Suspension, Blast and Ballistics Trauma

What is suspension trauma?

• A casualty who is experiencing pre-syncopal symptoms or who is unconscious whilst suspended in a harness

What is the pathology behind suspension trauma?

• Lower extremity venous circulation is exclusively dependent on muscle contraction

• When suspending and immobile, cascading can occur almost immediately

What is a suspension cascade?

Victims that can’t escape vertical position with dangling legs

• after 3-6 mins venous pooling begins unless legs are moving

• 6-12 mins - obstruction of venous return worsens as harness compresses femoral veins

What are the two types of hanging?

• Short drop - Death due to compression of airway

• Long drop - Death due to fracture-dislocation of spine

How would you manage a patient who is hanging?

• Remove ligatures

• Call for help

• Consider C-spine

• Airway > C-spine though

What are examples of causes of blast injuries?

• Warfare/ terrorism

• Gas leaks

• Factories, commercial sites

• Fuel refineries

• Transport

Primary blast injuries

Blast shock wave

Secondary blast injuries

Flying fragments/ debris

Tertiary blast waves

Blast wave propels patient against objects

Quaternary blast waves

Other explosion related injury and illnesses

Quinary blast waves

Resulting from additives such as bacteria and radiation