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Disease and Non-Battle Traumatic Injuries Evaluated by Emergency Physicians in a US Tertiary Combat Hospital

Published online by Cambridge University Press:  13 December 2017

Vikhyat S. Bebarta ,
Alejandra G. Mora ,
Patrick C. Ng ,
Phillip E. Mason ,
Andrew Muck  and
Joseph K. Maddry
Vikhyat S. Bebarta
Affiliation:
University of Colorado, Anschutz Medical Campus, Aurora, ColoradoUSA
Alejandra G. Mora
Affiliation:
Air Force En Route Care Research Center, San Antonio Military Medical Center, US Army Institute of Surgical Research, Joint Base San Antonio, Fort Sam Houston, San Antonio, TexasUSA
Patrick C. Ng*
Affiliation:
San Antonio Military Medical Center, Joint Base San Antonio, San Antonio, TexasUSA
Phillip E. Mason
Affiliation:
San Antonio Military Medical Center, Joint Base San Antonio, San Antonio, TexasUSA
Andrew Muck
Affiliation:
Department of Emergency Medicine, University of Texas Health Sciences Center, San Antonio, TexasUSA
Joseph K. Maddry
Affiliation:
Air Force En Route Care Research Center, San Antonio Military Medical Center, US Army Institute of Surgical Research, Joint Base San Antonio, Fort Sam Houston, San Antonio, TexasUSA
*
Correspondence: Capt Patrick C. Ng, MD, MC USAF San Antonio Military Medical Center 3551 Roger Brooke Drive Joint Base San Antonio, San Antonio Texas USA 78234-7767 E-mail: Patrickcng1@gmail.com
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Abstract

Introduction

Analysis of injuries during military operations has focused on those related to combat. Non-combat complaints have received less attention, despite the need for many troops to be evacuated for non-battle illnesses in Iraq. This study aims to further characterize the disease and non-battle injuries (DNBIs) seen at a tertiary combat hospital and to describe the types of procedures and medications used in the management of these cases.

Methods

In this observational study, patients were enrolled from a convenience sample with non-combat-related diseases and injuries who were evaluated in the emergency department (ED) of a US military tertiary hospital in Iraq from 2007-2008. The treating emergency physician (EP) used a data collection form to enroll patients that arrived to the ED whose injury or illness was unrelated to combat.

Results

Data were gathered on 1,745 patients with a median age of 30 years; 84% of patients were male and 85% were US military personnel. The most common diagnoses evaluated in the ED were abdominal disorders, orthopedic injuries, and headache. Many cases involved intravenous access, laboratory testing, and radiographic testing. Procedures performed included electrocardiogram, lumbar puncture, and intubation.

Conclusion

Disease and non-battle traumatic injuries are common in a tertiary combat hospital. Emergency providers working in austere settings should have the diagnostic and procedural skills to evaluate and treat DNBIs.

BebartaVS, MoraAG, NgPC, MasonPE, MuckA, MaddryJK. Disease and Non-Battle Traumatic Injuries Evaluated by Emergency Physicians in a US Tertiary Combat Hospital. Prehosp Disaster Med. 2018;33(1):53–57.

Keywords

deployDNBIemergencyprehospital
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 1 , February 2018 , pp. 53 - 57
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest: none

References

1. Eastridge, BJ, Hardin, M, Cantrell, J, et al. Died of wounds on the battlefield: causation and implications for improving combat casualty care. J Trauma. 2011;71(1 Suppl):S4-S8.Google ScholarPubMed
2. Eastridge, BJ, Mabry, RL, Seguin, P, et al. Death on the battlefield (2001-2011): implication for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431-S437.Google Scholar
3. Blood, CG, Jolly, R. Comparisons of disease and non-battle injury incidence across various military operations. Mil Med. 1995;160(5):258-263.Google Scholar
4. Withers, BG, Erickson, RL, Petruccelli, BP, et al. Preventing disease and non-battle injury in deployed units. Mil Med. 1994;159(1):39-43.Google Scholar
5. Cohen, SP, Brown, C, Kurihara, C, et al. Diagnosis and factors associated with medical evacuation and return to duty for service members participating in Operation Iraqi Freedom or Operation Enduring Freedom: a prospective cohort study. Lancet. 2010;375(9711):301-309.Google Scholar
6. Hauret, KG, Taylor, BJ, Clemmons, NS, et al. Frequency and causes of non-battle injuries air evacuated from Operations Iraqi Freedom and Enduring Freedom, US Army, 2001-2006. Am J Prev Med. 2010;38(1S):S94-S107.Google Scholar
7. Sanders, JW, Putnam, SD, Frankart, C, et al. Impact of illness and non-combat injury during Operations Iraqi Freedom and Enduring Freedom (Afghanistan). Am J Trop Med Hyg. 2005;73(4):713-719.Google Scholar
8. Miller, MA, Hall, BT, Agyapong, F, et al. Traumatic non-combat-related hand injuries in US troops in the combat zone. Mil Med. 2011;176(6):652-655.Google Scholar
9. Belmont, PJ, Goodman, GP, Waterman, B, et al. Disease and non-battle injuries sustained by a US Army Brigade Combat Team during Operation Iraqi Freedom. Mil Med. 2010;175(7):469-476.Google Scholar
10. Mahomed, Z, Motara, F, Bham, A. Humanitarian medical response to the Syrian Arab Republic (April 7, 2013 to April 23, 2013). Prehosp Disaster Med. 2016;31(1):114-116.CrossRefGoogle Scholar
11. Bonnet, S, Bertani, A, Savoie, PH, et al. Humanitarian surgical care provided by a French forward surgical team: ten years of providing medical support to the population of the Ivory Coast. Mil Med. 2015;180(10):1075-1082.CrossRefGoogle Scholar
12. Noone, M. Field Report: medical response to super typhoon Haiyan. Prehosp Disaster Med. 2015;30(5):543-544.Google Scholar
13. Skeehan, CD, Tribble, DR, Sanders, JW, et al. Non-battle injury among deployed troops: an epidemiologic study. Mil Med. 2009;174(12):1256-1262.CrossRefGoogle Scholar
14. Maddry, JK, Ng, PC, Sessions, D, et al. A prospective observation study of medical toxicology consultation in a US combat theater. Mil Med. 2016;181(11).Google Scholar
15. Emergency Department Visits. National Hospital Ambulatory Medical Care Survey: 2011 Emergency Department Summary. http://www.cdc.gov/nchs/fastats/emergency-department.htm. Accessed June 14, 2016.Google Scholar
16. Gerhardt, RT, De Lorenzo, RA, Oliver, J, et al. Out-of-hospital combat casualty care in the current war in Iraq. Ann Emerg Med. 2009;53(2):169-174.CrossRefGoogle ScholarPubMed