Close proximity blast injury patterns from improvised explosive devices in Iraq: a report of 18 cases.

摘要

With the increasing threat of terrorism and the ongoing requirements for military operations in Afghanistan and Iraq, the use of improvised explosive devices (IEDs) has brought blast injury to the forefront of the management of combat and civilian trauma victims. Civilian experience from the 1993 World Trade Center and the 1995 Oklahoma City bombings and the recent use of stockpiled ordinance for IEDs in Iraq have posed formidable challenges to physicians and surgeons charged with the care of the wounded.1'2 We describe in detail a case series with the specifics regarding mechanisms of wounding, injury patterns, and outcomes of patients who have fallen victim to close-proximity blast injury secondary to IEDs in our area of care in Iraq. This is an attempt to elucidate the patterns of wounding and their physiologic effects. We hope to better prepare clinicians without previous exposure to blast mechanisms to treat these patients' injuries while deployed to military theaters of operation or in the unfortunate instances of terrorist acts directed against the civilian populace. In addition, it is our aim to show the devastating effects of high explosive injuries and the constellation of injuries to diminish the steep learning curve experienced in the care of blast victims. We hope the injury patterns and significant mechanisms of injury described can be used as potential predictors of mortality to better allocate limited resources.