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The Operational Emergency Department Attendance Register (OPEDAR): A New Epidemiological Tool
  1. Lieutenant Colonel R Russell, MRCP(UK) FCEM DipIMC RCSEd MIHM RAMC, Senior Lecturer in Emergency Medicine1,
  2. T Hodgetts1,
  3. J Ollerton1,
  4. P Massetti1,
  5. J Skeet2,
  6. I Bray2 and
  7. K Harrison2
  1. 1Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine
  2. 2Defence Analytical Services Agency
  1. Academic Department of Military Emergency Medicine Royal Centre for Defence Medicine, Birmingham Research Park, Birmingham B15 2SQ 0121 415 8848 SenLecEM.ADMEM{at}rcdm.bham.ac.uk

Abstract

Aim To determine the number, status and nature of emergency department attendances to deployed field hospitals.

Population All attendances to the emergency department (ED) of deployed field hospitals in support of Operation TELIC (Iraq) from initial entry war fighting to enduring operations.

Methods Analysis of hand written and electronic registers ED attendance registers and validation with four other data sources.

Results Validation of data held on OpEDAR against 4 other data sources shows that OpEDAR is accurate, but that accuracy can be further improved. 26,746 ED attendances recorded on OP TELIC from 19 March 2003 to 11 November 2006. 21,112 (78.9%) were UK military. Overall, 43.5% were admitted from ED. Attendances peaked during TELIC phases 2 (422.9 per 1,000 troops deployed), but have settled to around 200 per 1,000 troops deployed in the more recent phases. Ophthalmology rates peaked in TELIC 2 to 20.72 per 1,000 and have since reduced to a consistent 10 to 15 per 1,000. This suggests that preventative measures introduced for eye injury are incompletely effective or incompletely utilised.

Conclusions OpEDAR is a clinical tool to inform manning, equipment and training requirements for enduring and new operations, focused on the requirements of the emergency department. Multivariate quality control models applied in industry could be applied to OpEDAR to produce a dynamic epidemiological tool that identifies emerging case clusters and facilitates deployed commanders to take preventative action.

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