Bmj Military Health最新文献

Objective: The selection process to the British Army's Brigade of Gurkhas is rigorous, demanding and competitive. The ethos of recruitment to the Gurkhas is grounded in an overarching tenant: that selection is free, fair and transparent. The aim of this study was to retrospectively review reasons for potential recruits (PRs) to be deemed medically unsuitable or deferred suitability on medical grounds for selection to the Brigade of Gurkhas.

Methods: A retrospective review was conducted by extracted data from published post-exercise reports for the past four years to ascertain numbers of PRs deemed medically fit, medically unsuitable or deferred suitability on medical grounds. The International Classification of Disease version 11 (ICD-11) codes were retrospectively assigned to code medical reasons for non-progression. Rates of medical non-progression were compared by year.

Results: A total of 3154 PRs were analysed between 2018 and 2021. There was no significant difference between PRs deemed medically fit and those deemed medically suitable or deferred on medical grounds over the study period (p=0.351). There was a significant difference in the ratio of PRs deferred on medical grounds and those deemed medically unsuitable over the study period (p<0.05).

Conclusion: Selection to the Gurkhas is extremely competitive. These data demonstrate that, overall, reasons for medical deferral or unsuitability have remained constant despite the impact of a global pandemic. These data reinforce the central tenant of Gurkha selection; that it continues to be free, fair, and transparent.

Administration of medication is a well-established part of prehospital trauma care. Guidance varies on the types of recommended medications and when they should be administered. Mnemonics have become commonplace in prehospital medicine to facilitate recall and retention. However, there is no comprehensive aid for the administration of medication in trauma patients. We propose a new mnemonic for the delivery of relevant intravenous or intraosseous medications in trauma patients. A '4A after Access' approach should enhance memory recall for the efficient provision of patient care. These 4As are: antifibrinolysis, analgesia, antiemesis and antibiotics. This mnemonic is designed to be used as an optional aide memoire in conjunction with existing treatment algorithms in the military prehospital setting.

Introduction: The clinical application of the arts among military personnel and veterans has been well documented, particularly in relation to service-related mental health difficulties. However, the impacts of engaging recreationally with art activities on general well-being remain underexplored and even more so among those living with visual impairment (VI). This pilot explored the artistic experiences of veterans with VI participating in a remotely delivered art and craft project during continued COVID-19 restrictions in Spring/Summer 2021.

Methods: Six participants received a mystery arts box (MAB) containing a selection of materials, collated to encourage experimentation with unfamiliar techniques. Participants were asked to journal their process as they developed a final piece/pieces. They were invited to join group video calls to share work and ideas and seek guidance. Semistructured interviews were run with participants at the end of the project. Journal and interview data were thematically analysed.

Results: Analysis identified 11 themes relating to initial and ongoing responses to the MAB and creative and journalling process. Several benefits were identified, including artistic learning, trying something new, and social, cognitive and emotional experiences. The value of the activity to participants' lives within the context of the ongoing pandemic was also considered. Challenges were associated with the use of unfamiliar materials, impacts of sight loss and the limitations of remote delivery.

Conclusion: This pilot brings to the fore the everyday artistic experience of veterans living with VI and considers the benefits, challenges and well-being implications of a remotely delivered arts activity. Findings illustrate the importance of ensuring accessibility of artistic activities to those for whom disability might limit participation and highlight the ongoing role that remotely delivered arts activities might play in meeting the social and recreational needs of individuals beyond the COVID-19 pandemic.

Background: Three permanent military operations are established in French Guiana. The Cayenne medical unit is a French military search and rescue unit and provides MEDEVAC and CASEVAC for ill and injured soldiers. The main objective of this study was to describe the temporal trends of its evacuation missions over 10 years. The secondary purpose was to document the means used for these missions.

Methods: This retrospective observational study included patients who were evacuated for a medical reason or an injury during military operations in French Guiana. We collected the data from the computerised registers the medical department had stored.

Results: From 1 January 2010 to 31 December 2019, 1070 patients were included, representing a median annual incidence of 115 (IQR 91-122) evacuations. Of these, 602 (59%) were evacuated by helicopter, 214 (21%) by airplane, 182 (18%) by ambulance and 19 (2%) by pirogue.Reasons for evacuation were diseases in 664 (62%) patients, non-battle injuries in 389 (36%) patients and battle injuries in 17 (2%) patients. Finally, 286 (29%) evacuations were MEDEVAC and 712 (71%) were CASEVAC.Over the years, the increasing number of evacuations reached a maximum of 183 in 2018. Helicopter evacuations, once the primary mode of evacuation, have declined proportionately in favour of other means of evacuation.

Conclusion: Evacuation missions by the Cayenne medical unit increased over the 10-year study period, while helicopter use decreased. This evolution is a response to the constraints of adapting military operations to fight against illegal gold mining in the Amazonian Forest. Improvement of the means and procedures allows provision of the best care to patients while ensuring the ongoing conduct of military operations.