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By Thomas E. Bowen

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Transport. ♦ If by helicopter, ground the casualty to the aircraft (there is a large electrostatic charge from rotors). ο Move into safe area. ♦ Revetment, parking lot, or back of building. ο Operate in safe area, not in main OR area. Operative management. ο Precautions for surgeon and staff. 13 Emergency War Surgery ♦ Sandbag operative area, use flak vests and eye protection. ο Avoid triggering stimuli. ♦ Electromagnetic (no defibrillator, monitors, Bovie cauterizer, blood warmers, or ultrasound or CT machines).

This may cause catastrophic wounds to soldiers who are hit, or it may ignite fuel, ammunition, or hydraulic fluid. ◊ There is a second type of debris, called spall, which is material knocked off from the inside face of the armored plate. This produces a spray of small, irregularly shaped fragments inside of the compartment (Fig. 1-7b). ο Kinetic energy round. ♦ The kinetic energy (KE) round contains an aerodynamically shaped piece of hard metal (such as depleted uranium or tungsten) shaped like a dart.

These landmine casualties have the highest reported mortality. 6 Weapons Effects and Parachute Injuries ο Horizontal spray mines propel fragments in one direction. This land mine can be command-detonated or detonated by tripwire. The US Claymore mine fires about 700 steel spheres of 3⁄4 g each over a 60° arc. Horizontal spray mines produce multiple small-fragment wounds to those nearby. An unconventional weapon (improvised explosive device, or IED) is a fourth type of antipersonnel landmine. Either another piece of ordnance is used, such as a grenade or a mortar shell, or the device is completely fabricated out of locally available materials.

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