Hotaling B, Theiss J, Cohen B, Wilburn K, Emberton J, Westrick R. 21(3). 72 - 77. (Journal Article)
Abstract
Purpose: This study evaluated the musculoskeletal injury (MSKI) self-reporting behaviors among active-duty Air Force Special Warfare personnel to explore potential limitations of injury surveillance approaches. Methods: Participants completed a 47-item survey between December 2018 and March 2019 regarding their MSKI history. Participants were asked if they sought medical care for symptoms consistent with MSKIs and reasons they did or did not report their injuries. Injury reporting rates were calculated with descriptive statistics and rank ordering was utilized to determine frequency. Results: A total of 398 airmen reported 1,057 injuries occurring in the previous 12-month period, including 508 (48%) injuries identified as not reported to medical personnel. Approximately 55% (N = 579) of all injuries were described as gradual onset. The most common reason for not reporting injuries (28.8%, N = 62) was "fear of potential impact on future career opportunities." Conclusion: Approximately half of MSKIs in this sample of US Air Force Special Warfare personnel were not reported to medical personnel. The underreporting of injuries may pose unknown levels of risk and negatively impact military readiness levels.
Keywords: underreporting; injury exaggeration; concealment; injury rates; symptoms; self-report MSKI; military
Wessels LE, Roper MT, Ignacio RC, Davis KL, Ambrosio AA. 21(3). 93 - 95. (Journal Article)
Abstract
Background: Virtual health (VH) may enhance mentorship to remote first responders. We evaluated the feasibility of synchronous bidirectional VH to mentor life-saving procedures performed by deployed novice providers. Methods: Video teleconferencing (VTC) was established between the USNS Mercy (T-AH 19) underway in the Pacific Ocean to Naval Medical Center San Diego using surgeon teleconsultation. The adult simulated clinical vignette included injuries following a shipboard explosion with subsequent fire. The pediatric simulated vignette included injuries that resulted from an improvised explosive device (IED) blast. Using VTC, augmented reality (AR) goggles, and airway simulation equipment, corpsmen (HMs) received visual cues to perform advanced life-saving procedures. Results: In adult scenarios, 100% of novice hospital HMs performed tasks on first attempt (n = 12). Mean time for tourniquet placement was 46 seconds (standard deviation [SD], 19 seconds); needle thoracostomy, 70 seconds (SD, 67 seconds); tube thoracostomy, 313 seconds (SD, 152 seconds); and cricothyroidotomy, 274 seconds (SD, 82 seconds). In pediatric scenarios, 100% of novice HMs performed tasks on first attempt (n = 5). Mean time for tube thoracostomy completion was 532 seconds (SD, 109 seconds). Conclusion: VH can enhance the training and delivery of trauma care during prolonged field care in resource-limited settings.
Keywords: Tactical Combat Casualty Care; thoracostomy, tube; cricothyroidotomy; augmented reality; tourniquet