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N7GCW > VETS 21.03.05 20:14l 80 Lines 3484 Bytes #999 (0) @ WW
BID : 40071_WA7V
Read: GUEST
Subj: Blast injuries..important issue
Path: DB0FHN<DB0RGB<OK0PPL<DB0RES<DK0WUE<7M3TJZ<W7NTF<W1NGL<WA7V<WA7V
Sent: 050318/1716z @:WA7V.#SEWA.WA.USA.NOAM [Walla Walla] $:40071_WA7V
Why are blast injuries an important issue right now?
America's armed forces are sustaining attacks by rocket-propelled
grenades, improvised explosive devices, and land mines almost daily in
Iraq and Afghanistan. These injured soldiers require specialized care
from providers experienced in treating traumatic brain injury.
Index
In combat, how often do blasts cause injury?
Blast injuries have become common in civilian disasters and military
conflicts. It has been suggested that over 50% of injuries sustained in
combat are the result of explosive munitions including bombs, grenades,
land mines, missiles, and mortar/artillery shells (Coupland & Meddings,
1999).
Index
How often do blasts result in brain injuries?
The data on blast injury induced brain injury is very limited.
Statistics from the October 23, 1983 terrorist bombing of the US Marine
barracks from (Scott et al, 1986) indicated that the large explosion
(equivalent to approximately 12 tons of TNT) resulted in 234 immediate
deaths and at least 122 injured survivors. Of the immediate deaths, 167
demonstrated evidence of head injury. There was a 59% rate of head
injury and a 70% fatality rate from head injury.
Between July and November 2003 DVBIC at Walter Reed Army Medical Center
screened 155 patients who had returned from Iraq and were deemed as
being at risk for brain injury. Ninety-six of the 155 screened or 62%
were identified as having sustained a brain injury. Of the 88 blast
cases included in the total number screened, 54 or 61% were identified
as having sustained a brain injury.
Index
How does a blast cause injury?
Blast injuries are injuries that result from the complex pressure wave
generated by an explosion. The explosion causes an instantaneous rise in
pressure over atmospheric pressure that creates a blast
overpressurization wave. Primary blast injury occurs from an interaction
of the overpressurization wave and the body with differences occurring
from one organ system to another. Air-filled organs such as the ear,
lung, and gastrointenstinal tract and organs surrounded by fluid-filled
cavities such as the brain and spinal are especially susceptible to
primary blast injury (Elsayed, 1997;Mayorga, 1997). The
overpressurization wave dissipates quickly, causing the greatest risk of
injury to those closest to the explosion.
In a blast, brain injuries can also occur by other means such as impact
from blast-energized debris, the individual being physically thrown,
burns and/or inhalation of gases and vapors.
Index
What symptoms may indicate a closed head injury?
Difficulties experienced as a result of a closed-head blast injury
include post concussion complaints such as decreased memory and
attention/concentration, headaches, slower thinking, irritability,
and/or depression.
Index
What is the DVBIC doing to care for those with blast injuries?
The Defense and Veterans Brain Injury Center (DVBIC) works to identify
all soldiers who have sustained a closed head injury during combat
operations and to ensure that they receive the best care available. For
example, at Walter Reed Army Medical Center, DVBIC reviews all incoming
casualty reports and screens all patients who may have sustained a brain
injury including those injured in blasts, motor vehicle crashes, falls,
and gunshot wounds to the head. Brain injury specialists evaluate
patients who are identified with a brain injury. Recommendations are
made for treatment and duty status.
>
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