Unexploded Ordnance Management
The purpose of this Clinical Practice Guide is to provide details on the procedures to safely remove unexploded ordnance from combat patients, both loose and impaled, to minimize the risks to providers and the medical treatment facility while ensuring the best outcome for the patient. Military ordna...
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Veröffentlicht in: | Military medicine 2018-09, Vol.183 (suppl_2), p.24-28 |
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creator | Oh, John S Seery, Jason M Grabo, Daniel J Ervin, Mark D Wertin, Tom M Hawks, Ryan P Benov, Avi Stockinger, Zsolt T |
description | The purpose of this Clinical Practice Guide is to provide details on the procedures to safely remove unexploded ordnance from combat patients, both loose and impaled, to minimize the risks to providers and the medical treatment facility while ensuring the best outcome for the patient. Military ordnance, to include bullets, grenades, flares, and explosive ordnance, retained by a patient can be a risk to all individuals and equipment along the continuum of care. This is especially true from the point of injury to the first treatment facility. Management of patients with unexploded ordnance either on or in their body is a rare event during combat surgery. Loose munitions are usually noted and easily removed prior to the patient receiving medical treatment. However, impaled munitions provide a significant challenge. These are usually caused by large caliber, high-velocity projectiles. Patients who survive to arrive at a treatment facility must be triaged safely and simultaneously treated appropriately to ensure both the survival of the patient and the treatment team. Between WWII and the Somalia conflict, there have been 36 reported cases of unexploded ordnance from U.S. soldiers. Since 2005, there have been six known cases during the U.S. wars in Afghanistan and Iraq and one additional case in Pakistan. Optimal outcomes require a basic knowledge of explosives and triggering mechanisms, as well as adherence to basic principles of trauma resuscitation and surgery. |
doi_str_mv | 10.1093/milmed/usy064 |
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Military ordnance, to include bullets, grenades, flares, and explosive ordnance, retained by a patient can be a risk to all individuals and equipment along the continuum of care. This is especially true from the point of injury to the first treatment facility. Management of patients with unexploded ordnance either on or in their body is a rare event during combat surgery. Loose munitions are usually noted and easily removed prior to the patient receiving medical treatment. However, impaled munitions provide a significant challenge. These are usually caused by large caliber, high-velocity projectiles. Patients who survive to arrive at a treatment facility must be triaged safely and simultaneously treated appropriately to ensure both the survival of the patient and the treatment team. Between WWII and the Somalia conflict, there have been 36 reported cases of unexploded ordnance from U.S. soldiers. Since 2005, there have been six known cases during the U.S. wars in Afghanistan and Iraq and one additional case in Pakistan. Optimal outcomes require a basic knowledge of explosives and triggering mechanisms, as well as adherence to basic principles of trauma resuscitation and surgery.</description><identifier>ISSN: 0026-4075</identifier><identifier>EISSN: 1930-613X</identifier><identifier>DOI: 10.1093/milmed/usy064</identifier><identifier>PMID: 30189069</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Blast Injuries - prevention & control ; Blast Injuries - therapy ; Casualties ; Explosive Agents - adverse effects ; Handling (Psychology) ; Hazardous Substances - administration & dosage ; Hazardous Substances - adverse effects ; Humans ; Land mines ; Medical treatment ; Military supplies ; Operating Rooms - methods ; Operating Rooms - trends ; Patients ; Surgery ; Trauma ; United States</subject><ispartof>Military medicine, 2018-09, Vol.183 (suppl_2), p.24-28</ispartof><rights>Copyright Oxford University Press Sep/Oct 2018</rights><rights>Published by Oxford University Press on behalf of Association of Military Surgeons of the United States 2018.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c388t-4a9b251d366bc05479af6c34cf7e91023d7a7e63a02dfa199f43d2552f2a71373</citedby><cites>FETCH-LOGICAL-c388t-4a9b251d366bc05479af6c34cf7e91023d7a7e63a02dfa199f43d2552f2a71373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30189069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oh, John S</creatorcontrib><creatorcontrib>Seery, Jason M</creatorcontrib><creatorcontrib>Grabo, Daniel J</creatorcontrib><creatorcontrib>Ervin, Mark D</creatorcontrib><creatorcontrib>Wertin, Tom M</creatorcontrib><creatorcontrib>Hawks, Ryan P</creatorcontrib><creatorcontrib>Benov, Avi</creatorcontrib><creatorcontrib>Stockinger, Zsolt T</creatorcontrib><title>Unexploded Ordnance Management</title><title>Military medicine</title><addtitle>Mil Med</addtitle><description>The purpose of this Clinical Practice Guide is to provide details on the procedures to safely remove unexploded ordnance from combat patients, both loose and impaled, to minimize the risks to providers and the medical treatment facility while ensuring the best outcome for the patient. Military ordnance, to include bullets, grenades, flares, and explosive ordnance, retained by a patient can be a risk to all individuals and equipment along the continuum of care. This is especially true from the point of injury to the first treatment facility. Management of patients with unexploded ordnance either on or in their body is a rare event during combat surgery. Loose munitions are usually noted and easily removed prior to the patient receiving medical treatment. However, impaled munitions provide a significant challenge. These are usually caused by large caliber, high-velocity projectiles. Patients who survive to arrive at a treatment facility must be triaged safely and simultaneously treated appropriately to ensure both the survival of the patient and the treatment team. Between WWII and the Somalia conflict, there have been 36 reported cases of unexploded ordnance from U.S. soldiers. Since 2005, there have been six known cases during the U.S. wars in Afghanistan and Iraq and one additional case in Pakistan. Optimal outcomes require a basic knowledge of explosives and triggering mechanisms, as well as adherence to basic principles of trauma resuscitation and surgery.</description><subject>Blast Injuries - prevention & control</subject><subject>Blast Injuries - therapy</subject><subject>Casualties</subject><subject>Explosive Agents - adverse effects</subject><subject>Handling (Psychology)</subject><subject>Hazardous Substances - administration & dosage</subject><subject>Hazardous Substances - adverse effects</subject><subject>Humans</subject><subject>Land mines</subject><subject>Medical treatment</subject><subject>Military supplies</subject><subject>Operating Rooms - methods</subject><subject>Operating Rooms - trends</subject><subject>Patients</subject><subject>Surgery</subject><subject>Trauma</subject><subject>United States</subject><issn>0026-4075</issn><issn>1930-613X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90M9LwzAUwPEgipvTo9cx8OKl7r28NGmOMvwFk10ceAtZk8pGm85mBfff29Ht4sHTg8eHx-PL2C3CA4KmabUuK--mbdyDFGdsiJogkUif52wIwGUiQKUDdhXjBgCFzvCSDQgw0yD1kI2Xwf9sy9p5N1k0LtiQ-8m7DfbLVz7srtlFYcvob45zxJbPTx-z12S-eHmbPc6TnLJslwirVzxFR1KuckiF0raQOYm8UF4jcHLKKi_JAneFRa0LQY6nKS-4VUiKRuy-v7tt6u_Wx52p1jH3ZWmDr9toOAJyhRp5R-_-0E3dNqH7znBBAJ1B_FehzLSUMqVOJb3KmzrGxhdm26wr2-wNgjnkNX1e0-ft_Ph4tV0d1id96km_agl0RA</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Oh, John S</creator><creator>Seery, Jason M</creator><creator>Grabo, Daniel J</creator><creator>Ervin, Mark D</creator><creator>Wertin, Tom M</creator><creator>Hawks, Ryan P</creator><creator>Benov, Avi</creator><creator>Stockinger, Zsolt T</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20180901</creationdate><title>Unexploded Ordnance Management</title><author>Oh, John S ; Seery, Jason M ; Grabo, Daniel J ; Ervin, Mark D ; Wertin, Tom M ; Hawks, Ryan P ; Benov, Avi ; Stockinger, Zsolt T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c388t-4a9b251d366bc05479af6c34cf7e91023d7a7e63a02dfa199f43d2552f2a71373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Blast Injuries - prevention & control</topic><topic>Blast Injuries - therapy</topic><topic>Casualties</topic><topic>Explosive Agents - adverse effects</topic><topic>Handling (Psychology)</topic><topic>Hazardous Substances - administration & dosage</topic><topic>Hazardous Substances - adverse effects</topic><topic>Humans</topic><topic>Land mines</topic><topic>Medical treatment</topic><topic>Military supplies</topic><topic>Operating Rooms - methods</topic><topic>Operating Rooms - trends</topic><topic>Patients</topic><topic>Surgery</topic><topic>Trauma</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oh, John S</creatorcontrib><creatorcontrib>Seery, Jason M</creatorcontrib><creatorcontrib>Grabo, Daniel J</creatorcontrib><creatorcontrib>Ervin, Mark D</creatorcontrib><creatorcontrib>Wertin, Tom M</creatorcontrib><creatorcontrib>Hawks, Ryan P</creatorcontrib><creatorcontrib>Benov, Avi</creatorcontrib><creatorcontrib>Stockinger, Zsolt T</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Military medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oh, John S</au><au>Seery, Jason M</au><au>Grabo, Daniel J</au><au>Ervin, Mark D</au><au>Wertin, Tom M</au><au>Hawks, Ryan P</au><au>Benov, Avi</au><au>Stockinger, Zsolt T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unexploded Ordnance Management</atitle><jtitle>Military medicine</jtitle><addtitle>Mil Med</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>183</volume><issue>suppl_2</issue><spage>24</spage><epage>28</epage><pages>24-28</pages><issn>0026-4075</issn><eissn>1930-613X</eissn><abstract>The purpose of this Clinical Practice Guide is to provide details on the procedures to safely remove unexploded ordnance from combat patients, both loose and impaled, to minimize the risks to providers and the medical treatment facility while ensuring the best outcome for the patient. Military ordnance, to include bullets, grenades, flares, and explosive ordnance, retained by a patient can be a risk to all individuals and equipment along the continuum of care. This is especially true from the point of injury to the first treatment facility. Management of patients with unexploded ordnance either on or in their body is a rare event during combat surgery. Loose munitions are usually noted and easily removed prior to the patient receiving medical treatment. However, impaled munitions provide a significant challenge. These are usually caused by large caliber, high-velocity projectiles. Patients who survive to arrive at a treatment facility must be triaged safely and simultaneously treated appropriately to ensure both the survival of the patient and the treatment team. Between WWII and the Somalia conflict, there have been 36 reported cases of unexploded ordnance from U.S. soldiers. 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subjects | Blast Injuries - prevention & control Blast Injuries - therapy Casualties Explosive Agents - adverse effects Handling (Psychology) Hazardous Substances - administration & dosage Hazardous Substances - adverse effects Humans Land mines Medical treatment Military supplies Operating Rooms - methods Operating Rooms - trends Patients Surgery Trauma United States |
title | Unexploded Ordnance Management |
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