Mortality and morbidity from combat neck injury

Breeze, Johno; Allanson-Bailey, L.; Hunt, Nicholas; Delaney, Russell J.; Hepper, A.; Clasper, Jon

doi:10.1016/j.bjoms.2011.04.060

Cited by 2 publications

(7 citation statements)

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“…Three percent to six percent of those lesions are fatal 2 . Uncontrollable hemorrhage is the most common cause of death 3 . Airway management can be difficult in such situations.…”

Section: Introductionmentioning

confidence: 99%

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Use of a Gum Elastic Bougie in a Penetrating Neck Trauma

Daniel¹,

Regloix²,

Kaiser

2014

Prehosp. Disaster med.

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The case of a patient with a zone II penetrating neck injury who was intubated successfully utilizing the gum elastic bougie (GEB) is reported. He presented at a forward operational base in Afghanistan with a shrapnel wound in his neck as well as a cough and hoarseness. There were two wounds on each side of his laryngeal cartilages. The patient's breathing rate gradually increased and labored inhalation developed while the aeromedical evacuation was delayed for tactical reasons. Subcutaneous emphysema and edema concealed the anatomical landmarks, making a cricothyrotomy unsafe, and no fiber optic devices were available on site. Intratracheal intubation was decided upon by the doctors involved. Because of the anticipated difficultly of intubation, the GEB was used from the outset. During direct laryngoscopy, edema, blood, and mucus concealed the anatomic reliefs of the larynx. The glottis was not visible. On the second attempt, "clicks" were clearly perceived and the tube was railroaded over the bougie. Finally, the patient was evacuated to an Afghan military hospital. In this report, the benefit-risk balance for the use of the GEB in penetrating neck trauma is discussed. Although the use of the GEB cannot be recommended in all cases of penetrating neck injury, it should be considered as an option. This technique is not without risk, but in very remote settings or hostile environments, especially when cricothyrotomy is not possible, it can be lifesaving.

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“…Three percent to six percent of those lesions are fatal 2 . Uncontrollable hemorrhage is the most common cause of death 3 . Airway management can be difficult in such situations.…”

Section: Introductionmentioning

confidence: 99%

“…2 Uncontrollable hemorrhage is the most common cause of death. 3 Airway management can be difficult in such situations. There could be injury to the airway and airway obstruction could happen anytime, even with a seemingly stable patient.…”

Section: Introductionmentioning

confidence: 99%

Use of a Gum Elastic Bougie in a Penetrating Neck Trauma

Daniel¹,

Regloix²,

Kaiser

2014

Prehosp. Disaster med.

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“…The proportion of UK service personnel sustaining neck wounds in the 21st century has increased from conflicts in the previous century, primarily reflecting the effectiveness of modern body armour in reducing head and thoraco-abdominal wounds. 1 UK forces experience 3-4 times more combat neck injuries than their US counterparts, 1 the difference being ascribed to the greater use of ballistic protective neck collars by US servicemen. 2,3 Explosively propelled fragments are responsible for 79% of neck wounds, and therefore, body armour covering the cervical anatomical area would be expected to prevent, and certainly reduce, a large number of these wounds had such protection been worn.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Explosively propelled fragments are responsible for 79% of neck wounds, and therefore, body armour covering the cervical anatomical area would be expected to prevent, and certainly reduce, a large number of these wounds had such protection been worn. 1 UK forces are currently issued with OSPREY Mark IV body armour, which comes with detachable ballistic neck collars in two heights, which attach to the top of the thoracic vest. However, these collars are disliked and rarely worn, [1][2][3][4] with the exception of when in static positions.…”

Section: Introductionmentioning

confidence: 99%

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An integrated approach towards future ballistic neck protection materials selection

Breeze

Helliker

Carr

2013

Proc Inst Mech Eng H

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Ballistic protection for the neck has historically taken the form of collars attached to the ballistic vest (removable or fixed), but other approaches, including the development of prototypes incorporating ballistic material into the collar of an under body armour shirt, are now being investigated. Current neck collars incorporate the same ballistic protective fabrics as the soft armour of the remaining vest, reflecting how ballistic protective performance alone has historically been perceived as the most important property for neck protection. However, the neck has fundamental differences from the thorax in terms of anatomical vulnerability, flexibility and equipment integration, necessitating a separate solution from the thorax in terms of optimal materials selection. An integrated approach towards the selection of the most appropriate combination of materials to be used for each of the two potential designs of future neck protection has been developed. This approach requires evaluation of the properties of each potential material in addition to ballistic performance alone, including flexibility, mass, wear resistance and thermal burden. The aim of this article is to provide readers with an overview of this integrated approach towards ballistic materials selection and an update of its current progress in the development of future ballistic neck protection.

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Mortality and morbidity from combat neck injury

Cited by 2 publications

References 0 publications

Use of a Gum Elastic Bougie in a Penetrating Neck Trauma

Use of a Gum Elastic Bougie in a Penetrating Neck Trauma

An integrated approach towards future ballistic neck protection materials selection

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