Following a large earthquake in Nepal, the experience of a small hospital in dealing with the resulting mass casualties is described. The value of pre-planning and effective triage of the injured is stressed, and aspects of surgical and medical care specific to earthquake victims discussed. Clinical and administrative challenges encountered in mounting a major relief exercise in a Third World s...

• increased frequency of high-velocity weapon wounds, which produce greater tissue destruction than the more-frequently seen low-velocity wounds, which are the ones seen in the civilian community; • increased frequency of multiple fragment wounds (from artillery and mortar shells, bombs, booby traps, land mines); • evacuation of casualties from the combat zone to multiple medical treatment faci...

Unique and expanded applications of staged operative management are undergoing careful evaluation in many civilian level I trauma centers under the rubric of damage control surgery. Recently there have been advocates for its broad application to the early management of critically injured combat casualties. However, the enormous logistic requirements for such strategies are contrary to the deman...

Armed conflicts have changed in complexity and nature over the past few decades magnifying health challenges for children. Conflict impacts children's health in four important ways. First, conflict‐driven displacement increases child death and injury, mainly through increased susceptibility to infectious disease from unsanitary living conditions. A case study on Southern Sudan illustrates that ...

BACKGROUND To manage the influx of patients with predominately extremity injuries from Operation Iraqi Freedom (OIF), our center was required to transform from a nontrauma academic hospital to a trauma hospital by using a multidisciplinary approach. STUDY DESIGN A retrospective chart review was performed of casualties from OIF who were received over 14 months. RESULTS A total of 313 casualt...

BACKGROUND By the principles of Tactical Combat Casualty Care, battlefield casualties are preferentially triaged on the basis of pulse character and mental status. A weak or absent palpable pulse correlates with a systolic blood pressure (SBP) of ≤ 100 mm Hg. Furthermore, the motor component of the Glasgow Coma Scale (GCS-M) has been shown to correlate with outcomes. In a previous study, the au...