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Twenty-one-year experience with land mine injuries
1Department of Surgery, United States Naval Hospital, Charleston, South Carolina.
The Journal of Trauma
|January 1, 1988
Summary
Land mine injuries are often fatal, with extremity amputations common. Aggressive prehospital and hospital resuscitation is critical for potentially salvageable patients with specific injury types.
Area of Science:
- Trauma surgery
- Military medicine
- Emergency medicine
Background:
- Antipersonnel land mines cause severe, often fatal injuries.
- M-16 series mines have resulted in 100% fatality in close-range incidents at Guantanamo Bay.
- All recorded fatalities involved extremity amputations.
Purpose of the Study:
- To analyze injury patterns from antipersonnel land mines.
- To identify potentially salvageable patients.
- To recommend optimized prehospital and hospital management strategies.
Main Methods:
- Review of casualties from antipersonnel land mine incidents.
- Classification of injuries into Type I (fatal head, neck, or truncal) and Type II (limb-focused).
- Analysis of prehospital and hospital treatment protocols.
Main Results:
- 15 antipersonnel mine fatalities were analyzed.
- Seven patients sustained immediately fatal Type I injuries.
- Three patients with Type II injuries survived with extremity amputations after resuscitation.
- Type II injuries, especially bilateral above-knee amputations, require specific triage considerations.
Conclusions:
- Potentially salvageable patients are those without immediate fatal Type I injuries.
- Aggressive prehospital and hospital resuscitation is vital for Type II patients.
- Triage protocols should prioritize Type II patients, potentially categorizing severe amputations for expectant care in mass casualty events.