From the battlefield to main street: Tourniquet acceptance, use, and translation from the military to civilian settings

Goodwin, Tress; Moore, Krista; Pasley, Jason; Troncoso, Ruben; Levy, Matthew J.; Goolsby, Craig

doi:10.1097/ta.0000000000002198

Cited by 40 publications

(35 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Efforts to publicize awareness about tourniquet use between civilians have increased in the last decades. Pre-hospital tourniquet application to people exposed to peripheral exsanguination harm was found to reduce the mortality rate in these patients ( Goodwin et al, 2019 ). However, measures to avoid the possible deleterious effects resulting from I/R upon tourniquet application must be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

CoQ10 augments candesartan protective effect against tourniquet-induced hind limb ischemia-reperfusion: Involvement of non-classical RAS and ROS pathways

Awad

El-Din

Kamel

2021

Saudi Pharmaceutical Journal

View full text Add to dashboard Cite

Tourniquet is a well-established model of hind limb ischemia–reperfusion (HLI/R) in rats. Nevertheless, measures should be taken to alleviate the expected injury from ischemia/ reperfusion (I/R). In the present study, 30 adult male Sprague-Dawley rats were randomly divided into 5 groups (n = 6): control, HLI/R, HLI/R given candesartan (1 mg/kg, P.O); HLI/R given Coenzyme Q10 (CoQ10) (10 mg/kg, P.O); HLI/R given candesartan (0.5 mg/kg) and CoQ10 (5 mg/kg). The drugs were administered for 7 days starting one hour after reperfusion. Candesartan and CoQ10 as well as their combination suppressed gastrocnemius content of angiotensin II while they raised angiotensin-converting enzyme 2 (ACE2) activity, angiotensin (1–7) expression, and Mas receptor mRNA level. Consequently, candesartan and/or CoQ10 reversed the oxidative stress and inflammatory changes that occurred following HLI/R as demonstrated by the rise of SOD activity and the decline of MDA, TNF-α, and IL-6 skeletal muscle content. Additionally, candesartan and/or CoQ10 diminished gastrocnemius active caspase-3 level and phospho-p38 MAPK protein expression. Our study proved that CoQ10 enhanced the beneficial effect of candesartan in a model of tourniquet-induced HLI/R by affecting classical and non-classical renin-angiotensin system (RAS) pathway. To our knowledge, this is the first study showing the impact of CoQ10 on skeletal muscle RAS in rats.

show abstract

Section: Discussionmentioning

confidence: 99%

CoQ10 augments candesartan protective effect against tourniquet-induced hind limb ischemia-reperfusion: Involvement of non-classical RAS and ROS pathways

Awad

El-Din

Kamel

2021

Saudi Pharmaceutical Journal

View full text Add to dashboard Cite

show abstract

“…Enhancing educational opportunities offered by an AMC by including comprehensive mental health content, thoughtful discussions about sources of distress, recognizing emerging pathology, and the importance of identifying beneficial strategies and behaviors are all well suited to healthcare curricula and research programs. In addition, offering the option of a medical history curriculum that highlights medical advances inspired by the military (Goodwin et al, 2019) will demonstrate the institution's tangible awareness of contributions by the military to healthcare (Gibbs, Lee, & Ghanbari, 2019).…”

Section: Relations With Peers and Facultymentioning

confidence: 99%

Experiences and Challenges of Students with a Military Background at an Academic Medical Center

Dudley-Miller

Radel

2020

JVS

View full text Add to dashboard Cite

Introduction With approximately 3.7 million potential students with a military background (SMB) more than 90,000 of them are studying health care as an academic major (Cate, 2014; National Center for Veterans Analysis and Statistics, 2015). This fast-growing population has garnered attention of university administrators who are questioning whether the needs of SMB are being met adequately (Jenner, 2019). Current academic studies have focused on SMB experiences of students in community colleges and four-year universities with less attention directed toward SMB experiences while attending health career programs at academic medical centers to earn advanced, terminal, or professional degrees (Plach & Sells, 2013; Rudd, Goulding & Bryan, 2011). This literature suggests military personnel and veterans attending such curricula in an academic medical center may experience this specialized academic environment differently than those attending classes at community colleges or four-year universities. The advanced curricular content, specialized knowledge, practical experiential components, and heightened interpersonal skills required by interactions with patients, caregivers, and peers on the healthcare team combine to present challenges in the academic medical center educational environment beyond those present in many undergraduate or technical settings (University of Kansas Medical Center, 2019). Current studies exploring academic endeavors have used a variety of different terms to capture similar experiences of SMB at community colleges and four-year universities (Barry, Whiteman, & MacDermid Wadsworth, 2014; Ford & Vignare, 2015; Morris, Albanesi, & Cassidy, 2019). We have narrowed these to represent three general categories identified by SMB as critical for success at an academic medical center in the areas of medicine, nursing, other health professions, and in graduate school: (a) relations with peers and faculty, (b) the learning experience, and (c) navigating campus services. SMB experiences relating with peers and faculty This area of study focuses on relationship dynamics of the SMB experience with civilian students, instructors, and campus administration. SMB in higher education identify the success of their academic programming partly through their satisfaction with integration among other students and with faculty (Barry et al., 2014; Eakman, Kinney, & Reinhardt, 2019). Differences in age, maturity, military life experience, and responsibilities outside of academic demands are most often identified as presenting barriers between SMB and peers in other academic settings (Barry, Whiteman, MacDermid Wadsworth, 2012; Shellenbarger & Decker, 2019). Some of the SMB share concerns about being identified as having a military background, and expressed uncertainty

show abstract

“…Hemorrhage is the leading cause of preventable death in both military and civilian trauma. Early application of extremity tourniquets at the point of injury is currently accepted as the standard treatment for life-threatening extremity hemorrhage [2][3][4]. The classic Pre-Hospital Emergency Care (PHEM) paradigm changed from airway-breathing-circulation (ABC) to Military-PHEM (M-PHEC) that addresses rst catastrophic hemorrhage, before airway, breathing or circulation (<C> ABC) [5].…”

Section: Introductionmentioning

confidence: 99%

Extremity Tourniquet Training at High Seas

Benítez

Ribeiro

Khan³

et al. 2021

World j. surg.

View full text Add to dashboard Cite

Background Future navy officers require unique training for emergency medical response in the isolated maritime environment. The authors issued a workshop on extremity bleeding control, using four different commercial extremity tourniquets onboard a training sail ship. The purposes were to assess participants' perceptions of this educational experience and evaluate self‐application simplicity while navigating on high seas. Methods A descriptive observational study was conducted as part of a workshop issued to volunteer training officers. A post‐workshop survey collected their perceptions about the workshops' content usefulness and adequacy, tourniquet safety, self‐application simplicity, and device preference. Tourniquet preference was measured by frequency count while the rest of the studied variables on a one‐to‐ten Likert scale. Frequencies and percentages were calculated for the studied variables, and application simplicity means compared using the ANOVA test (p < 0.05). Results Fifty‐one Spanish training naval officers, aged 20 or 21, perceived high sea workshop content's usefulness, adequacy, and safety level at 8.6/10, 8.7/10, and 7.5/10, respectively. As for application simplicity, CAT and SAM‐XT were rated equally with a mean of 8.5, followed by SWAT (7.9) and RATS (6.9), this one statistically different from the rest (p < 0.01). Windlass types were preferred by 94%. Conclusions The training sail ship's extremity bleeding control workshop was perceived as useful and its content adequate by the participating midshipmen. Windlass types were regarded as easier to apply than elastic counterparts. They were also preferred by nine out of every ten participants.

show abstract

From the battlefield to main street: Tourniquet acceptance, use, and translation from the military to civilian settings

Cited by 40 publications

References 32 publications

CoQ10 augments candesartan protective effect against tourniquet-induced hind limb ischemia-reperfusion: Involvement of non-classical RAS and ROS pathways

CoQ10 augments candesartan protective effect against tourniquet-induced hind limb ischemia-reperfusion: Involvement of non-classical RAS and ROS pathways

Experiences and Challenges of Students with a Military Background at an Academic Medical Center

Extremity Tourniquet Training at High Seas

Contact Info

Product

Resources

About