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The Mechanical Behaviour of Biological Tissues at High Strain Rates
Published in Melanie Franklyn, Peter Vee Sin Lee, Military Injury Biomechanics, 2017
Feng Zhu, Tal Saif, Barbara R. Presley, King H. Yang
The readiness of a military combat unit could be substantially affected when the number of troops is reduced due to injuries, which most often occur during combat missions. Prevention and adequate recovery from such injuries require precise knowledge of underlying causational factors, many of which have not been fully elucidated. Due to advances in protective equipment for military personnel, such as Kevlar body armour and advanced combat helmets, there has been an increase in survival of soldiers exposed to penetrating missiles from bullets and flying debris caused by blast winds. However, even without penetration, both bony and soft tissues can sustain damage from the high-speed pressure waves present during blasts, such as those caused by improvised explosive devices (IEDs). The higher survival rate of soldiers subjected to blasts, coupled with ruptures in unexposed soft tissues induced from high-energy blast waves, has resulted in a higher percentage of wounded soldiers in need of protection and treatment for soft tissue injuries (Mahoney et al. 2005; Okie 2005; Wolf et al. 2009). In addition to the advanced protective measures, modern soldiers are much more likely to be riding in military vehicles than soldiers who were primarily exposed to combat in jungles. Soldiers in military vehicles are additionally subjected to risks of lower extremity bone fractures due to extreme loading conditions from underbelly blasts. These extreme conditions produce intensive dynamic loads with much higher energy and strain rates than those induced in civilian settings. Impact-induced injuries in the civilian population are typically blunt trauma (Champion et al. 2003) and are induced during events such as automobile accidents, falls and contact sports. Understanding that responses are different for human tissues exposed to modern combat conditions versus combat in jungles or civilian scenarios is necessary for better mitigation of injuries, which in turn serves to better maintain combat readiness of military units.
Miscellaneous procedures
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The type of injury will influence the nature and extent of an abdominal injury. MDCT is used to assess for vascular injury and to characterise (e.g. site/grading) solid organ injuries. Spleen and liver injures are the most common type of blunt trauma injury.
Development of injury risk models to guide CT evaluation in the emergency department after motor vehicle collisions
Published in Traffic Injury Prevention, 2018
Thomas Hartka, George Glass, Christopher Kao, Timothy McMurry
Imaging was performed in over 70% of ED visits for evaluation after MVCs and computed tomography (CT) scans were performed in almost 30% of cases (Albert and McCaig 2015). Yet the majority of patients received the ultimate diagnosis of sprain, strain, or contusion of unbroken skin, and fractures were only diagnosed in 6.1% of patients. However, studies have shown that physical exam and clinical gestalt may be insufficient to detect all injury after blunt trauma (Gupta et al. 2011; Nishijima et al. 2012; Smith et al. 2011). Whole-body CT (performing a CT scan of all major body regions of the head, neck, and trunk) has become common in the evaluation of blunt trauma and there are several retrospective studies that show decreased mortality with its use (Huber-Wagner et al. 2009; Hutter et al. 2011; Kanz et al. 2010; Salim et al. 2006). This reliance on CT has led to a large number of CT scans that ultimately show no major injuries. In a single-center study of an academic trauma center, 21.2% of intermediate trauma victims received CT scans of all 4 major body regions (head, neck, chest, and abdomen/pelvis). On average, patients received 2.36 CT scans, 2.1 of which did not show any injury (Hansen et al. 2016). The exact risk posed by CT usage is not known, but a retrospective analysis found that children exposed to radiation from CT scans had a 24% higher incidence of cancer compared to those with no exposure (Mathews et al. 2013). The risk for an adult undergoing a whole-body CT has been estimated at 0.08% (Brenner and Elliston 2004; Brenner and Hall 2009). Patients are largely unaware of the potential risks of ionizing radiation (Baumann et al. 2011; Rodriguez et al. 2014). In addition to radiation exposure, there is a substantial financial cost to patients; in 2011, the charges for performing and interpreting a whole-body CT were approximately $17,000 (Gupta et al. 2011).