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Journal of the Royal Naval Medical Service最新文献

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Surgeon Commander (D) Ed Madgwick Royal Navy, 1973–2019 埃德·马德威克皇家海军外科指挥官(D), 1973-2019
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-155
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引用次数: 0
Medical leadership and management for military clinicians 军队临床医生的医疗领导与管理
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-180
L. Cottey, C. Lillington, E. Frost
The development of medical leadership and management skills is an essential requirement for the progression of Defence Medical Services personnel in both military and medical training. This review will summarise how military experience can contribute to achieving medical leadership and management competencies and will signpost further opportunities and resources available. While it specifically focuses on doctors, this article has relevance to all Defence Healthcare Professionals.
发展医疗领导和管理技能是国防医务人员在军事和医疗培训方面取得进步的基本要求。这一审查将总结军事经验如何有助于实现医疗领导和管理能力,并指出进一步的机会和可用资源。虽然它特别关注医生,但这篇文章与所有国防医疗保健专业人员有关。
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引用次数: 0
The Institute of Naval Medicine 1969-2019: departments past and present 海军医学研究所1969-2019:过去和现在的部门
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-191
J. Wickenden, G. Mcmillan
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引用次数: 0
An interview with Surgeon Vice Admiral Anthony Revell Royal Navy: “the early days and my career” 英国皇家海军外科医生安东尼·雷维尔中将的采访:“早期和我的职业生涯”
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-58
T. S. Spalding
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引用次数: 0
Key appointments in the Royal Naval Medical Service – the Red List 皇家海军医疗服务部门的重要任命——红色名单
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-72
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引用次数: 0
Role 2 Afloat support to the QUEEN ELIZABETH (QE) Class – an update from WESTLANT 18 角色2:支持伊丽莎白女王级(QE) - WESTLANT 18的更新
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-103
J. Matthews
WESTLANT 18 saw a Role 2 Afloat (R2A) team deploy on HMS QUEEN ELIZABETH (QNLZ) to support the First of Class Flying Trials for the F-35 Lightning 2 aircraft. This team established the R2A capability onboard QNLZ and began the process of developing R2A support to Carrier Strike Group (CSG) operations. The deployment was a great success and many lessons were identified. The experience from this deployment is summarised and the current R2A support to CSG is described.
WESTLANT 18看到了一个角色2漂浮(R2A)小组部署在伊丽莎白女王号(QNLZ)上,以支持F-35闪电2飞机的首次飞行试验。该团队在QNLZ上建立了R2A能力,并开始开发R2A支持航母打击群(CSG)行动的过程。这次部署取得了巨大成功,并从中吸取了许多教训。总结了这次部署的经验,并描述了当前R2A对CSG的支持。
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引用次数: 0
The Institute of Naval Medicine 1969-2019: past and future 海军医学研究所1969-2019:过去与未来
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-135
J. Wickenden, G. Mcmillan
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引用次数: 1
How do you solve a problem like… missing data? Lessons from the PAin SoluTions In the Emergency Setting (PASTIES) trials 如何解决数据丢失之类的问题?紧急情况下疼痛解决方案(PASTIES)试验的经验教训
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-23
J. Smith, S. Creanor, M. Rockett, P. Ewings
When studies measure the effect of a treatment longitudinally over time, multiple data points are generated, but are sometimes incomplete. This may affect studies in a range of different settings, including studies on military patients. When analysing the data from such a study, one of the challenges is how to deal with missing data points in the final analysis. This article describes the possible different ways of dealing with missing data points in such a context, and outlines some pragmatic methods used for handling missing pain scores in the recent PAin SoluTions In the Emergency Setting (PASTIES) trials.
当研究在一段时间内纵向测量治疗的效果时,会产生多个数据点,但有时是不完整的。这可能会影响一系列不同环境下的研究,包括对军人患者的研究。在分析此类研究的数据时,其中一个挑战是如何在最终分析中处理缺失的数据点。本文描述了在这种情况下处理缺失数据点的可能不同方法,并概述了在最近的紧急情况下疼痛解决方案(PASTIES)试验中用于处理缺失疼痛评分的一些实用方法。
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引用次数: 0
Surgeon Commander Peter Urwin Royal Navy, 1943-2018 皇家海军外科指挥官彼得·厄温,1943年至2018年
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-154
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引用次数: 0
Efficacy of pre-hospital fracture manipulation following ketamine administration: the experience of a single civilian air ambulance trust 氯胺酮给药后院前骨折手法的疗效:单一民用空中救护信托的经验
Pub Date : 2019-01-01 DOI: 10.1136/jrnms-105-167
A. Follows, R. H. James, J. Vassallo
Limb fractures are common in pre-hospital care and can be associated with significant haemorrhage and neurovascular compromise. The pre-hospital management of these injuries centres around reduction and splinting. The aim of this study was to quantify the effectiveness of pre-hospital reduction of displaced fractures or dislocations and the incidence of the need for further manipulation in the emergency department. A three-year retrospective database analysis was conducted for all patients sustaining limb injuries who were attended by a single air ambulance and subsequently conveyed to the regional major trauma centre. Only patients who received ketamine, either as an analgesic or sedative, were included. Pre-hospital clinical records and emergency department (ED) notes were examined to determine outcomes. Over the study period, 122 patients sustained a limb injury and received ketamine; ED notes were available for 96 (78.7%). Of these, the majority (n=51, 41.8%) received ketamine for analgesia with n=10 (8.2%) receiving it to facilitate manipulation. The principal indication for pre-hospital manipulation was neurovascular compromise (n=7, 70.0%). Of those undergoing manipulation pre-hospital, the majority (n=7, 70.0%) required further manipulation in the ED. Pre-hospital manipulation by our regional air ambulance is a relatively low frequency event and in those undergoing a manipulation, a high proportion require further intervention in the ED or operative intervention within the acute phase of care.
肢体骨折在院前护理中很常见,可能与严重出血和神经血管损伤有关。院前处理这些损伤的中心是复位和夹板。本研究的目的是量化院前复位移位性骨折或脱位的有效性以及在急诊科需要进一步操作的发生率。对所有肢体损伤患者进行了为期三年的回顾性数据库分析,这些患者由一辆空中救护车护理,随后被送往区域重大创伤中心。只有接受氯胺酮作为镇痛药或镇静剂的患者被纳入研究。检查院前临床记录和急诊科(ED)记录以确定结果。在研究期间,122名患者肢体受伤并接受氯胺酮治疗;ED笔记96份(78.7%)。其中,大多数(51例,41.8%)使用氯胺酮镇痛,10例(8.2%)使用氯胺酮以方便操作。院前操作的主要指征是神经血管损伤(n=7, 70.0%)。在院前接受手法治疗的患者中,大多数(n=7, 70.0%)需要在急诊科进行进一步的手法治疗。我们的区域空中救护车院前手法治疗的频率相对较低,在接受手法治疗的患者中,有很高比例需要在急诊科进行进一步干预或在急性期进行手术干预。
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引用次数: 0
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Journal of the Royal Naval Medical Service
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