Author : AZEEZ ALI FRCS, ALI
journal of kerbala university,
Volume 2, Issue 4, Pages 212-222
Terroristic offences kill or disable people and destroy the infrastructures. Triage and management of the victims are challenge for the health personals and exhaust resources.
Ten percent of the injuries involve the abdominal and thoracic regions. Many of the clinical findings may present lately. Surgical teams should be initiative in dealing with such misshapen. The health personals should have continuous training and concerns, to do the best.
To determine abdominal organ injuries in relation to other body parts involvement, with evaluation of our triage and management system.
A dual terrorist explosion violated people in Karbala city on fifth of Jan. 2006. Victims were evacuated and treated in Al Hossain General Hospital, triage was carried out by the clinical teams and marked as four severity scores.
Victims were 186.Survivors 74%, mortals 26%, arrived Emergency Department (ED) but not admitted cases 57%, admitted cases 43%; simple cases 56%, moderate 18%, severe 22%, and extensive 3.5%. Fifty one percent of the admitted survivors were treated conservatively, 26 (44%) cases needed major operative procedures; 20 laparotomies; 3 of them with no findings. Most common abdominal organ injuries were the small bowel, liver, spleen and colon. There were 24.5% extra bed occupation in the1st week.
The high Mortality Rate) MR) at the scene was correlating the explosion tactic. The intra hospital MR, in part, depends on the triage, preparedness and facilities. The severity depends on the target organ involvement, and its severity rather than the regional multiplicity. Most traumas were penetrating, without a real barotraumas. Laparotomies highlighted other surgeries; some abdominal trauma entities were unappreciated.
Recommendations include initiation of trauma scoring system; the discharged victims need follow-up, introducing more ED investigations, beds, resources, and transport tools.
Consecutive scenario drills can be invaluable in our health service preparedness