Fleet Hospital Research Articles

235 YEARS ON THE GUARD OF HEALTH OF SEAS OF THE BLACK SEA FLEET

June 16, 2018 year marks anniversary 235 Rams 1472 VMKG Russian Defense Ministry hospital is Today. Multidisciplinary specialized military medical institution, standing at the forefront of modern medicine. Being coeval of the city of Sevastopol and the Black Sea fleet hospital in 235 anniversary rightfully takes its dignified and Honorable place. With 2016 year experts of the hospital, the first in the southern military region among military medical organizations, began to provide high-tech medical care. The hospital is a major methodological centre of medical service The Black Sea fleet and the Southern military district, with rich experience of practical work in the context of war and peace.

DHA Director Describes Integration of Military Health Care Services

Back to table of contents Previous article Next article Professional NewsFull AccessDHA Director Describes Integration of Military Health Care ServicesMark MoranMark MoranSearch for more papers by this authorPublished Online:5 Jul 2017https://doi.org/10.1176/appi.pn.2017.7a12AbstractVice Adm. Raquel Bono directs an agency mandated to standardize best health care practices across military service lines and create a more globally integrated health care system. “We are strongest when we work together across service lines,” said Navy Vice Adm. Raquel Bono, director of the Defense Health Agency (DHA). “As a surgeon, I am not going to ask for a scalpel in a different way because the patient is in the Army or the Navy. Our common mission is the patient we serve, regardless of what kind of boots he or she wears.” Raquel Bono, M.D., said the military seeks the expertise of psychiatrists in the civilian sector in treating the “invisible wounds of war.”David HathcoxBono made her remarks at APA’s 2017 Annual Meeting in San Diego, where her theme was partnerships—across military service lines and, importantly, with physicians in the civilian sector.“As director of the DHA, I have the opportunity to oversee where our best practices are occurring and work to expand, integrate, and standardize those practices across the military,” Bono said. “If we do this the right way, we have a real opportunity to create a robust system serving all of our military service men and women and their families.”Bono said that the integration of health care across service lines is codified now in the most recent National Defense Authorization Act. Under the law, the mission of the DHA is to do the following: Create a more globally integrated health system, accountable as a combat support agency.Direct enterprise-wide shared services, standardizing clinical and business practices that produce better health and better care. Manage TRICARE for 9.4 million beneficiaries around the world. TRICARE is the health care program for uniformed service members and their families around the world.Deliver coordinated health care and support high-quality coordinated care in all multiservice markets.Regarding the visible wounds of battle, Bono said that the integration of the services is producing results. In the years since the wars in Afghanistan and Iraq started, the case fatality rate per battle injury has dropped. The invisible wounds have been more challenging. Bono solicited the help of psychiatrists in the civilian community to treat returning soldiers with traumatic brain injury and posttraumatic stress disorder. “We are very concerned about the suicide rate,” she said. “We are not dealing with a single, unitary phenomenon, but one that is very complex depending on the individual. We recognize that we don’t have all the answers, and we can’t do it alone. Partnering with others is going to be invaluable.” Vice Adm. Bono brings to her role a distinguished career in medicine and the military. She obtained her baccalaureate degree from the University of Texas at Austin and attended medical school at Texas Tech University. She completed a surgical internship and a general surgery residency at Naval Medical Center Portsmouth and a trauma and critical care fellowship at the Eastern Virginia Graduate School of Medicine in Norfolk. Shortly after training, Bono saw duty in Operations Desert Shield and Desert Storm as head of Casualty Receiving at Fleet Hospital 5 in Saudi Arabia from August 1990 to March 1991. Upon returning, she was stationed at Naval Medical Center Portsmouth as a surgeon in the General Surgery Department and attending surgeon at the Burn Trauma Unit at Sentara Norfolk General Hospital. Before becoming the director of the DHA, Bono served as director of the National Capital Region Medical Directorate of the DHA and as the 11th Chief of the Navy Medical Corps from September 2013 to October 2015.Bono said military and civilian health care providers share a common overarching mission and have much to offer each other. The military is prepared to reach out to the civilian sector, she said, such as when Patrick Downes and Jessica Kensky—victims of the 2013 Boston Marathon bombing—were invited to Walter Reed National Military Army Hospital in Washington, D.C., and partnered with “battle buddies” who had lost limbs in battle. Bono showed a video clip of a moving interview with Downes, who said, “We feel like we were embraced by the military family in a home that was meant for them.”Said Bono: “We have a sacred mission to care for our military service men and women and their families, but we also have a mission to share our experience and expertise with others. We hope you will share your experience and expertise with us.” ■ ISSUES NewArchived

Patient Demographics at Fleet Hospital Eight Intensive Care Unit

PURPOSE: US Navy fleet hospitals can be deployed to any global location to support combat operations. In February of 2003, Fleet Hospital Eight was deployed to Rota, Spain to support operation Enduring Freedom/Operation Iraqi Freedom. The Fleet Hospital cared for Americans evacuated from more forward deployed military medical facilities in Afghanistan, Iraq, Kuwait and ships at sea.

From “weekend warrior” to active duty Navy: Three nurses’ experience during Noble Eagle and Enduring Freedom

From “weekend warrior” to active duty Navy: Three nurses’ experience during Noble Eagle and Enduring Freedom

Ambulatory Surgery in a Navy Fleet Hospital Training Set

A series of 51 active duty patients who elected to undergo ambulatory surgery in a Navy Fleet Hospital Training Set (a modified field hospital) over a 2-year period were followed prospectively for perioperative complications. All patients were active duty personnel, ranging in grade from E1 to O5, who voluntarily gave specific informed consent to have their surgery performed in the training set. Patients were offered surgery in the training set only if attending surgeons were confident that the surgery could be done safely and with the same expected outcome as if performed in the hospital. Their entire surgical experience was contained within this tent-based field facility from admission to discharge. There were 12 orthopedic surgery, 4 general surgery, 3 otolaryngology, 2 urology, 1 ophthalmology, and 29 oral and maxillofacial surgery cases. General, regional, or local anesthesia or intravenous conscious sedation were used as indicated. No patients developed wound infections, and there were no anesthetic, bleeding, or other significant perioperative complications. Selected ambulatory surgical procedures can be safely performed on appropriate patients in this field hospital assemblage.

A Descriptive Analysis of Patient Encounter Data from the Fleet Hospital FIVE Humanitarian Relief Mission in Haiti

Fleet Hospital FIVE personnel treated more than 24,000 patients during a 1997 military operation other than war in Haiti. Sample data were analyzed for 10,215 Haitians who received humanitarian assistance care at field treatment sites and for 353 military, United Nations personnel, and Haitian nationals who were treated at the fleet hospital. Demographic data, type of encounter, diagnoses, and prescriptions were tabulated. Children aged 1 to 10 years accounted for 31% of humanitarian assistance visits. Females outnumbered males; in adults aged 21 to 30 years, the proportion was almost three to one. Most (97%) were initial encounters. Infectious and parasitic diseases, such as worms or scabies, accounted for 25% of diagnoses. At the fleet hospital, more than 80% of patients were males; these were most often older than 21 years. Injuries and aftercare procedures constituted 51.5% of diagnoses. Of 18,100 prescriptions, 57% were for anti-inflammatories, vitamins, or anti-parasitics. Implications for medical planning are described.

Value of the Multi-Service Casualty Processing Unit in Operation Desert Storm: Teamwork and Flexibility

This paper examines the role and implementation of a casualty processing unit (CPU) developed by a multi-service group during Operation Desert Storm in Saudi Arabia. Data were obtained from review of flight manifests, fleet hospital admission records, 24-hour follow-up of patients admitted to Fleet Hospital 15, and patient chart reviews following Desert Storm. The data indicate the CPU proved to be an effective and practical approach to health care in a combat zone, and provided an increased number of returned-to-duty personnel and timely triage of most seriously wounded combatants. In addition, it provided an opportunity for medical personnel of all branches of the armed services to participate as a team. As a result of this study, we propose consideration be given to use of this type of multi-service facility in future combat arenas.

Military Medicine in Operations Other Than War Part II: Humanitarian Relief Missions for Naval Reserve Fleet Hospitals

The U.S. military has a long tradition of providing emergency humanitarian assistance to civilian populations overwhelmed by natural disasters or civil strife. Military medicine is designed primarily to provide operational support for combat-oriented missions. The humanitarian relief mission requires different doctrine, configuration, supplies, and training for proper response. The Naval Reserve Fleet Hospital can be used as a crisis-response asset tasked for this specific mission to lessen the negative impact on active duty military operations and medical treatment facilities.

Medical Department Operations in a Fleet Hospital during Operation Desert Storm

Fleet hospital 15 was deployed to Saudi Arabia in Operation Desert Storm. The facility was a 500-bed echelon-3 hospital located near Al Jubail, which served the fleet marines from February to April 1991. The medical staff of the department of medicine consisted of reserve medical officers with a variety of backgrounds. The desert environment, concern for endemic diseases, limitations of equipment, and the environment of conflict presented challenges to the medical department that required adaptation of civilian skills to this new environment. The hospital served as a community medical center, with 86% of the inpatient and outpatient treatment provided for non-battle-related illness and injury. Design considerations of fleet hospitals for future deployments should include the likelihood of treating a large number of non-battle-related injuries and illnesses.

US Military Medical Teams Begin Third Year of United Nations Support in War-Torn Balkans

TOMORROW marks the beginning of the third year for US military medicine's operation of the United Nations (UN) hospital in the former republic of Yugoslavia. It was November 10, 1992, when an advance team of medical and support personnel from the 212th Mobile (US) Army Surgical Hospital (MASH) arrived in Zagreb, Croatia, from Germany to set up the facility at Camp Pleso near the city's airport to care for UN peacekeepers. The 502nd MASH, also from US Army posts in Germany, Belgium, and Italy, succeeded the 212th MASH 6 months later. The US Air Force's 48th Medical Group Hospital from RAF (Royal Air Force base) Lakenheath, England, then operated the Zagreb facility from September 1993 until the US Navy's Fleet Hospital 6 took over March 17 ( JAMA . 1994;271:894). Another US Navy mobile medical unit, Fleet Hospital 5, arrived 11 weeks ago and will operate the UN facility until mid-February 1995.

Nursing Research Priorities for the Care of the Naval Hospital Patient: A Delphi Survey

The purpose of this study was to identify priorities for nursing research in a naval hospital using the Delphi technique. A general objective was to provide empirically based information to guide the development of a nursing research program at a regional medical treatment facility. Via a three-round Delphi survey, priority research questions were identified for the nursing department of a naval regional medical treatment facility. A serendipitous result was the identification of nursing research priorities within a deployed naval fleet hospital.

Book Review

Journal Article Book Review Get access Plant Kairomones in Insect Ecology and Control: Contemporary Topics in Entomology 1Metcalf Robert L. Metcalf Esther R. [eds.] (Miller T. A. van Emden H. F., series eds.) Chapman and Hall, New York, 1992 168 pp., $35.00 (hardcover) ISBN 0-412-01991-4 Louis C. Rutledge Louis C. Rutledge U.S. Navy Fleet Hospital Support Office Alameda, CA Search for other works by this author on: Oxford Academic PubMed Google Scholar Environmental Entomology, Volume 21, Issue 5, 1 October 1992, Page 1225, https://doi.org/10.1093/ee/21.5.1225 Published: 01 October 1992

1990 Mary J. Nielubowicz Award Winner

Intense field medical exercises, survival and weapons training are of vital importance to the Naval Reserve Fleet Hospital. This training is, of necessity, stressful and chaotic in order to simulate combat conditions. It must be planned that way to be realistic. We must do this to test our ability to function in abnormal situations. Yet, we must be sensitive to the needs of our shipmates. We need to provide support and understanding so that all can successfully carry the burdens placed upon them. Education, stress debriefings, and leadership skills may answer this need.

Thanks From US Forces in the Gulf

To the Editor. — On behalf of Fleet Hospital FIVE in Saudi Arabia, my staff and I would like to express our sincere appreciation for providing us with weekly issues ofThe Journal. Your enthusiastic support is extremely reassuring to those deployed. Fleet Hospital FIVE is a 500-bed shore-based navy medical treatment facility in Saudi Arabia. The staff is composed of corpsmen, nurses, physicians, dentists, medical service officers, and the construction battalion. We have been kept busy with the treatment of personnel from all branches of the armed services as well as allied forces. The medical staff have been completing various training courses and have been doing quite a lot of reading to stay on top of our respective specialties. Issues ofThe Journalwill be a well-received addition to our medical library. Once again, thanks to you and the American Medical Association for your support and thoughtfulness.

Environment adds to challenges facing Desert Shield physicians

HOSTILE WEAPONS aren't the only threat to the forces arrayed against Iraq in this fateful first month of 1991. For nearly 6 months, US military physicians, dental personnel, nurses, and corpsmen have been applying preventive and therapeutic measures against more than a score of potential environmental illness or injury threats. The fact that none of these threats has put any appreciable number of US military people out of action, physicians say, is a tribute to the unit commanders' and the troops' understanding of and compliance with primary preventive measures. Richard A. Mayo, MD, a US Navy captain who commands Fleet Hospital 5 somewhere in Saudi Arabia, attributes this in large part to today's "well educated, well disciplined" all-volunteer US military forces. Both James A. Zimble, MD, the vice admiral who is surgeon general of the US Navy, and Frank F. Ledford, Jr, MD, the lieutenant general who is surgeon general

Environment Adds to Challenges Facing Desert Shield Physicians

HOSTILE WEAPONS aren't the only threat to the forces arrayed against Iraq in this fateful first month of 1991. For nearly 6 months, US military physicians, dental personnel, nurses, and corpsmen have been applying preventive and therapeutic measures against more than a score of potential environmental illness or injury threats. The fact that none of these threats has put any appreciable number of US military people out of action, physicians say, is a tribute to the unit commanders' and the troops' understanding of and compliance with primary preventive measures. Richard A. Mayo, MD, a US Navy captain who commands Fleet Hospital 5 somewhere in Saudi Arabia, attributes this in large part to today's "well educated, well disciplined" all-volunteer US military forces. Both James A. Zimble, MD, the vice admiral who is surgeon general of the US Navy, and Frank F. Ledford, Jr, MD, the lieutenant general who is surgeon general

The Navy goes ashore: the deployment of fleet hospital five in Saudi Arabia

The Navy goes ashore: the deployment of fleet hospital five in Saudi Arabia

An integrated liquid-frozen blood banking system.

Frozen red cells have been field-tested at the Mobile Fleet Hospital deployed at 29 Palms, Calif., and at Bridgeport, Calif., and at the PACOM Blood Program Office, Okinawa, Japan, to evaluate the feasibility of using these products to support the US Navy and Marines in combat areas. We studied both nonrejuvenated and rejuvenated cryopreserved red cell concentrates. Red cells stored at 4 degrees C in CPD or CPDA-1 for 3-6 days (nonrejuvenated), and red cells stored at 4 degrees C in CPD for 22-26 days or in CPDA-1 for 36-38 days before biochemical modification (rejuvenated), were frozen with 40% w/v glycerol at -80 degrees C. A multiple-bag collection system with a 600 or 800 ml primary bag was used for blood collection, and the primary bag was used for processing from preparation of the red cell concentrate through prewash dilution. The thawed red cells were washed with 1.5 liters of a sodium chloride-glucose-phosphate solution. As part of this feasibility study, frozen red cells were shipped by air in dry ice (-79 degrees C), and previously frozen washed red cells were shipped in wet ice (4 degrees C). In vitro red cell recovery values were at least 90%. After postwash storage at 4 degrees C for as long as 3 days, the red cells had 24-hour posttransfusion survivals of at least 70%, normal or slightly impaired oxygen transport function, and minimal hemolysis.