Emergency Medicine in the Persian Gulf War—Part3: Battlefield Casualties

Study objective: To report the type and frequency of battlefield casualties and the procedures performed to treat them. Study design: A prospective analysis of trauma record data incorporating anatomic categories and the Revised Trauma Score. Setting: Two military field trauma centers during the primary ground assault into Kuwait. Type of participants: Four hundred two trauma admissions of coalition and enemy forces. Main results: Forty-eight percent of casualties suffered fragmentation wounds, including 43 land mine injuries. Only 10% sustained gunshot wounds. Forty-four percent of casualties had injuries limited to the extremities; 29% had combined extremity injury and injury to another anatomic region. Extremity wounds occurred nearly twice as frequently in the lower extremities as in the upper extremities. Surgical procedures were undertaken in 164 patients, with 108 debridements for major soft tissue injuries or open fractures. Conclusion: The composite casualty admitted to US Navy-Marine trauma facilities was injured by shrapnel in the lower extremity and required surgical debridement only. Soldiers with land mine injuries, as in other wars, were among those in greatest need of emergency resuscitation. [Burkle FM Jr, Newland C, Meister SJ, Blood CG: Emergency medicine in the Persian Gulf War — Part 3: Battlefield casualties. Ann Emerg Med April 1994;23:755-760.]