The ongoing severe acute respiratory syndrome coronavirus 2 or disease 2019 pandemic has demonstrated the potential need for a low-cost, rapidly deployable ventilator. Based on this premise, we sought to design ventilator with following criteria: 1) standard components that are accessible public, 2) "open-source" compatibility allow anyone easily recreate system, 3) ability ventilate in distress syndrome, and 4) lowest possible cost provide adequate oxygenation ventilation.We pursued...

Background The administration of epidural anesthesia during labor is a common technique used to reduce the pain childbirth. We sought compare standard infusion strategies continuous infusions (CEI) with programmed intermittent bolus (PIEB) assess length spread in terms vertebral body length. Based on previous clinical data humans, PIEB was associated improved control and decreased total dose local anesthetic. hypothesized that increased when compared CEI. Methods Thirty female...

Hyponatremia and hypernatremia, as conventionally defined (<135 mEq/L >145 mEq/L, respectively), are associated with increased perioperative morbidity mortality. However, the effects of subtle deviations in serum sodium concentration within normal range not well-characterized.The purpose this analysis is to determine association between borderline hyponatremia (135-137 mEq/L) hypernatremia (143-145 on mortality.A retrospective cohort study was performed using data from American College...

Whole blood transfusion is being increasingly used for trauma resuscitation, particularly in military settings. Low-titre group O whole simplifies the logistical challenges and maximises benefits of when compared with component therapy austere battlefield conditions. Screening protocols testing requirements prescreened donors walking banks (WBBs), which are emergency transfusions, established by both USA most partner nations, though they not necessarily uniform across these combined forces....

The Health Experts onLine at Portsmouth teleconsultation system is designed to connect health providers in the Navy Medicine East Region specialists Naval Medical Center Portsmouth.A review of first year was performed. Data on each were extracted from database and analyzed.From June 2014 May 2015 there have been 585 teleconsultations. Providers stationed 36 ships/submarines 28 remote military treatment facilities utilized system. Over 280 34 different specialties consulted. median time...

Murine translational models are an important tool to understand pain pathophysiology. One procedure used frequently in murine research is the sciatic nerve block. This study sought demonstrate use of ultrasound-guided block a cadaveric model. A total 40 injections were performed 20 Sprague-Dawley male 18-month-old rat cadavers. Necropsy was identify staining nerve. Staining with methylene blue occurred injections. The extremely accurate nature this under ultrasound guidance favorable for...

Post-Traumatic Stress Disorder (PTSD) is a common psychiatric disorder. Recent investigations have demonstrated effectiveness of Stellate Ganglion Blocks (SGB) for reducing symptoms associated with PTSD. Both fluoroscopic guided and ultrasound SGB been described are regularly used in clinical practice. This study sought to evaluate differences block performance when comparing versus SGB.Cadaveric Pilot Study.Academic Research Laboratory.Ten Soft-Cured Human Cadavers.Ten soft-cured human...

This work explores the challenges of delivering medical care in geographically dispersed and resource-constrained environment Distributed Maritime Operations (DMO) Expeditionary Advanced Base (EABO). Traditional planning approaches may struggle to adapt vast operational space, extended evacuation times, limited force present these scenarios. The concept a Medical Common Operating Picture (COP) emerges as potential solution. By providing shared view situation across theater, encompassing...

Regional anesthesia (RA) is commonly used in perioperative settings of developed and well-resourced environments. RA has significant potential benefits when resource-limited environments, including disaster, mass casualty, wartime offers over general opioid-based analgesia, decreased risk complications, reliance on mechanical ventilation, improved cost efficiency, others. The decreasing ultrasound matched with its smaller size portability increases the availability these making...

We were pleased to read the Clinical Focus Review by Richards et al., "Damage Control Resuscitation in Traumatic Hemorrhage: It Is More Than Fixing Holes and Filling Tank"1 March 2024 issue of Anesthesiology. This review is one most succinct yet comprehensive discussions evidence-based trauma resuscitation that we have encountered. As military anesthesiologists, this topic particular interest us. feel will serve as a valuable reference for service members deployed combat zones. also look...

The Falklands Campaign was fought a significant distance from the home base of British Fleet. planning and delivery medical care during this campaign can provide lessons for strategic in other far spread geographic locations, including Indo-Pacific region. Consideration doctrine, Role 1-4 facilities golden hour, may need to be reconsidered light changing scenarios. New concepts such as "90-in-90" "3-in-3" are also discussed framework future U.S. Command area responsibility.

Most patients who undergo epidural anesthesia are pregnant and thus a protected population, which has limited investigations of the human space. Among several species studied as models for spine, porcine spine been used model instrumentation. Although spread colored dye within space investigated, no demonstrated in situ by using radiopaque contrast dye. To this end, we here 10 Yorkshire swine cadavers through an approved tissue sharing agreement. Epidural catheters were placed landmark-based...

Abstract Objective Radiofrequency ablation (RFA) of the medial branch nerve is a commonly performed procedure for patients with facet syndrome. RFA has previously been demonstrated to provide long-term functional improvement in approximately 50% patients, including those who had significant pain relief after diagnostic block. We sought identify factors associated success pain. Design Active-duty military underwent lumbar (L3, L4, and L5 levels) over 3-year period were analyzed. Defense...

ABSTRACT Background Hemorrhage is a major cause of preventable death worldwide, and early identification can be lifesaving. Pulse wave contour analysis has previously been used to infer hemodynamic variables in variety settings. We hypothesized that pulse arrival time (PAT), form which assessed via electrocardiography (ECG) photoplethysmography (PPG), associated with hemorrhage volume. Methods Yorkshire-Cross swine were randomized (30 mL/kg over 20 minutes) vs. control. Continuous ECG PPG...

In light of the ongoing opioid crisis, Naval Medical Center Portsmouth (NMCP) created Long-Term Opioid Therapy Safety (LOTS) program to reduce risks and improve long-term therapy outcomes. Our primary outcome was change in compliance with recommended safety metrics.This is a retrospective cohort study performed at NMCP, large military academic medical center providing comprehensive care DoD beneficiaries. The NMCP LOTS provides both patient provider narcotic education as well record...