Management of Embedded Unexploded Ordnance in Low-resource Settings: A Scoping Review

Area of Science:

• Medical management
• Trauma surgery
• Public health in conflict zones

Background:

• Embedded unexploded ordnance (eUXO) amplifies the effects of explosive weapons, posing unique risks during medical care.
• Routine procedures can inadvertently detonate eUXO, leading to severe patient and provider consequences.
• Management of eUXO is particularly challenging in low-resource settings due to limited infrastructure and expertise.

Purpose of the Study:

• To identify and synthesize existing literature on the management of casualties with embedded unexploded ordnance (eUXO).
• To specifically address the challenges and strategies for eUXO management in low-resource environments.
• To identify gaps in current knowledge and guide future research and practice.

Main Methods:

• A comprehensive scoping review was performed adhering to PRISMA-ScR guidelines.
• Literature was evaluated across all languages and date ranges up to January 31, 2024.
• Included studies focused on injury patterns, diagnostics, treatment, resource use, and outcomes related to eUXO.

Main Results:

• Analysis of 13 selected reports revealed heterogeneous data reporting.
• Key themes identified include the critical importance of safety protocols, meticulous planning, and effective communication.
• The review highlighted significant gaps in the literature regarding standardized eUXO management strategies.

Conclusions:

• Effective management of eUXO necessitates a multidisciplinary approach involving diverse clinical and non-clinical expertise.
• Further research is needed to develop standardized protocols for eUXO care, particularly in resource-limited settings.
• Enhanced coordination and communication are paramount for ensuring patient and provider safety when dealing with eUXO incidents.