Emergency donor panels (EDPs) provide a source of prescreened whole blood donors when there is a requirement for transfusion with no other sources of blood available. Transfusion of group O blood with a low titre of anti-A and anti-B haemolysins (OLO) reduces the risk of haemolytic transfusion reactions. There has been no large-scale investigation of UK service persons (SPs) with OLO blood. The aim of the current study was to investigate the proportion of UK SPs with OLO blood available for donation over a 5-year period and to identify proportion and reasons for deferral of donors at screening.

The role of a Defence General Practitioner (DGP) is beyond the scope of an NHS GP due to their extended role that includes clinical leadership, pre-hospital emergency medicine, occupationally focussed primary care, operational medicine and force health protection.

Peripheral nerve blocks have been widely used during the Russo-Ukrainian war due to their safety benefits during prolonged unsupervised transportation and opioid-sparing effects that are highly desirable during prolonged treatment that requires multiple surgical interventions. Sedation during minor surgical procedures is optional when regional anaesthesia is used and is often omitted due to its cost and potential adverse effects (respiratory depression, delayed patient mobilisation and risk of agitation). Previous observations suggest that combat casualties may benefit psychologically from sedation during invasive surgical procedures. This prospective observational study sought to assess the difference in stress response and pain following procedures conducted under regional anaesthesia with and without sedation.

Hand-held dynamometers (HHDs) are widely used to measure isometric muscle force in clinical practice. However, reliability may be affected when there is a difference in muscle force generation between examiner and patient, raising concerns about accuracy in physically trained populations, such as military personnel. This study aimed to examine the inter-rater and intrarater reliability of HHD for lower limb strength assessment in a healthy military population. Secondary aims were to evaluate the validity of HHD for knee extensor strength compared with fixed dynamometry and explore the impact of assessor and participant characteristics on reliability.

Scorpions are venomous arthropods with a wide geographical footprint and are endemic throughout all UK Armed Forces operational areas outside of Northern Europe. Scorpion stings are common on military exercises and operations. Here, we present a narrative review summarising epidemiological data pertaining to scorpions in geographical areas of contemporary operational relevance to the UK Armed Forces and suggest evidence-based treatment recommendations suitable for use in a military environment, providing an update to the last detailed review in 2008. The overwhelming majority of stings will result only in local pain and can be managed with analgesia at Role 1 medical treatment facilities. The risk of severe envenoming is greatest in the Middle East. Children and pregnant women are at increased risk of severe envenoming which most commonly manifests as hypertensive crisis. These patients should be evacuated to hospital care and managed supportively in a critical care environment.

Overuse musculoskeletal injuries (MSKIs), including tendinopathies, are the most common types of MSKIs experienced by US active-duty military service members (ADSMs). There are limited granular tendinopathy prevalence data in military populations. Thus, we describe tendinopathy prevalence among ADSM and quantitatively compare tendinopathy prevalence by military and demographic factors.

Lower limb musculoskeletal injuries (MSKIs) are a leading cause of reduced operational capability and medical discharge in UK military personnel. Late-stage rehabilitation (LSR) is critical for restoring function and readiness for return to duty (RTD) yet remains under-represented in research and clinical guidelines. This service evaluation examines current practices, perspectives and challenges among UK Defence rehabilitation practitioners and physical training instructors (PTIs) in delivering LSR and facilitating RTD for lower limb MSKIs.

In response to Ukrainian-identified training gaps in the Ukrainian Armed Forces Special Operations Forces (UAF SOF) medical evacuation chain, NATO SOF medical elements developed the Prolonged Evacuation Transport Team (PETT) training programme. The PETT programme provides critical knowledge and skills to Ukrainian SOF medical personnel to increase survivability and decrease morbidity during contested or prolonged evacuation. The bespoke 3-week curriculum uses components of existing US Joint Trauma System products. Medical professionals, such as paramedics, feldshers and nurses, excelled in the full curriculum, resulting in requests for serial iterations of the programme. However, those with limited medical training (1-3 weeks) faced a steeper learning curve. This finding revealed a requirement for the development of a truncated version of PETT, termed Prolonged Critical Lifesaving Skills. The PETT programme successfully advanced UAF SOF's medical capabilities and established a model for future standardised training in contested environments with prolonged evacuation timelines.

There are unique ethical challenges faced by evaluators of military health engagement (MHE) activities. Existing ethical frameworks provide important evaluation considerations but are either (1) not applicable to the breadth of activities that MHEs may involve or 2) do not adequately address ethical considerations necessary in a military setting.

Individuals who experience repeated suicidality (ideation, self-harm and attempted suicide) are more at risk of future death by suicide and are often more clinically complex than those with a single suicidality event. Despite this, repeated suicidality appears to be under-researched in military populations.

Carrying heavy loads and body armour may alter posture and increase the risk of low back pain in military personnel. This observational study aimed to assess how two designs of body armour affect posture and pain in German soldiers following loaded marches.

Explosive remnants of war (ERW) include landmines, unexploded ordnance (UXO) and abandoned explosive ordnance. Nearly every conflict in modern times has left behind large amounts of ERW, and they remain a persistent problem and a deadly threat that can kill and injure those who encounter or disturb them. A rare UXO hazard may present when military medics begin to assess and treat survivors of combat injury and discover UXO 'loose' (on the patient's gear or stored in their pockets) or rarely 'embedded' in the patient's body. UXO threats to treating clinicians have been documented throughout history, including the most recent significant conflicts. With the threat of large-scale combat operations, it is timely for the UK Defence Medical Services to discuss how to manage this rare, but high-risk situation. This article scrutinises the anatomy of UXO, examines clinical priorities during management of UXO in survivors of combat injury and considers how to establish an effective medical treatment facility to cope with this unique situation, including the risk from a Chemical, Biological, Nuclear and Radiological perspective. We aim to summarise the current literature regarding the treatment of a patient after a UXO has been discovered, to inform clinical management for deployed service personnel in the modern battlespace.