Journal of the Royal Army Medical Corps
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In situations with relatively small numbers of patients with pulmonary blast injury aggressive modern intensive care treatment may allow a return to normal function. The additional effects of radiation poisoning are more difficult to factor in, but new treatments such as colony stimulating factors may improve the outlook for a group with moderate to severe radiation exposure who would previously have died of infection or haemorrhage.
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During this conflict 34 Field Hospital, the sole Coalition field hospital located in Iraq, received and treated casualties with a wide range of injuries. Located very close to the front line during the period of combat hostilities, it was potentially going to deal with relatively fewer battle-injured extremities. ⋯ The experience at 34 Field Hospital confirms that extremity injuries do confer a high surgical workload in war. Surgical resources should, therefore, be aimed at this and surgical teams deployed to such environments should be well versed in the surgical management of casualties with limb trauma.
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The management of casualties involved at the scene of a RoadTraffic Collision or Accident (RTC or RTA) is hazardous, challenging and resource intensive. Some pre-hospital care providers work in locations where there is little or no support and where they act as both the rescuer and the medical carer. This paper tries to break down the management of the extrication into key areas in order to suggest how the rescue can, where necessary, be managed with only a small amount of simple equipment.
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The decisions required for the provision of an appropriate medical response to a radiological or nuclear incident range from the traditional major incident response through to a compromised response due to a catastrophic event. A summary of the most likely clinical findings in the first 12-24 hours is given in Table 4. From these findings, appropriate management based upon the needs and available resources can be planned. This includes triage for surgery and the use of the expectant (T4) triage category.