Incidence, Cause and Treatment of Burn Casualties Under War Circumstances

Abstract

Five to ten percent of all combat injuries in the last decade of armed conflicts have been burns. Here, the incidence, demographics, and treatment are different compared to civilian practice. The percentage of hand and facial burns is higher, the population of patients is healthier, there are more associated injuries, and the transportation time is longer. Due to the prolonged transportation time, emergency treatment and also intermediate treatment are important for a good outcome in patients with burns suffered in a military environment. Treatment guidelines and education of the involved medical personnel according to the findings described herein are important for better results in future combat casualties.

A New Field Triage Method for Burn Disasters-FTB (Fast Triage in Burns)

“…In the military review of the algorithm, patients from the group with 5-50% of deep burns, palpable pulse (with no signs of shock), and below 50% TBSA burned receive priority medical treatment and evacuation. There are reports in literature of 40-45% TBSA burns being considered borderline fatal in the battlefield [1]. Patients with more extensive burns need to be categorised as "expectant".…”

“…Burns in the battlefield occur in 5% to 20% of all military injuries [1,2]. 20% of burned soldiers are diagnosed with severe burns, over 20% TBSA [3,4].…”

“…20% of burned soldiers are diagnosed with severe burns, over 20% TBSA [3,4]. Face, with inhalation injury, and hands are most often burned, because they are not protected with the military uniform [1]. Burned soldiers are usually between the age of 20 and 55 years old, but when the incident deals with civilians, all age groups can be affected.…”

“…Burned soldiers are usually between the age of 20 and 55 years old, but when the incident deals with civilians, all age groups can be affected. Military burns over 50% of TBSA are classified as mortal, especially when there is limited access to specialist burn units [1]. Rescuers in the battlefield dealing with severe situations and burn catastrophes, when not all injured can be reached, use segregation systems, from French 'triage', to optimize actions and use medical supplies most effectively.…”

Focus on Disaster Medicine Introduction to the second “Focus-on” Disaster and Military Surgery

“…The first discusses the role of selective management of penetrating injuries in mass-casualty incidents, based on the recent extensive experiences within this field from Demetriades' group in Los Angeles (Talving et al [2]). The second review is from the Netherlands and summarizes experiences from burn casualties under war circumstances [3].…”