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Tooth Wear in Patients Undergoing Sleep Studies: A Blinded Observational Study. 接受睡眠研究的患者牙齿磨损:一项盲法观察研究。
Ryan Allred, David Shaha, Lowell Stanford, Thomas Beltran

Objectives: Obstructive sleep apnea (OSA) is a common health problem that remains an underdiagnosed issue. Screening tools and clinical markers are needed from a variety of providers to determine patients at risk for OSA. Tooth wear could be a good potential identifier of patients at risk of having OSA.

Methods: This is an ambidirectional observational cohort. Participants were identified as retrospectively having undergone a sleep study and then tooth wear data was prospectively collected at patients' annual dental exam. The participants also completed an anonymous questionnaire to determine correlations with possible confounding factors.

Results: A total of 107 individuals were included in the analyses. No significant differences in wear were found between participants with an Apnea-Hypopnea Index (AHI) less than 5 and those with AHI ≥ 5 for any of the teeth examined (all P > 0.05). Overall, both groups had median tooth wear scores of 2 (IQR 1). Similarly, no differences in tooth wear were found between participants based on their body mass index (BMI) classification or consumption data (all P > 0.05).

Conclusion: Sleep is a complicated entity with many possible confounding factors. There is no correlation between AHI and tooth wear in the selected military cohort. Dentists should screen patients for possible medical and dental conditions whenever tooth wear is detected. Further research is needed to determine if tooth wear could be used as a potential identifier of patients at risk for OSA.

目的:阻塞性睡眠呼吸暂停(OSA)是一种常见的健康问题,但仍未得到充分诊断。筛查工具和临床标志物需要从各种提供者确定患者的OSA风险。牙齿磨损可能是一个很好的潜在识别患者是否有患阻塞性睡眠呼吸暂停的风险。方法:这是一个双向观察队列。研究人员对参与者进行了回顾性的睡眠研究,然后在患者的年度牙科检查中前瞻性地收集牙齿磨损数据。参与者还完成了一份匿名问卷,以确定可能的混杂因素的相关性。结果:共有107人被纳入分析。所有牙齿的呼吸暂停低通气指数(AHI)小于5和AHI≥5的受试者磨损无显著差异(均P > 0.05)。总体而言,两组的牙齿磨损中位数得分均为2 (IQR 1)。同样,根据参与者的身体质量指数(BMI)分类或消费数据,两组之间的牙齿磨损无差异(均P > 0.05)。结论:睡眠是一个复杂的整体,有许多可能的混杂因素。在选定的军人队列中,AHI与牙齿磨损之间没有相关性。一旦发现病人牙齿磨损,牙医应检查病人是否有可能出现医疗和牙科问题。需要进一步的研究来确定牙齿磨损是否可以作为OSA患者风险的潜在标识符。
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引用次数: 0
Association between the History of Traumatic Brain Injury and Rates of Dental Treatment, Endodontic Therapy, and Caries Risk: A Records-Based Study. 创伤性脑损伤史与牙科治疗、牙髓治疗和龋齿风险之间的关系:一项基于记录的研究。
Joseph Ferguson, Scott Mooney, Joseph Dutner, Stephanie Sidow, Matthew Phillips

Introduction: Traumatic Brain Injury (TBI) is a prevalent health issue in the US and even more prevalent amongst members of the armed forces. The purpose of this project was to evaluate the association between history of TBI and rates of dental treatment performed, endodontic therapy, and high caries risk.

Methods: This was a retrospective medical and dental records study. The first 100 of a chosen dental hygienist's patients in 2016 who were seen for dental prophylaxis appointments were chosen as subjects. Armed Forces Health Longitudinal Technology Application (AHLTA) and Corporate Dental System (CDS) records were used to gather information on these subjects including rank, age, gender, duty status, tobacco use, history of TBI, total number of dental procedures, total Dental Weighted Value (DWV), number of endodontic procedures, endodontic DWV, high caries risk categorization, total days dental fitness class 1, and total days dental fitness class 3. From these subjects, a "TBI group" and a "Non-TBI group" were formed. T-Test analyses were performed to compare these groups to each other in categories of total number of dental procedures, total DWV, total days dental fitness class 1, and total days class 3. Relative risks ratio analysis was used to compare these groups in terms of high caries risk categorization.

Results: Eight out of 100 subjects had a history of TBI. All TBI events were mild. Six subjects had 1 event, 1 had 2 events, and 1 had 4 events. The TBI group had a statistically higher mean number of dental procedures (P=0.00000025) and mean total DWV (P=0.0000062) compared to the non-TBI group. No subjects from the TBI group had an endodontic procedure. The TBI group had lower mean days in dental fitness class 1 and more mean days in dental fitness class 3, but the results were not statistically significant. The TBI group had lower high caries risk categorization rates than the non-TBI group, but the results were not statistically significant.

Conclusions: Patients with a history of TBI had a significantly higher number of dental procedures performed and DWV generated compared to patients without a history of TBI.

简介:创伤性脑损伤(TBI)是美国普遍存在的健康问题,在武装部队成员中更为普遍。该项目的目的是评估TBI病史与牙科治疗率、牙髓治疗率和高龋风险之间的关系。方法:这是一项回顾性医学和牙科记录研究。选定的牙科保健师在2016年接受牙科预防预约的前100名患者被选为研究对象。使用军队健康纵向技术应用(AHLTA)和企业牙科系统(CDS)记录收集这些受试者的信息,包括军衔、年龄、性别、职务状况、吸烟情况、TBI病史、牙科手术总数、牙科加权值(DWV)、牙髓治疗次数、牙髓DWV、高龋风险分类、牙齿健康总天数1级和牙齿健康总天数3级。将这些受试者分为“TBI组”和“非TBI组”。进行t检验分析,比较这些组在牙科手术总数、总DWV、牙齿健康等级1的总天数和等级3的总天数。采用相对风险比分析比较各组在高龋风险分类方面的差异。结果:100例受试者中有8例有TBI病史。所有创伤性脑损伤事件都是轻微的。6名受试者有1个项目,1名受试者有2个项目,1名受试者有4个项目。与非TBI组相比,TBI组的平均牙科手术次数(P=0.00000025)和平均总DWV (P=0.0000062)在统计学上高于TBI组。TBI组没有受试者进行牙髓治疗。TBI组1级牙体健康平均天数较低,3级牙体健康平均天数较高,但差异无统计学意义。TBI组高龋风险分类率低于非TBI组,但结果无统计学意义。结论:与没有TBI病史的患者相比,有TBI病史的患者进行牙科手术的次数和产生的DWV明显更高。
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引用次数: 0
Sports Injuries among Deployed US Service Members between October 2001 and December 2018. 2001年10月至2018年12月期间美国现役军人的运动损伤
Marc A Schweizer, Jud Janak, Brock Graham, Jennifer M Gurney, Stacy A Shackelford

Background: Sports injuries are an important non-battle cause of attrition and morbidity among deployed US service members (SMs). Injuries secondary to sport may cause physical disability and prolonged periods of limited duty days. Our objective was to provide a descriptive analysis of sports injuries sustained by US SMs which may assist in the preventive strategies and thereby decrease their burden on the deployed force.

Methods: Using the Department of Defense Trauma Registry's (DoDTR) data between October 2001 and December 2018, a retrospective cross-sectional analysis was conducted. We reported summary statistics of injury characteristics and care provided, stratified by geographic location.

Results: We found 1,578 causalities with sport injuries (4.9% of DoDTR); 1,081 (68.5%) in Iraq and Syria and 497 (31.5%) in Afghanistan. Most casualties had mild injuries (injury severity score: 1-9; n=1,514; 95.9%) and most sustained injuries in the lower extremities (n=741; 47%) followed by upper extremities (n=430; 27.2%). Most injuries were caused by a striking force (n=827; 52.4%) followed by overexertion (n=444; 28.2%), and 512 casualties (32.4%) had a fall incident. About 833 casualties (52.8%) received at least one surgery, and 931 casualties (59%) were hospitalized for two days or more. One casualty died of wound (0.1%).

Conclusions: Sports injuries continue to be an important source of morbidity and attrition and require disproportional medical attention, relative to their mild severity, representing a significant burden to the deployed health care system and impact combat readiness. Further research addressing the prevention of sports injury among deployed US SMs is needed.

背景:运动损伤是美国现役军人(SMs)消耗和发病的重要非战斗原因。运动引起的伤害可能导致身体残疾和延长有限的工作时间。我们的目标是提供美国SMs持续运动损伤的描述性分析,这可能有助于预防策略,从而减少他们对部署部队的负担。方法:利用2001年10月至2018年12月美国国防部创伤登记处(DoDTR)的数据,进行回顾性横断面分析。我们报告了按地理位置分层的损伤特征和提供的护理的汇总统计数据。结果:我们发现1,578例运动损伤死亡(占总死亡人数的4.9%);伊拉克和叙利亚有1081人(68.5%),阿富汗有497人(31.5%)。大多数伤亡者为轻伤(伤重评分:1-9分;n = 1514;95.9%)和大多数下肢持续性损伤(n=741;47%),其次是上肢(n=430;27.2%)。大多数损伤是由撞击力造成的(n=827;52.4%),其次是过度劳累(n=444;28.2%), 512人(32.4%)发生跌倒事故。约833名伤亡者(52.8%)至少接受了一次手术,931名伤亡者(59%)住院2天以上。1人因伤死亡(0.1%)。结论:运动损伤仍然是发病率和减员的重要来源,相对于其轻微的严重程度,需要不成比例的医疗照顾,代表了部署的卫生保健系统的重大负担,并影响战备。需要进一步研究在部署的美国SMs中预防运动损伤。
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引用次数: 0
Ultrasound at the Role 1: An Analysis of After-Action Reviews from the Prehospital Trauma Registry. 超声的作用1:院前创伤登记的事后评价分析。
Melissa A Myers, Eric J Chin, Amie R Billstrom, Jared L Cohen, Kerri A Van Arnem, Steven G Schauer

Background: Ultrasound is a portable and adaptable imaging modality used widely in the care of trauma patients. The initial exam, known as the "Focused Assessment in Trauma (FAST) exam focused on the evaluation for hemoperitoneum and hemopericardium. In recent years, the exam has expanded to include evaluate for thoracic pathology, including pneumothorax, and is now known as the "Extended Focused Assessment in Trauma" (E-FAST) exam.

Methods: We reviewed after-action reviews (AAR) from the Joint Trauma System Prehospital Trauma Registry from 2013-2014 in which the use of an ultrasound exam was noted. Given the largely unstructured nature of the AARs, we selected relevant information from the free text available.

Results: Our initial dataset contained 705 casualties, of which we identified 45 cases containing the key words with AAR data for review: 39 cases involved the use of the FAST exam, three explicitly described the use of pulmonary ultrasound and they were categorized as E-FAST exams, two cases described the use of point of care echo to evaluate for cardiac standstill, and two cases described the use of ultrasound to evaluate for vascular injury. Of those with vital signs documented, 25% (11) reported at least one episode of tachycardia (≥120/min) and 16% (7) with at least one episode of systolic hypotension (less than 90mmHg). Of the 45 cases reviewed, six were recorded as equivocal, which we interpreted to indicate more training in either performance or interpretation of the exam was needed.

Conclusions: Our findings suggest that training in both the FAST exam and E-FAST has the potential to improve patient care for military trauma patients. A performance improvement system would enable real-time confirmation of findings and feedback for training and quality improvement.

背景:超声是一种便携、适应性强的成像方式,广泛应用于创伤患者的护理。最初的检查,被称为“创伤集中评估(FAST)”检查,侧重于评估腹膜和心包积血。近年来,该检查已扩大到包括评估胸部病理,包括气胸,现在被称为“创伤扩展重点评估”(E-FAST)检查。方法:我们回顾了2013-2014年联合创伤系统院前创伤登记处的行动后回顾(AAR),其中超声检查的使用被注意到。考虑到AARs在很大程度上是非结构化的性质,我们从可用的免费文本中选择了相关信息。结果:我们的初始数据集包含705例伤亡,其中我们确定了45例包含AAR数据关键词的病例进行回顾:39例涉及使用FAST检查,3例明确描述使用肺超声并归类为E-FAST检查,2例描述使用护理点回声评估心脏停止,2例描述使用超声评估血管损伤。在有生命体征记录的患者中,25%(11)报告至少一次心动过速(≥120/min), 16%(7)报告至少一次收缩期低血压(小于90mmHg)。在审查的45个案例中,有6个被记录为模棱两可,我们认为这表明需要在考试表现或解释方面进行更多的培训。结论:我们的研究结果表明,FAST考试和E-FAST培训有可能改善军事创伤患者的患者护理。业绩改进系统将能够实时确认结果并对培训和质量改进提供反馈。
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引用次数: 0
An Analysis of the Shock Index and Pulse Pressure as a Predictor for Massive Transfusion and Death in US and Coalition Iraq and Afghanistan. 休克指数和脉压作为美国和联军在伊拉克和阿富汗大量输血和死亡的预测因子的分析。
David A Sorensen, Michael D April, Andrew D Fisher, Steven G Schauer

Among combat casualties with survivable injuries, the most common cause of mortality is massive hemorrhage. The objective of this study was to identify the accuracy of shock index (SI) and pulse pressure (PP) for predicting receipt of massive transfusion and death on the battlefield. The study searched the Department of Defense Trauma Registry from January 2007 to August 2016 using a series of procedural codes to identify casualties which has been previously described. This is a secondary analysis of casualties analyzing SI. This study analyzed using receiver operating characteristic (ROC) and regression analyses. Within that dataset, there were 15,540 that were US Forces (75.1%), Coalition Forces (14.5%) or contractors (10.3%)-of which, 1,261 (7.9%) underwent massive transfusion. On ROC analyses for SI, this study found an overall optimal threshold at 0.91 with an area under the curve (AUC) of 0.89 with a sensitivity of 0.81 and specificity of 0.87 for predicting massive transfusion. The study found an optimal threshold of 0.91 with an AUC of 0.76 with a sensitivity of 0.67 and specificity of 0.82 for predicting death. On ROC analyses for PP, the study found an overall optimal threshold at 48 with an AUC of 0.71 with a sensitivity of 0.56 and specificity of 0.76 for predicting massive transfusion. The study found an optimal threshold of 44 with an AUC of 0.75 with a sensitivity of 0.60 and specificity of 0.82 for predicting death. SI and PP may accurately predict receipt of massive transfusion and of mortality in a combat casualty population.

在可存活的战斗伤亡中,最常见的死亡原因是大出血。本研究的目的是确定休克指数(SI)和脉压(PP)的准确性,以预测战场上大量输血的接收和死亡。该研究检索了2007年1月至2016年8月期间国防部创伤登记处的数据,使用了一系列程序代码来识别先前描述的伤亡情况。这是对SI伤亡的二次分析。本研究采用受试者工作特征(ROC)及回归分析进行分析。在该数据集中,有15540人是美军(75.1%)、联军(14.5%)或承包商(10.3%),其中1261人(7.9%)接受了大规模输血。在SI的ROC分析中,本研究发现预测大量输血的总体最佳阈值为0.91,曲线下面积(AUC)为0.89,敏感性为0.81,特异性为0.87。研究发现,预测死亡的最佳阈值为0.91,AUC为0.76,敏感性为0.67,特异性为0.82。在PP的ROC分析中,该研究发现预测大量输血的最佳阈值为48,AUC为0.71,敏感性为0.56,特异性为0.76。研究发现,预测死亡的最佳阈值为44,AUC为0.75,敏感性为0.60,特异性为0.82。SI和PP可以准确地预测大量输血的接受和战斗伤亡人口的死亡率。
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引用次数: 0
Defining Combat-Relevant Endpoints for Early Trauma Resuscitation Research in a Resource-Constrained Civilian Setting. 在资源受限的民用环境下,确定早期创伤复苏研究的战斗相关终点。
Nee-Kofi Mould-Millman, Lina Mata, Steven G Schauer, Julia Dixon, Sean Keenan, John B Holcomb, Joshua M Tobin, E Moore, Shaheem de Vries, Alexander Bedard, Vikhyat S Bebarta, Adit A Ginde

Introduction: Studies assessing early trauma resuscitation have used long-term endpoints, such as 28- or 30-day mortality or Glasgow Outcomes Scores at 6-months. These endpoints are convenient but may not accurately reflect the effect of early resuscitation. We sought expert opinion and consensus on endpoints and definitions of variables needed to conduct a Department of Defense- (DoD) funded study to epidemiologically assess combat-relevant mortality and morbidity due to timeliness of resuscitation among critically injured civilians internationally.

Methods: We conducted an online modified Delphi process with an international panel of civilian and US military experts. In several iterative rounds, experts reviewed background information, appraised relevant scientific evidence, provided comments, and rendered a vote on each variable. A-priori, we set consensus at ≥80% concordant votes.

Results: Twenty panelists participated with a 100% response rate. Eight items were presented, with the following outputs for the epidemiologic study: Assess mortality within 7-days of injury; assess multi-organ failure using SOFA scores measured early (at day 3) and late (at day 7); assess traumatic brain injury mortality early (≤7-days) and late (28-days); hybrid (anatomic and physiologic) injury severity scoring is optimal; capture comorbidities per the US National Trauma Data Standard list with specific additions; assign resuscitative interventions to one of five standardized phases of trauma care; and, use a novel trauma death categorization system.

Conclusions: A modified Delphi process yielded expert-ratified definitions and endpoints of variables necessary to conduct a combat-relevant epidemiologic study assessing outcomes due to early trauma resuscitation. Outputs may also benefit other groups conducting trauma resuscitation research.

评估早期创伤复苏的研究使用了长期终点,如28天或30天死亡率或6个月时的格拉斯哥结局评分。这些终点是方便的,但可能不能准确反映早期复苏的效果。我们就终点和变量定义寻求专家意见和共识,以开展一项由国防部(DoD)资助的研究,从流行病学角度评估国际上重伤平民因抢救及时性而导致的战斗相关死亡率和发病率。方法:我们与国际民间和美国军事专家小组进行了在线修改的德尔菲过程。在几个迭代的回合中,专家们审查了背景信息,评估了相关的科学证据,提供了评论,并对每个变量进行了投票。先验地,我们将共识设定为≥80%的一致投票。结果:20名小组成员参与,回复率100%。共有8个项目,流行病学研究结果如下:评估伤后7天内的死亡率;使用早期(第3天)和晚期(第7天)测量的SOFA评分评估多器官衰竭;评估早期(≤7天)和晚期(28天)的颅脑损伤死亡率;混合(解剖和生理性)损伤严重程度评分是最佳的;根据美国国家创伤数据标准列表捕获合并症,并添加具体内容;将复苏干预措施分配到创伤护理的五个标准化阶段之一;并且,使用一种新的创伤死亡分类系统。结论:经过改进的德尔菲过程产生了专家认可的定义和变量终点,这些变量是开展与战斗相关的流行病学研究评估早期创伤复苏结果所必需的。产出也可使其他进行创伤复苏研究的团体受益。
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引用次数: 0
Comparing the Sensitivity of a Low Frequency Versus a High Frequency Probe in the Detection of Pneumothorax in a Swine Model. 低频与高频探头检测猪模型气胸的灵敏度比较。
Melissa Myers, Amie Billstrom, Jared Cohen, Ryan Curtis

Background: Correct diagnosis of pneumothorax in trauma patients is essential. Under-diagnosis can lead to development of life-threatening tension pneumothorax, but overdiagnosis leads to placement of unnecessary chest tubes with potential related morbidity and pain. It is unclear from previous work if there is a benefit to switching from the phased array (low frequency) probe to the linear (high frequency) probe. Is the improvement in image quality worth the time lost changing probes?

Methods: We compared the sensitivity and specificity of a low frequency and high frequency ultrasound probe for the detection of pneumothorax. Images were obtained using swine models and were interpreted by Emergency Medicine residents, attendings, and physician assistants.

Results: We found a specificity of 89% and sensitivity of 99% for the low frequency probe and specificity of 96% and sensitivity of 99% for the high frequency probe. There was a statistically different specificity between the two probes, suggesting that the linear probe may be the superior probe for confirming the presence of pneumothorax.

Conclusion: We conclude switching to the linear probe for the thoracic portion of the Extended-Focused Assessment in Trauma will lead to more accurate diagnosis of pneumothorax and decreased false-positive exams.

背景:创伤患者气胸的正确诊断至关重要。诊断不足可导致危及生命的紧张性气胸的发展,但过度诊断导致放置不必要的胸管与潜在的相关发病率和疼痛。从以前的工作中还不清楚从相控阵(低频)探头切换到线性(高频)探头是否有好处。为了提高图像质量而花费更换探头的时间值得吗?方法:比较低频与高频超声探头检测气胸的敏感性和特异性。使用猪模型获得图像,并由急诊医学住院医师、主治医师和医师助理进行解释。结果:低频探针特异性为89%,灵敏度为99%,高频探针特异性为96%,灵敏度为99%。两种探针的特异性有统计学差异,提示线形探针可能是确认气胸存在的首选探针。结论:我们的结论是,在创伤扩展聚焦评估中,将胸椎部分转换为线性探头将有助于更准确地诊断气胸并减少假阳性检查。
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引用次数: 0
Comprehensive Decision Support for Prehospital Combat Casualty Care: The Airway Clearance Model. 院前战斗伤员护理的综合决策支持:气道清除模型。
Katherine Raczek, David Restrepo, R Lyle Hood, Robert A De Lorenzo

Airway management is a foremost priority for combat medics treating battlefield casualties, as a compromised airway is the second leading cause of potentially survivable death on the battlefield, accounting for 1 in 10 preventable combat deaths. Effective suction is a critical component of airway clearance. However, currently available commercial devices are too heavy and bulky for combat medics to carry, and/or lack sufficient power to be useful. Clinical decision support systems (DSS) can close the gap between existing commercial devices and their clinical use and enhance combat medic clinical performance by providing the right "tooth-to-tail" tools to accomplish the task of clearing the airway. Our DSS approach will provide a focused, real-time set of guidelines and recommendations that are tailored to the combat medic. Our proposal will create a knowledge-based algorithm and clinical guideline regarding the use of suction, delivering to the combat medic the "right information, to the right person, in the right format, through the right channel at the right time."

气道管理是战斗医务人员治疗战场伤亡的首要任务,因为气道受损是战场上可能存活死亡的第二大原因,占可预防战斗死亡的十分之一。有效吸痰是气道清除的重要组成部分。然而,目前可用的商业设备对于战斗医务人员来说太重太笨重,而且/或者缺乏足够的功率。临床决策支持系统(DSS)可以通过提供正确的“牙齿到尾巴”工具来完成清理气道的任务,缩小现有商用设备与其临床使用之间的差距,提高战斗医疗临床性能。我们的DSS方法将提供一套针对性的、实时的指导方针和建议,为战斗医务人员量身定制。我们的提案将创建一种基于知识的算法和临床指南,用于使用吸痰,将“正确的信息,以正确的格式,通过正确的渠道,在正确的时间,传递给正确的人。”
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引用次数: 0
New Versus Old, The i-View Video Laryngoscope Versus the GlideScope: A Prospective, Randomized, Crossover Trial. 新与旧,i-View视频喉镜与滑梯镜:前瞻性,随机,交叉试验。
David H Taylor, Eric M Wagner, Jerry S Hu, Michael R Tobin, Aaron J Cronin, Kyle S Couperus, Michael D April, Steven G Schauer, Jason F Naylor

Background: A novel video laryngoscope device, the i-view, may extend intubation capability to the lowest echelons of deployed military medicine. The i-view is a one-time use, disposable laryngoscope. We compared time to completion of endotracheal intubation (ETI) between the i-view and GlideScope among military emergency medicine providers in a simulation setting.

Methods: We conducted a prospective, randomized, crossover trial. We randomized participants to i-view or GlideScope first before they performed 2 ETI-1 with each device. The primary outcome was time to completion of ETI. Secondary outcomes included first-pass success, optimal glottic view, and end-user appraisal. We used a Laerdal Airway Management Trainer for all intubations.

Results: Thirty-three emergency medicine providers participated. ETI time was less with GlideScope than i-view (22.2 +/- 9.0 seconds versus 30.2 +/- 24.0 seconds; p=0.048). Optimal glottic views, using the Cormack-Lehan scale, also favored the GlideScope (2 [1,2] versus 2[2,2]; p=0.044). There was no difference in first-pass success rates (100% versus 100%). More participants preferred the GlideScope (24 versus 9; p=0.165); however, participants agreed that the i-view would be easier to use than the GlideScope in an austere environment (4[4,5]).

Conclusions: We found the GlideScope outperformed the i-view with respect to procedural completion time. Participants preferred the GlideScope over i-view, but indicated the i-view would be easier to use than the GlideScope in an austere setting. Our findings suggest the i-view may be a suitable alternative to GlideScope for US military providers, especially for those in the prehospital setting.

背景:一种新型视频喉镜设备,i-view,可以将插管能力扩展到部署军事医学的最低梯队。i-view是一次性使用的喉镜。我们在模拟环境中比较了i-view和GlideScope在军事急救医学提供者中完成气管插管(ETI)的时间。方法:我们进行了一项前瞻性、随机、交叉试验。我们将参与者随机分配到i-view或GlideScope,然后使用每种设备进行2次ei -1。主要指标为ETI完成时间。次要结果包括首次通过成功、最佳声门视图和最终用户评价。我们在所有插管中使用了一个气道管理培训师。结果:33名急诊医师参与。GlideScope的ETI时间比i-view短(22.2 +/- 9.0秒vs 30.2 +/- 24.0秒);p = 0.048)。使用Cormack-Lehan量表的最佳声门视图也倾向于GlideScope (2 [1,2] vs . 2[2,2]);p = 0.044)。第一次通过的成功率没有差别(100%和100%)。更多的参与者更喜欢GlideScope(24比9;p = 0.165);然而,参与者一致认为,在严峻的环境下,i-view比GlideScope更容易使用(4[4,5])。结论:我们发现GlideScope在手术完成时间方面优于i-view。参与者更喜欢GlideScope而不是i-view,但他们指出,在严格的环境下,i-view比GlideScope更容易使用。我们的研究结果表明,对于美国军方来说,i-view可能是GlideScope的合适替代品,特别是对于那些在院前环境中的人。
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引用次数: 0
The Impact of Military Emergency Medicine Scholarly Activity. 军队急诊医学学术活动的影响。
Zachary Sletten, Norah Shemery, James K Aden, Michael Morris, Brit Long, Steven G Schauer

Background: Emergency medicine is recognized as a critical wartime specialty within the US military. Military emergency medicine contributes to medical literature in unique ways not seen with our civilian counterparts. The impact of this contribution, especially regarding innovations in military medicine, has not been previously examined. This study evaluates the numbers of citations for emergency medicine manuscripts published by members of the US military.

Methods: Utilizing the Scopus database, we identified published manuscripts from 2000 to 2020 with an emergency medicine author affiliated with a US military treatment facility. We sorted manuscripts on the number of citations in Scopus and categorized each paper as to whether it addressed military unique topics.

Results: We identified 1,718 manuscripts through Scopus, and based on a 10-citation minimum, we further analyzed 508 manuscripts. After verification of military affiliation, we included 421 manuscripts. The mean number of citations per manuscript was 31.7 ± 40.5; the Mean Cite Score was 4.75 ± 6.17 with a Field Weighted Citation Index (FWCI) of 2.96 ± 6.25. Citation count of publications has been steadily increasing in recent years with significantly more citations for military relevant publications when compared to non-military relevant publications.

Conclusions: These findings highlight the importance of military emergency medicine scholarly activity which has a history of contributions that address specific medical needs of the warfighter and advance the specialty. Military emergency medicine papers have seen rising numbers of citations in the medical literature, particularly those related to military relevant topics emphasizing combat casualty care and military readiness.

背景:急诊医学在美国军队中被认为是一个关键的战时专业。军队急诊医学以独特的方式为医学文献做出了贡献,这是我们的平民同行所看不到的。这一贡献的影响,特别是在军事医学创新方面的影响,以前没有得到审查。本研究评估了美国军方成员发表的急诊医学手稿的引用次数。方法:利用Scopus数据库,我们确定了一名隶属于美国军事治疗机构的急诊医学作者2000年至2020年发表的手稿。我们根据Scopus中的引用次数对稿件进行了分类,并根据是否涉及军事独特主题对每篇论文进行了分类。结果:我们通过Scopus检索到1718篇论文,并在10次引用的基础上进一步分析了508篇论文。经过军事单位的核实,我们收录了421份手稿。论文平均被引次数为31.7±40.5次;平均引文得分为4.75±6.17,场加权引文指数(FWCI)为2.96±6.25。近年来,出版物的被引次数稳步增加,军事相关出版物的被引次数明显高于非军事相关出版物。结论:这些发现突出了军事急诊医学学术活动的重要性,这些学术活动在解决作战人员的特定医疗需求和推进专业方面具有历史贡献。军事急诊医学论文在医学文献中的引用次数不断增加,特别是那些与军事相关主题有关的论文,强调战斗伤亡护理和军事准备。
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Medical journal (Fort Sam Houston, Tex.)
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