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Care Under Austere Conditions: Unlimited Restraints

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Penetrating Trauma

Abstract

There are many reasons why you, as a surgeon, could find yourself practicing under adverse or austere conditions. This is clearly to be expected in the case of a military deployment or a volunteer mission to a developing nation. Austere conditions are also seen in the setting of natural disasters where urgent surgical care is hindered by widespread damage to infrastructure and other resources. Recent examples include the 2010 Haiti earthquake the 2011 Tohoku Earthquake and Tsunami off the northwest coast of Japan. Both natural events such as those mentioned above and man-made stressors such as wars, political unrest, and terrorism can all generate large numbers of injured patients that exceed the capabilities of existing medical resources.

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  1. Alfes CM, Steiner SL, Manacci CF (2015) Critical care transport training: new strides in simulating the austere environment. Air Med J 34(4):186–187. doi:10.1016/j.amj.2015.03.006

    Article  PubMed  Google Scholar 

  2. Allen AT, Flinn AM, Moore WF (2007) The 81st Medical Group obstetrics and gynecology flight’s role during Hurricane Katrina. Mil Med 172(2):199–201

    Article  PubMed  Google Scholar 

  3. Bar-Dayan Y, Leiba A, Beard P et al (2005) A multidisciplinary field hospital as a substitute for medical hospital care in the aftermath of an earthquake: the experience of the Israeli Defense Forces Field Hospital in Duzce, Turkey, 1999. Prehosp Disaster Med 20(2):103–106

    Article  PubMed  Google Scholar 

  4. Beekley AC, Watts DM (2004) Combat trauma experience with the United States Army 102nd Forward Surgical Team in Afghanistan†. Am J Surg 187(5):652–654. doi:10.1016/j.amjsurg.2004.02.001

    Article  PubMed  Google Scholar 

  5. Brevard SB, Weintraub SL, Aiken JB et al (2008) Analysis of disaster response plans and the aftermath of Hurricane Katrina: lessons learned from a level I trauma center. J Trauma 65(5):1126–1132. doi:10.1097/TA.0b013e318188d6e5

    Article  PubMed  Google Scholar 

  6. Carlson LC, Hirshon JM, Calvello EJ, Pollak AN (2013) Operative care after the Haiti 2010 earthquake: implications for post-disaster definitive care. Am J Emerg Med 31(2):429–431. doi:10.1016/j.ajem.2012.10.020

    Article  PubMed  Google Scholar 

  7. Counihan TC, Danielson PD (2012) The 912th forward surgical team in operation new dawn: employment of the forward surgical team during troop withdrawal under combat conditions. Mil Med 177(11):1267–1271. doi:10.7205/MILMED-D-12-0O137

    Article  PubMed  Google Scholar 

  8. Demetriades D, Murray JA, Chan L et al (2001) Penetrating colon injuries requiring resection: diversion or primary anastomosis? An AAST prospective multicenter study. J Trauma 50(5):765–775

    Article  CAS  PubMed  Google Scholar 

  9. Eastman AL, Rinnert KJ, Nemeth IR, Fowler RL, Minei JP (2007) Alternate site surge capacity in times of public health disaster maintains trauma center and emergency department integrity: Hurricane Katrina. J Trauma 63(2):253–257. doi:10.1097/TA.0b013e3180d0a70e

    Article  PubMed  Google Scholar 

  10. Eastridge BJ, Stansbury LG, Stinger H, Blackbourne L, Holcomb JB (2009) Forward Surgical Teams provide comparable outcomes to combat support hospitals during support and stabilization operations on the battlefield. J Trauma 66(4 Suppl):S48–S50. doi:10.1097/TA.0b013e31819ce315

    Article  PubMed  Google Scholar 

  11. Giannou C, Baldan M (2010) War surgery: working with limited resources in armed conflict and other situations of violence. International Committee of the Red Cross, Geneva

    Google Scholar 

  12. Gordon WT, Grijalva S, Potter BK (2012) Damage control and austere environment external fixation: techniques for the civilian provider. J Surg Orthop Adv 21(1):22–31

    PubMed  Google Scholar 

  13. Halpern P, Rosen B, Carasso S et al (2003) Intensive care in a field hospital in an urban disaster area: lessons from the August 1999 earthquake in Turkey. Crit Care Med 31(5):1410–1414. doi:10.1097/01.CCM.0000059439.07851.BD

    Article  PubMed  Google Scholar 

  14. Harrington S, Gorgone P, Jocelyn J (2012) Aftermath of an earthquake: a first responder’s perspective. AORN J 96(4):419–433. doi:10.1016/j.aorn.2012.06.008

    Article  PubMed  Google Scholar 

  15. Higgins RA (2010) MEDEVAC: critical care transport from the battlefield. AACN Adv Crit Care 21(3):288–297. doi:10.1097/NCI.0b013e3181e6741f

    CAS  PubMed  Google Scholar 

  16. Jawa RS, Heir JS, Cancelada D, Young DH, Mercer DW (2012) A quick primer for setting up and maintaining surgical intensive care in an austere environment: practical tips from volunteers in a mass disaster. Am J Disaster Med 7(3):223–229

    Article  PubMed  Google Scholar 

  17. Kodama Y, Oikawa T, Hayashi K et al (2014) Impact of natural disaster combined with nuclear power plant accidents on local medical services: a case study of Minamisoma Municipal General Hospital after the Great East Japan Earthquake. Disaster Med Public Health Prep 8(6):471–476. doi:10.1017/dmp.2014.112

    Article  PubMed  Google Scholar 

  18. Menon AS, Norris RL, Racciopi J et al (2012) The expanded scope of emergency medical practice necessary for initial disaster response: lessons from Haiti. J Spec Oper Med Peer Rev J SOF Med Prof 12(1):31–36

    Google Scholar 

  19. Missair A, Gebhard R, Pierre E et al (2010) Surgery under extreme conditions in the aftermath of the 2010 Haiti earthquake: the importance of regional anesthesia. Prehosp Disaster Med 25(6):487–493

    Article  PubMed  Google Scholar 

  20. Nessen SC, Cronk DR, Edens J et al (2009) US army two-surgeon teams operating in remote Afghanistan—an evaluation of split-based forward surgical team operations. J Trauma Inj Infect Crit Care 66(Suppl):S37–S47. doi:10.1097/TA.0b013e31819ce302

    Article  Google Scholar 

  21. Pesola G, Bayshtok V, Kvetan V (1989) American critical care team at a foreign disaster site: the Armenian experience. Crit Care Med 17(6):582–585

    Article  CAS  PubMed  Google Scholar 

  22. Rasmussen TE, Clouse WD, Jenkins DH, Peck MA, Eliason JL, Smith DL (2006) The use of temporary vascular shunts as a damage control adjunct in the management of wartime vascular injury. J Trauma Inj Infect Crit Care 61(1):8–15. doi:10.1097/01.ta.0000220668.84405.17

    Article  Google Scholar 

  23. Rentas F, Lincoln D, Harding A et al (2012) The Armed Services Blood Program: blood support to combat casualty care 2001 to 2011. J Trauma Acute Care Surg 73(6 Suppl 5):S472–S478. doi:10.1097/TA.0b013e31827546e4

    Article  PubMed  Google Scholar 

  24. Robertson JP, Puckett J, Vather R, Jaung R, Bissett I (2015) Early closure of temporary loop ileostomies: a systematic review. Ostomy Wound Manage 61(5):50–57

    PubMed  Google Scholar 

  25. Robertson‐Steel I (2006) Evolution of triage systems. Emerg Med J 23(2):154–155. doi:10.1136/emj.2005.030270

    Article  PubMed  PubMed Central  Google Scholar 

  26. Smith CP, Sorrells A, Coburn M (2010) Management of urinary retention in an austere environment: suprapubic catheter placement. J Spec Oper Med Peer Rev J SOF Med Prof 10(3):36–40

    Google Scholar 

  27. Strandenes G, Hervig TA, Bjerkvig CK et al (2015) The lost art of whole blood transfusion in austere environments. Curr Sports Med Rep 14(2):129–134. doi:10.1249/JSR.0000000000000130

    Article  PubMed  Google Scholar 

  28. World Health Organization (2003) Surgical Care at the District Hospital–The WHO Manual. The World Health Organization, Geneva.

    Google Scholar 

  29. Venticinque SG, Grathwohl KW (2008) Critical care in the austere environment: providing exceptional care in unusual places. Crit Care Med 36(7 Suppl):S284–S292. doi:10.1097/CCM.0b013e31817da8ec

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Trauma/Critical Care and Emergency Surgery, The University of Arizona, 1501 N Campbell Avenue, Rm 5411, 245063, Tucson, AZ, 85724-5063, USA

    Matthew B. Singer & Terence O’Keeffe

Authors
  1. Matthew B. Singer
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  2. Terence O’Keeffe
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Corresponding author

Correspondence to Matthew B. Singer .

Editor information

Editors and Affiliations

  1. Professor of Surgery Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital Harvard University Medical School, Boston, USA

    George C. Velmahos

  2. Professor Emeritus, Department of Surgery, University of the Witwatersrand Medical School, Milpark Hospital Academic Trauma Centre and Leratong Hospital, Johannesburg, South Africa

    Elias Degiannis

  3. Honorary Senior Lecturer, Department of Surgery, University of the Witwatersrand Medical School, Johannesburg, South Africa

    Dietrich Doll

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© 2017 Springer-Verlag Berlin Heidelberg

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Singer, M.B., O’Keeffe, T. (2017). Care Under Austere Conditions: Unlimited Restraints. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49859-0_76

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  • DOI: https://doi.org/10.1007/978-3-662-49859-0_76

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49857-6

  • Online ISBN: 978-3-662-49859-0

  • eBook Packages: MedicineMedicine (R0)

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