Background/objectives Prolonged hospital care is described as deployed medical care, applied beyond doctrinal planning timelines and military medical planning envisages that in future conflicts, patients will have to be managed for up to 5 days without evacuation to their home country. We aimed to investigate the effect of prolonged hospital care on visual outcomes in the management of open and closed globe injures. Methods We conducted a retrospective cohort study in the setting of British military operations in Afghanistan. We included consecutive UK military patients with ocular trauma evacuated from Afghanistan between December 2005 and April 2013. We assessed outcome using best-corrected visual acuity (VA) 6-12 months after injury. Results All patients were male, with a mean age of 25. Outcomes adjusted for ocular trauma score (OTS) at presentation were similar to previous reports of military ocular trauma. The mean time to arrival at a centre with an ophthalmologist was 1.74 days. Both patients with penetrating open globe injuries and patients with hyphaema and an OTS of 3 or less displayed an association between worsening 6-12 month VA and time between injury and repair or assessment by an ophthalmologist. Conclusion Time to specialist ophthalmic care contributes to outcome after military open and closed globe injuries, supporting deployment of ophthalmologists on military operations.
Background/Objectives: Prolonged hospital care is described as deployed medical care, applied beyond doctrinal planning timelines and military medical planning envisages that in future conflicts, patients will have to be managed for up to five days without evacuation to their home country. We aimed to investigate the effect of prolonged hospital care on visual outcomes in the management of open and closed globe injures. Methods: We conducted a retrospective cohort study in the setting of British military operations in Afghanistan. We included consecutive UK military patients with ocular trauma evacuated from Afghanistan between December 2005 and April 2013. We assessed outcome using best corrected visual acuity (VA) 6-12 months after injury. Results: All patients were male, with a mean age of 25. Outcomes adjusted for ocular trauma score (OTS) at presentation were similar to previous reports of military ocular trauma. The mean time to arrival at a centre with an ophthalmologist was 1.74 days. Both patients with penetrating open globe injuries and patients with hyphaema and an OTS of 3 or less displayed an association between worsening 6- 12 month VA and time between injury and repair or assessment by an ophthalmologist. Conclusion: Time to specialist ophthalmic care contributes to outcome after military open and closed globe injuries, supporting deployment of ophthalmologists on military operations.
It is well established that simulation can help individuals and teams improve their clinical skills and confidence in managing medical emergencies The aim of the study was to adapt the SHINE course for virtual delivery.We replaced live simulations for pre-recorded scenarios. We filmed these on the labour ward and our simulation room with members of our Neonatal Unit, instructing ‘candidates’ to act in specific ways which would bring out learning objectives. The videos were edited to optimize quality. We delivered the course via Zoom, playing the videos followed by a live debrief. The workshops remained the same. We increased participants to 12, split them into two break-out rooms. We ran the course twice during the peak of the pandemic. We evaluated self-rated confidence pre-attending and post-attending the course.We ran the course with four members of faculty instead of eight required face-to-face. We encountered minor technical difficulties which were easily resolved. Twenty-four paediatric trainees of various grades attended. Candidates rated their confidence managing scenarios from 1 (very low) to 5 (very high). The average score before the course was 2.8 and improved to 3.9 after the course. 81% (22) candidates agreed/strongly agreed that the workshops were well structured and educational, 96% (23) agreed/strongly agreed that they had enough opportunities to interact and 81% (22) agreed/strongly agreed that the virtual environment worked well. All candidates agreed/strongly agreed that the video debrief sessions were well structured and educational and that the virtual learning environment was safe and supportive. All trainees would recommend the course to colleagues.SHINE is a well-established sought-after course. We were able to continue this training virtually during the COVID-19 pandemic Whist we recognize that there is no replacement for hands-on experiential learning, we have demonstrated that virtual simulation is possible, effective, highly valued by trainees and has the advantage of being less resources intense and accessible to more candidates. We propose that virtual simulation training should be offered where face-to-face teaching is not possible.
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