从案例分析探讨应急医学救援分队的筹组

目前,我军的师级医院大多寓编有野战医疗所和国家级应急救援医疗队,分别承担军事行动和非战争军事行动卫勤保障任务.从我军2007年以来的多次应急医学救援卫勤保障任务来看,在现有的建制应急机动力量或军队医院卫勤力量中临时抽组分队,已经成为完成多样化军事任务卫勤保障力量组成的重要形式[1].本文力图从近年来执行卫勤保障任务的实践,探讨分析应急医学救援分队的筹组.     

应急卫勤分队快速机动饮食保障思考

快速机动，是部队为争取主动，有组织地移动兵力或火力的行动，也是应急卫勤分队积极主动完成应急卫勤保障任务的重要行动。组织良好的饮食保障，是应急卫勤分队顺利完成快速机动任务的重要保证。随着科学技术和武器装备的迅猛发展，战争爆发的突然性显著增加，应急卫勤分队往往在紧急情况下受领机动任务，加之敌方可能利用多种高技术武器或手段袭击，使分队快速机动面临严重威胁。因此，组织快速机动时的饮食保障是一项繁重而复杂的工作，必须掌握其组织实施方法。     

武警医院应急卫勤保障分队规范化建设探讨

 目的 研究武警部队医院应急卫勤保障分队的规范化建设.方法 综合采用文献综述法、德尔菲专家咨询法、卫勤演练、桌面推演和实践检验等研究方法,对应急卫勤分队的人员抽组、物资配备、组织指挥、集成运行、训练实战和评价验收等要素进行研究,建立规范化标准.结果 以任务需求为牵引,建立了以组织指挥体系、物资保障体系、训练实践体系、评价验收体系为标准的应急卫勤分队标准化指标.结论 应急卫勤保障分队的规范化建设要立足于快速机动能力、战伤救治能力、组织指挥效能、医疗后送能力的提高.     

青藏线医院机动卫勤分队卫勤协同的探讨

立足青藏线某军队医院实际,着眼多样化军事任务卫勤保障课题,以多部门卫勤协同为方向,从卫勤协同的部门与内容、方法等方面分析探讨了机动卫勤分队卫勤协同的实践做法,提出了不同部门组织协同的注意事项,解决了医院应急机动力量执行任务时单靠自身力量难以胜任工作的现实问题,为机动卫勤分队科学化、规范化、高效化实施应急救援奠定了合作基础。     

联勤保障体制下应急作战海上卫勤保障

未来海上联合作战是由以海军作战力量为主，陆、海、空及导弹部队诸军兵种联合实施的，多维一体的战役行动，对海上卫勤保障提出了全新的要求。在一体化卫勤保障体制下，探讨未来海战的卫勤保障的组织实施，对加强部队应急作战卫勤准备工作将产生重要的影响。     

武警医院卫勤应急保障分队训练工作的思考

适应新军事变革,履行武警部队职能,在紧急、突然、复杂情况下实施遂行卫勤保障任务是当前武警部队医院的一项重大任务,是卫勤应急保障分队建设的根本出发点。卫勤训练是应急卫勤力量形成的重要支撑点,是增强卫勤保障整体能力的重要途径,决定着整个卫勤应急力量建设的成败。为此,笔者分析了目前武警医院卫勤应急保障分队训练中存在的问题,提出了武警医院抓好卫勤应急保障分队训练工作应采取的主要措施。     

青藏线某医院机动卫勤分队卫勤侦察分析与探讨

立足青藏线地区某军队医院实际,着眼多样化军事任务卫勤保障这个课题,以前期情况研判和卫勤侦察为导向,从科学实施情况研判、自然地理环境侦察、伤员医疗后送侦察和卫生防疫防护侦察四个方面分析探讨了机动卫勤分队卫勤侦察的实践经验,提出了所要侦察的内容及方法,解决了医院应急机动力量执行任务时目标职责不清、工作存在一定盲目性等现实问题,为机动卫勤分队科学化、规范化、高效化实施应急救援提供了有力的决策支持。     

卫勤分队组织指挥存在的问题与对策

卫勤组织指挥在完成卫勤保障任务中起着重要作用。为此,我们对近年来我院卫勤分队执行各种卫勤保障任务情况进行了总结,发现在卫勤分队指挥方面还存在一些需要改进的问题。现报告如下。     

加强卫勤战备演练的组织工作

军队医院以新时期军事斗争卫勤保障为牵引,依据高技术条件下局部战争的特点和医院卫勤保障力量的实际情况,要平战结合,加强训练,提高卫勤分队组织指挥能力、机动保障能力和战伤救治能力,确保在未来战争和突发事件时的卫勤救援水平.     

军队医院卫勤保障平战结合形式研究

加强军队医院卫勤保障平战结合形式的研究已成为军队医院卫勤保障的重要课题[1]。本研究旨在探讨军队医院卫勤保障平战结合的形式,寻求做好卫勤保障准备工作的有效途径。1指挥体制,寻求战时垂直指挥我军已实行新的联勤保障体制,军队医院由多头领导管理,变为联勤统一领导管理,这样,军队医院业务领导关系也就十分明确了。领导体制的变革,较好地解决了战时医院垂直领导、指挥问题。战时从总部(战略)、军区(战役)、集团军、联勤分部指挥所内设立卫勤指挥小组,为合成军军政首长统一筹划卫勤保障、使用卫勤力量、组织伤病员医疗后送和将卫勤保障纳入后方保障方案创造了条件。2学科设置,寻求战时最佳结合目前,我军各类医院包括驻军医院、中心医院、总医院和疗养院等,都是在固定院址内按照分科收治伤病员。随着军队编制体制的改革和精简,军队医院数量减少、规模缩小,按照平战结合卫勤保障需求,须探讨战时医院保障体制与运行机制。不少军队医院寻求大专科小综合,试行大内、外科的分科形式,目的是为卫勤保障平战结合及平时为战时野战内科、战(创)伤外科做准备。但军队医院卫勤保障平战结合仍存在不少问题,如何正确分析军队医院卫勤保障平战结合的影响因素,军队医院如何平战结合、快速...     

Use of sentinel health events (occupational) in computer assisted occupational health surveillance

The U.S. Coast Guard has developed a Coast Guard-wide comprehensive system for surveillance of workplace diseases. The American Medical Association's fifth edition of the Current Medical Information and Terminology (CMIT) was used as a reference to expand the basic list of 50 Sentinel Health Events (Occupational) [SHE(O)] published by the National Institute of Occupational Health and Safety (NIOSH), September, 1983. The expanded list of 107 sentinel events serves as a framework for the development of a computerized system of occupational health surveillance in the U.S. Coast Guard. This application of SHE(O) surveillance can have application in the early detection and prevention of environmental diseases.     

Health assessment of U.S. military personnel deployed to Bosnia-Herzegovina for operation joint endeavor.

In anticipation of U.S. forces deploying to Bosnia-Herzegovina, plans were established to conduct medical surveillance of all military service members. This surveillance would provide the Department of Defense with an overview of the hospitalization and outpatient morbidity experience of U.S. forces. Standardized collection of medical data from all U.S. camps using 14 diagnostic categories based on International Classification of Diseases, 9th Revision, codes began in March 1996. Special assessments for hantavirus and tick-borne encephalitis (TBE) infection risk were also conducted. The average disease and nonbattle injury rate for U.S. forces was 7.1 per 100 soldiers per week. Injuries accounted for 28% of medical visits, whereas undefined/other visits accounted for 33%. The majority of remaining visits were for respiratory (14%), dermatologic (10%), and gastrointestinal (6%) complaints. There was one confirmed and one suspected case of hemorrhagic fever with renal syndrome; only 0.1% of individuals (2 of 1,913) tested seroconverted to hantavirus during deployment. No cases of TBE were reported, and the overall low seroconversion rate (0.42%, 4 seroconversions among 959 unimmunized personnel) reflected a very low risk of infection with TBE-related viruses. Operation Joint Endeavor and follow-on Operations Joint Guard and Joint Forge have been extremely healthy deployments.     

The role of state government,local government,and nongovernmental organizations in medical innovative readiness training

This article describes the Medical Innovative Readiness Training program of the Wisconsin Army National Guard. State government coordinates the various entities involved, and local government does most of the planning for the actual medical care that will be rendered. Funding is through the National Guard Bureau. The bulk of the medical professional manpower comes from National Guard medical units.     

Statewide air medical transports for Massachusetts

In 1997, the Massachusetts Department of Public Health (MDPH) established a process to centralize air medical transport information. This database is one of the first statewide, population-based sources for civilian rotary-wing air medical transports (U.S. Coast Guard, police, and military missions are not included). The purpose of this database is to facilitate MDPH review of air medical transport service utilization, with input from a multidisciplinary committee. This article discusses the challenges in producing uniform data from multiple service submissions and presents aggregate "baseline" utilization information for 1996. These data served as a starting point for later studies using data linkage. This indexed article is the first to report statewide, population-based data for all types of air medical helicopter transports. The only other indexed "statewide air medical transport" paper focused on scene transports to trauma centers in Pennsylvania. A previous article by the authors in the July-September 2000 Air Medical Journal provided an overview of air medical transports for fatal motor vehicle crashes for 1 region of the state.     

Incarceration and veterans of the first Gulf War

OBJECTIVE: This study investigated the prevalence of incarceration and the association with deployment among veterans of the first Persian Gulf War (GW). METHODS: A structured telephone interview of military personnel from Iowa deployed to the Persian Gulf and a comparison sample of nondeployed military personnel was conducted. The interview consisted of validated questions, validated instruments, and investigator-derived questions to assess relevant medical and psychiatric conditions. A total of 4,886 subjects were randomly drawn from one of four study domains, i.e., GW regular military, GW National Guard/Reserve, non-GW regular military, or non-GW National Guard/Reserve. Symptoms of medical conditions, psychiatric disorders, and health care utilization were the main outcome measures. RESULTS: Nearly one-quarter (845 of 3,695 subjects, 22.9%) had been incarcerated at some point before the interview ("ever incarcerated"). Ever incarcerated veterans had a higher frequency of psychiatric and medical comorbidity and higher rates of health care utilization. Ever incarcerated status was associated with male gender, enlisted rank, lower educational levels, low levels of military preparedness, discharge from service, cigarette smoking, antisocial traits, court martial and/or other military discipline, having seen a mental health professional, and having used illegal drugs. GW veterans who participated in combat had a modestly higher risk for incarceration after the GW than did noncombatants (odds ratio, 1.6; 95% confidence interval, 1.0-2.5). CONCLUSIONS: Military recruits with a history of incarceration more often displayed problematic behaviors, more often developed psychiatric/medical conditions, and had high rates of health care utilization. A history of incarceration may be a behavioral marker for substance abuse, antisocial behavior, and mental illness. Importantly, GW deployment carried no increased risk of subsequent incarceration overall.     

2011年度美军卫生勤务进展概述

本文分析了2011年度美军卫勤发展的重要动态,概述了美军卫勤发展的总体态势,总结归纳了美军卫勤转型中的主要成就和经验.主要内容包括:卫勤组织管理、战时医疗保障、平时医疗保障、医学教育训练和军事医学科研.     

海警某基层单位医疗保障现状与需求调研

 目的 了解海警某基层单位医疗保障的现状与需求,为海警医疗建设提供科学参考依据。方法 2018-10至2019-04,便利抽样法选取3个海警基层单位行政管理人员作为调查对象,采用自制的《海警医疗保障状况与需求信息采集表》对其进行问卷调查。利用构成比和选择率进行相关统计分析。结果 本次调查共3个单位270名人员,男250名,女20名,年龄23~49岁,工龄1~32年,学历专科25.6%,本科72.6%,硕士1.9%,职务分布范围广。95.2%的人员认为拥有医疗应急预案和卫生信息化建设装备,但是大多数属于不完善状态。19.0%的人员认为拥有舰艇-岛礁-岸基三级救治平台, 78.7%的人员认为应该加强医疗体系建设,95.2%的人员认为执行任务时舰船需要配备卫生救援人员;对于医疗信息化建设的需求和医学远程会诊和急救指导的需求几乎达到100%。结论 海警某基层单位医疗保障现状不理想,分任务分类别准备预案,加强医疗信息化建设,加强梯队和救治平台建设都是下一步需要加强的方向。     

Emergency department duty: a training model for the future.

Air National Guard (ANG) medical units perform 2 weeks of active duty training each year to develop and maintain essential medical skills. Providing meaningful training is, however, a great challenge to both the Guard unit and its active duty counterpart. Too often, annual training is not a relevant learning experience and so the ability of some Guard medical units to respond to actual medical taskings is compromised. The 135th Tactical Clinic, an ANG medical unit, devised and implemented a unique plan--a plan particularly relevant to the medical support requirements of Operation Desert Shield.     

Documentation of activity and rest of a U.S. National Guard attack helicopter battalion.

A. U.S. National Guard attack helicopter battalion was monitored in order to document the activity and rest obtained during the annual training exercises. A total of 39 soldiers wore wrist activity monitors during the 2-week training period. The data from these monitors discriminate activity from rest. Results indicated the following: 1) at some point during the exercises, everyone became sleep deprived; 2) the participants who received the most rest of the group were the enlisted headquarters personnel and the pilots; 3) the soldiers who received the least amount of sleep were the commander of the battalion and the maintenance personnel. Some recommendations are offered for future planning of National Guard training exercises.     

Pharmacy officer support of U.S. Coast Guard cutters

U.S. Public Health Service commissioned officers serve in 16 pharmacy billets with the U.S. Coast Guard (USCG). Thirteen of these billets involve serving as points of contact for, and providing logistical, materiel, and educational support to, USCG cutters. USCG instructions have solidified the role of pharmacy officers in the support of USCG afloat units. This article describes one USCG pharmacy officer's experience in providing pharmacy service support to USCG cutters based in Alameda, California, Yerba Buena Island (San Francisco), California, and Honolulu, Hawaii.