Clinical activity at the UK military level 2 hospital in Bentiu, South Sudan during Op TRENTON from June to September 2017

Bailey, M S; Gurney, I; Lentaigne, J; Biswas, J S; Hill, Neil

doi:10.1136/jramc-2018-001154

Cited by 13 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These operations frequently evolved into mature missions allowing for targeted physical training prior to deployment and large-scale graded acclimatization practices upon arrival to operational theaters. In more recent history, several militaries have contributed to internationally-sponsored security projects including the protection of internally displaced civilian populations (Bailey et al, 2019) and the containment of infectious diseases outbreaks, such as Ebola (Dickson et al, 2018). Achieving peak occupational performance and developing and maintaining resilience in the face of thermal threat has been a critical endpoint in all such circumstances.…”

Section: Introductionmentioning

confidence: 99%

Heat Adaptation in Military Personnel: Mitigating Risk, Maximizing Performance

2019

View full text Add to dashboard Cite

The study of heat adaptation in military personnel offers generalizable insights into a variety of sporting, recreational and occupational populations. Conversely, certain characteristics of military employment have few parallels in civilian life, such as the imperative to achieve mission objectives during deployed operations, the opportunity to undergo training and selection for elite units or the requirement to fulfill essential duties under prolonged thermal stress. In such settings, achieving peak individual performance can be critical to organizational success. Short-notice deployment to a hot operational or training environment, exposure to high intensity exercise and undertaking ceremonial duties during extreme weather may challenge the ability to protect personnel from excessive thermal strain, especially where heat adaptation is incomplete. Graded and progressive acclimatization can reduce morbidity substantially and impact on mortality rates, yet individual variation in adaptation has the potential to undermine empirical approaches. Incapacity under heat stress can present the military with medical, occupational and logistic challenges requiring dynamic risk stratification during initial and subsequent heat stress. Using data from large studies of military personnel observing traditional and more contemporary acclimatization practices, this review article (1) characterizes the physical challenges that military training and deployed operations present (2) considers how heat adaptation has been used to augment military performance under thermal stress and (3) identifies potential solutions to optimize the risk-performance paradigm, including those with broader relevance to other populations exposed to heat stress.

show abstract

Section: Introductionmentioning

confidence: 99%

Heat Adaptation in Military Personnel: Mitigating Risk, Maximizing Performance

2019

View full text Add to dashboard Cite

show abstract

“…Op TRENTON demonstrated a continuation of this trend, with cases of gastroenteritis being the greatest workload for the medical team (37%) followed by UFI (12%). Non-malarial UFI represented the largest proportion of emergency department consultations (17%) 2…”

Section: Discussionmentioning

confidence: 99%

“…UK Defence Medical Services personnel provided, in addition to ongoing integrated Level 1 Medical Treatment Facilities (MTFs), an enhanced Level 2 MTF in Bentiu from 2017 to 2018, with enhanced laboratory and radiology capability. We previously outlined a snapshot of clinical activity at this hospital2—this paper aims to describe a case series of UFI seen during this time.…”

Section: Introductionmentioning

confidence: 99%

Undifferentiated febrile illnesses in South Sudan: a case series from Operation TRENTON from June to August 2017

et al. 2020

Self Cite

View full text Add to dashboard Cite

Undifferentiated febrile illnesses present diagnostic and treatment challenges in the Firm Base, let alone in the deployed austere environment. We report a series of 14 cases from Operation TRENTON in South Sudan in 2017 that coincided with the rainy season, increased insect numbers and a Relief in Place. The majority of patients had headaches, myalgia, arthralgia and back pain, as well as leucopenia and thrombocytopenia. No diagnoses could be made in theatre, despite a sophisticated deployed laboratory being available, and further testing in the UK, including next-generation sequencing, was unable to establish an aetiology. Such illnesses are very likely to present in tropical environments, where increasing numbers of military personnel are being deployed, and clinicians must be aware of the non-specific presentation and treatment, as well as the availability of Military Infection Reachback services to assist in the management of these cases.

show abstract

“…Throughout the military deployments of recent years, disease and non-battle injury (DNBI) has been mostly managed by primary care providers in role 1 facilities14 24 with a smaller proportion being managed by deployed hospital physicians in role 2 or 3 facilities 25 26. The vast majority of DNBI has been straightforward disease such as gastroenteritis, musculoskeletal injury and climatic injury.…”

Section: Diagnosismentioning

confidence: 99%

“…Diagnostic equipment is advancing rapidly, with lots of new portable, accurate and rapid methods of identifying pathogens available. Rapid diagnosis of communicable disease allows earlier treatment with specific therapy and may also prevent unnecessary use of antibiotics—the use of broad-spectrum antibiotics in high risk areas of Africa has been demonstrated to result in colonisation with MDR pathogens 26…”

Section: Diagnosismentioning

confidence: 99%

Communicable diseases in humanitarian operations and disasters

Murphy¹

2020

BMJ Mil Health

View full text Add to dashboard Cite

Military organisations have battled communicable disease for millennia. They have pioneered disease prevention from the Crusades to the World Wars and continue to do so today. Predeployment vaccinations and chemoprophylaxis are effective in preventing communicable disease, as is reliable vector destruction and bite prevention, especially in the era of multidrug resistant organisms. These measures are unlikely to be fully possible in disasters, but reactive vaccination and efforts to reduce exposure to communicable disease should be a priority. Communicable diseases can be challenging to diagnose—the UK Defence Medical Services have become familiar with tools such as multiplex PCR and mass spectrometry. These have the potential to accurately identify organisms and sensitivity patterns in austere environments. Management of communicable diseases depends on accurate diagnosis and has a largely well-established evidence base but can be limited by a lack of resources and skills in an austere setting, therefore telemedicine can assist diagnosis and treatment of infections by projecting specialist skill. Systems such as EpiNATO2 are useful in monitoring diseases and identifying trends in order to establish control measures. Many of these tools and techniques are effective in austere environments and offer learning opportunities for those providing care in similar settings. Further research is ongoing into diagnostic tools as well as remote management.

show abstract

Clinical activity at the UK military level 2 hospital in Bentiu, South Sudan during Op TRENTON from June to September 2017

Cited by 13 publications

References 19 publications

Heat Adaptation in Military Personnel: Mitigating Risk, Maximizing Performance

Heat Adaptation in Military Personnel: Mitigating Risk, Maximizing Performance

Undifferentiated febrile illnesses in South Sudan: a case series from Operation TRENTON from June to August 2017

Communicable diseases in humanitarian operations and disasters

Contact Info

Product

Resources

About