Emergency War Surgery NATO Handbook: Part I: Types of Wounds and Injuries: Chapter VIII: Multiple Injuries

Etiological Considerations

United States Department of Defense
Peer Review Status: Internally Peer Reviewed

The patients in this group most often have sustained multiple missile wounds involving a number of organs or anatomical areas. In addition to missile wounds, these casualties frequently present with associated traumata of other kinds, as follows:

1. Thermal traumata (burns or cold injuries).
2. Physical traumata, including blast injuries, underwater compression as seen in submarine or ship crews, injuries following decompression (aviation or diving crews), crush injury, electrical injury, and rapid deceleration injuries as commonly seen in aircraft and vehicular accidents.
3. Chemical traumata such as phosphorus burns; exposure to organic fuels or propellants; injuries resulting from other chemical agents causing either cutaneous, respiratory or other systemic irritation, or depression of the nervous system.
4. Ionizing radiation injuries with either local or systemic effects.

These special injuries are seen with increasing frequency either in combination with the usual battle wounds or in combination with each other. Personnel working in various military specialties are subject to combinations of injuries which may be unique to their specialty or environment. Physiological disturbances secondary to multiple factors, such as climatic or environmental temperature extremes, dietary inadequacies, superimposed acute or chronic infectious diseases, and systemic poisoning, must also be considered and dealt with.

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