Differences in Disease Non-battle Injury Between Combatant Commands

Hall, Andrew B.; Ahmed, Anwar; Cieurzo, Christopher; Payne, Chelsea; Wilson, Ramey L

doi:10.1093/milmed/usac413

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…Finally, combat-related injuries, as well as diseases and nonbattle injuries, represent huge challenges for SOF medical teams in nonpermissive, austere, and remote environments. 35 Therefore, a rigorous predeployment medical screening of military personnel, medical prevention information campaigns, and dedicated training for medical teams are implemented to limit this medical threat. Table 1 summarizes the French SOF Medical Command's proposals addressing the challenges of providing medical support in special operations.…”

Section: Challenges Encountered In Providing Medical Support In Speci...mentioning

confidence: 99%

“…In case of air denial, this in-flight capacity can be deployed in other medical evacuation platforms on land or even at sea, the aim being to push SOF DCR and DCS capabilities far-forward, whatever the platforms used. Finally, combat-related injuries, as well as diseases and nonbattle injuries, represent huge challenges for SOF medical teams in nonpermissive, austere, and remote environments 35 . Therefore, a rigorous predeployment medical screening of military personnel, medical prevention information campaigns, and dedicated training for medical teams are implemented to limit this medical threat.…”

Section: Challenges Encountered In Providing Medical Support In Speci...mentioning

confidence: 99%

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Irregular warfare must combine good medicine, with both good tactics and good strategies: Position paper by the French Special Operations Forces Medical Command

Pasquier,

David,

Petit

et al. 2024

J Trauma Acute Care Surg

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Introduction Military operations are no longer limited to the application of counterterrorism and counterinsurgency strategies; they are now characterized by hybrid, irregular, and unconventional features. While some authors have indicated the need for medical support to adapt to these new modes of military operations, they have focused mainly on the tactical level of care on the battlefield. As Sun Tzu states, “Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat,” further proposals are still needed on the application of both medical tactics and medical strategies in irregular warfare. Methods Medical experts from the French Special Operations Forces (SOF) Medical Command have identified specific medical challenges that special operations face in the context of the current transformation of armed confrontations into irregular warfare. Results This position paper presents original tactical medical proposals for improving medical support in irregular warfare, ranging from the definition of a Primary-Alternate-Contingency-Emergency medical plan to the promotion of telemedical support. Original strategic medical proposals have highlighted the importance of recognizing medical issues in irregular warfare, including the medical actions carried out through and with local partners and the multiple approaches to countering medical threats. Conclusions The SOF medical community must be closely involved with and facilitate the responses to the shift to irregular warfare. International collaboration and interoperability are more necessary than ever, as they will enable a more effective combination of good medicine with both good tactics and good strategies. These perspectives can also be extended to improve medical care in the conventional armed forces and austere civilian settings. Level of Evidence N/A. Study Type Original research

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Section: Challenges Encountered In Providing Medical Support In Speci...mentioning

confidence: 99%

Section: Challenges Encountered In Providing Medical Support In Speci...mentioning

confidence: 99%

Irregular warfare must combine good medicine, with both good tactics and good strategies: Position paper by the French Special Operations Forces Medical Command

Pasquier,

David,

Petit

et al. 2024

J Trauma Acute Care Surg

View full text Add to dashboard Cite

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Optimizing Care for Military Women: The Value of the Dual-Certified Family and Women’s Health Nurse Practitioner

Johnson

Best

Johnson³

et al. 2023

Military Medicine

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The number of women in the military has more than tripled over the past 50 years, increasing from 5% in the 1970s to 17% in 2023, making them essential for global health engagement and military operations. Provider competence and confidence are barriers to the consistent availability of preventive, gynecologic, and reproductive services for women across service locations and duty platforms. The Defense Health Board recommends standardizing services and improving the availability and scope of services for women at every point of care. In direct conflict with these recommendations, however, is a congressional call for a drawdown of medical forces, which creates a need for operationally trained clinicians with a broad skill set including comprehensive care for women. Advanced practice registered nurses, such as family and women’s health nurse practitioners, are key assets to fill this gap on military medical health-care teams. At the request of the U.S. Air Force, the Graduate School of Nursing at the Uniformed Services University began offering a Women’s Health Nurse Practitioner (WHNP) program in 2014. The WHNP curriculum was layered onto the existing Family Nurse Practitioner program so that Family Nurse Practitioner students receive enhanced education in women’s health and WHNP students are prepared to meet the holistic, primary care needs of patients across the lifespan in addition to caring for women with obstetric and urogenital health concerns. This article highlights the value of dual-certified Family Nurse Practitioners and WHNPs in the military health-care system. These Uniformed Services University alumni are uniquely prepared to provide comprehensive primary and specialty care for female warfighters across the lifecycle from stable, well-resourced duty stations to austere, operational settings or deployment platforms.

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Relative Risk of All-Cause Medical Evacuation for Behavioral Health Conditions in U.S. Central Command

Hall¹,

Olsen

Gomes³

et al. 2023

Military Medicine

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Introduction Behavioral health disorders are the leading category of evacuations from the U.S. Central Command (USCENTCOM) area of responsibility. Understanding the relative risk of behavioral health conditions associated with all-cause evacuation is important for the allocation of resources to reduce the evacuation burden. Materials and Methods Data from the USTRANSCOM Regulating and Command & Control Evacuation System and Theater Medical Data Store covering personnel deployed to the USCENTCOM area of responsibility between January 1, 2017 and December 31, 2021 were collected and analyzed. All individuals who were diagnosed with a behavioral health–specific ICD-9 (290–316) or ICD-10 (F00–F99) code during the period were included. Using the earliest medical encounter, the number of individuals diagnosed with a particular code and the frequency individuals were evacuated being diagnosed with any code were calculated. Results The mean monthly USCENTCOM population during this period was 62,535. A total of 22,870 individuals were diagnosed with a behavioral health–related disorder during the study period. Of this population, 1,414 individuals required an evacuation. The relative risk of the top 30 diagnosis codes used during the initial visit of individuals during the study period was calculated. Within this group of initial diagnoses, F32.9 ‘Major depressive disorder, single episode, unspecified’ had the highest proportion evacuated at 15.9%. Conclusions There is a broad array of behavioral health–specific diagnoses used initially in the care of behavioral health disorders with a great variation in their association with evacuation risk. Variations of diagnoses associated with anxiety, depressive, and adjustment disorders are most associated with eventual evacuation.

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Differences in Disease Non-battle Injury Between Combatant Commands

Cited by 6 publications

References 11 publications

Irregular warfare must combine good medicine, with both good tactics and good strategies: Position paper by the French Special Operations Forces Medical Command

Irregular warfare must combine good medicine, with both good tactics and good strategies: Position paper by the French Special Operations Forces Medical Command

Optimizing Care for Military Women: The Value of the Dual-Certified Family and Women’s Health Nurse Practitioner

Relative Risk of All-Cause Medical Evacuation for Behavioral Health Conditions in U.S. Central Command

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