Complex dismounted blast injury

Complex dismounted blast injury

In contrast, the dismounted IED casualty may sustain a char acteristic pattern of injuries, including lower limb amputation, pelvic fracture and genital, perineal and rectal injuries. The most common cause of death in such casualties is from 26 haemorrhage. Initial management is therefore focused upon control of bleeding with tourniquets and swift proximal vascular control. This group may in the future benefit from the judicious use of resuscitative endovascular balloon occlusion 14,32 of the aorta (REBOA) as a bridge to definitive control. role of REBOA in civilian trauma remains greatly contested and its use in military and austere settings may be complicated by long timelines entailing a prohibitively high burden of ischaemic injury . Following control of bleeding and DCR, management principles for complex dismounted blast injury include debridement and delayed reconstruction of soft tissues. Orthopaedic considerations include external fixation of pelvic injuries and the r etention of maximal limb length for rehabilitation. High rates of rectal injuries requir e careful rec - tal examination with proctoscopy and early considera tion of faecal diversion. Genitourinary injuries should be managed with careful catheterisation if possible (and consideration of 33 suprapubic catheters) with exploration of scrotal wounds. - Complex dismounted blast injury

In contrast, the dismounted IED casualty may sustain a char acteristic pattern of injuries, including lower limb amputation, pelvic fracture and genital, perineal and rectal injuries. The most common cause of death in such casualties is from 26 haemorrhage. Initial management is therefore focused upon control of bleeding with tourniquets and swift proximal vascular control. This group may in the future benefit from the judicious use of resuscitative endovascular balloon occlusion 14,32 of the aorta (REBOA) as a bridge to definitive control. role of REBOA in civilian trauma remains greatly contested and its use in military and austere settings may be complicated by long timelines entailing a prohibitively high burden of ischaemic injury . Following control of bleeding and DCR, management principles for complex dismounted blast injury include debridement and delayed reconstruction of soft tissues. Orthopaedic considerations include external fixation of pelvic injuries and the r etention of maximal limb length for rehabilitation. High rates of rectal injuries requir e careful rec - tal examination with proctoscopy and early considera tion of faecal diversion. Genitourinary injuries should be managed with careful catheterisation if possible (and consideration of 33 suprapubic catheters) with exploration of scrotal wounds. - Complex dismounted blast injury

In contrast, the dismounted IED casualty may sustain a char acteristic pattern of injuries, including lower limb amputation, pelvic fracture and genital, perineal and rectal injuries. The most common cause of death in such casualties is from 26 haemorrhage. Initial management is therefore focused upon control of bleeding with tourniquets and swift proximal vascular control. This group may in the future benefit from the judicious use of resuscitative endovascular balloon occlusion 14,32 of the aorta (REBOA) as a bridge to definitive control. role of REBOA in civilian trauma remains greatly contested and its use in military and austere settings may be complicated by long timelines entailing a prohibitively high burden of ischaemic injury . Following control of bleeding and DCR, management principles for complex dismounted blast injury include debridement and delayed reconstruction of soft tissues. Orthopaedic considerations include external fixation of pelvic injuries and the r etention of maximal limb length for rehabilitation. High rates of rectal injuries requir e careful rec - tal examination with proctoscopy and early considera tion of faecal diversion. Genitourinary injuries should be managed with careful catheterisation if possible (and consideration of 33 suprapubic catheters) with exploration of scrotal wounds. -