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A Novel In Vitro Model of Blast Traumatic Brain Injury
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A Novel In Vitro Model of Blast Traumatic Brain Injury

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The pattern of paediatric blast injury in Afghanistan

Daniel C Thompson1,2, R J Crooks3, J C Clasper4,5

  • 1Defence Medical Group South, Queen Alexandra Hospital, Portsmouth, UK dcthompson101@gmail.com.

BMJ Military Health
|October 23, 2017
PubMed

Insights

Children injured by explosive remnants of war and improvised explosive devices (IEDs) are at higher risk for severe head injuries. This study reviewed paediatric blast injuries, finding children are disproportionately affected by head trauma.

Area of Science:

  • Trauma Surgery
  • Paediatric Injury Epidemiology
  • Military Medicine

Background:

  • Armed conflict in Afghanistan resulted in significant child casualties from 2009-2015.
  • Improvised explosive devices (IEDs) and explosive remnants of war (ERW) comprised 29% of child injuries in 2015.
  • Paediatric blast injuries represent a critical public health concern in conflict zones.

Purpose of the Study:

  • To assess the burden of paediatric blast injuries treated at Camp Bastion, Afghanistan.
  • To investigate if children sustain proportionally more head injuries than adults from blast events.
  • To analyze injury patterns and severity in paediatric blast trauma.

Main Methods:

  • Retrospective analysis of prospectively collected data from the UK Joint Theatre Trauma Registry.
  • Inclusion of ambulant paediatric patients (aged 2-15 years) admitted with blast injuries from June 2006 to March 2013.
  • Examination of demographic data, injury profiles (New Injury Severity Score), and operative findings.

Main Results:

  • 295 paediatric admissions were identified, with a 18.5% mortality rate.
  • Improvised explosive devices (IEDs) were the primary cause, accounting for 68% of blast mechanisms and 80% of fatalities.
  • Lower extremities were most frequently injured (31%), but severe head/neck injuries were more prevalent in younger children (2-7 years) and unsurvivable head injuries accounted for 88% of deaths.

Conclusions:

  • Paediatric blast casualties, though a small fraction of the workload, exhibit distinct injury patterns.
  • Children are more susceptible to severe head, face, and neck injuries compared to adults.
  • Findings highlight the vulnerability of children to devastating blast-related trauma, particularly to the head.
Abstract

Keywords:
AfghanistanIEDblastorthopedicspaediatricstrauma

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