Tactical Medicine News Blog

Researchers at the Institute of Science and Technology Austria have developed a brain imaging technique called Live Information Optimized Nanoscopy Enabling Saturated Segmentation (LIONESS). The method lets the researchers create high-resolution 3D images of living brain tissue that reveal its cellular complexity, and even how it changes over time, allowing for monitoring of neural plasticity. […]

Download TRAINING CIRCULAR HEADQUARTERS No. 21-24 DEPARTMENT OF THE ARMY WASHINGTON, DC, 10 September 1997 RAPPELLING

 ¿Qué pasa cuando duermes?Durante el sueño, nuestro cerebro pasa por ciclos de sueño con movimientos oculares no rápidos (NREM) y movimientos oculares rápidos (REM).En las etapas NREM, nuestra actividad de ondas cerebrales se ralentiza, creando el entorno para la consolidación de la memoria. Los productos de desecho se eliminan, lo que ayuda a desintoxicar el cerebro.Una vez que alcanzamos el...

Background: Getting a definitive airway in a critically ill trauma patient can be a stressful situation.  The potential for soiled airways, cervical spine injuries, maxillofacial injuries and head injuries combined with agitation/delirium, altered mental status and hypoxemia can make securing a definitive airway both an anatomic and physiologic challenge. Traditional RSI entails preoxygenation followed by near-simultaneous administration of an induction agent followed by a neuromuscular blocker. Rapid sequence intubation can be modified for patients who are agitated or combative and not tolerating standard preoxygenation.  Delayed sequence intubation (DSI) uses a dissociative dose of ketamine, goal-directed preoxygenation for a minimum of 3 minutes, followed by a neuromuscular blocker and ultimately intubation. This helps relieve agitation/pain while maintaining spontaneous breathing and airway reflexes allowing for adequate pre-oxygenation as well as facilitates other resuscitation interventions including IV access, vasopressors, fluids, etc.  that would not be possible in an agitated/combative patient.

Background Information: Delirium is a common and serious condition in patients in the intensive care unit (ICU). It is estimated to affect 30-50% of patients in the ICU and haloperidol is the most frequently used agent in treatment (3).  One of the most common methods of assessing delirium in the ICU is using the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) which has been found to have a sensitivity of 80% and a specificity of 95.9% (6). A previous similar study, the Modifying the Impact of ICU-Associated Neurological Dysfunction (MIND-USA) trial seeked to study whether antipsychotics (haloperidol or ziprasidone) are better or worse than placebo in delirious ICU patients. The authors of the AID-ICU study aim to determine whether haloperidol leads to a significantly greater number of days alive and out of the hospital at 90 days than placebo in ICU patients with delirium.