Bailey Mark S, Gurney I, Lentaigne J, Biswas J S, Hill N E
Department of Infection and Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK
Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK.
BMJ Mil Health. 2021 Oct;167(5):304-309. doi: 10.1136/jramc-2018-001154. Epub 2019 Apr 20.
Diseases and non-battle injuries (DNBIs) are common on UK military deployments, but the collection and analysis of clinically useful data on these remain a challenge. Standard medical returns do not provide adequate clinical information, and clinician-led approaches have been laudable, but not integrated nor standardised nor used long-term. Op TRENTON is a novel UK military humanitarian operation in support of the United Nations Mission in South Sudan, which included the deployment of UK military level 1 and level 2 medical treatment facilities at Bentiu to provide healthcare for UK and United Nations (UN) personnel.
A service evaluation of patient consultations and admissions at the UK military level 2 hospital was performed using two data sets collected by the emergency department (ED) and medicine (MED) teams.
Over a three-month (13-week) period, 286 cases were seen, of which 51% were UK troops, 29% were UN civilians and 20% were UN troops. The ED team saw 175 cases (61%) and provided definitive care for 113 (40%), whereas the MED team saw and provided definitive care for 128 cases (45%). Overall, there were 75% with diseases and 25% with non-battle injuries. The most common diagnoses seen by the ED team were musculoskeletal injuries (17%), unidentified non-malarial undifferentiated febrile illness (UNMUFI) (17%), malaria (13%), chemical pneumonitis (13%) and wounds (8%). The most common diagnoses seen by the MED team were acute gastroenteritis (AGE) (56%), UNMUFI (12%) and malaria (9%). AGE was due to viruses (31%), diarrhoeagenic (32%), other bacteria (6%) and protozoa (12%).
Data collection on DNBIs during the initial phase of this deployment was clinically useful and integrated between different departments. However, a standardised, long-term solution that is embedded into deployed healthcare is required. The clinical activity recorded here should be used for planning, training, service development and targeted research.
疾病和非战斗损伤(DNBIs)在英国军事部署中很常见,但收集和分析有关这些情况的临床有用数据仍然是一项挑战。标准医疗报告无法提供足够的临床信息,临床医生主导的方法值得称赞,但未实现整合、标准化,也未长期使用。“特伦顿行动”是英国一项新型军事人道主义行动,旨在支持联合国南苏丹特派团,其中包括在本提乌部署英国军队的一级和二级医疗设施,为英国和联合国人员提供医疗服务。
利用急诊科(ED)和内科(MED)团队收集的两个数据集,对英国军队二级医院的患者会诊和住院情况进行了服务评估。
在三个月(13周)的时间里,共诊治286例病例,其中51%为英国军队人员,29%为联合国文职人员,20%为联合国军队人员。急诊科团队诊治了175例(61%),并为113例(40%)提供了确定性治疗,而内科团队诊治并为128例(45%)提供了确定性治疗。总体而言,75%为疾病患者,25%为非战斗损伤患者。急诊科团队最常见的诊断为肌肉骨骼损伤(17%)、不明非疟疾未分化发热性疾病(UNMUFI)(17%)、疟疾(13%)、化学性肺炎(13%)和伤口(8%)。内科团队最常见的诊断为急性胃肠炎(AGE)(56%)、UNMUFI(12%)和疟疾(9%)。AGE病因包括病毒(31%)、致腹泻菌(32%)、其他细菌(6%)和原生动物(12%)。
此次部署初期关于DNBIs的数据收集在临床上是有用的,且不同科室之间实现了整合。然而,需要一个嵌入到部署医疗体系中的标准化长期解决方案。此处记录的临床活动应用于规划、培训、服务发展和针对性研究。