Mechanism-of-injury approach to evaluating patients with blast-related polytrauma.
Civilians and military personnel alike are increasingly being exposed to explosives in war zones and other regions of political conflict and, consequently, they are suffering associated blast-related polytrauma (multiple complex injuries). Although acute, emergency-based medical care for patients with blast-related trauma has been well described, postacute clinical management--which is of greatest interest to primary care physicians and rehabilitation specialists--has not been well discussed or researched. The authors offer a description of the common injuries seen in patients with blast-related polytrauma, as well as a conceptual model of a potential evaluation and treatment strategy in the postacute setting. Although medical evaluation of a patient typically proceeds in a sequential manner based on primary symptoms, the authors advocate a parallel approach to patient evaluation based on mechanism (cause) of injury. Such an approach relies on knowledge of the typical physical and psychological sequelae associated with a particular mechanism of injury to guide patient assessment and treatment. The authors highlight the mechanism-of-injury approach used with patients who have blast-related polytrauma at the Veterans Health Administration's (VHA) Veterans Affairs Medical Center in Tampa, Fla, site of one of the VHA's four Polytrauma Rehabilitation Centers.
Scott
Steven G
SG
US Department of Veterans Affairs, James A. Haley Veterans' Hospital, Tampa, FL 33612-4745, USA.
Belanger
Heather G
HG
Vanderploeg
Rodney D
RD
Massengale
Jill
J
Scholten
Joel
J
D019090:Case Management; D005107:Explosions; D006801:Humans; D009104:Multiple Trauma; D010021:Osteopathic Medicine; D010348:Patient Care Team; D012017:Referral and Consultation; D014481:United States