The Arctic Ram Exercise was conducted in February 2016, near Resolute Bay on Cornwallis Island in Nunavut, Canada, to demonstrate the ability of the Canadian Armed Forces (CAF) to rapidly deploy to the arctic as an immediate response team. This report describes medical problems experienced by the 187 CAF and 28 U.S. forces involved in the exercise. Sixty-six airborne soldiers performed tactical static line jumps and linked up with soldiers on the ground for the exercise. Medical events were recorded by medics on the drop zone and by medical personnel at the Unit Medical Station in Resolute Bay. Average temperature during the exercise was −21°C and wind chill was −44°C. Two U.S. soldiers were injured in association with the jump and an additional 62 patients presented at the clinic during the exercise for an overall medical event incidence of 30%. The incidence of frostbite was 17%. At the end of the exercise, a physician actively examined CAF soldiers in one unit (n = 126) and found that 21% had experienced frostbite. The incidence of frostbite was high in this exercise compared to past cold-weather military operations, likely related to the very low temperatures and wind chills.

We describe the treatment course and last days of a 33-year-old man from Western Africa who died from Ebola-related complications. Specifically, the issues around declaring a patient palliative in a low resource environment while dealing with a largely unknown entity, Ebola viral disease, make this an important discussion-stimulating case. The patient presented as a confirmed Ebola-positive case from a peripheral holding centre and then proceeded to deteriorate under our care. Significant neurological decline was noted and the prognosis was felt to be grim by certain providers. Other providers disagreed and a number of treatment algorithms were started and stopped during the patient's last days. He succumbed to Ebola complications after 17 days under our care.

Text message surveillance decreases outpatient waiting times and increases quality of care.

No abstract

A middle aged woman presented to an Ebola Treatment Centre in West Africa with a 4-day history of fever, fatigue, joint pain and vomiting. She tested positive for Ebola virus disease (EVD) and a standard treatment platform of care was started. On day 3 of her admission, she was found to have suffered a left-sided CVA of unknown aetiology. Treatment was largely supportive within a resource-constrained environment and the added layer of providing care with extensive personal protective equipment, and human resource and safety constraints. The patient was able to clear the EVD and did regain some functional use of her arm and leg. She was discharged on day 15 of her stay, as a survivor of both stroke and Ebola.