Hurt Locker and Blast Injuries
I just saw the Hurt Locker directed and produced by Kathryn Bigelow.
A movie about the solitude of explosive munitions neutralizer soldiers. The entire movie portrays disarming Improvised Explosive Devices (IED) sometimes successfully and sometimes not. The movie is nominated for an Oscar.
An IED is a device fabricated or placed in an improvised manner, incorporating lethal, noxious, pyrotechnic, or incendiary materials designed to destroy, incapacitate, harass, or distract. It may incorporate military parts, but is normally constructed from nonmilitary components.
What the movie does not provide is the reality these repeated trauma have on soldiers.
To study such biomechanics and injury, the North American Brain Injury Society (NABIS) formed one of the first committees. Blast Injury and TBI by Ronald C. Savage, EdD Executive Vice President, NABIS, states:
During the Vietnam War and the Persian Gulf War, 76 percent of American troops survived combat wounds. But in this century, the U.S. military's surgical teams "have saved the lives of an unprecedented 90 percent of the soldiers wounded in battle…" (New England Journal of Medicine, December, 2006). Furthermore, Walter Reed Army Medical Center reported that nearly 30% of all patients with combat-related injuries seen at Walter Reed from 2003 to 2005 sustained a TBI and that blast injuries are a significant cause of TBIs In addition, they reported that TBI is often associated with severe multiple trauma, post traumatic stress disorder (PTSD) or undiagnosed concussions. Thus, screening soldiers who are at risk for a TBI is important in order to ensure that TBIs are identified and appropriately treated.
Diagnosis can be difficult even when TBI is apparent or the patient is able to describe a concussive head injury to their doctors. The more common mild brain injury often has more than mild consequences and can cause depression, reduced cognitive functioning, nausea,
sleep disturbance, erratic behavior, and mood swings. These impairments are exacerbated by misdiagnosis, lack of treatment and the public’s misperceptions about brain injury and mental illness. For veterans with brain injuries, the lack of physical signs and the diffuse nature of symptoms may be met with skepticism, considered to be psychological, or worse, malingering.
As professionals in the field know, the “walking wounded” do not disappear. And many more will be seen and heard in this decade. Thanks to improvements in protective gear and swift medical treatment, more of America's wounded are surviving - and returning home with serious, permanent injuries. How will these veterans fare in the routines of daily life? Will they be able to maintain employment? How will their injuries impact their families, friends, co-workers, and communities?
The North American Brain Injury Society has begun to address these important issues. We recently published a special edition of Brain Injury Professional that focused solely on blast injury and TBI. NABIS would like to extend our sincere appreciation and thanks to Representative Bill Pascrell, co-chair of the Congressional Brain Injury Task Force, who wrote a thoughtful introduction, and also to Dr. Tina Trudel who served as Guest Editor.
In addition, the Planning Committee of our 2007 conference has organized a number of sessions devoted to the topic of blast injury. NABIS will continue to explore additional ways that we can create positive change in this area and we look forward to sharing those ideas with our membership in the future.
Susan Lance, a speech pathologist specializing in •developmental problems •strokes
•brain injuries and •other neurological disorders, states,
According to the Defense and Veterans Brain Injury Center (DVBIC), over 50% of injuries sustained in combat are the result of explosive munitions including bombs, grenades, land mines, missiles, and mortar/artillery shells (Coupland & Meddings). The polytrauma conditions sustained by these explosions affect various systems of the body. TBI has been associated with between 59% and 61% of blast-associated injuries seen at Walter Reed Army Medical Center (WRAMC). Since November 4, 2006, blasts have been the most common cause of injury among American soldiers treated at WRAMC (Ippolitito).
How The Explosion Creates a Blast Wave
Blast injuries result from the complex pressure wave generated by an explosion, causing an instantaneous rise in pressure over atmospheric pressure. This is called a blast over-pressurization wave (CDC, Mass Casualties).
Primary blast injury occurs from an interaction of the over-pressurization wave and the body. The resulting injuries affect various organs. Air-filled organs such as the ear, lung, and gastrointestinal tract are especially vulnerable to blast injury. Equally susceptible are organs surrounded by fluid-filled cavities, such as the brain and spinal cord (Elsayed; Mayorga). The over-pressurization wave dissipates quickly, causing the greatest risk of injury to those closest to the explosion.
There are two categories of explosives:
-
High-order explosives (HE) such as TNT, C-4 and dynamite produce a definitive supersonic over-pressurization shock wave.
-
Low-order explosives (LE) such as pipe bombs, gunpowder and Molotov cocktails create a subsonic explosion and lack HE’s over-pressurization wave.
How The Blast Wave Creates Blast Injuries
There are four basic mechanisms of blast injury, all of which may result in Central Nervous System (CNS) injuries (CDC, Mass Casualties).
Read more at Suite101: What Are Blast Injuries?: Explosive Munitions Cause Multiple Injuries In Combat http://disabilities.suite101.com/article.cfm/what_are_blast_injuries#ixzz0df3sNthr
