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Selected Works

2011

Combat

Articles 1 - 5 of 5

Full-Text Articles in Medicine and Health Sciences

Principles Of Combat Surgical Care In A Staged Evacuation System, Vivian C. Mcalister, Rob Stiegelmar, Brian Church, Ray Kao Oct 2011

Principles Of Combat Surgical Care In A Staged Evacuation System, Vivian C. Mcalister, Rob Stiegelmar, Brian Church, Ray Kao

Vivian C. McAlister

Background: The NATO hospital classification of hospitals describes an orderly transfer of patients with severe injuries through a series of increasingly sophisticated hospitals as they are brought from the point of injury to their home hospital. Forward hospital surgery is restricted to damage control and resuscitation while definitive surgery is performed at home by the destination surgical team. In reality many patients enter the hospital chain higher up and some receive definitive surgery as they proceed through the chain of evacuation. The purpose of this paper is to determine if clear doctrine exists to guide the performance of surgery on …


Utilization Profile Of The Trauma Intensive Care Unit At The Role 3 Multinational Medical Init At Kandahar Airfield Between May 1 And Oct. 15, 2009., Sha K, Pirie S, Compton L, Vivian C. Mcalister, Brian Church, Ray Kao Oct 2011

Utilization Profile Of The Trauma Intensive Care Unit At The Role 3 Multinational Medical Init At Kandahar Airfield Between May 1 And Oct. 15, 2009., Sha K, Pirie S, Compton L, Vivian C. Mcalister, Brian Church, Ray Kao

Vivian C. McAlister

Background: In the war against the Taliban, Canada was the lead North Atlantic Treaty Organization (NATO) nation to provide medical and surgical care to NATO soldiers, Afghanistan National Army soldiers, Afghanistan Nation Police, civilians working in and outside Kandahar Airfield and Afghanistan civilians at the Role 3 Multinational Medical Unit (R3MMU) from February 2006 to October 2009. Methods: We obtained data from the Joint Theatre Trauma Registry between May 1 and Oct. 15, 2009; 188 patients were admitted to the R3MMU intensive care unit (ICU). We analyzed the ICU data according to types and causes of trauma, mechanical ventilation prevalence, …


The Role 3 Multinational Medical Unit At Kandahar Airfield 2005-2010., R Brisebois, P Hennecke, R Kao, Vivian C. Mcalister, J Po, R Stiegelmar, H Tien Oct 2011

The Role 3 Multinational Medical Unit At Kandahar Airfield 2005-2010., R Brisebois, P Hennecke, R Kao, Vivian C. Mcalister, J Po, R Stiegelmar, H Tien

Vivian C. McAlister

In late 2005, Canadian Forces Health Services (CFHS) was tasked with the command of the NATO Role 3 Multinational Medical Unit (R3MMU) on Kandahar Airfield in southern Afghanistan. Preparations drew on past experience and planning. Eight complete hospital contingents were trained and deployed in rotation. Near-reality simulation training was undertaken with the combat brigade, including complete deployment of the field hospital in the exercise area. Standard operating procedures (SOP) were developed and applied by each rotation so successfully that they were adopted by the new command in late 2009. The Canadian period at R3MMU had the highest survival rate ever …


The Role Of Surgery In Building Resilience To Blast Attacks, Vivian C. Mcalister Aug 2011

The Role Of Surgery In Building Resilience To Blast Attacks, Vivian C. Mcalister

Vivian C. McAlister

Blast attacks are the commonest form of terrorist attack on civilians. Blast often causes injury from industrial accidents. Blast injury is the most common cause of injury and death in modern combat. A recent review of Canadian fatal casualties in Afghanistan found 81% to have been caused by blast, almost four times the number killed by gun shot wounds. Improvised explosive devices (IED) caused 78% of the blasts with another 20% being due to rocket propelled grenades (RPG).1 The purpose of this review is to outline the mechanisms of injury, to define the surgical response and to understand the implications …


Composite Tissue Allotransplantation To Treat Veterans With Complex Amputation Injuries, Vivian C. Mcalister, Ray Kao, Brian Church, Markus Besemann, Rob Stiegelmar Dec 2010

Composite Tissue Allotransplantation To Treat Veterans With Complex Amputation Injuries, Vivian C. Mcalister, Ray Kao, Brian Church, Markus Besemann, Rob Stiegelmar

Vivian C. McAlister

Amputee rehabilitation may be limited by complexity of injury (e.g. bilateral arm amputation), associated injury (e.g. colostomy) or by the level of amputation (e.g. high above knee). Our objective is to assess the potential for composite tissue allotransplantation (CTA) to overcome these barriers. Medical literature was searched and programs were surveyed regarding the current status of CTA. Results CTA remains an experimental reconstructive option that involves a large collaborative (physiatry, orthopaedic, plastic and transplant surgeons). Limb transplantation has evolved out of limb reimplantation surgery and organ transplantation. Approximately 10 programs world wide, with almost a decade of experience, report 90% …