Military treatment of splenic injury in the era of non-operative management

Mossadegh, Somayyeh; Midwinter, Mark J.; Sapsford, W; Tai, N

doi:10.1136/jramc-2013-000039

Cited by 3 publications

(2 citation statements)

References 21 publications

(19 reference statements)

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“…Patients are attentively monitored for any clinical observation changes to indicate bleeding, including increased respiration rate, haemodynamic changes and reduced oxygenation of peripheral tissues 3–7. In the military setting, where there is a high prevalence of multiorgan penetrating injury, bed rest has been routinely non-selectively encouraged 8. However, there is evidence to suggest that bed rest has a negative impact on multiple body systems, including altered fluid dynamics, pressure ulcers and thrombotic events 3–8.…”

Section: Introductionmentioning

confidence: 99%

“…In the military setting, where there is a high prevalence of multiorgan penetrating injury, bed rest has been routinely non-selectively encouraged 8. However, there is evidence to suggest that bed rest has a negative impact on multiple body systems, including altered fluid dynamics, pressure ulcers and thrombotic events 3–8. There is no evidence as to whether bed rest is required for recovery to be achieved, with no accepted national or international guidelines or protocol available to guide early ambulation 3–7…”

Section: Introductionmentioning

confidence: 99%

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Bed rest: outdated following traumatic solid organ injury?

Ashcroft

Khan

2020

BMJ Mil Health

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IntroductionThis systematic review aimed to evaluate early ambulation protocols implemented for traumatic solid organ injury.MethodsThe electronic databases PubMed, Medline (Ovid), Embase and Cochrane Library were searched without time constraint to identify prospective and retrospective analyses, randomised controlled trials, cohort studies, and case series that investigated early ambulation in solid organ trauma.ResultsSix studies met the predefined inclusion criteria and were reviewed. Three studies investigated early ambulation protocols in direct comparison with bed rest. The remaining three studies were early ambulation case series. In all studies there was no convincing evidence to suggest differences in clinical outcomes between early ambulation and bed rest protocols. In all studies early ambulation resulted in a reduced length of hospitalisation and decreased cost to national healthcare services.ConclusionsThis systematic review has found preliminary evidence that suggests bed rest has no clinical benefit in those with low-grade to mid-grade (grades 1–2) solid organ injury. Further studies are required to inform guidance to improve trauma patient outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bed rest: outdated following traumatic solid organ injury?

Ashcroft

Khan

2020

BMJ Mil Health

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Defining the essential anatomical coverage provided by military body armour against high energy projectiles

et al. 2015

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Those structures requiring essential medical coverage by a plate were demonstrated to be the heart, great vessels, liver and spleen. For the 50th centile male anthropometric model used in this study, the front and rear plates from the Enhanced Combat Body Armour system only provide limited coverage, but do fulfil their original requirement. The plates from the current Mark 4a OSPREY system cover all of the structures identified in this study as requiring coverage except for the abdominal sections of the aorta and inferior vena cava. Further work on sizing of plates is recommended due to its potential to optimise essential medical coverage.

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