FEMA Avoids Shutdown

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Faced with the imminent possibility of running out of money this week, the Federal Emergency Management Agency scoured every financial nook and cranny to come up with enough money to keep its disaster relief fund in the black for a few more days. Congress has been fighting over possible fixes.

Learn more about FEMA’s financial issues

Top 10 Deadliest Natural Disasters

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U.S. Army and Air Force to Participate in Austere Environment Training

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The 30th MEDCOM will provide real-world and notional support during the training. They are preparing for an austere environment, non-specific injuries, and to work with their peers from Germany and Great Britain. It’s a new concept. The exercise tests the 173rd ABCT’s ability to conduct operations against a modern, capable hybrid threat, an unknown enemy in an under-developed environment.

Learn more about austere environment training

Solider Should Have Been Given Expired Rabies Shot

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A Livermore soldier who may have been only partially treated for rabies in Afghanistan and died eight months later from the rare disease might have lived if he had been given a full course of vaccines, even after their expiration dates, a leading rabies doctor said Friday.

Find out more about the expired rabies shot

National Disaster Response Force Have Not Reached Sikkim

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400 personnel and a team of doctors from the National Disaster Response Force have not been able to reach Sikkim which was affected by a 6.9 magnitude earthquake on September 18th.

Learn about the mission in Sikkim

Open Subtrochanteric Femur Fracture Part 2 Now Live

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Open Subtrochanteric Femur Fracture

PART II:

I performed an external fixation and irrigation and debridement of the fracture.  Then I elected to place antibiotic beads in the wound bed while giving the soft tissue in the wound bed time to settle down.

Unfortunately, I’m not thrilled about my currently available options for continued treatment:

1. Repeat irrigation and debridement in 48 hours and treat definitively for multiplanar external fixation

2. Use second generation T2 standard intramedullary nailing

3. Employ a first generation 90 degree dynamic condylar screw (DCS) plate

4. Utilize a latest generation distal locking condylar combination plate

The following fluoro-shots are with implants superimposed over the proximal thigh.

What is your advice on definitive management? 

What would be your prognosis for Kamal’s long-term outcome?