A short history of Camp Bastion Hospital: part 2—Bastion's catalytic role in advancing combat casualty care

Vassallo, David

doi:10.1136/jramc-2015-000437

Cited by 3 publications

(3 citation statements)

References 20 publications

(18 reference statements)

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“…Continual improvements in mortality throughout recent conflicts have raised expectations for survival after military trauma. [17][18][19] Reproducing the survival rate achieved at the UK DHC(F) MTF at Camp Bastion on Op HERRICK at the start of any future operation will be challenging. There will be no guarantee of air evacuation or fixed MTFs in the country of operation.…”

Section: Discussionmentioning

confidence: 99%

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Extending existing recommended military casualty evacuation timelines will likely increase morbidity and mortality: a UK consensus statement

et al. 2020

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IntroductionFuture conflicts may have limited use of aviation-based prehospital emergency care for evacuation. This will increase the likelihood of extended evacuation timelines and an extended hold at a forward hospital care facility following the completion of damage control surgery or acute medical interventions.MethodsA three-round Delphi Study was undertaken using a panel comprising 44 experts from the UK armed forces including clinicians, logisticians, medical planners and commanders. The panel was asked to consider the effect of an extended hold at Deployed Hospital Care (Forward) from the current 2-hour timeline to +4, +8, +12 and +24 hours on a broad range of clinical and logistical issues. Where 75% of respondents had the same opinion, consensus was accepted. Areas where consensus could not be achieved were used to identify future research priorities.ResultsConsensus was reached that increasing timelines would increase the personnel, logistics and equipment support required to provide clinical care. There is a tipping point with a prolonged hold over 8 hours, after which the greatest number of clinical concerns emerge. Additional specialties of surgeons other than general and orthopaedic surgeons will likely be required with holds over 24 hours, and robust telemedicine would not negate this requirement.ConclusionsRetaining acute medical emergencies at 4 hours, and head injuries was considered a particular risk. This could potentially be mitigated by an increased forward capacity of some elements of medical care and availability of a CT scanner and intracranial pressure monitoring at over 12 hours. Any efforts to mitigate the effects of prolonged timelines will come at the expense of an increased logistical burden and a reduction in mobility. Ultimately the true effect of prolonged timelines can only be answered by close audit and analysis of clinical outcomes during future operations with an extended hold.

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Section: Discussionmentioning

confidence: 99%

“…Damage control surgery 42 Consultant-led resuscitation 19 Whole blood 60 timelines may result in some of these temporising measures failing during evacuation.…”

Section: Consensus Statementmentioning

confidence: 99%

Extending existing recommended military casualty evacuation timelines will likely increase morbidity and mortality: a UK consensus statement

et al. 2020

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“…The successful outcome of so many patients managed at Camp Bastion Hospital, including the unprecedentedly high proportion of unexpected survivors discussed in the previous articles in this series,1 2 owed much to the high-calibre multidisciplinary and collective training of medical services personnel before they deployed. This training built upon their individual skills and competencies, concentrating on non-technical skills (human factors), communication and team-working.…”

Section: Introductionmentioning

confidence: 98%

A short history of Camp Bastion Hospital: preparing for war, national recognition and Bastion's legacy

Vassallo¹

2015

J R Army Med Corps

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Surgical skill decay in the contingency era

Stansfield

Tai

2021

BMJ Mil Health

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A short history of Camp Bastion Hospital: part 2—Bastion's catalytic role in advancing combat casualty care

Cited by 3 publications

References 20 publications

Extending existing recommended military casualty evacuation timelines will likely increase morbidity and mortality: a UK consensus statement

Extending existing recommended military casualty evacuation timelines will likely increase morbidity and mortality: a UK consensus statement

A short history of Camp Bastion Hospital: preparing for war, national recognition and Bastion's legacy

Surgical skill decay in the contingency era

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