Northallerton, United Kingdom
Northallerton, United Kingdom

Time filter

Source Type

Hutchings S.D.,King's College | Howarth G.,Ministry of Defence Hospital Unit | Rees P.,Barts Health NHS Trust
Journal of the Royal Naval Medical Service | Year: 2013

Conducting research in the deployed environment is challenging but if the various obstacles are overcome then the data captured can be vital in developing future treatment strategies. Perhaps the most important aspect is having an enthusiastic individual who is dedicated to research and can thus concentrate on maximising the potential of this unique environment.


Pearson J.D.,James Cook University | Ingram M.,Ministry of Defence Hospital Unit
Anaesthesia and Intensive Care Medicine | Year: 2011

Shock is failure of the circulatory system to provide the organ perfusion and tissue oxygenation required to meet cellular metabolic demands. Traumatic shock is most commonly associated with haemorrhage, however the trauma patient may present with non-haemorrhagic shock. The 'lethal triad' of acute coagulopathy, metabolic acidosis and hypothermia seen in trauma patients is developing the current approach to management of traumatic shock. The 'ABCDE' paradigm involves recognition of shock in a primary survey with simultaneous initiation of treatment. Hypotensive resuscitation involves limited volume replacement, during which time poor end-organ perfusion is tolerated, in order to prevent clot dislodgement and re-bleeding. Evidence now suggests that aggressive correction of coagulopathy associated with trauma will help reduce transfusion requirements, decrease bleeding and improve overall outcome. Ratios of packed red blood cells to fresh frozen plasma and platelets closer to 1:1:1 appear to improve outcome and reduce mortality. Damage control resuscitation encompasses key resuscitative strategies including damage control surgery, hypotensive resuscitation and the use of blood products as primary resuscitative fluids to correct coagulopathy. 'Horizontal' trauma team assessment with assigned roles including a designated leader, improves outcome when managing the trauma patient. © 2011 Elsevier Ltd. All rights reserved.


Ingram M.,Ministry of Defence Hospital Unit | Wood P.,University of Birmingham
Anaesthesia | Year: 2011

A British soldier presented to the UK Field Hospital, Afghanistan with bilateral traumatic lower limb amputations. Resuscitation and surgery followed accepted damage control principles. Blood component therapy was in keeping with UK military guidelines and included platelets and cryoprecipitate. The patient's trachea was extubated following insertion of an effective epidural. Ten days later, in the UK, he developed neurological symptoms and the presence of a subdural haematoma was confirmed on magnetic resonance imaging. Conventional laboratory coagulation results in this patient were above accepted limits for epidural insertion; however, thromboelastometry before insertion was suggestive of reduced platelet function. This case highlights the risk of relying solely on platelet count as a marker of platelet function following massive transfusion. Thromboelastometry provides additional information for the assessment of coagulation and should form part of the assessment of coagulation following massive transfusion before epidural insertion. © 2010 The Authors. Anaesthesia © 2010 The Association of Anaesthetists of Great Britain and Ireland.


PubMed | Barts Health NHS Trust, King's College and Ministry of Defence Hospital Unit
Type: Journal Article | Journal: Journal of the Royal Naval Medical Service | Year: 2014

Conducting research in the deployed environment is challenging but if the various obstacles are overcome then the data captured can be vital in developing future treatment strategies. Perhaps the most important aspect is having an enthusiastic individual who is dedicated to research and can thus concentrate on maximising the potential of this unique environment.


Breeze J.,University of Birmingham | Gibbons A.J.,Ministry of Defence Hospital Unit | Opie N.J.,University of Birmingham | Monaghan A.,University of Birmingham
British Journal of Oral and Maxillofacial Surgery | Year: 2010

Since its formation in June 2001, the Royal Centre for Defence Medicine (RCDM) at Birmingham University Hospitals NHS Foundation Trust has treated most of the British military personnel who have sustained serious maxillofacial injuries while serving abroad. We retrospectively analysed all recorded maxillofacial injuries of personnel evacuated to the RCDM between June 2001 and December 2007. We know of no existing papers that describe oral and maxillofacial injuries of military personnel, or workload in the 21st century. During the period 119 personnel with maxillofacial injuries were evacuated to the RCDM for treatment 83% of whom were injured in Iraq or Afghanistan. In total 61% (72/119) of injuries were caused by improvised explosive devices, 9% (11/119) were gun shot wounds, and 1% were caused by aircraft incidents. A further 29% (35/119) of patients had injuries not associated with battle. The most common injuries were facial lacerations (106/119). There were 54 facial fractures of which 17 primarily affected the maxilla, and 15 the mandible. Associated injuries were to the brain (24%), torso (26%), upper limb (39%), and lower limb (31%). The number of maxillofacial injuries has risen over the last 7 years, and has also increased in proportion to the total number of injured soldiers evacuated between 2005 and 2007. © 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.


Roberts M.,Denver Health Medical Center | Jagdish S.,Ministry of Defence Hospital Unit
Journal of Anesthesia History | Year: 2016

The practice of anesthesia in war places significant restraints on the choice of anesthetic technique used; these include, but are not limited to, safety, simplicity, and portability. Ever since intravenous anesthesia became a practical alternative, there have been military doctors who felt that this technique was particularly suited to this environment. The challenge, as in civilian practice, has been to find the appropriate drugs as well as simple and safe delivery systems.The urgency of war has always stimulated innovation in medicine to counteract the ongoing development of weapons of war and their effects on the human body and to achieve improved survival as public expectations rise.This article traces the development of and the use of intravenous anesthesia by military physicians for battle casualties. The story starts long before the era of modern anesthesia, and the discussion concludes in the dog days of the cold war. The rapidly increasing interest in intravenous anesthesia in both civilian and military practice since the early 1990s is left for other authors to examine. © 2015 Elsevier B.V.


PubMed | Denver Health Medical Center and Ministry of Defence Hospital Unit
Type: Journal Article | Journal: Journal of anesthesia history | Year: 2016

The practice of anesthesia in war places significant restraints on the choice of anesthetic technique used; these include, but are not limited to, safety, simplicity, and portability. Ever since intravenous anesthesia became a practical alternative, there have been military doctors who felt that this technique was particularly suited to this environment. The challenge, as in civilian practice, has been to find the appropriate drugs as well as simple and safe delivery systems. The urgency of war has always stimulated innovation in medicine to counteract the ongoing development of weapons of war and their effects on the human body and to achieve improved survival as public expectations rise. This article traces the development of and the use of intravenous anesthesia by military physicians for battle casualties. The story starts long before the era of modern anesthesia, and the discussion concludes in the dog days of the cold war. The rapidly increasing interest in intravenous anesthesia in both civilian and military practice since the early 1990s is left for other authors to examine.


Gibbons A.J.,Ministry of Defence Hospital Unit
Journal of the Royal Army Medical Corps | Year: 2010

This article describes the combined lessons learned from two deployments of a cadre of British Oral and Maxillofacial surgeons to Kandahar between July 2006 to April 2007, and September 2008 to April 2009.


Midwinter M.J.,RCDM | Mercer S.,University of Liverpool | Lambert A.W.,Ministry of Defence Hospital Unit | de Rond M.,University of Cambridge
Journal of the Royal Army Medical Corps | Year: 2011

The purpose of this article is to consider three underappreciated but important features of high performance teams: the trade-off relation between social and technical competence, the relevance of team size on productivity, and the inevitability of tensions that, while often experienced as dysfunctional, are in fact quite useful. It does so by reviewing a series of related studies in aviation and the organisation sciences, and by extrapolating insights for crew resource management in major military trauma along two generic themes: team context and team process. © 2013, Published by the BMJ Publishing Group Limited.


PubMed | Ministry of Defence Hospital Unit
Type: Journal Article | Journal: Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2016

Nurses have a professional responsibility under the UKCC Code of Professional Conduct (UKCC 1992), to offer patients the highest possible standard of care, care that is not compromised by infection.

Loading Ministry of Defence Hospital Unit collaborators
Loading Ministry of Defence Hospital Unit collaborators