Volume 24 Number 2 April 2016 Journal of Military and Veterans’ Health Health characteristics and self-identified health promotion needs of Army personnel in Perth Western Australia Y ME Effects of Penthrox® (methoxyflurane) as an analgesic on Cardiovascular and respiratory AR D T IC I I IL N functions in the pre-hospital setting E M A N S A I S O S A Aligning Defence Environmental and Occupational Health (EOH) Capability with Future C L I A A T R I T O S Requirements: The 4th Australian Defence Force EOH Conference N U A IN C. The Journal of the Australasian Military Medicine Association Medibank’s Garrison Health Services Delivering a national, integrated healthcare service to the Australian Defence Force Through Medibank’s extensive network, Garrison Health Services (GHS) provides seamless access to quality healthcare to the 60 000+ permanent and 20 000+ reservist uniformed ADF personnel—from point of injury or illness to recovery. The health of the ADF is central to everything we do. medibankhealth.com.au/garrisonhealthservices Image courtesy of Dept of Defence Table of Contents Original Articles Health characteristics and self-identified health promotion needs of Army personnel in Perth Western Australia ..................................................................................................................... 6 Effects of Penthrox® (methoxyflurane) as an analgesic on Cardiovascular and respiratory functions in the pre-hospital setting ............................................................................. 14 Commentary Aligning Defence Environmental and Occupational Health (EOH) Capability Medibank’s Garrison Health Services with Future Requirements: The 4th Australian Defence Force EOH Conference ..................................... 21 Delivering a national, integrated healthcare History Malariology in Australia between the First and Second World Wars service to the Australian Defence Force (Part 2 of ‘Pioneers of Australian military malariology’) ......................................................................... 28 Through Medibank’s extensive network, Garrison Health Services (GHS) provides seamless Review Article access to quality healthcare to the 60 000+ A Review of Art Therapy Among Military Service Members and Veterans permanent and 20 000+ reservist uniformed with Post-Traumatic Stress Disorder ..................................................................................................... 40 ADF personnel—from point of injury or illness to recovery. Reprint The Legacy of the Anaesthesia ‘Events’ at Pearl Harbor, 7th December 1941. ......................................... 52 The health of the ADF is central to everything we do. The “Triangle of Death” – Medical Sustainability in Expeditionary Sea-Based Operations. ..................... 58 medibankhealth.com.au/garrisonhealthservices Cover photo courtesy of the Australian Government Department of Defence Caption: Thumbs up, Corporal Garry Francis, a medic with the First Mentoring Task Force gives the all clear to a local child after providing some first aid. © Copyright: Commonwealth of Australia Department of Defence. Defence Images are not to be used for tender or bid documentation. Image courtesy of Dept of Defence Volume 24 Number 2; April 2016 Journal of Military and Veterans’ Health EDITORIAL BOARD CDRE Andy Robertson, CSC, PSM (Editor in Chief) Maj Gen Prof Dr Mohd Zin Bidin (Ret’d) BRIG Anne Campbell CDRE Michael Dowsett Dr Helen Kelsall COL Prof Peter Leggat, AM Benjamin Mackie Dr Mike O’Connor Tyler C Smith, MS, PhD Dr Darryl Tong Australasian Military Medicine Association PATRON STATEMENT OF OBJECTIVES RADM Jenny Firman The Australasian Military Medicine Association is an Surgeon General Australian Defence Force Reserves independent, professional scientific organisation of health professionals with the objectives of: COUNCIL • Promoting the study of military medicine President Dr Greg Mahoney • Bringing together those with an interest in military medicine Vice President Dr Nader Abou-Seif • Disseminating knowledge of military medicine Secretary Dr Janet Scott • Publishing and distributing a journal in military Treasurer GPCAPT Geoff Robinson medicine Council Members CDRE Andrew Robertson • Promoting research in military medicine Dr Peter Peters Membership of the Association is open to doctors, dentists, nurses, pharmacists, paramedics and Dr Peter Hurly anyone with a professional interest in any of the Rachelle Warner disciplines of military medicine. The Association is Public Officer Ms Paula Leishman totally independent of the Australian Defence Force. JMVH is published by the Australasian Military Medicine Association 113 Harrington Street Hobart Tas 7000 Australia Ph: +61 3 62347844 Email: [email protected] ISSN No. 1835-1271 Journal of Military and Veterans’ Health Editorial The major Naval battle of World War 1 occurred latest book entitled ‘Honour, Duty, Courage’. between the Royal Navy’s Grand Fleet and the Whilst ostensibly written as a novel, it is based Imperial German Navy’s High Seas Fleet from 31 on numerous interviews with Australian military May to 1 June 1916 near the Jutland Peninsula doctors and nurses, which has allowed him to in Denmark. The Germany intention was to trap dramatise events that have occurred over a range and destroy a portion of the Grand Fleet, so as to of conflicts whilst maintaining confidentiality. The break the British blockade of German shipping. fictional format has also allowed him to explore Fourteen British and eleven German ships were some of the ethical and moral challenges facing sunk, with the British losing more ships and twice military health practitioners, while acknowledging as many sailors. While both sides claimed victory, the impacts such challenges invariably have on it was not decisive for either side and there was those involved. This is a useful and unique addition to be no further such battles for the remainder of to the military medical literature. the war. One of the Royal Navy ships, HMS Shark, Our second issue has a range of interesting articles, an Acasta-class destroyer built in 1912, was sunk with excellent articles on Army health promotion by torpedo after being crippled by gunfire during needs, the effects of methoxyflurane as an analgesic an unsuccessful torpedo attack on the evening of on cardiovascular and respiratory functions, the 31 May 1916. Amongst those killed was Surgeon second part of the pioneers of Australian military Probationer Robert Walker, a 4th year medical malariology series, Defence environmental and student at Edinburgh University, who had joined occupational health, and the use of art therapy the Royal Navy Volunteer Reserve (RNVR) and was in PTSD. Finally, there are two reprints, which assigned to HMS Shark in August 1915. At the look at anaesthetic use during the Pearl Harbour time, due to a serious shortage of naval doctors, attacks and medical sustainability in expeditionary third- and fourth-year medical students were sea-based operations, which is very timely with enrolled into the Navy as Surgeon Probationers the commissioning of HMAS Canberra and HMAS (Surgeon Sub-Lieutenants), given some further Adelaide. practical training and then dispatched around the Fleet. He was last seen tending a wounded sailor We continue to get a good range of articles, but who had lost his hand when there was another other military and veterans’ health articles are blast. He was not seen again but was thought to always very welcome and we would encourage all have been killed. Surgeon Probationer Walker had our readers to consider writing on their areas of been born in Fremantle, WA in 1893 and was one military or veterans’ health interest. Our themes of the 8 Australians listed as killed in the Battle of are now available for both 2016 and 2017 to allow Jutland. While there is little further information for authors to research and develop their articles readily available, the loss of an Australian medical – we certainly welcome articles in these areas but student 100 years ago highlights the challenges welcome any articles across the broader spectrum facing the Navy at the time. of military health. On a more modern note, Dr Mohamed Khadra, Dr Andy Robertson, CSC, PSM a Sydney surgeon, has recently published his Commodore, RANR Editor-in-Chief 1 Khadra M. Honour, duty, courage. Penguin Random House Australia; Sydney:2015. Volume 24 Number 2; April 2016 Page 5 Original Article Health characteristics and self- identified health promotion needs of Army personnel in Perth Western Australia S. Batt1, P. Geerlings2, C. Fetherston1 Introduction to foster the community ownership and action required for successful health promotion.12 In this Australian Defence Force (ADF) personnel require study, the workplace provides an opportune setting, high levels of health and fitness to cope with the and engagement with the target group early in the inherently stressful situations that occur as part health promotion evaluation cycle can encourage of military life. However, several health and lifestyle empowerment, self-help, social support and issues among ADF personnel have been identified participation, which are essential requirements for 1 relating to mental health and alcohol use , tobacco health behaviour change.13 smoking in deployed personnel2 and increased body 3 mass index (BMI). Mental disorders among service Materials and Methods personnel have been of increasing concern,1,4 and recent recognition of issues around alcohol use Study design and