Journal of the Royal Army Medical Corps
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Haemodynamically unstable patients with mechanically unstable pelvic ring injuries continue to present a challenge to all personnel involved. Road traffic accidents remain a significant cause of soldier morbidity and mortality in peacetime and in war. These pelvic ring disruptions are markers of high-energy transfer injuries and are associated with fatal exsanguinating haemorrhage. ⋯ Dealing with these issues in the military environment adds additional stress to this volatile situation. Multidisciplinary practice guidelines have been shown to reduce mortality and should be adopted by all establishments treating these causalities. A well-rehearsed
ABC approach with a proactive approach to dot protection and promotion is ideal. -
Review
Improvised explosive devices: pathophysiology, injury profiles and current medical management.
The improvised explosive device (IED), in all its forms, has become the most significant threat to troops operating in Afghanistan and Iraq. These devices range from rudimentary home made explosives to sophisticated weapon systems containing high-grade explosives. Within this broad definition they may be classified as roadside explosives and blast mines, explosive formed pojectile (EFP) devices and suicide bombings. ⋯ The "Global War on Terror" has meant that incidents which were previously exclusively seen in conflict areas, can occur anywhere, and clinicians who are involved in emergency trauma care may be required to manage casualties from similar terrorist attacks. An understanding of the types of devices and their pathophysiological effects is necessary to allow proper planning of mass casualty events and to allow appropriate management of the complex poly-trauma casualties they invariably cause. The aim of this review article is to firstly describe the physics and injury profile from these different devices and secondly to present the current clinical evidence that underpins their medical management.
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Review
Current concepts in the epidemiology and management of battlefield head, face and neck trauma.
There has been a significant increase in the incidence of head, face and neck (HFN) injuries in the 21st century in comparison to that experienced in the previous century. In the majority of HFN injuries the primary cause of death is secondary to airway compromise and with the exception of severe neck wounds haemorrhage is an unusual cause of death. ⋯ Equivalent armour to protect the neck and face is not yet effective and requires development. We describe the current epidemiology and management of battlefield head, face and neck trauma.