabil 2017 12 21;98(12):2355-2363. Epub 2017 Jun 21.

Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada.

Objective: To examine whether motivational interviewing (MI) leads to more sustainable return-to-work outcomes for injured workers undergoing rehabilitation.

Design: Cluster randomized controlled trial.

Setting: Workers' compensation rehabilitation facility. Read More

Medicine (Baltimore) 2017 Jun;96(25):e7274

aDivision of Physiotherapy, Department of Medical and Health Sciences bRehab Väst, County Council of Östergötland, Departments of Rehabilitation and Medical and Health Sciences cCentre for Clinical Research Sörmland, Uppsala University dAllied Health Professionals Function, Karolinska University Hospital eDivision of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge fKarolinska Institutet, Institute of Environmental Medicine, Unit of Occupational Medicine, Stockholm gDivision of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Sweden.

Background: Fifty percent of people injured by whiplash still report neck pain after 1 year and costs associated with whiplash associated disorders (WAD) are mostly attributed to health service and sick-leave costs in chronic conditions. With increasing health care expenditures the economic impact of interventions needs to be considered.

Objective: To analyze the cost-effectiveness of physiotherapist-led neck-specific exercise without (NSE) or with a behavioral approach (NSEB), or prescription of physical activity (PPA) in chronic WAD, grade 2 to 3. Read More

J Emerg Nurs 2018 Jan 17;44(1):19-25. Epub 2017 Jun 17.

Roanoke, VA.

Problem: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. Read More

Health Promot Pract 2017 07 21;18(4):505-515. Epub 2016 Dec 21.

4 VA Puget Sound Medical Center, Seattle, WA, USA.

We designed a safety and health curriculum for dairy immigrant workers aiming to increase knowledge, encourage safe behavior, and reduce worker communication inequalities to prevent occupational injury and diseases. The design is largely based on the Taxonomy of Significant Learning and incorporated behavioral and adult learning theories and principles of occupational hazard control. Trainings were implemented with 836 Spanish-speaking workers from 67 farms in Wisconsin. Read More

J Med Internet Res 2017 05 10;19(5):e159. Epub 2017 May 10.

Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA, United States.

Background: In order to meet the challenges of caring for an injured person, caregivers need access to health information. However, caregivers often feel that they lack adequate information. Previous studies of caregivers have primarily focused on either their time and emotional burdens or their health outcomes, but the information needs of caregivers have not been thoroughly investigated. Read More

Mil Med 2017 03;182(3):e1651-e1658

Alaska Radiology Associates, TBI Imaging and Research, 3650 Piper Street, Suite A, Anchorage, AK 99508.

Mild traumatic brain injury (mTBI) is a major health concern among active duty service members and Veterans returning from combat operations, and it can result in variable clinical and cognitive outcomes. Identifying biomarkers that can improve diagnosis and prognostication has been at the forefront of recent research efforts. The purpose of this study was to compare the sensitivity and specificity of abnormalities identified using more traditional magnetic resonance imaging (MRI) sequences such as fluid attenuation inversion recovery (FLAIR) to more advanced MRI sequences such as susceptibility weighted imaging (SWI) among a cohort of active duty service members experiencing persistent cognitive symptoms after mTBI. Read More

BMC Emerg Med 2017 03 9;17(1). Epub 2017 Mar 9.

Departments of Family Medicine, Clinical Epidemiology and Biostatistics, Quality Assurance Program Coordinator for Family Medicine Residency, Residency Program Research Coordinator, Family Medicine Residency Program, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada.

Background: Seniors living in subsidized housing have lower income, poorer health, and increased risk for cardiometabolic diseases and falls. Seniors also account for more than one third of calls to Emergency Medical Services (EMS). This study examines the effectiveness of the Community Health Assessment Program through EMS (CHAP-EMS) in reducing blood pressure, diabetes risk, and EMS calls. Read More

J Am Acad Orthop Surg 2017 Mar;25(3):e45-e52

From the Department of Orthopedics, Alpert Medical School of Brown University, Providence, RI.

Workers' compensation is an employer-funded insurance program that provides financial and medical benefits for employees injured at work. Because many occupational injuries are musculoskeletal in nature, the orthopaedic surgeon plays an important role in the workers' compensation system. Along with establishing the correct diagnosis and implementing an appropriate treatment plan, the clinician must understand the fundamental components of the workers' compensation system to manage an injured employee. Read More

Mil Med 2017 01;182(1):e1658-e1664

Director, Center for the Intrepid, San Antonio Military Medical Center, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234.

A functional capacity evaluation (FCE) evaluates the ability of an individual to perform activities related to employment. There is no FCE specific to the military population; therefore, a FCE for the military population (FCE-M) was developed to evaluate an injured service member's (SM) ability to return to duty. The FCE-M is herein described along with descriptions of three active duty SMs who completed the evaluation. Read More

Pediatrics 2016 12 11;138(6). Epub 2016 Nov 11.

American Academy of Pediatrics, Elk Grove Village, Illinois

Pediatric Life Support (PLS) courses and instructional programs are educational tools developed to teach resuscitation and stabilization of children who are critically ill or injured. A number of PLS courses have been developed by national professional organizations for different health care providers (eg, pediatricians, emergency physicians, other physicians, prehospital professionals, pediatric and emergency advanced practice nurses, physician assistants). PLS courses and programs have attempted to clarify and standardize assessment and treatment approaches for clinical practice in emergency, trauma, and critical care. Read More

Inj Prev 2018 02 24;24(1):81-88. Epub 2016 Nov 24.

University of Evansville, School of Physical Therapy, Evansville, Indiana, USA.

Background: Musculoskeletal injuries are a primary source of disability in the US Military, and low back pain and lower extremity injuries account for over 44% of limited work days annually. History of prior musculoskeletal injury increases the risk for future injury. This study aims to determine the risk of injury after returning to work from a previous injury. Read More

Injury 2017 Jan 7;48(1):64-69. Epub 2016 Sep 7.

Oregon Health & Science University, Department of Surgery, Division of Trauma, Critical Care, and Acute Care Surgery, United States. Electronic address:

Introduction: The purpose of this study was to review the inpatient traumatic brain injury (TBI) screening program at a Role IV regional resource trauma center. TBI has been coined the "signature wound" during current U.S. Read More

Nurse Pract 2016 Oct;41(10):51-4

Stephanie Hammond is an instructor at The University of Alabama at Birmingham School of Nursing, Birmingham, Ala. Melanie Gibbons Hallman is an instructor at The University of Alabama at Birmingham School of Nursing, Birmingham, Ala. Michael Hyde is an instructor at The University of Alabama at Birmingham School of Nursing, Birmingham, Ala.

The primary care NP has a significant opportunity to meet the special healthcare needs of the occupational community. While NPs routinely diagnose and treat workers, writing return-to-work restrictions can pose a challenge. Read More

Gac Med Mex 2016 Jul-Aug;152(4):534-46

Departamento de Radiación Ionizante, Hospital Central Militar, Dirección de la Unidad Médica de Consulta Externa de la SEDENA, Ciudad de México, México.

Background: Trauma is the most common cause of death in young adults. A multidisciplinary trauma team consists of at least a surgical team, an anesthesiology team, radiologic team, and an emergency department team.

Objective: Recognize the integration of multidisciplinary medical team in managing the trauma patient and which must include the radiologist physician responsible for the institutional approach to the systematization of the trauma patient regarding any radiological and imaging study with emphasis on the FAST (del inglés, Focused Assessment with Sonography in Trauma)/USTA, Whole body computed tomography. Read More

Mil Med 2016 08;181(8):777-85

10106 Mike Road, Fort Washington, MD 20744.

In 2010, the U.S. Congress directed the Department of Defense to establish the Recovering Warrior Task Force (RWTF) to examine the effectiveness of, and recommend improvements to, military programs and policies for the care, management, and transition of wounded, ill, and injured personnel. Read More

Inj Prev 2017 02 25;23(1):27-32. Epub 2016 Jul 25.

Pacific Institute for Research and Evaluation, Calverton, Maryland, USA.

Objective: To count and characterise injuries resulting from legal intervention by US law enforcement personnel and injury ratios per 10 000 arrests or police stops, thus expanding discussion of excessive force by police beyond fatalities.

Design: Ecological.

Population: Those injured during US legal police intervention as recorded in 2012 Vital Statistics mortality census, 2012 Healthcare Cost and Utilization Project nationwide inpatient and emergency department samples, and two 2015 newspaper censuses of deaths. Read More

Prehosp Emerg Care 2017 Jan-Feb;21(1):46-53. Epub 2016 Jul 19.

Background: Prehospital care providers are in a unique position to provide initial unadulterated information about the scene where a child is abusively injured or neglected. However, they receive minimal training with respect to detection of Child Abuse and Neglect (CAN) and make few reports of suspected CAN to child protective services.

Aims: To explore barriers and facilitators to the recognition and reporting of CAN by prehospital care providers. Read More

Disabil Health J 2017 01 21;10(1):114-122. Epub 2016 Jun 21.

Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, Hines, IL, USA; Center of Innovation for Complex Chronic Health Care (CINCCH), Edward Hines Jr. VA Hospital, Hines, IL, USA; Center for Evaluation of Practices and Experiences of Patient-Centered Care (CEPEP), Edward Hines Jr. VA Hospital, Hines, IL, USA; Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Chicago, IL, USA.

Background: Assessments of function in persons with spinal cord injury (SCI) often utilize pre-defined constructs and measures without consideration of patient context, including how patients define function and what matters to them.

Objectives/hypothesis: We utilized photovoice to understand how individuals define function, facilitators and barriers to function, and adaptations to support functioning.

Methods: Veterans with SCI were provided with cameras and guidelines to take photographs of things that: (1) help with functioning, (2) are barriers to function, and (3) represent adaptations used to support functioning. Read More

J Occup Rehabil 2017 06;27(2):268-283

Department of Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.

Purpose Unintentional injuries occur frequently and many of the accident survivors suffer from temporary or permanent disabilities. Although most accident victims recover quickly, a significant fraction of them shows a complicated recovery process and accounts for the majority of disability costs. Thus, early identification of vulnerable persons may be beneficial for compensation schemes, government bodies, as well as for the worker themselves. Read More

NeuroRehabilitation 2016 Jun;39(1):53-64

Oliver Zangwill Centre for Neuropsychological Rehabilitation, Ely, UK.

Background: Following acquired brain injury (ABI), deficits in executive functioning (EF) are common. As a result many brain-injured patients encounter problems in every-day functioning, and their families experience significant strain. Previous research has documented the benefits of cognitive rehabilitation for executive dysfunction, and rehabilitation programmes designed to ameliorate functional problems associated with ABI. Read More

Orthop Nurs 2016 May-Jun;35(3):152-8

Ann Regina Lurati, ACNP-BC, MPH, DNP, COHN-S, is lecturer at San Jose State and lives in Pebble Beach, CA.

Occupational acute lumbar injuries are a common injury. One intervention that is unique to occupational health is the determination of the amount of physical activity that an injured worker can perform without increasing the risk of further injury. Clinical recommendations suggest that workers continue to stay active; however, it is still the clinician's responsibility to determine the level of activity. Read More

J Orthop Sports Phys Ther 2016 Jul 12;46(7):590-5. Epub 2016 May 12.

Study Design Cross-sectional cohort study. Background Symptoms of depression, panic disorder (PD), and posttraumatic stress disorder (PTSD) have been associated with musculoskeletal complaints and could represent barriers to recovery in injured workers. Objectives To determine the prevalence of symptoms of depression, PD, and PTSD utilizing the Patient Health Questionnaire (PHQ) in a cohort of patients presenting to an upper extremity injured-worker clinic; secondarily, to identify any relationships between patients screening positive and patient-reported outcome measures. Read More

Psychol Assess 2017 01 7;29(1):76-86. Epub 2016 Apr 7.

Project Air Force, RAND Corporation.

The Posttraumatic Stress Disorder (PTSD) Checklist (PCL) is commonly used to screen for PTSD in clinical and research contexts. While the PCL is utilized within numerous settings and populations, research has not yet established the extent to which individuals respond similarly across different modes of administration. The use of both telephone and web survey administration modes has numerous potential benefits, including data quality improvement, but may introduce an additional source of measurement error. Read More

BMC Public Health 2016 Apr 6;16:298. Epub 2016 Apr 6.

Department of General Practice, School of Primary Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Rd, Notting Hill, Victoria, 3168, Australia.

Background: Work-related injuries resulting in long-term sickness certification can have serious consequences for injured workers, their families, society, compensation schemes, employers and healthcare service providers. The aim of this study was to establish what factors potentially are associated with the type of sickness certification that General Practitioners (GPs) provide to injured workers following work-related injury in Victoria, Australia.

Methods: This was a retrospective population-based cohort study was conducted for compensation claims lodged by adults from 2003 to 2010. Read More

J R Army Med Corps 2016 Oct 23;162(5):324-325. Epub 2016 Feb 23.

King's Centre for Military Health Research, King's College London, London, UK.

Concerns have been raised about the level of support available to those families who provide unpaid care for wounded, injured or sick (WIS) personnel in the UK. In this opinion piece, support services for families of WIS personnel in the UK and their associated evaluations are reviewed. Support services are found to be provided by government-led initiatives, third sector organisations and the Service Family Federations. Read More

J Occup Rehabil 2017 03;27(1):70-81

Department of Environmental and Occupational Health Sciences, University of Washington (UW), 4225 Roosevelt Way NE, Suite 100, Box 354695, Seattle, WA, 98105, USA.

Purpose Supervisors in the healthcare sector have the potential to contribute to disability prevention in injured employees. Published data on the evaluation of return to work (RTW) interventions aimed at direct supervisors are scarce. We sought to determine the effect of a brief audiovisual supervisor training module on supervisor RTW attitudes and knowledge. Read More

US Army Med Dep J 2016 Jan-Mar:30-4

US Army Institute of Surgical Research, Joint Base San Antonio Fort Sam Houston, Texas.

Background: Combat injuries are most often to the extremities, resulting in a majority of long term disabilities being of orthopaedic nature. Some injuries are expected to improve with time. The Army Physical Evaluation Board (PEB) gives consideration for conditions that may improve with further care by placing eligible patients on a temporary retirement list. Read More

West J Emerg Med 2016 Jan 12;17(1):1-7. Epub 2016 Jan 12.

Loma Linda University Medical Center, Department of Emergency Medicine, Loma Linda, California.

On December 2, 2015, a terror attack in the city of San Bernardino, California killed 14 Americans and injured 22 in the deadliest attack on U.S. soil since September 11, 2001. Read More

J R Army Med Corps 2016 Oct 14;162(5):321-323. Epub 2016 Jan 14.

Although prolonging life is usually in the best interests of patients, the British Medical Association states that it is not appropriate to prolong life with no regard to its quality. Medical advances both on the battlefield and within the field hospitals have resulted in the unexpected survival of a number of British personnel, and in some cases, soldiers are being repatriated with injuries categorised as 'catastrophic'. This paper considers medical ethics based on the Beauchamp and Childress Four Principles framework with regard to whether catastrophically injured individuals should be repatriated without any prior advanced directive and without evaluation of future quality of life. Read More

Unfallchirurg 2017 May;120(5):409-416

Department für Orthopädie, Unfall- und Wiederherstellungschirurgie, Martin-Luther- Universität Halle-Wittenberg, Magdeburger Straße 22, 06112, Halle(Saale), Deutschland.

Background: Prehospital assessment of injury type and severity by emergency medical services physicians impacts treatment including appropriate destination hospital selection, especially in (potentially) life-threatening cases. Injuries which are underestimated or overlooked by the emergency physician can delay adequate therapy and thus significantly influence the overall outcome. The current study used data from the TraumaRegister DGU® to evaluate the reliability of prehospital injury assessments made by emergency physicians. Read More

Health Technol Assess 2016 Jan;20(1):1-198

EMRiS Group, Health Services Research, School of Health and Related Research (SCHaRR), University of Sheffield, Sheffield, UK.

Background: Reconfiguration of trauma services, with direct transport of traumatic brain injury (TBI) patients to neuroscience centres (NCs), bypassing non-specialist acute hospitals (NSAHs), could potentially improve outcomes. However, delays in stabilisation of airway, breathing and circulation (ABC) and the difficulties in reliably identifying TBI at scene may make this practice deleterious compared with selective secondary transfer from nearest NSAH to NC. National Institute for Health and Care Excellence guidance and systematic reviews suggested equipoise and poor-quality evidence - with regard to 'early neurosurgery' in this cohort - which we sought to address. Read More

J Rehabil Res Dev 2015 ;52(7):785-92

Extremity Trauma and Regenerative Medicine, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX;.

Extremity injuries comprise the majority of battlefield injuries and contribute the most to long-term disability of servicemembers. The purpose of this study was to better define the contribution of muscle deficits and volumetric muscle loss (VML) to the designation of long-term disability in order to better understand their effect on outcomes for limb-salvage patients. Medically retired servicemembers who sustained a combat-related type III open tibia fracture (Orthopedic cohort) were reviewed for results of their medical evaluation leading to discharge from military service. Read More

J Trauma Nurs 2016 Jan-Feb;23(1):13-22

Parkview Adult and Pediatric Level 2 Trauma Center, Fort Wayne, Indiana.

The study evaluates (1) health care provider perception of the Rural Trauma Team Development Course (RTTDC); (2) improvement in acute trauma emergency care knowledge; and (3) early transfer of trauma patients from rural emergency departments (EDs) to a verified trauma center. A 1-day, 8-hour RTTDC was given to 101 nurses and other health care providers from nine rural community hospitals from 2011 to 2013. RTTDC participants completed questionnaires to address objectives (1) and (2). Read More