Lower Leg Injury Mechanism Investigation During an IED Blast Under a Vehicle Using an Anatomic Leg Model

Attacks with improvised explosive device (IED) constituted the main threat to, for example, Polish soldiers in Iraq and Afghanistan. Improving safety during transport in an armored vehicle has become an important issue. The main purpose of the presented research is to investigate the mechanism of lower leg injuries during explosion under an armored vehicle. Using a numerical anatomic model of the lower leg, the analysis of the leg position was carried out. In all presented positions, the stress limit of 160 (MPa) was reached, which indicates bone damage. There is a difference in stress distribution in anatomic elements pointing to different injury mechanisms.

A Case Report of External Cardiac Pads Used for Internal Cardiac Defibrillation During Resuscitative Thoracotomy

ABSTRACT This is a case report regarding the use of non-conventional methods to perform internal cardiac defibrillation on a trauma patient in an austere environment. The patient was a polytrauma causality of an improvised explosive device who arrived to a far forward resuscitative surgical team during a recent armed conflict. After arrival, the patient lost pulses. An emergency resuscitative thoracotomy was performed, and the patient was noted to have ventricular fibrillation on direct cardiac visualization. In the absence of standard surgical defibrillation paddles, the team applied external defibrillator stickers directly to the patient’s myocardium to deliver an electrical shock. The procedure successfully led to the return of spontaneous circulation. This report highlights a novel approach to resuscitation in resource-limited environments by a military surgical team.

Blast mitigation using polymeric 3D printed auxetic re-entrant honeycomb structures: A preliminary study

Protection of critical infrastructure in an urban environment is a challenging task, specifically against the vehicle bourne improvised explosive device threat. To design infrastructure to withstand this evolving threat, novel solutions and advanced materials need to be developed. One such material of interest are auxetics. This study experimentally analysed the mitigation of blast response of auxetic re-entrant honeycomb structures, with geometries varying between −ve 30° and +ve 30° using additive manufacturing (3D printing) techniques and non-explosive loading via shock tube. Re-entrant auxetic structures (−ve 15°) exhibited repeatable blast mitigation of 23% and reduced the transmitted pressure and impulse of the blast wave. Further highlighting their potential application as a protective measure to enhance a structures blast survivability.

Buccal mucosa graft tube urethroplasty for the treatment of bulbopenile urethral trauma accompanied with massive tissue loss due to improvised explosive device injury

Urinary diversion with suprapubic cystostomy and delayed urethroplasty is recommended for the treatment of penetrating posterior urethral traumas. A devastating urethral trauma caused by a blast injury due to an improvised explosive device is an extremely rare clinical condition and treatment options are limited due to accompanying massive tissue and muscle loss. Staged urethral reconstruction using a pedicled gracilis muscle flap with a skin or buccal mucosa graft is the preferred treatment option for complex urethral traumas. In case of a devastated urethra due to an intensive explosive device injury, treatment options are limited, especially if the gracilis muscle cannot be used. We report the case of a 30-year-old male patient with a devastated bulbopenile urethra and massive local tissue and adjacent muscle loss including the gracilis muscle. The patient was successfully treated by buccal mucosa graft tube urethroplasty. Urethral stricture recurred but was successfully treated by means of endoscopy. At 24 months’ follow-up, the patient was continent and urinated normally.

GENITOURINARY INJURIES DURING WAR AGAINST TERROR: A SINGLE-CENTER EXPERIENCE

Objective: To compare our experience of genitourinary injuries during the war against terrorism with the record of those in previous wars of the World. Study Design: Cross sectional study. Place and Duration of Study: Urology department, Combined Military Hospital Peshawar, from Jun 2011 to Aug 2014. Methodology: We treated 89 (5.6%) cases of genitourinary injuries received in our tertiary care hospital in Khyber Pakhtunkhwa. The hospital was located at a distance of 2-3 hours of evacuation time by helicopter from the forward operational area. Results: The frequency of genitourinary injuries among 1589 war casualties was (5.6%). Out of these 49 (55%) were due to sniper shots and 40 (45%) due to improvised explosive device. Kidney was the most common organ injured 30 (33.7%), followed by bladder 20 (22.5%) and urethra 14 (15.7%). Majority of renal and bladder injuries were afflicted in those soldiers who were not wearing the protective jackets. Associated injuries to other organs were identified in 81% cases. Salvage of all genitourinary organs was the aim; however, nephrectomy and orchiectomy had to be performed in 30% and 50% respectively. Conclusion: Salvage of genitourinary war injuries poses a challenge to the trauma surgeon as lifesaving measures take precedence over organ preservation. Renal trauma in war was found to be the leading critical genitourinary injury.

Characteristics of Homemade Explosive Materials and the Possibilities of their Identification

One of the greatest challenges for explosive ordnance disposal operators is the disarming process of an improvised explosive device. These dangerous devices are often made from homemade explosive. Committing a bomb attack in urban areas is a basic weapon of terrorists, which may claim civilians’ lives. The main aim of experts is to avoid any lethal attack and to stop terrorists who endanger our life. Identifying homemade explosives may also help during the fight against terrorism since information may be provided this way, which is essential for professionals who work in the areas of operations. Usage of high-tech equipment provides stable and reliable background in the field of explosives’ analysis.

A Simulation Algorithm Capable Of Modelling Spatial Impact Points From The Neutralization Of An Improvised Explosive Device

An improvised explosive device (IED) is a bomb constructed from unknown materials, often concealed, such as inside an innocuous container, and deployed in unconventional ways resulting in a potentially deadly weapon. Public safety personnel such as Explosive Disposal Units (EDUs), are trained in the safe handling of explosives and the threats posed by IEDs. One method of neutralizing a suspect IED is to use water fired from a high-powered dispersion weapon commonly known as a disrupter cannon. Our research proposes an algorithm for developing an IED neutralization simulation that can emulate real-world physical effects of the successful neutralization of an IED without danger to the public or first responders. This algorithm includes 6 methodologies with the goal of providing EDU with additional information on the potential physical dispersion of the components of an IED and any major points of impact (splatter) and possible actionable intelligence on the pose and direction of a disrupter cannon for a successful neutralization of an IED. We have developed a prototype simulation based on this algorithm and evaluated the simulation with an appropriate real-world disrupter and compared the real-world splatter to our simulation’s splatter. We argue systems developed with our algorithm may provide relevant information directly from the simulation and can be accurately used to analyze particle dispersion for the purposes of augmenting EDU IED neutralization processes.

A Simulation Algorithm Capable Of Modelling Spatial Impact Points From The Neutralization Of An Improvised Explosive Device

An improvised explosive device (IED) is a bomb constructed from unknown materials, often concealed, such as inside an innocuous container, and deployed in unconventional ways resulting in a potentially deadly weapon. Public safety personnel such as Explosive Disposal Units (EDUs), are trained in the safe handling of explosives and the threats posed by IEDs. One method of neutralizing a suspect IED is to use water fired from a high-powered dispersion weapon commonly known as a disrupter cannon. Our research proposes an algorithm for developing an IED neutralization simulation that can emulate real-world physical effects of the successful neutralization of an IED without danger to the public or first responders. This algorithm includes 6 methodologies with the goal of providing EDU with additional information on the potential physical dispersion of the components of an IED and any major points of impact (splatter) and possible actionable intelligence on the pose and direction of a disrupter cannon for a successful neutralization of an IED. We have developed a prototype simulation based on this algorithm and evaluated the simulation with an appropriate real-world disrupter and compared the real-world splatter to our simulation’s splatter. We argue systems developed with our algorithm may provide relevant information directly from the simulation and can be accurately used to analyze particle dispersion for the purposes of augmenting EDU IED neutralization processes.

Extraction of a bullet floating in the pulmonary artery after a gunshot wound

Background Patients with thoracic trauma caused by gunshots face a high risk of death, and medical staff often encounter technical difficulties in resolving these cases. Most gunshot wounds result in an entrance and exit wound. In cases with no exit wound, missiles are seen in other areas with screening radiographs. The bullet may migrate depending on gravity, coughing, swallowing, blood flow, or local erosion. Case presentation We present the case of a teenager who was hospitalized in critical condition owing to a left hemithorax injury caused by an improvised explosive device. The patient underwent two surgeries: an anterior left thoracotomy during which a hole in the myocardium was sutured, and after radiography, anterolateral right thoracotomy was performed, in which a deformed projectile was found at the level of the intermediate right pulmonary artery. Conclusions This case highlights the crucial importance of repeated imaging to assess the possibility of projectile migration within the cardiovascular system in similar cases of penetrating injury. Immediate surgery was necessary and very important for the survival of our patient, despite the difficulties presented by this complicated case.