Regular audit of MEDEVAC response should be routine for Medical Operations staff, in order to ensure the optimal casualty care pathway from point of wounding to field hospital.

IntroductionThe 2016 Interim Report on the Health Risks to Women in Ground Close Combat Roles highlighted an increased risk of skeletal injury and significant physiological changes, including increased ligament laxity and decreased bone mineral content, during the postpartum period. The report called for further research and a re-evaluation of postpartum policy to optimise the return of female Service personnel to arduous employment. The purpose of this study was to determine whether returning to duty is at greater risk of injury and illness in the first year postpartum than they were prepregnancy.MethodsFifty-five female UK Army Service personnel aged 18–41 years, who had given birth in the previous 4 years, completed a lifestyle questionnaire and gave written consent for a review of their medical records. The number of working days lost (WDL) due to illness, injury and combined illness and injury was obtained from medical records, for 1 year prepregnancy and 1 year postpartum. Female Service personnel returned to duty at different time-points postpartum, so data were expressed as WDL/week.ResultsWDL/week due to illness and combined illness and injury were higher postpartum compared with prepregnancy (p<0.05). WDL/week due to combined illness and injury was significantly lower prepregnancy (p<0.05) and at 0–26 weeks postpartum (p<0.05), compared with 26–52 weeks postpartum.ConclusionsPostpartum female UK Army Service personnel are at greater risk of illness and a combination of illness and injury in the year after giving birth, compared with prepregnancy. The study suggests female Service personnel are unprepared for the demands of full active duty in the first year postpartum.

The aim of this paper is to reflect on the proceedings of three training injuries symposia run by the British Army's training organization from 2001 to 2003. The essence of the presentations are reproduced, highlighting the role of medical staff in advising commanders on how injuries might be prevented. The importance of placing the emphasis on prevention rather than rehabilitation as a means of reducing the impact of training injuries is first examined. Pre-employment medical selection standards, the design of training courses, nutrition, smoking, training injuries among women, heat injury and the psycho-social environment are then all reviewed. Finally, the outcome of workshop discussion groups are presented as practical guidance for medical officers and other clinicians, advising commanders on how training injuries amongst their personnel might be minimised.

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