Out of the Crucible


Book Description

Out of the Crucible: How the U.S. Military Transformed Combat Casualty Care in Iraq and Afghanistan edited by Arthur L. Kellermann, MD and MPH, and Eric Elster, MD is now available by the US Army, Borden Institute. This comprehensive resource, part of the renowned Textbooks of Military Medicine series, documents one of the most extraordinary achievements in the history of American medicine - the dramatic advances in combat casualty care developed during Operations Enduring Freedom and Operation Iraqi Freedom. Each chapter is written by one or more military health professionals who played an important role in bringing the advancement to America's military health system. Written in plain English and amply illustrated with informative figures and photographs, Out of the Crucible engages and informs the American public and policy makers about how America's military health system, devised, tested and widely adopted numerous inventions, innovations, technologies that collectively produced the highest survival rate from battlefield trauma in the history of warfare.







A National Trauma Care System


Book Description

Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.




Textbook of Disaster Psychiatry


Book Description

This book presents a decade of advances in the psychological, biological and social responses to disasters, helping medics and leaders prepare and react.







Principles and Practice of Case-based Clinical Reasoning Education


Book Description

This book is open access under a CC BY 4.0 license. This volume describes and explains the educational method of Case-Based Clinical Reasoning (CBCR) used successfully in medical schools to prepare students to think like doctors before they enter the clinical arena and become engaged in patient care. Although this approach poses the paradoxical problem of a lack of clinical experience that is so essential for building proficiency in clinical reasoning, CBCR is built on the premise that solving clinical problems involves the ability to reason about disease processes. This requires knowledge of anatomy and the working and pathology of organ systems, as well as the ability to regard patient problems as patterns and compare them with instances of illness scripts of patients the clinician has seen in the past and stored in memory. CBCR stimulates the development of early, rudimentary illness scripts through elaboration and systematic discussion of the courses of action from the initial presentation of the patient to the final steps of clinical management. The book combines general backgrounds of clinical reasoning education and assessment with a detailed elaboration of the CBCR method for application in any medical curriculum, either as a mandatory or as an elective course. It consists of three parts: a general introduction to clinical reasoning education, application of the CBCR method, and cases that can used by educators to try out this method.




Care of the Combat Amputee


Book Description

This resource addresses all aspects of combat amputee care ranging from surgical techniques to long-term care, polytrauma and comorbidities such as traumatic brain injury and burns, pain management, psychological issues, physical and occupational therapy, VA benefits, prosthetics and adaptive technologies, sports and recreational opportunities, and return to duty and vocational rehabilitation.




Soul Repair


Book Description

The first book to explore the idea and effect of moral injury on veterans, their families, and their communities Although veterans make up only 7 percent of the U.S. population, they account for an alarming 20 percent of all suicides. And though treatment of post-traumatic stress disorder has undoubtedly alleviated suffering and allowed many service members returning from combat to transition to civilian life, the suicide rate for veterans under thirty has been increasing. Research by Veterans Administration health professionals and veterans’ own experiences now suggest an ancient but unaddressed wound of war may be a factor: moral injury. This deep-seated sense of transgression includes feelings of shame, grief, meaninglessness, and remorse from having violated core moral beliefs. Rita Nakashima Brock and Gabriella Lettini, who both grew up in families deeply affected by war, have been working closely with vets on what moral injury looks like, how vets cope with it, and what can be done to heal the damage inflicted on soldiers’ consciences. In Soul Repair, the authors tell the stories of four veterans of wars from Vietnam to our current conflicts in Iraq and Afghanistan—Camillo “Mac” Bica, Herman Keizer Jr., Pamela Lightsey, and Camilo Mejía—who reveal their experiences of moral injury from war and how they have learned to live with it. Brock and Lettini also explore its effect on families and communities, and the community processes that have gradually helped soldiers with their moral injuries. Soul Repair will help veterans, their families, members of their communities, and clergy understand the impact of war on the consciences of healthy people, support the recovery of moral conscience in society, and restore veterans to civilian life. When a society sends people off to war, it must accept responsibility for returning them home to peace.




A Framework for Educating Health Professionals to Address the Social Determinants of Health


Book Description

The World Health Organization defines the social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These forces and systems include economic policies, development agendas, cultural and social norms, social policies, and political systems. In an era of pronounced human migration, changing demographics, and growing financial gaps between rich and poor, a fundamental understanding of how the conditions and circumstances in which individuals and populations exist affect mental and physical health is imperative. Educating health professionals about the social determinants of health generates awareness among those professionals about the potential root causes of ill health and the importance of addressing them in and with communities, contributing to more effective strategies for improving health and health care for underserved individuals, communities, and populations. Recently, the National Academies of Sciences, Engineering, and Medicine convened a workshop to develop a high-level framework for such health professional education. A Framework for Educating Health Professionals to Address the Social Determinants of Health also puts forth a conceptual model for the framework's use with the goal of helping stakeholder groups envision ways in which organizations, education, and communities can come together to address health inequalities.