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Incidents involving ballistic trauma are likely to produce more than one casualty. Some incidents (e.g., bombings) may generate large numbers of casualties creating Major Incidents or even Mass Casualties. Once the number of casualties outstrips the medical resources available, a system is required to ensure optimal medical care whilst making the best use of those resources.
Prehospital care of the ballistic casualty should be considered as two intertwined areas: 1.Management of the situation. 2. Management of the casualty. Managing the situation involves understanding what is happening at the ballistic incident, who is in charge, the medic’s role within this situation, and what medical advice and actions are appropriate. Managing the injured casualty consists of first...
The Emergency Department management of patients with ballistic trauma should include rapid assessment and life-saving intervention, followed by appropriate investigation and referral for definitive management depending on the haemodynamic status of the patient (Figs. 17.1–17.4).
The initial evaluation for ballistic trauma continues to consist of a thorough physical exam followed by evaluation of the physiologic status of the patient. The patient should be fully exposed followed by detailed wound examination to determine projectile trajectory. Based on the suspected path of the missile, determinations can be made as to what structures are likely injured and what interventions...
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