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PubMed2002

Simulation-based training of medical teams to manage chemical warfare casualties.

With chemical warfare becoming an imminent threat, medical systems need to be prepared to treat the resultant mass casualties. Medical preparedness should not be limited to the triage and logistics of mass casualties and first-line treatment, but should include knowledge and training covering the whole medical spectrum. In view of the unique characteristics of chemical warfare casualties the use of simulation-assisted medical training is highly appropriate. Our objective was to explore the potential of simulator-based teaching to train medical teams in the treatment of chemical warfare casualties. The training concept integrates several types of skill-training simulators, including high tech and low tech simulators as well as standardized simulated patients in a specialized simulated setting. The combined use of multistimulation modalities makes this maverick program an excellent solution for the challenge of multidisciplinary training in the face of the looming chemical warfare threat.

Chemical Warfare↗
PubMed2002

Training Israeli medical personnel to treat casualties of nuclear, biologic and chemical warfare.

Recent events have significantly increased concern about the use of biologic and chemical weapons by terrorists and other countries. Since weapons of mass destruction could result in a huge number of casualties, optimizing our diagnostic and therapeutic skills may help to minimize the morbidity and mortality. The national demands for training in medical aspects of nuclear, biologic and chemical warfare have increased dramatically. While Israeli medical preparedness for non-conventional warfare has improved substantially in recent years especially due to extensive training programs, a standardized course and course materials were not available until recently. We have developed a core curriculum and teaching materials for a 1 or 2 day modular course, including printed materials.

Biological Warfare↗
PubMed2002

Injuries and injury prevention among senior military officers at the Army War College.

Injuries and activities associated with injuries were extracted from a retrospective review of the medical records of officers attending the U.S. Army War College during academic years 1999 and 2000 (AY99 and AY00). In AY99, cumulative injury incidence (officers with one or more injuries) was 56%. The next year (AY00), there was command emphasis on injury reduction and education of students on injury prevention strategies. Cumulative injury incidence in AY00 was 44%, significantly lower than in AY99 (p = 0.01, risk ratio [AY99/AY99] = 1.3, 95% confidence interval = 1.1-1.5). Among activities that could be linked to injuries, sports were associated with 41% in AY99 and 45% in AY00. Recommendations for ongoing injury reduction include the following: (1) continued command emphasis and instruction on injury reduction techniques; (2) encouraging the use of semirigid ankle braces to reduce ankle sprains; (3) reducing the number of practice and game sessions in sports activities; (4) encouraging overrunning of second and third base in softball; (5) prohibiting contact with the center line below the net in volleyball; and (6) encouraging medical care providers to record the activity associated with each injury in the medical records.

Adult↗
PubMed2002

Teaching the International Law of Armed Conflict to a wide military community.

The rules governing armed conflict are numerous and in many respects complex. In areas that are very complex, experts such as lawyers may be called in to assist, especially in the planning of military action. But the nature and tempo of warfare rarely allows a person in the field to enjoy such a luxury. Therefore, everyone involved in a military mission must have a basic working knowledge of their responsibilities according to the Law of Armed Conflict. The type and degree of knowledge will differ depending on the role and responsibility of the person. Accordingly, the knowledge base necessary for a foot soldier is often different from that which is required by a pilot. Even within a select group of combatants, the knowledge base required may differ from subgroup to subgroup. The knowledge required by a fighter pilot may be different, in some respects, from that of a pilot of an aircraft that provides transportation and logistical support. The fighter pilot must know what is an appropriate target; the transportation/logistical pilot may not need such knowledge.

Education, Medical, Continuing↗
PubMed2002

[Identification of the metabolites of penehyclidine hydrochloride raceme in rats by LC-MS/MS and ion cluster].

AIM: To study the metabolites of penehyclidine hydrochloride (PH) raceme, a new anticholinerigic drug invented by the Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences. METHODS: Three healthy rat urine samples were collected within 24 h after a single i.m. dose of PH raceme and PH-d5 [(5 + 5) mg.kg-1] simultaneously. The eight metabolites of PH raceme were identified by the methods of LC-MS/MS, GC-MS, FAB-MS and the stable isotope ion cluster. Mass spectrometry was operated in the positive mode for the method of LC-MS/MS. RESULTS: M1 and M1* were identified as the oxygenated products of PH in the cyclopentyl group; M2 and M2* were as the hydroxylated products of PH in the cyclopentyl group; M3 and M3* were as the oxygented and hydroxylated products of PH at the meta-position of cyclopentyl group; M4 and M4* were identified as the dihydroxylated metabolites of PH, the hydroxylated position were at the cyclopentyl group and quiniuclidinol ring of PH. Among them, M1 and M1*, M2 and M2*, M3 and M3*, M4 and M4* were the isomers of each other. CONCLUSION: These characteristics can be used for future structure elucidation in studies of the metabolites of PH optical isomers. The structure data of PH metabolites provide important information for the clinical use and for developing better anticholinerigic drug.

Animals↗