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Wat te doen bij een bomaanslag? 15 tips

4/26/2016

 
Foto
Ned Tijdschr Geneeskd. 2016;160:D379

​De recente aanslagen in Parijs en Brussel maken het onderwerp ‘letsels door explosieven’, ook wel ‘blastletsel’ genoemd, ook voor Nederland actueel. Er is weinig ervaring in Nederland met terroristische aanslagen. Hierdoor hebben medische zorgverleners mogelijk onvoldoende kennis van blastletsel. Na uitleg over het mechanisme van explosies en de uitwerking op het menselijk lichaam geven wij 15 tips met belangrijke behandelprincipes. Deze tips kunnen hulpverleners helpen bij de opvang van deze complexe slachtoffers.
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Trauma Care at a Multinational United Kingdom-Led Role 3 Combat Hospital: Resuscitation Outcomes From a Multidisciplinary Approach

11/10/2014

 
Mil Med. 2014 Nov;179(11):1258-62.  


Abstract:
Recent conflicts have led significant advancements in casualty care. Facilities serving combat wounded operate in challenging environments. Our purpose is to describe the multidisciplinary resuscitation algorithm utilized at a United Kingdom-led, Role 3 multinational treatment facility in Afghanistan focusing on injury severity and in-hospital mortality. Methods: Data were extracted from our prospectively collected trauma registry on military members wounded in action. Results: From November 1, 2009 to September 30, 2011, there were 3483 military trauma admissions. Common mechanisms of injury were improvised explosive devices (48%), followed by gunshot wounds (29%). Most patients (83.1%) had an Injury Severity Score (ISS) <15. For patients with complete ISS data, 8.4% had massive transfusion and 6.1% had an initial base deficit >5. Patients admitted with signs of life had a died of wounds rate of 1.8% with an average 1.2 day hospital stay. The mortality rate for patients undergoing massive transfusion was 4.8%, and for patients with a base deficit >5, mortality was 12.3%. Severely injured patients (ISS > 24) had a mortality rate of 16.5%. Conclusion: A systematic, multidisciplinary approach to trauma is associated with low in-hospital mortality. The outcomes in this study serve as a measure for future care in Role 3 facilities.
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