Trauma to the eye and associated structures account for a significant number of combat-related injuries, and combat ocular trauma has steadily risen in frequency over the last century. Ophthalmology in Military and Civilian Casualty Care comprehensively examines the accommodations and modifications that must be made in order to treat such ocular traumas in a military setting. Created by ophthalmology experts actively serving in the military at various levels, this book is designed to improve ophthalmic casualty outcomes across military settings. A history of military ophthalmology serves as the opening chapter, setting the stage for subsequent chapters examining the intricacies and advancements of damage control ophthalmology, prehospital care of combat eye injuries, neuro-ophthalmic manifestations of trauma, and further severe ocular conditions. Later chapters explore the preventative and proactive efforts to reduce and treat combat-related ocular trauma by developing “eye armor” for the American infantry and military-affiliated ophthalmic surgical missions. Complete with high-quality color illustrations and figures, this unique book will serve as an invaluable, practical reference for military physicians, military ophthalmologists, ophthalmology professors, residents, and fellows interested in combat medicine and eye trauma.
This landmark book is the most extensive and complete oculofacial plastic surgery guide available in the market. Updated and broadened from the three previous editions, it includes advances in the use of surgical navigation systems, and new techniques and treatments for diseases involving the eyelid, orbital and lacrimal system. Organized across 11 sections of in-depth, expertly written text, Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery, Fourth Edition has taken the best of the field’s classic reference text and expanded upon it. Detailed chapters cover a multitude of topics relating to various ocular surgeries, pediatric considerations, ocular traumas, and anatomy. Supplemented with a myriad of high-quality illustrations, Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery, Fourth Edition is an indispensable reference for oculoplastics surgeons and physicians in other fields.
Innovative Bio-Based Technologies for Environmental Remediation explores the recent applications of both the latest and broad practical and theoretical aspects of environmental remediation with an aim to combine various innovation-based biotechnology for waste management, waste minimization, and waste to economy. This book summarizes the recent progress of bio-based technologies for environmental remediation at both an experimental and a theoretical model level. An emphasis has been made on trends and the probable future of sustainable techniques to reduce waste and harmful compounds from the environment. Biological-based technologies have low operating costs and involve direct degradation of organic pollutants without the release of toxic intermediates. Recent applications covered in this book include process intensification in bio-based approaches, green technology, phytoremediation, biopolymers, biosurfactants for environmental applications, and other bio-based technologies with sustainable design and the future of remediation are also discussed. This book is an important reference source for environmental scientists and engineers who are seeking to improve their understanding of how bio-based technologies are playing an increasingly important role in environmental remediation. It brings together recent innovations and practices of bio-based technologies for environmental remediation, outlines major bio-based technologies, and discusses biopolymers and biosurfactants for environmental management.
Almost 1,000 total pages; see index at beginning of publications for a complete list of included CPGs. Each CPG includes a section on the following: 1. GOAL 2. BACKGROUND 3. EVALUATION 4. TREATMENT 5. PERFORMANCE IMPROVEMENT (PI) MONITORING 6. SYSTEM REPORTING & FREQUENCY 7. RESPONSIBILITIES & 8. REFERENCES. OVERVIEW Clinical Practice Guidelines (CPGs) are the backbone of the system-wide JTS Performance Improvement program. Health data abstracted from patient records and after action reports is analyzed and distilled into globally relevant CPGs to remove medical practice variations and prevent needless deaths. The CPGs compiled from DoDTR data and used by healthcare providers worldwide are largely responsible for the decreased Case Fatality Rate for the wars in Iraq and Afghanistan. Examples are better transfusion practices; reduced burn morbidity and mortality; near elimination of extremity compartment syndrome; better patient care documentation; and improved communication across the spectrum of care between geographically dispersed facilities. CPGs are evidence-based and developed with experts in the military and civilian communities, deployed clinicians, Service trauma/surgical consultants, JTS leadership and formerly deployed Trauma Directors and Coordinators. JTS has a formalized process for developing, reviewing, updating, and approving CPGs. The guidelines are developed and implemented by clinical subject matter experts in response to needs identified in the military area of responsibility. CPGs were developed originally for U.S. Central Command. However, collaborative efforts are ongoing with the other Combatant Commands to customize CPGs to their COCOMs. INTRODUCTION TO THE JOINT TRAUMA SYSTEM (JTS) The Joint Trauma System (JTS) is the Department of Defense (DoD) authority for the military’s trauma care system. The vision of the Joint Trauma System is that every Soldier, Sailor, Marine and Airman injured on the battlefield will have the optimum chance for survival and maximum potential for functional recovery. To achieve this vision, in 2006, the JTS implemented programs for data -driven trauma system development and improvement in addition to the collection of trauma data. As part of its data collection efforts, the JTS maintains a registry of trauma patients who received care at medical treatment facilities (MTFs). Since 2007, this registry – known as the DoD Trauma Registry (DoDTR) – has documented demographic, injury, treatment, and outcomes data for all trauma patients admitted to any DoD MTF, regardless of whether the injury occurred during on-going military operations, and is the largest military trauma data source in the world. Development of the DoDTR began during the early years of the Global War on Terror (GWoT) when the need to systematically improve trauma care for combat wounded resulted in the impromptu creation of a demonstration registry, known then as the Combat Trauma Registry (CTR). The CTR was constructed by the Center for AMEDD Strategic Studies (CASS); trauma-related information was initially abstracted into it from paper medical records received from trauma nurse coordinators (TNCs) at Landstuhl Regional Medical Center (LRMC) in Germany. Shortly after the demonstration program started, the Army Surgeon General approved its transition to an operational mode, leading to the formation of the Joint Theater Trauma System (JTTS) and, eventually, the Joint Trauma System (JTS).
"This book is designed to deliver combat casualty care information that will facilitate transition from a continental US or civilian practice to the combat care environment. Establishment of the Joint Theater Trauma System and the Joint Theater Trauma Registry, coupled with the efforts of the authors, has resulted in the creation of the most comprehensive, evidence-based depiction of the latest advances in combat casualty care. Lessons learned in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have been fortified with evidence-based recommendations to improve casualty care. The educational curriculum was designed overall to address the leading causes of preventable death and disability in OEF and OIF. Specifically, the generalist combat casualty care provider is presented requisite information for optimal cae of US combat casualties in the first 72 to 96 hours after injury. The specialist provider is afforded similiar information, supplemented by lessons learned for definitive care of host nation patients."--
Counting Civilian Casualties aims to promote open scientific dialogue by high lighting the strengths and weaknesses of the most commonly used casualty recording and estimation techniques in an understandable format.
Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.
