Terrorist attacks: common injuries and initial surgical management.

Terrorism-related incidents and shootings that involve the use of war weapons and explosives are associated with gunshot and blast injuries. Despite the perceived threat of terrorism, these incidents and injuries are rare in Germany. For this reason, healthcare providers are unlikely to have a full...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 46; no. 4; pp. 683 - 695
Autores principales: Bieler, Dan, Franke, Axel, Kollig, Erwin, Güsgen, Christoph, Mauser, Martin, Friemert, Benedikt, Achatz, Gerhard
Formato: algorithm pictorial tables/charts Journal Article
Publicado: Springer Nature 2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        atl: Terrorist attacks: common injuries and initial surgical management.
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          Bieler, Dan
          Franke, Axel
          Kollig, Erwin
          Güsgen, Christoph
          Mauser, Martin
          Friemert, Benedikt
          Achatz, Gerhard
        affil: Department of Trauma Surgery and Orthopaedics, Reconstructive and Hand Surgery, Plastic Surgery, Burn Medicine, German Armed Forces Central Hospital, Koblenz, Rübenacher Straße 170, 56072, Koblenz, Germany
      sug:
        subj:
          Terrorism
          Mass Casualty Incidents
          Wounds, Gunshot Surgery
          Blast Injuries Surgery
          Wounds, Gunshot Physiopathology
          Blast Injuries Physiopathology
          Emergency Care
          Kinematics
          Life Support Care
      ab: Terrorism-related incidents and shootings that involve the use of war weapons and explosives are associated with gunshot and blast injuries. Despite the perceived threat of terrorism, these incidents and injuries are rare in Germany. For this reason, healthcare providers are unlikely to have a full understanding of the special aspects of managing these types of injuries. Until a clear and complete picture of the situation is available after a terrorist or shooter incident, tactical and strategic approaches to the clinical management of the injured must be tailored to circumstances that have the potential to overwhelm resources temporarily. Hospitals providing initial care must be aware that the first patients who are taken to medical facilities will present with uncontrollable bleeding from injuries to the trunk and body cavities. To improve the outcome of these patients in extremis, the aim of the index surgery is to stop the bleeding and control the contamination. Unlike damage control surgery, which is tailored to the patient's condition, tactical abbreviated surgical care (TASC) is first and foremost adapted to the overall situation. Once the patients are stabilised and all information on the situation is available, the surgical management and reconstruction of gunshot and blast injuries can follow the principles of damage control (DC) and definitive early total care (ETC). The purpose of this article is to provide an overview of the pathophysiology of gunshot and blast injuries, wound ballistics, and the approach and procedures of successful surgical management.
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    language: English
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