Al Jubail--an aeromedical staging facility during the Gulf conflict: discussion paper.
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During the latter half of 1990 the Royal Air Force established a medical evacuation chain in support of the British First Armoured Division during Operation Granby (known as Operation Desert Storm in the USA). Medical contingency plans, formulated prior to embarkation from the UK, foresaw the need for five aeromedical staging facilities sub-deployed throughout the east of the Arabian Peninsula. The early days of the deployment found personnel busy with the construction of tented and hardened facilities and with the establishment of local operating procedures. Many problems were initially encountered, especially with supply, communications and in co-ordinating with collaborating coalition and host nation units. Nevertheless, progress was rapid and non-combatant operations were started within days of arrival. As the ground offensive became more imminent, training took on a sense of urgency. Advanced first aid techniques were taught to all non-medical staff, whereas doctors, nurses and paramedical personnel were taught ACLS and ATLS skills. All studied field hygiene, the hazards of nuclear, chemical and biological warfare, casualty handling, battle psychology and the intricacies of loading and unloading various types of aircraft. By the start of the ground phase of the war the British evacuation chain was fully operational and capable of treating and transferring hundreds of casualties per day. In the event, only about 850 patients were transported down the evacuation chain during the conflict, and less than 10% of these were battle casualties. This paper presents an overview of the British aeromedical evacuation system and discusses, in more detail, the establishment and operation of the busiest aeromedical staging facility at Al Jubail in the Eastern Province of Saudi Arabia. (+info)
The mobile Army surgical hospital (MASH): a military and surgical legacy.
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Operation Iraqi Freedom was perhaps the last military campaign that will ever utilize the services of a mobile Army surgical hospital (MASH). The Army has now essentially replaced the MASH with combat surgical hospitals (CSH) and forward surgical teams (FST). MASH units were designed as mobile, flexible, forward-deployed military hospitals, providing care for the wounded near the frontlines of the battlefield. These hospitals not only saved thousands of lives during war but also greatly influenced the delivery of trauma and critical care in civilian hospitals. The MASH was made popular by the television series of the 1970s, depicting the 4077th during the Korean War. Although a comical series, these television episodes provided viewers with a glimpse of life in a MASH during time of war. This article chronicles the history of the MASH from its inception during World War II to recent experiences in Operation Iraqi Freedom. (+info)
Characterisation of patients treated at the Red Cross field hospital in Kashmir during the first three weeks of operation.
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OBJECTIVE: To evaluate the characteristics of patients treated at a field hospital in the first month after a major earthquake. METHODS: Age, sex, diagnosis, and operations performed on patients admitted to the field hospital of the International Committee of the Red Cross in Pakistani Kashmir between 21 October and 10 November 2005 were recorded and the data analysed. RESULTS: During the three week period of this study, 316 patients were treated at the hospital; 246 were women and children (77.9%). Two thirds were hospitalised, over 90% because of the need for surgery or surgical consultation. Altogether 345 operations were performed on 157 patients. The majority of patients had infected wounds with or without fractures. CONCLUSIONS: Most patients need medical evaluation in consequence of earthquake-related trauma even weeks after the catastrophe, especially in areas difficult of access. (+info)
Modified critical care and treatment space considerations for mass casualty critical illness and injury.
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Mass critical care events are increasingly likely, yet the resource challenges to augment everyday, unrestricted critical care for a surge of disaster victims are insurmountable for nearly all communities. In light of these limitations, an expert panel defined a circumscribed set of key critical care interventions that they believed could be offered to many additional people and yet would also continue to offer substantial life-sustaining benefits for nonmoribund critically ill and injured people. They proposed Emergency Mass Critical Care, which is based on the set of key interventions and includes recommendations for necessary surge medical equipment, treatment space characteristics, and staffing competencies for mass critical care response. To date, Emergency Mass Critical Care is untested, and the real benefits of implementation remain uncertain. Nonetheless, Emergency Mass Critical Care currently remains the only comprehensive construct for mass critical care preparedness and response. This paper reviews current concepts to provide life-sustaining care for hundreds or thousands of people outside of traditional critical care sites. (+info)
Post-earthquake injuries treated at a field hospital --- Haiti, 2010.
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On January 12, 2010, a 7.0-magnitude earthquake struck Haiti, resulting in an estimated 222,570 deaths and 300,000 persons with injuries. The University of Miami Global Institute/Project Medishare (UMGI/PM) established the first field hospital in Port-au-Prince, Haiti, after the earthquake. To characterize injuries and surgical procedures performed by UMGI/PM and assess specialized medical, surgical, and rehabilitation needs, UMGI/PM and CDC conducted a retrospective medical record review of all available inpatient records for the period January 13-May 28, 2010. This report describes the results of that review, which indicated that, during the study period (when a total of 1,369 admissions occurred), injury-related diagnoses were recorded for 581 (42%) admitted patients, of whom 346 (60%) required a surgical procedure. The most common injury diagnoses were fractures/dislocations, wound infections, and head, face, and brain injuries. The most common injury-related surgical procedures were wound debridement/skin grafting, treatment for orthopedic trauma, and surgical amputation. Among patient records with documented injury-related mechanisms, 162 (28%) indicated earthquake-related injuries. Earthquake preparedness planning for densely populated areas in resource-limited settings such as Haiti should account for injury-related medical, surgical, and rehabilitation needs that must be met immediately after the event and during the recovery phase, when altered physical and social environments can contribute to a continued elevated need for inpatient management of injuries. (+info)
1 Canadian Field Hospital in Haiti: surgical experience in earthquake relief.
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In order to provide first class treatment for casualties in the recent Falklands war it was necessary to apply rigid rules. Those who required treatment most urgently received earlier resuscitative and surgical care to give the best possible chance of good quality survival. The concept of Triage was applied at every level of medical care but was found to be most crucial at surgical centres. The dynamic nature of the Triage system was noted. Patients required constant reassessment and updating by experienced well trained teams. The system worked well. The success in employing resuscitation trained dental officers in the Triage role was particularly worth noting. (+info)