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PubMedDate not supplied

A tuberculosis outbreak from a patient's draining lesion: how did it happen?

1. Mycobacterium tuberculosis can be transmitted from a pulmonary source when droplet nuclei in the 1 to 5 micron range are generated by coughing, singing, or even talking. 2. It is possible for large numbers of droplet nuclei containing M tuberculosis bacteria to be generated during the surgical drainage, débridement, and syringe irrigation of abscesses caused by M tuberculosis. These procedures can produce such a high concentration of droplet nuclei that the ventilation system cannot remove them fast enough to protect the surgical staff from infection. 3. The unrecognized case of tuberculosis is much more likely to be the source of transmission of M tuberculosis than is the individual who has a diagnosis of TB or "rule-out TB." This is because once a diagnosis is known or suspected, interventions are initiated that make the patient less infectious.

Abscess↗
PubMed2002

Military trauma training performed in a civilian trauma center.

BACKGROUND: In 1996, Congress passed legislation requiring the Department of Defense to conduct trauma training in civilian hospitals. In September of 1998 an Army team composed of surgeons, nurses, emergency medical technicians (EMTs), and operating room technicians (OR techs) trained in a civilian level 1 trauma center. This study analyzes the quality of the training. METHODS: The training period was 30 days. Before and after training all members completed a questionnaire of their individual and team ability to perform at their home station, at the civilian hospital, and in the combat setting. Surgeons maintained an operative log, which was compared with their prior year's experience. Primary trauma cases (PTCs) met Residency Review Committee criteria as defined category cases and were done acutely. Other personnel tracked the percentage of supporting soldier tasks (SSTs) they performed or were exposed to during the training period. RESULTS: Review of the questionnaires revealed a significant increase in confidence levels in all areas tested (P < 0.005). The three general surgeons performed a total of 42 PTCs during the 28 call periods, or 1.5 PTCs per call period. During the prior year, the same three general surgeons performed 20 PTCs during 114 call periods for 0.175 cases per call period (P = 0.003). The maximum number of PTCs performed during one call period at the civilian center was 4, compared with 5 PTCs performed by one Army surgeon during the Somalia 1993 mass casualty event. Performance of or exposure to SSTs was 71% for the EMTs, 94% for the nurses, and 79% for the OR techs. CONCLUSIONS: A 1-month training experience at a civilian trauma center provided military general surgeons with a greater trauma experience than they receive in 1 year at their home station. Other personnel on the team benefited by performing or being exposed to their SSTs. Further training of military teams in civilian trauma centers should be investigated.

Education↗
PubMed1972

"Technicians".

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Operating Room Technicians↗