This paper outlines the system developed by the United Kingdom’s Defence Medical Services to manage the pain associated with combat trauma from the point of wounding, through repatriation back home to rehabilitation and eventual discharge from the Forces, whenever that may be. The system is founded upon the principles of integration and sustainability and this article includes discussion of both clinical and non-clinical components.
LookerJAldingtonD. Pain scores – as easy as counting to three. J R Army Med Corps2009; 155: 42–43.
3.
MooreRAMooreRAStraubeSStraubeSAldingtonD. Pain measures and cut-offs – ‘no worse than mild pain’ as a simple, universal outcome. Anaesthesia2013; 68(4): 400–412.
4.
HodgettsTJDaviesSRussellRMcLeodJ. Benchmarking the UK military deployed trauma system. J R Army Med Corps2007; 153(4): 237–238.
5.
BeecherHK. Pain in men wounded in battle. Ann Surg1946; 123(1): 96–105.
6.
AldingtonDJMcquayHJMooreRA. End-to-end military pain management. Philos Trans R Soc Lond B Biol Sci2011; 366(1562): 268–275.
7.
GauntCGillJAldingtonD. British military use of morphine: a historical review. J R Army Med Corps2009; 155(1): 46–49.
WoodsKLAldingtonD. Current epidural practice – results of a survey of military anaesthetists. J R Army Med Corps2010; 156(4Suppl 1): 393–397.
11.
HughesSBirtD. Continuous peripheral nerve blockade on OP HERRICK 9. J R Army Med Corps2009; 155(1): 57–58.
12.
ClasperJCAldingtonDJ. Regional anaesthesia, ballistic limb trauma and acute compartment syndrome. J R Army Med Corps2010; 156(2): 77–78.
13.
WoodPRHaldaneAGPlimmerSE. Anaesthesia at Role 4. J R Army Med Corps2010; 156(4Suppl 1): 308–310.
14.
FlutterCRuthMAldingtonD. Pain management during Royal Air Force strategic aeromedical evacuations. J R Army Med Corps2009; 155(1): 61–63.
15.
HickmanTA. ‘Mania Americana’: narcotic addiction and modernity in the United States, 1870–1920. J Am Hist2004; 90(4): 1269.
16.
JagdishSAldingtonD. The use of opioids during rehabilitation after combat-related trauma. J R Army Med Corps2009; 155(1): 64–66.
17.
FearNTJonesMMurphyDHullLIversenACCokerB. What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study. Lancet2010; 375(9728): 1783–1797.
18.
National Collaborating Centre for Mental Health (UK). Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care. Leicester, UK: Gaskell, 2005.
19.
ParkCLRobertsDEAldingtonDJMooreRA. Prehospital analgesia: systematic review of evidence. J R Army Med Corps2010; 156(4Suppl 1): 295–300.
MercerSJWhittleCSiggersBFrazerRS. Simulation, human factors and defence anaesthesia. J R Army Med Corps2010; 156(4Suppl 1): 365–369.
22.
DaveyCMTMievilleKESimpsonRAldingtonD. A proposed model for improving battlefield analgesia training: post-graduate medical officer pain management day. Journal of the Royal Army Medical Corps2012; 158(3):190–193.
23.
BriggsEVCarrECJWhittakerMS. Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom. Eur J Pain2011; 15(8): 789–795.
