War Injuries, Trauma, and Disaster Relief

Gosselin, Richard A.

doi:10.1097/01.bto.0000162986.50568.88

Cited by 70 publications

(13 citation statements)

References 58 publications

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“…Conducive schedules among academic volunteers and an interest in disaster preparedness research might account for the substantial number of university faculty respondents. Interview themes and the observed disaster management scores support the importance of prior training and experience for volunteer surgeons who face mass casualties and injuries in a disaster [25,50]. Training might have directly contributed to differences observed in storage security and equipment distribution, or indirectly led to logistical assistance if trained volunteers could more easily collaborate with the military [2,8].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, since airport-related delays impeded resource distribution and likely contributed to the observed difficulty with these equipment management tasks [18,45], some have suggested ''pre-positioning'' medical and surgical supplies at strategic airfields with ''pre-clearance'' through international customs [13]. Concerns regarding the intentions, experience, and credentialing of responders to the Haiti earthquake led to labels such as SUVs or ''disaster tourists'' [58], as in prior disasters [25,51]. Inexperienced and untrained volunteers were urged to stay home because they lacked security, equipment, patient followup systems, and cultural sensitivity preparedness [9,18].…”

Section: Discussionmentioning

confidence: 99%

“…Although the indications and specific circumstances around these procedures are unknown, some experts and organizations advise against guillotine amputations [19,25,47], fasciotomies for acute closed muscle-crush injury [39,48,49,53], and internal fixation [21,25] in disaster and war settings. In addition, the observed ratio of greater than one revision for every primary amputation suggests higher revision rates than those documented in the developed world (25%-30%) [11,28,59].…”

Section: Discussionmentioning

confidence: 99%

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Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

Sonshine

Caldwell

Gosselin

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

Sonshine

Caldwell

Gosselin

et al. 2012

Clinical Orthopaedics &Amp; Related Research

Self Cite

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“…American surgeon Michael DeBakey understood that the delay between injury and surgery was a major obstacle to arterial repair [39]. Debakey studied the results of over 2,000 arterial injuries during WWII [40].…”

Section: Wound Mortality and Amputation Ratementioning

confidence: 99%

A Brief History of War Amputation

Kinch

2011

J R Army Med Corps

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Throughout the history of warfare, changes in weaponry have produced changes in the nature of war injury. The 16th century saw the introduction of firearms in conventional warfare, bringing the destructive power of weaponry to new and unseen heights with a dramatic increase in the severity and complexity of battle injuries. Destructive gunshot wounding associated with embedded foreign material often led to sepsis and demanded the more radical treatment of amputation. Over the past 500 years innumerable developments have taken place in anaesthesia, asepsis, transfusion therapy and resuscitation, antibiotic therapy, vascular surgery and wound management. Medical services have had to adapt in order to cope with the changing volume and changing nature of battle casualties resulting from modern weaponry. Despite the progress made, amputation is still a commonly performed operation following traumatic limb injury. In those cases where the decision to amputate is not so clearly and distinctly defined, history has shown that prevention of infection requires aggressive primary surgery and removal of all devitalised tissue. This paper examines the history of amputation in the management of the battlefield casualty suffering limb injury, beginning in the 16th century and continuing into present day.

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“…As conflict has evolved, ground troops have been exposed to a changing pattern of injuries: penetrating injuries predominate and are currently more frequently sustained from improvised explosive devices (IEDs) than gunshot wounds11 and here they face an increasing risk of thermal injury.…”

Section: Introductionmentioning

confidence: 99%

One year of burns at a Role 3 Medical Treatment Facility in Afghanistan

Jeevaratnam¹,

Pandya²

2013

J R Army Med Corps

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Objectives Historically, burns have formed a significant proportion of the casualties of war. The management of burns in recent conflict has been found to be a resourceheavy undertaking, though its impact on both personnel and resources in current conflicts is unclear. A case analysis has been carried out in order to quantify the logistical impact of the management of burns on Role 3 Medical Treatment Facility (MTF) infrastructure and to examine if and how the cause and management of burns have evolved in early 21st century conflict. Methods All casualties treated for burns at a Role 3 MTF over one calendar year were identified and scanned copies of their notes obtained from the UK Joint Theatre Trauma Registry and retrospectively analysed. Results 88 of the 1461 (6.0%) trauma patients presenting to the Role 3 MTF over the year were treated for burns of whom 52.3% were combat troops and 45.4% civilians. Half of the burns were caused by non-conflict related mechanisms; the two commonest mechanisms were flame burns in 38/88 mostly non-conflict related cases and blast in 30/88 cases most of which were conflict related. Conclusions The management of burns at war is a complex process. It is further confounded by the management of civilians with non-conflict related burns, which places a predictable strain on Role 3 MTF resources: theatre time, nursing time, dressing resources and bed space. This must be planned for in current and future deployed operations.

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War Injuries, Trauma, and Disaster Relief

Cited by 70 publications

References 58 publications

Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

A Brief History of War Amputation

One year of burns at a Role 3 Medical Treatment Facility in Afghanistan

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