Those in the military go through a collective training of the mind and exhibit consistent behaviors that can inform a provider on a patient’s behavior. Even the language is different.6 Medical schools have noted this as well and responded with specific teaching activities to prepare students to care for members of the military and military veterans in the future. The Rocky Vista University School of Osteopathic Medicine requires all of its students to participate in training in both basic and advanced disaster life support. The Nova Southeastern University, through its Institute for Disaster Preparedness, trains medical students to deal with issues of bioterrorism and all hazards preparedness. It is important to note that military personnel are trained for different environments than civilians. This training will lead to a different perspective on healthcare, and different responses. Being aware of the issues is a first step.
General Medical History Questions to Ask Military Personnel • • • •
Tell me about your military experience. When and where did you serve? What did you do while in the service? How has military service affected you?
Follow-up Questions: "Yes" to any of the above, ask: • • • •
"Can you tell me more about that?" Did you see combat, enemy fire, or casualties? Were you or a buddy wounded, injured, or hospitalized? Did you ever become ill while you were in the service?
Vol. 13, Issue 3
Stress Reactions/Adjustment Problems In your life, have you ever had an experience so frightening, horrible, or upsetting that, in the past month, you: • Have had nightmares about it or thought about it when you did not want to? • Tried hard not to think about it or went out of your way to avoid situations that reminded you of it? • Were constantly on guard, watchful, or easily startled? • Felt numb or detached from others, activities, or your surroundings?
Unique Health Risks from Serving in the Military by Era Operation Iraqi Freedom/Operation Enduring Freedom/ Operation New Dawn: • Animal bites/rabies • Blast injuries-may cause penetrating, blunt trauma, and/or burn injuries • Dermatologic issues • Embedded fragments (shrapnel) • Leishmaniasis • Mental health issues • Multi-drug resistant acinetobacter • Reproductive health issues • Traumatic amputation • Traumatic brain or spinal cord injury • Vision loss
Maryland Medicine, the quarterly publication of MedChi, the Maryland State Medical Society