Roadside bombs and routes to life: The experience of Turkey

INTRODUCTION: Injuries caused by roadside improvised explosive devices (IEDs) have recently been on the increase in Turkey. The aim of the present study is to evaluate the types of injuries sustained by victims of IEDs, and the pre-hospital/inter-hospital handling of patients transported to a Level 1 trauma center following roadside bombings.
METHODS: Data were obtained from the registry of an earlier multi-centric prospective study designed to evaluate injuries caused by high kinetic energy weapons. Here, we retrospectively analyze injuries resulting from roadside bombs. All patients in the registry from August 2015 to May 2016 who were victims of roadside explosions were included. Patient demographics, injury severity scores (ISS), wound types, and transfusions needs were recorded and outcomes (length of hospital stay and mortalities) were evaluated.
RESULTS: Of 390 patients injured by high kinetic energy weapons, 51 were wounded by roadside bombs (an estimated hospital incidence of 13; 1%). Fourteen separate incidents were observed (an average of 3.6 patients per incident). Of these patients, 8 were civilian and 43 were security personnel. The injury ratio to multiple body regions was 71.8% and the mortality ratio was 15.7%. Pneumothorax and pulmonary contusion were the leading pathologies in terms of lethality. Vehicular accidents were frequently observed as causes of tertiary blast injuries. Twelve patients were transported to hospital who did not have physical injuries
DISCUSSION AND CONCLUSION: Our experience has shown that a roadside bomb not only causes an explosion, but also possibly a vehicular accident, burns, and, severe psychological trauma as well.