Journal of the Royal Army Medical Corps

No abstract text is available yet for this article.

No abstract text is available yet for this article.

INTRODUCTION: The Journal of the Royal Army Medical Corps ( JRAMC ) is published with the aim of propagating current knowledge and expertise while also acting as institutional memory for the practice of medicine within the military. This work aimed to examine how the interests of the JRAMC , and by inference the Army Medical Services, have changed over time as reflected by the articles published in the journal. METHODS: A text mining analysis of the titles of all published articles in the JRAMC between 1903 and 2019 was performed...

The 700+ Caribbean islands present a vast area of operations (AO) with challenges providing healthcare to the local population and deployed personnel. Predisaster host nation medical care relied on casevac for basic primary and secondary healthcare, with medivac by air for advanced medical treatment. Disruption to facilities and transport links by Hurricane Irma rendered the native healthcare system on its knees. During Op RUMAN, the Royal Air Force Medical Services (RAFMS) provided expertise in prehospital emergency care and critical care aeromed to enable emergency treatment and access to definitive care for local nationals and our own personnel...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

A case of panfacial trauma is reported comprising of multiple facial fractures and a clearly evident Guerin's sign along with an oronasal communication. The case reinforces the importance of recognising this sign and its classical presentation.

INTRODUCTION: Supplemental oxygen is a key element of emergency treatment algorithms. However, in the operational environment, oxygen supply poses a challenge. The lack of high-quality evidence alongside emerging technologies provides the opportunity to challenge current guidelines. The aim of this review was to appraise the evidence for the administration of oxygen in emergency patients and give recommendations for its use in clinical practice. METHODS: A critical review of the literature was undertaken to determine the evidence for emergency supplemental oxygen use...

BACKGROUND: Non-freezing cold injury (NFCI) occurs when the peripheral tissue is cooled sufficiently that damage occurs, but not to the point of tissue freezing. Historically, the phenotype of the injuries studied was often severe, and it is unclear whether knowledge gained from these cases is entirely relevant to the frequently subtle injuries seen today. METHODS: We therefore sought to characterise a recent case series of 100 patients referred with suspected NFCI to a military UK NFCI clinic...

OBJECTIVES: Catastrophic haemorrhage is a leading cause of morbidity and mortality in trauma, in both military and civilian settings. There are numerous studies looking at the effectiveness of different haemostatic agents in the laboratory but few in a clinical setting. This study analyses the use of haemostatic dressings used in patients injured on the battlefield and their association with survival. METHOD: A retrospective database review was undertaken using the UK Joint Theatre Trauma Registry from 2003 to 2014, during combat operations in Iraq and Afghanistan...

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INTRODUCTION: The extent of the French forces' territory in the Sahel band generates long medical evacuations. In case of many victims, to respect the golden hour rule, first-line sorting is essential. Through simulation situations, the aim of our study was to assess whether the use of ultrasound was useful to military doctors. METHODS: In combat-like exercise conditions, we provided trainees with a pocket-size ultrasound. Every patient for whom the trainees chose to perform ultrasound in role 1 was included...

A 34-year-old female soldier presented with fever and behavioural changes while deployed in Kenya and was diagnosed with encephalitis. The patient underwent urgent aeromedical evacuation to the Queen Elizabeth Hospital, Birmingham for further management. Microbiology tests excluded common infectious causes that are endemic in the East Africa region. However, an autoantibody screen was positive for antibodies against the N-methyl-D-aspartate receptor (NMDAR). Full body imaging confirmed the presence of limbic encephalitis and an ovarian mass suggestive of a teratoma...

Animal tests are conducted in all fields of trauma research, but transferability of these data to humans is limited. For example, it is still unclear which animal species is most similar to humans in terms of physiology of blood coagulation. To improve transferability and raise awareness of the existing differences, we compared human coagulation to coagulation of different animals. Rotational thromboelastometry was used to analyse the blood of pigs, sheep, rabbits and dogs. Animal data were compared with human coagulation based on the number of significant differences of the test parameters and on a descriptive comparison of the extent of relative deviation of the single values...

BACKGROUND: General Practice training in the civilian and military environments follows a common training pathway, yet the scope of practice of a military General Practitioner (GP) varies significantly. A level of care for the acutely unwell and traumatically injured patients is frequently provided in austere environments remotely located from definitive medical care. This qualitative service needs evaluation scopes current level of trauma and acute care training and requirement for further training within military GPs and GP trainees...

The Diploma in Immediate Medical Care (DipIMC) is the entry-level interprofessional civilian qualification for prehospital emergency care (PHEC) in the UK. It is designed to test the knowledge, skills and behaviours of PHEC practitioners. Military personnel are eligible to enter, dependent on the level of PHEC experience they have. The DipIMC examination has changed in recent years; this paper aims to update aspiring candidates on the application process, recommended preparation and skill-set required to pass...

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Moral theory should be practically useful, but without oversight from the philosophical community, the practical application of ethics by other institutions such as the military may drift into forms that are not theoretically robust. Ethical approaches that drift in this way run the risk of becoming 'cargo cults': simulations that will never properly fulfil their intended purpose. The four quadrant approach, a systematic method of ethical analysis that applies moral principles to clinical cases, has gained popularity in the last 10 years in a variety of medical contexts, especially the military...

This article argues that medical personnel of armed forces occupy a ' peace role ' , which continues and dominates their professional ethos during armed conflict. The specific role and its associated legal and ethical obligations are elaborated, and on that basis arguments are provided why and how the work of military healthcare providers is interpreted as a continuation of peace during war.