From Northern Ireland to Afghanistan: half a century of blast injuries

McGuire, Ruth; Hepper, A.; Harrison, Kate

doi:10.1136/jramc-2017-000892

Cited by 16 publications

(8 citation statements)

References 15 publications

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“…[1][2][3][4] UK military deployment to Afghanistan (Operation HERRICK, 2002-14) has represented a unique period in which the trauma management was advanced to the point that severely injured personnel were more likely to survive than at any other point in history. 5 The mechanisms by which the UK military personnel sustained injuries in Afghanistan were primarily from improvised explosive devices, rocket-propelled grenades, and gunshots, which together accounted for over 90% of all UK military personnel injuries. 6 Lower limb injuries were the most prevalent, followed by upper limb injuries and head injuries.…”

Section: Introductionmentioning

confidence: 99%

Mental health outcomes of male UK military personnel deployed to Afghanistan and the role of combat injury: analysis of baseline data from the ADVANCE cohort study

Dyball

Bennett

Schofield

et al. 2022

The Lancet Psychiatry

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Section: Introductionmentioning

confidence: 99%

Mental health outcomes of male UK military personnel deployed to Afghanistan and the role of combat injury: analysis of baseline data from the ADVANCE cohort study

Dyball

Bennett

Schofield

et al. 2022

The Lancet Psychiatry

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“…21 Similar trends for conflictrelated blast injury have been reported. 19 These data highlight the need for reliable scoring systems across different severity levels of injury, which take into account healthcare improvements and the progressively lower observed-toexpected death ratio over time in the wider population. 57…”

Section: The Saturation Effect In Scoring Systemsmentioning

confidence: 97%

Injury scoring systems for blast injuries: a narrative review

Hazell

Péarce

Hepper

et al. 2022

British Journal of Anaesthesia

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Injury scoring systems can be used for triaging, predicting morbidity and mortality, and prognosis in mass casualty incidents. Recent conflicts and civilian incidents have highlighted the unique nature of blast injuries, exposing deficiencies in current scoring systems. Here, we classify and describe deficiencies with current systems used for blast injury. Although current scoring systems highlight survival trends for populations, there are several major limitations. The reliable prediction of mortality on an individual basis is inaccurate. Other limitations include the saturation effect (where scoring systems are unable to discriminate between high injury score individuals), the effect of the overall injury burden, lack of precision in discriminating between mechanisms of injury, and a lack of data underpinning scoring system coefficients. Other factors influence outcomes, including the level of healthcare and the delay between injury and presentation. We recommend that a new score incorporates the severity of injuries with the mechanism of blast injury. This may include refined or additional codes, severity scores, or both, being added to the Abbreviated Injury Scale for high-frequency, blastspecific injuries; weighting for body regions associated with a higher risk for death; and blast-specific trauma coefficients. Finally, the saturation effect (maximum value) should be removed, which would enable the classification of more severe constellations of injury. An early accurate assessment of blast injury may improve management of mass casualty incidents.

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“…Energized blast fragments from explosive devices have been the most common mechanism of injury to both military personnel and civilians in recent conflicts [1,2] and terrorist attacks [3,4]. Primary fragments originate from the detonation device itself such as munition casings, or from embedded objects within the explosive device such as nuts and bolts [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Penetration of Energized Metal Fragments to Porcine Thoracic Tissues

Nguyen

Breeze

Masouros

2022

Journal of Biomechanical Engineering

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Energised fragments from explosive devices have been the most common mechanism of injury to both military personnel and civilians in recent conflicts and terrorist attacks. Fragments that penetrate into the thoracic cavity are strongly associated with death due to the inherent vulnerability of the underlying structures. The aim of this study was to investigate the impact of fragment-simulating projectiles (FSPs) to tissues of the thorax in order to identify the thresholds of impact velocity for perforation through these tissues and the resultant residual velocity of the FSPs. A gas-gun system was used to launch 0.78-g cylindrical and 1.13-g spherical FSPs at intact porcine thoracic tissues from different impact locations. The sternum and rib bones were the most resistant to perforation, followed by the scapula and intercostal muscle. For both FSPs, residual velocity following perforation was linearly proportional to impact velocity. These findings can be used in the development of numerical tools for predicting the medical outcome of explosive events, which in turn can inform the design of public infrastructure, of personal protection, and of medical emergency response.

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From Northern Ireland to Afghanistan: half a century of blast injuries

Cited by 16 publications

References 15 publications

Mental health outcomes of male UK military personnel deployed to Afghanistan and the role of combat injury: analysis of baseline data from the ADVANCE cohort study

Mental health outcomes of male UK military personnel deployed to Afghanistan and the role of combat injury: analysis of baseline data from the ADVANCE cohort study

Injury scoring systems for blast injuries: a narrative review

Penetration of Energized Metal Fragments to Porcine Thoracic Tissues

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