Popliteal cystic adventitial disease is a rare arterial condition characterised by mucinous cyst formation in the adventitia of the popliteal artery producing stenosis or occlusion of the arterial lumen. It predominantly affects males and typically presents in the thirties with disabling intermittent calf claudication. Because of the demographic it affects it is of relevance to military medical practitioners. We present such a case and describe the presentation, clinical features, differential diagnoses and imaging findings as well as the theories surrounding pathogenesis, clinical management and surgical treatment options.
{"title":"Popliteal cystic adventitial disease: a rare case of calf claudication in\u0000 a young man","authors":"A. Collingwood, D. Ablett","doi":"10.1136/jrnms-105-172","DOIUrl":"https://doi.org/10.1136/jrnms-105-172","url":null,"abstract":"Popliteal cystic adventitial disease is a rare arterial condition characterised by mucinous cyst formation in the adventitia of the popliteal artery producing stenosis or occlusion of the arterial lumen. It predominantly affects males and typically presents in the thirties with disabling intermittent calf claudication. Because of the demographic it affects it is of relevance to military medical practitioners. We present such a case and describe the presentation, clinical features, differential diagnoses and imaging findings as well as the theories surrounding pathogenesis, clinical management and surgical treatment options.","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64206967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fittest of the fit: health and morale in the Royal Navy,\u0000 1939-1945","authors":"Kevin Brown","doi":"10.1136/jrnms-105-215","DOIUrl":"https://doi.org/10.1136/jrnms-105-215","url":null,"abstract":"","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"663 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64207414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract During Operation HERRICK, increasing numbers of battlefield casualties resulted in the need for innovation in the medical management of trauma. The aim of diagnostic radiology was to provide fast and accurate diagnostic information to the trauma team. The Bastion Protocol Computed Tomography (CT) Traumagram played a vital part in achieving this aim in the Joint Force Role 3 Medical Treatment Facility (R3), Camp Bastion. The CT Traumagram comprises a non-contrast CT scan of the head, followed by a biphasic intravenous contrast injection with single-pass acquisition from the Circle of Willis to the ischial tuberosities or as far down the legs as is necessary. Diagnostic CT, once a time-consuming process, became one of the major medical successes of Operation HERRICK. As a result, the Bastion Protocol, in modified forms, has been widely accepted and adopted in civilian trauma practice throughout the United Kingdom (UK). This paper aims to document the inception of the Bastion Protocol.
{"title":"The inception of the Bastion Protocol for trauma CT scanning","authors":"N. Carter, G. Kirkwood, R. Miles","doi":"10.1136/jrnms-104-183","DOIUrl":"https://doi.org/10.1136/jrnms-104-183","url":null,"abstract":"Abstract During Operation HERRICK, increasing numbers of battlefield casualties resulted in the need for innovation in the medical management of trauma. The aim of diagnostic radiology was to provide fast and accurate diagnostic information to the trauma team. The Bastion Protocol Computed Tomography (CT) Traumagram played a vital part in achieving this aim in the Joint Force Role 3 Medical Treatment Facility (R3), Camp Bastion. The CT Traumagram comprises a non-contrast CT scan of the head, followed by a biphasic intravenous contrast injection with single-pass acquisition from the Circle of Willis to the ischial tuberosities or as far down the legs as is necessary. Diagnostic CT, once a time-consuming process, became one of the major medical successes of Operation HERRICK. As a result, the Bastion Protocol, in modified forms, has been widely accepted and adopted in civilian trauma practice throughout the United Kingdom (UK). This paper aims to document the inception of the Bastion Protocol.","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"104 1","pages":"183-186"},"PeriodicalIF":0.0,"publicationDate":"2018-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49391717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Royal Navy’s Role 2 Afloat (R2A) capability has now been firmly established in support of United Kingdom (UK) troops on contingency operations such as humanitarian aid and disaster relief operations. This article reviews the current capability of R2A to deliver medical care to children and pregnant women, including the challenges facing the deployed Biomedical Scientist (BMS).
{"title":"Consideration of the medical care and biomedical support of women and children on Role 2 Afloat maritime contingency operations.","authors":"C. Hillman, R. Horrobin, S. Mills, S. Mercer","doi":"10.1136/jrnms-103-21","DOIUrl":"https://doi.org/10.1136/jrnms-103-21","url":null,"abstract":"The Royal Navy’s Role 2 Afloat (R2A) capability has now been firmly established in support of United Kingdom (UK) troops on contingency operations such as humanitarian aid and disaster relief operations. This article reviews the current capability of R2A to deliver medical care to children and pregnant women, including the challenges facing the deployed Biomedical Scientist (BMS).","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"103 1 1","pages":"21-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64204630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obstructive jaundice is a clinical condition that indicates the possibility of a significant underlying disease process. This clinical review considers the pathophysiology, investigation and management of patients with obstructive jaundice and considers the particular challenges that medical personnel may face when deployed away from the United Kingdom (UK). It aims to give guidance with regard to the short- and long-term investigation and management of such patients.
{"title":"Obstructive jaundice: a clinical review for the UK armed forces.","authors":"S. Roy, A. Lambert","doi":"10.1136/jrnms-103-44","DOIUrl":"https://doi.org/10.1136/jrnms-103-44","url":null,"abstract":"Obstructive jaundice is a clinical condition that indicates the possibility of a significant underlying disease process. This clinical review considers the pathophysiology, investigation and management of patients with obstructive jaundice and considers the particular challenges that medical personnel may face when deployed away from the United Kingdom (UK). It aims to give guidance with regard to the short- and long-term investigation and management of such patients.","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"29 1","pages":"44-8"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64205445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Mercer, M. A. Khan, C. Hillman, J. Robin, J. Matthews
Since 2006, the Defence Medical Services (DMS) pre-hospital care focus has been the Medical Emergency Response Team (MERT), which has enabled the projection of Damage Control Resuscitation (DCR) to the point of wounding as part of consultant- delivered care. Now in a period of contingency operations, the Royal Navy (RN)’s Role 2 medical capability, Role 2 Afloat (R2A) delivers DCR (including surgery) on a maritime platform. This article will focus on the development of the Maritime MERT component of R2A (termed Maritime In Transit Care (MITC) in Maritime Medical Doctrine) and will discuss the requirements based on experience of and preparation for an operation in 2016. Also discussed are the individual competencies and training required to be part of the Maritime MERT; it is hoped that this will simulate debate around this evolving team.
{"title":"The Maritime Medical Emergency Response Team: what do we really need?","authors":"S. Mercer, M. A. Khan, C. Hillman, J. Robin, J. Matthews","doi":"10.1136/jrnms-103-17","DOIUrl":"https://doi.org/10.1136/jrnms-103-17","url":null,"abstract":"Since 2006, the Defence Medical Services (DMS) pre-hospital care focus has been the Medical Emergency Response Team (MERT), which has enabled the projection of Damage Control Resuscitation (DCR) to the point of wounding as part of consultant- delivered care. Now in a period of contingency operations, the Royal Navy (RN)’s Role 2 medical capability, Role 2 Afloat (R2A) delivers DCR (including surgery) on a maritime platform. This article will focus on the development of the Maritime MERT component of R2A (termed Maritime In Transit Care (MITC) in Maritime Medical Doctrine) and will discuss the requirements based on experience of and preparation for an operation in 2016. Also discussed are the individual competencies and training required to be part of the Maritime MERT; it is hoped that this will simulate debate around this evolving team.","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"76 1","pages":"17-20"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64204430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Shaw, S. Downie, F. Gunner, L. Morrow, T. Davey, J. Fallowfield
{"title":"Second Sea Lord’s Feeding the Fleet initiative: the health of Royal Navy personnel aboard Type-45 destroyers – an executive summary.","authors":"A. Shaw, S. Downie, F. Gunner, L. Morrow, T. Davey, J. Fallowfield","doi":"10.1136/jrnms-103-2","DOIUrl":"https://doi.org/10.1136/jrnms-103-2","url":null,"abstract":"","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"103 1 1","pages":"2-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64204529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Free Open Access Medical Education (FOAM) and its relevance to military clinicians","authors":"M. Winstanley, D. Henning, I. Gurney","doi":"10.1136/jrnms-104-192","DOIUrl":"https://doi.org/10.1136/jrnms-104-192","url":null,"abstract":"","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"104 1","pages":"192-195"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64206556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Too hot to handle: how quickly do surgical instruments cool sufficiently to use safely following sterilisation using the Medical Device Decontamination Capability (Forward)?","authors":"D. Roper, A. McClean, C. Hand","doi":"10.1136/jrnms-104-87","DOIUrl":"https://doi.org/10.1136/jrnms-104-87","url":null,"abstract":"","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"104 1","pages":"87-92"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64206195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Operation BUCKTAIL is the UK contribution to migrant surveillance and reconnaissance in the Aegean Sea. This paper describes two different and novel medical configurations which deployed in early 2016 to this Area of Operations (AO). Casualties in this situation would be treated under the Convention of Safety Of Life At Sea, a humanitarian role which may be less familiar to some of the Defence Medical Services. Casualty management is discussed and the composition of medical teams examined.
{"title":"Role 1 Enhanced: a new paradigm in humanitarian operations.","authors":"D. Henning, A. Bennett","doi":"10.1136/jrnms-103-32","DOIUrl":"https://doi.org/10.1136/jrnms-103-32","url":null,"abstract":"Operation BUCKTAIL is the UK contribution to migrant surveillance and reconnaissance in the Aegean Sea. This paper describes two different and novel medical configurations which deployed in early 2016 to this Area of Operations (AO). Casualties in this situation would be treated under the Convention of Safety Of Life At Sea, a humanitarian role which may be less familiar to some of the Defence Medical Services. Casualty management is discussed and the composition of medical teams examined.","PeriodicalId":76059,"journal":{"name":"Journal of the Royal Naval Medical Service","volume":"103 1 1","pages":"32-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64204695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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