The Origins Of The Golden Hour Of Medical Care And Its Applicability To Combat Medicine
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The Origins Of The Golden Hour Of Medical Care And Its Applicability To Combat Medicine
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Author :
language : en
Publisher:
Release Date : 2017
The Origins Of The Golden Hour Of Medical Care And Its Applicability To Combat Medicine written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017 with categories.
This excellent report has been professionally converted for accurate flowing-text e-book format reproduction. The Golden Hour standard is used in emergency medicine and trauma care and states a person must receive definitive care within one hour to ensure optimal outcomes. The medical community accepted this standard without supporting evidence. It is a cornerstone of modern trauma systems. Secretary of Defense Gates endorsed this standard for military medicine (Gates 2009). His stance, combined with strong opinions from the trauma community, resulted in a requirement for units to operate within one hour of ROLE III care during deployments. A review of the association between evacuation time and outcomes fails to support the Golden Hour. The evidence suggests if combat injury is properly treated in the first several minutes, focusing on hemorrhage, airway management, and treatment of tension pneumothorax, combined with high quality en route care during evacuation, there is significantly more time available to reach ROLE III care before outcomes suffer. Therefore, the Golden Hour is an improper standard for combat medicine resulting in increased resource requirements and unnecessary restrictions on units. A more appropriate approach is enhanced individual soldier training on the management of the major immediate causes of combat death as well as positioning advanced resuscitative care as far forward as possible.CHAPTER 1 - INTRODUCTION AND OVERVIEW * Primary Research Question * Secondary Research Questions * Assumptions * Definitions * Limitations * Delimitations * Significance of Study * CHAPTER 2 - LITERATURE REVIEW * The Origin of the Golden Hour * World War I Medical Care * World War II Medical Care * Korean War Medical Care * Vietnam War Medical Care * Scientific Evaluation of the Golden Hour since the Vietnam War * Mechanism of Injury and Causes of Death in a Combat Setting * Approaches other than Reducing Evacuation Time for Improving Outcome * Current Doctrine Regarding the Golden Hour * CHAPTER 3 - METHODOLOGY * CHAPTER 4 - ANALYSIS * The Evidence behind the Initial Golden Hour Standard * The Golden Hour in Practice * Doctrine * CHAPTER 5 - CONCLUSIONS AND RECOMMENDATIONS * Doctrine * Organizational * Training * Materiel * Leadership and Education * Personnel and Facilities * PolicyDespite the absence of doctrine and a significant lack of high quality medical research, the "Golden Hour ring" is now a major limiting factor in planning combat operations. This time ring not only restricts operational reach with respect to distance from advanced trauma and initial surgical care, but it also creates a significant vulnerability by providing both a source of information to the enemy as well as a relatively soft target for irregular warfare. Enemy forces can now plan on no major US action outside this one hour ring which significantly shrinks in size when atmospheric conditions prevent rotary wing medical evacuation flight. Additionally, they can anticipate major future action by the relocation of ROLE III medical as well as rotary wing medical evacuation assets. They can correctly assume there will be no major combat action initiated by the United States in an area until these assets are within adequate proximity. Finally, denying access to ROLE III care through irregular warfare measures can severely limit combat operations in an area. These issues raise the question of whether the Golden Hour is the appropriate standard form medical coverage planning. Additionally, it questions what doctrine should be regarding operational reach with respect to medical evacuation assets in an austere or hostile environment.
The Origins Of The Golden Hour Of Medical Care And Its Applicability To Combat Medicine History Of Casualty Care From World War I Through Vietnam Injury And Death In Combat Evacuation Doctrine
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Author : U. S. Military
language : en
Publisher:
Release Date : 2017-04-05
The Origins Of The Golden Hour Of Medical Care And Its Applicability To Combat Medicine History Of Casualty Care From World War I Through Vietnam Injury And Death In Combat Evacuation Doctrine written by U. S. Military and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-04-05 with categories.
This excellent report has been professionally converted for accurate flowing-text e-book format reproduction. The Golden Hour standard is used in emergency medicine and trauma care and states a person must receive definitive care within one hour to ensure optimal outcomes. The medical community accepted this standard without supporting evidence. It is a cornerstone of modern trauma systems. Secretary of Defense Gates endorsed this standard for military medicine (Gates 2009). His stance, combined with strong opinions from the trauma community, resulted in a requirement for units to operate within one hour of ROLE III care during deployments. A review of the association between evacuation time and outcomes fails to support the Golden Hour. The evidence suggests if combat injury is properly treated in the first several minutes, focusing on hemorrhage, airway management, and treatment of tension pneumothorax, combined with high quality en route care during evacuation, there is significantly more time available to reach ROLE III care before outcomes suffer. Therefore, the Golden Hour is an improper standard for combat medicine resulting in increased resource requirements and unnecessary restrictions on units. A more appropriate approach is enhanced individual soldier training on the management of the major immediate causes of combat death as well as positioning advanced resuscitative care as far forward as possible. CHAPTER 1 - INTRODUCTION AND OVERVIEW * Primary Research Question * Secondary Research Questions * Assumptions * Definitions * Limitations * Delimitations * Significance of Study * CHAPTER 2 - LITERATURE REVIEW * The Origin of the Golden Hour * World War I Medical Care * World War II Medical Care * Korean War Medical Care * Vietnam War Medical Care * Scientific Evaluation of the Golden Hour since the Vietnam War * Mechanism of Injury and Causes of Death in a Combat Setting * Approaches other than Reducing Evacuation Time for Improving Outcome * Current Doctrine Regarding the Golden Hour * CHAPTER 3 - METHODOLOGY * CHAPTER 4 - ANALYSIS * The Evidence behind the Initial Golden Hour Standard * The Golden Hour in Practice * Doctrine * CHAPTER 5 - CONCLUSIONS AND RECOMMENDATIONS * Doctrine * Organizational * Training * Materiel * Leadership and Education * Personnel and Facilities * Policy Despite the absence of doctrine and a significant lack of high quality medical research, the "Golden Hour ring" is now a major limiting factor in planning combat operations. This time ring not only restricts operational reach with respect to distance from advanced trauma and initial surgical care, but it also creates a significant vulnerability by providing both a source of information to the enemy as well as a relatively soft target for irregular warfare. Enemy forces can now plan on no major US action outside this one hour ring which significantly shrinks in size when atmospheric conditions prevent rotary wing medical evacuation flight. Additionally, they can anticipate major future action by the relocation of ROLE III medical as well as rotary wing medical evacuation assets. They can correctly assume there will be no major combat action initiated by the United States in an area until these assets are within adequate proximity. Finally, denying access to ROLE III care through irregular warfare measures can severely limit combat operations in an area. These issues raise the question of whether the Golden Hour is the appropriate standard form medical coverage planning. Additionally, it questions what doctrine should be regarding operational reach with respect to medical evacuation assets in an austere or hostile environment.
A National Trauma Care System
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2016-09-12
A National Trauma Care System written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-09-12 with Medical categories.
Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.
Ems In The United States Fragmented Past Future Of Opportunity
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Author : Donnie Woodyard, Jr
language : en
Publisher: Donnie Woodyard
Release Date : 2023-10-01
Ems In The United States Fragmented Past Future Of Opportunity written by Donnie Woodyard, Jr and has been published by Donnie Woodyard this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-10-01 with Medical categories.
"EMS in the United States: Fragmented Past, Future of Opportunity" is the first comprehensive Desk Reference for aspiring EMS leaders, managers, and government officials. Written from the perspective and experience of a state and national EMS leader, the book provides an exploration into the evolution, current state, and future of Emergency Medical Services (EMS) in the United States. From the humble origins of EMS to the impact of influential visionaries, Hollywood, and determined community volunteers, this book provides a deep dive into the rich, often overlooked history. The author, a respected state and national EMS leader, also leverages his experience to explain different service delivery models, financial challenges, and the significance of insurance and billing. The text delves into key aspects of personnel management, touching on recruitment, retention, mental health, and a professional code of conduct. As a resource for emerging EMS leaders, the book guides the reader through state regulation and administration, providing an introduction to interstate compacts, investigations, enforcement, and public protection. In its final sections, the book outlines leadership lessons, stakeholder engagement, and change management in the EMS environment. Amidst rapidly emerging issues like health equity, aging populations, and the advent of telehealth, the book posits that understanding our past is vital to navigating the future. By appreciating the influence of historic decisions on our present situation, we can forge an opportunity-rich future for EMS in the United States. As both a reference book and a history guide, this is an indispensable tool for anyone involved in or interested in the evolution and future of EMS.
The Trauma Golden Hour
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Author : Adonis Nasr
language : en
Publisher: Springer Nature
Release Date : 2019-11-27
The Trauma Golden Hour written by Adonis Nasr and has been published by Springer Nature this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-11-27 with Medical categories.
The Golden Hour is a well-established concept in emergency medicine, related to the critical period of one hour after an injury, accident or trauma. This term implies that the mortality rates increase substantially if efficient care is not provided within 60 minutes after the trauma. This book is intended as a practical manual in Trauma Care within the context of the golden hour, addressing all trauma types and all body parts. Readers will find essential decision-making algorithms and protocols with commentary for traumas, along with easily accessible information on how to treat patients in a very practical and handy fashion. Furthermore, the content is presented in a didactic way suitable for a wide audience, from medical students who want to learn about the basics of trauma care to experienced surgeons seeking a comprehensive guide to trauma-related interventions.The book combines contributions from experts at two renowned Trauma Centers, the Hospital do Trabalhador at Curitiba, Brazil, and the Ryder Trauma Center in Miami, USA. Therefore, considering the different local environments and resources, the book provides distinct perspectives for several injuries, presenting the state of the art in Trauma Care. The diversity of perspectives in this book contributes to a global health care approach suitable for trauma-related events from developed countries to remote areas. The Trauma Golden Hour – A Practical Guide celebrates the Centennial Anniversary of the Federal University of Parana (Brazil), the 25th Anniversary of the Ryder Trauma Center (USA) and the 20th Anniversary of the Hospital do Trabalhador (Brazil).
Damage Control In Trauma Care
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Author : Juan Duchesne
language : en
Publisher: Springer
Release Date : 2018-05-25
Damage Control In Trauma Care written by Juan Duchesne and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-05-25 with Medical categories.
This book describes current, evidence-based guidelines for damage control interventions across the field of trauma care with the aim of enabling clinicians to apply them to best effect in daily clinical practice. Emphasis is placed on the need for trauma surgeons and their teams to recognize that optimal damage control in severely traumatized patients depends upon the combination of immediate assessment, resuscitation, and correct surgical management. The book opens by examining the evolution of damage control and the very significant impact that military damage control interventions have had on civilian emergency health care through improvements as simple as bandaging and tourniquets. Damage control measures in different specialties, including neurosurgery, orthopedics, vascular surgery, cardiothoracic surgery, anesthesia, and critical care, are then covered in detail. Readers will also find helpful information on a range of other important topics, such as the role of pre-hospital care providers, damage control within the emergency department, adjuncts of damage control, and damage control in austere environments. This book is a ‘must read’ for all clinicians in the trauma field.
Annual Update In Intensive Care And Emergency Medicine 2014
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Author : Jean-Louis Vincent
language : en
Publisher: Springer Science & Business Media
Release Date : 2014-02-06
Annual Update In Intensive Care And Emergency Medicine 2014 written by Jean-Louis Vincent and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-02-06 with Medical categories.
The Yearbook compiles the most recent developments in experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.
Textbook Of Emergency Trauma Care
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Author : Devendra Richhariya
language : en
Publisher: JP Medical Ltd
Release Date : 2018-02-28
Textbook Of Emergency Trauma Care written by Devendra Richhariya and has been published by JP Medical Ltd this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-02-28 with Medical categories.
This book is a comprehensive guide to emergency and trauma care covering the complete process, from pre-hospital care, rapid and point of care assessment, and triaging, to care of the patient during transfer, and in-hospital care. Beginning with a general overview of emergency care and resuscitation, the following sections discuss the treatment of emergencies and trauma in different systems of the body. A complete section is dedicated to paediatric emergencies. The final chapters cover trauma management, toxicology, disaster management, and environmental emergencies such as thermal and chemical burns, and snake bites. The descriptive text is further enhanced by more than 700 flowcharts, tables, diagrams, clinical photographs, and short notes to assist learning. Key points Comprehensive guide to emergency and trauma care Covers management of emergencies in different systems of the body Includes section on paediatric emergencies Highly illustrated with flowcharts, tables, diagrams, photographs and short notes
The Death Of The Golden Hour And The Return Of The Future Guerrilla Hospital
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Author : Warner Farr
language : en
Publisher: Independently Published
Release Date : 2019-05-10
The Death Of The Golden Hour And The Return Of The Future Guerrilla Hospital written by Warner Farr and has been published by Independently Published this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-05-10 with categories.
Colonel Warner "Rocky" Farr has made an important contribution to the body of SOF knowledge with this well-researched monograph. He advances the understanding of the many challenges and accomplishments related to guerrilla warfare medicine-care provided by predominantly indigenous medical personnel under austere conditions with limited evacuation capability-by providing a survey of the historical record in UW literature. Colonel Farr relates many historical experiences in the field, assesses their effectiveness, and lays a foundation for further in-depth study of the subject. The Joint Special Operations University is pleased to offer this monograph as a means of providing those scholars and operators, as well as policymakers and military leaders, a greater understanding of the complex and complicated field of guerrilla warfare medicine.
Textbook Of Clinical Neonatology
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Author : Ranjan Kumar Pejavar
language : en
Publisher: Jaypee Brothers Medical Publishers
Release Date : 2021-05-31
Textbook Of Clinical Neonatology written by Ranjan Kumar Pejavar and has been published by Jaypee Brothers Medical Publishers this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021-05-31 with Medical categories.