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The aim of this paper is to discuss areas of possible intervention where CIHSO can enhance quality and safety in allied healthcare systems by progressing from an operational application of clinical governance into a strategic evidence-based decision-making medical tool of the Alliance.Traumatic brain injury is the leading cause of death in conflict and early surgical intervention achieves better outcomes. The British Army surgical kit includes a Hudson Brace and bit and Gigli saw for decompression of the cranial cavity. He