Step on a mine
Have the leg amputated in the FST
Next stop the Invictus Games
Slam Bang Dunk
All done and dusted
Except of course it is not quite that simple.
The study of blast injuries commenced with observations by Dr Gilbert Blane in 1785 who was then “Physician to the Fleet”. The term “Wind of Ball” was coined for those who had perished when a cannon ball passed close but did not leave a mark.
In a series arising from the battle of Monte Cassino in spring 1944 evidence of Blast Lung Injury (BLI) was found in 34.5 per cent of a series of 87 autopsies performed in soldiers who died with no external evidence of thoracic injury, while diffuse pulmonary contusions were found in 47 per cent of the fatalities in Northern Ireland in the period between 1969 and 1974.The type of explosive is significant
There is for the, purposes of this website, one type of explosive
Military explosive – the type found in mines, shells, mortar bombs.
(Non-military explosives – sodium chlorate, fertiliser types – not seen in Oman)
(Fuel/Air explosives causing barotrauma also not seen in Oman)
The military type have a characteristic and brutal shock wave pattern associated with them.
The shock wave smashes into the victim causing multi organ damage much of which is not immediately apparent. It may be a simple shockwave or if the victim in in an enclosed area a complex multiple shockwave. They both cause multi-system injuries. The mechanism are described as spallation, implosion and inertia.
It has been classified as having four main elements
Immediate Primary Injuries
The place that is most vulnerable to blast injury is where a solid organ contains or meets a hollow gas filled space; a vulnerable interface. This does not exclude other parts of the body.
Long term Effects
Where does all this start ? The obvious suggestion must be at he moment of injury.
The so-called “unexpected survivors” appear to age more quickly, develope hypertension, coronary artery disease and chronic kidney disease sooner than their peers.
They may suffer long term PAIN which is especially challenging to manage.
There are also the obvious long term effects of blast injury – missing limbs, deafness, shortness of breath.
What of conditions that have only been widely recognised since the wars in Iraq and Afghanistan. – Heterotrophic Ossification ? Muscle, tendons and blood vessels which progressively become ossified and turn into bone requiring yet more surgery.
There are less obvious consequences that are a consequence of Traumatic Brain Injury (TBI) ?
It is not all over and done with once the damaged limb is removed.
One of the injured from the battle at Mirbat died a few months later in the UK.
On arrival in the FST he had a shattered lower right jaw from what was probably a bullet from an AK-47; up to 1500ft lbs of muzzle energy at 2,500 ft per second.
There was considerable rumour about the cause of his death including malaria but the one that has most currency is that it was a portion of tooth blasted deep into a lung. The tooth fragment may have contributed but it is not unreasonable to suggest that the blast wave of the bullet hitting his upper respiratory tract caused damage throughout his lungs which eventually proved to be fatal and that attributing it simply to the tooth fragment is possibly over-simplistic.
There are a number of articles in the Journal of the Royal Army Medical Corps which deal with both actual blast injuries from “Ireland to Afghanistan” and the experimental investigation of blast injuries in the UK at Porton Down