Battlefield radiology

Abstract

ABSTRACT. With the increasing tempo of military conflicts in the last decade, much has been learnt about imaging battlefield casualties in the acute setting. Ultrasound in the form of focused abdominal sonography in trauma (FAST) has proven invaluable in emergency triage of patients for immediate surgery. Multidetector CT allows accurate determination of battlefield trauma injuries. It permits the surgeons and anaesthetists to plan their interventions more thoroughly and to be made aware of clinically occult injuries. There are common injury patterns associated with blast injury, gunshot wounds and blunt trauma. While this body of knowledge is most applicable to the battlefield, there are parallels with peacetime radiology, particularly in terrorist attacks and industrial accidents. This pictorial review is based on the experiences of a UK radiologist deployed in Afghanistan in 2010.

An analysis of casualties presenting to military emergency departments in Iraq and Afghanistan

“…In our study, ED providers frequently obtained plain radiographs and computed tomography (CT) examinations. Published military research evaluating ED utilization of diagnostic imaging for adult trauma casualties is limited [52,[54][55][56]. The high rates of CT utilization we observed may be due to the complexities of explosive injuries, which produce penetrating, blunt, and thermal injury patterns.…”

FAST in the deployed military setting

“…The radiologist can interpret CT imaging with an intrinsic knowledge of the mechanism of injury and clinical condition of the patient. The initial read of the CT images can be undertaken immediately; this identifies potentially life-threatening findings which are reported verbally to the surgeons within 1–2 min, before a further in-depth report 15. After CT, further decision-making is made regarding surgery and ongoing resuscitation, while considering there may be multiple casualties in the department with injuries of varying severity.…”

Whatʼs new in operative trauma surgery in the last 10 years

“…Importantly, CT has allowed for the assessment of the trajectory of fragments and bullets delineated by a path showing air, blood and debris, this is known as 'tractology', by combat surgeons in the combat theatre [7,9]. Importantly, CT has allowed for the assessment of the trajectory of fragments and bullets delineated by a path showing air, blood and debris, this is known as 'tractology', by combat surgeons in the combat theatre [7,9].…”