Combat Radiology (eBook)

Col. Les Folio, a retired air force radiologist and flight surgeon with over twenty years of service, presents a comprehensive introduction to diagnostic imaging technology for the deployed military physician.

Foreword 8
Preface 10
Acknowledgments 12
Contents 14
Chapter 1: The Combat Environment: Preparation for Deployment 18
1.1 Introduction 18
1.2 Preparation for Deployment 19
1.3 Personal Effects 19
1.4 Military Training for Deployment 21
1.5 Trauma and Critical Care Imagining Training 23
Chapter 2: Echelons of Combat Casualty Care and Associated Imaging Resources 28
2.1 Introduction 28
2.2 Echelons of Care 28
2.3 Imaging Resources at a Level 3 Facility 32
2.3.1 Radiology Staffing, Hours 32
2.3.2 Radiology Equipment 33
2.3.2.1 Orex Computed Radiography Readers 34
2.3.2.2 Portable/Fixed X-Ray Units 35
2.3.2.3 Ultrasound 35
2.3.2.4 MedWeb and MedWeb Reading Stations 35
2.3.3 RIS/HIS 36
2.4 Hospital Resources/Staffing 37
2.5 Summary 37
2.6 Our Combat Radiology Department Library 37
References 38
Chapter 3: Blast and Ballistics: Types, Background, Terminology 39
3.1 Introduction 39
3.2 Types of Explosives and Types of Resultant Blast Injuries 39
3.2.1 Blast and Ballistic Terminology 42
3.2.2 Ballistics 42
3.2.3 Wound Ballistics 42
3.2.4 Wound Cavities 43
3.2.5 Even Number Guide 44
3.3 Summary 44
References 45
Chapter 4: Introduction to Imaging of Penetrating/Perforating Blast and Ballistic Injuries 46
4.1 Trauma Flow and Throughput of Casualties in a Deployed Combat Hospital 47
4.2 Damage Control Imaging 50
4.3 Unique Radiology Protocolization in Extreme Trauma 52
References 55
Chapter 5: Significant Medical Advances on the Battlefield and the Changing Roles of Imaging 56
5.1 Record Survival Rates of Combat Casualties 56
5.2 Imaging Advances in Deployed Combat Hospitals 57
5.3 Anatomic Positioning System and Trajectory Analysis 58
5.4 Compass Analogy 63
5.5 Construction of the Trajectory Plane(s) from the CT Dataset 64
5.6 The Trajectory Mapping Is Accomplished in the Following Manner 69
5.7 Additional Cases Presented to Highlight Complex Plane Application 72
5.8 Abdominal Trajectories 78
5.9 Ricochet Trajectories 80
5.10 Description of Mapped Planes 83
5.11 Further Quantification and Application of Coordinate System Relative, to a Standard Reference 89
5.12 Decision Support Tools, Expert Systems 101
5.13 Telehealth on the Battlefield 105
References 110
Chapter 6: Imaging Thresholds of Salvageability of Life, Limb, and Eyesight 112
6.1 Introduction 112
6.2 Pushing the Imaging Threshold of Mortality: Cases on the Edge of Life 113
6.2.1 Imaging Spectrum of Penetrating and Perforating Head Trauma on the Battlefield 113
6.3 Example Penetrating Head Injury Cases in Increasing Severity 117
6.4 Blast and Ballistic Injuries to the Neck 118
6.5 Eyesight Salvageability in Penetrating Trauma 124
6.6 Imaging in Limb Salvage 130
6.7 Radiology-Assisted Autopsy 135
6.8 Summary 142
References 147
Chapter 7: Imaging Traumatic Brain Injury On and Off the Battlefield 150
7.1 Introduction 150
7.2 Clinical and Public Health Considerations in mTBI in Combat 151
7.3 Imaging in TBI 152
7.4 Future of Imaging in mTBI due to Blast Injuries 155
7.5 Summary of Closed Head Injury and mTBI Imaging 159
7.6 Penetrating TBI 159
7.7 TBI Treatment 160
7.8 Summary 163
References 166
Chapter 8: Chest Imaging in a Battlefield Hospital 168
8.1 Introduction 168
8.2 Chest X-Rays in the Combat Hospital 168
8.3 ICU Chest X-Ray 168
8.4 Imaging Techniques 169
8.5 Blast Lung Injury 169
8.5.1 Airway BLI 170
8.5.2 Generalized Overpressure/Compression 175
8.5.3 Focal Blast Injury to Lung 177
8.6 Summary 180
References 184
Chapter 9: Abdomen and Pelvis Imaging in Iraq 185
9.1 Introduction 185
9.2 Cases 185
9.3 Summary 197
References 197
Chapter 10: Skeletal Trauma in Iraq 198
10.1 Introduction 198
10.2 Summary 216
References 226
Index 227