n engl j med 360;16 nejm.org april 16, 2009 1588 of potential victims, supports the assessment that executions have been applied systematically and strategically to civilians in Iraq.5 Certainly, different perpetrators can use similar weapons in different ways, with different effects on civilians. Nevertheless, our findings regarding the rates of Iraqi civilian death resulting from different ty...

Since the terrorist suicide truck bombing of the U.S. Marine barracks in Beirut in 1983, the “imagination” of Americans has continued to be taxed with devastating consistency. Explosions and bombings remain the most common deliberate cause of disasters involving large numbers of casualties, especially as instruments of terrorism, yet we still have not learned how to anticipate and manage the tr...

Despite the large number of gunshot wounds treated in civilian and military practice, embolization of missiles to the pulmonary artery is relatively uncommon. In a review of 7,500 medical reports from casualties from the Vietnam Vascular Registry, only 22 patients with known vascular trauma had missile emboli (0.3%), and of those, only 4 (.0005%) were to the pulmonary artery. Causative agents o...

The present study examined the relation between disengagement of moral self–sanctions and support of military force. The modes of moral disengagement included moral sanctioning of lethal means, disavowal of personal responsibility for detrimental effects accompanying military campaigns, minimization of civilian casualties, and attribution of blame and dehumanization of one’s foes. The responden...

The transfusion of fresh whole blood (FWB) for trauma-induced coagulopathy is unusual in civilian practice. However, US military physicians have used FWB in every combat operation since the practice was introduced in World War I and continue to do so during current military operations. We discuss our review of all blood products administered to US military casualties in Operation Iraqi Freedom ...

Based on media reports, neurotrauma has emerged as the signature wound in the Global War on Terrorism (GWOT). Brain trauma is frequently the result of blast injury, producing a unique syndrome with a high incidence of traumatic sub-arachnoid hemorrhage (SAH) and vasospasm. Cortical spreading depolarizations (CSD) are a pathologic short-circuiting of brain function that cause secondary brain dam...

Civilians constitute a large share of casualties in civil wars across the world. They are targeted to create fear and punish allegiance with the enemy. This maximizes collaboration with the perpetrator and strengthens the support network necessary to consolidate control over contested regions. I develop a model of the magnitude and structure of civilian killings in civil wars involving two arme...

BACKGROUND Historic advances in combat prehospital care have been made in the last decade. Unlike other areas of critical care, most of these innovations are not the result of significant improvements in technology, but by conceptual changes in how care is delivered in a tactical setting. The new concept of Tactical Combat Casualty Care has revolutionized the management of combat casualties in ...

care and evacuation. In addition, all of the chapters include material on the handling of mass casualties. This is a most useful and authoritative little book, which brings together current concepts in the care of the many forms of trauma seen in war time. To have access to such a handbook would be of great value to a physician faced with the problems of care of the wounded. It should be requir...

This article presents findings of an original survey experiment on public attitudes toward nuclear use conducted a representative sample Russian citizens. We randomly assigned our participants to experimental treatments with vignettes describing military conflict between Russia and NATO in the Baltics, where Moscow considered limited “escalate-to-deescalate” strike avert defeat. Our show that R...