Abstract

The medical effects of weapons used in modern conventional warfare are, overwhelmingly, penetrating. Fragments from explosive munitions such as shells, rockets, and grenades are the predominate source of missiles, especially in high-intensity war. Bullets from assault rifles and machine guns cause fewer casualties, except in counterinsurgency operations. The threat from penetrating missiles depends upon the part of the body that is struck and, to a lesser extent, upon the physical characteristics of the missile. The missile's mass and velocity determine its potential to do physical damage, but the extent to which this potential is realized depends upon diverse factors such as shape, construction, and stability. The American experience in the wars of this century indicate that approximately 20%-25% of all casualties died on the battlefield and are therefore classified as killed in action. Approximately 3%-5% die while receiving care, and thus are classified as died of wounds. Wounds of the brain or heart and great vessels are the most common causes of death. Prevention of sepsis in soft-tissue and orthopedic wounds is the major medical treatment problem in survivors. Since it determines the quality and quantity of combat casualty care, the single most important factor determining mortality or morbidity for combat casualties is the tactical situation.

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