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Emergency first responder management of combat injuries to the torso in the military, remote and austere settings
  1. Amritpal Sandhu1,
  2. H A Claireaux2,
  3. G Downes3,
  4. N Grundy3 and
  5. D N Naumann4
  1. 13 Medical Regiment, Royal Army Medical Corps, Preston, UK
  2. 24 Armoured Medical Regiment, Royal Army Medical Corps, Tidworth, UK
  3. 31 Armoured Medical Regiment, Royal Army Medical Corps, Tidworth, UK
  4. 4Academic Department of Military Surgery and Trauma, Birmingham, UK
  1. Correspondence to Maj D N Naumann, Academic Department of Military Surgery and Trauma, Birmingham B15 2TH, UK; david.naumann{at}


Traumatic injuries to the torso account for almost a quarter of all injuries seen in combat and are typically secondary to blast or gunshot wounds. Injuries due to road traffic collisions or violence are also relatively common during humanitarian and disaster relief efforts. There may also be multiple injured patients in these settings, and surgical care may be limited by a lack of facilities and resources in such a non-permissive environment. The first responder in these scenarios should be prepared to manage patients with severe injuries to the torso. We aim to describe the management of these injuries in the military and austere environment, within the scope of practice of a level 5 registered prehospital practitioner.

  • trauma management
  • surgery
  • thoracic surgery

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  • Twitter @davidnnaumann

  • Contributors Literature reviews were conducted by all authors. The first draft was written by AS, HC, GD and NG. Critical appraisal and manuscript revisions were done by AS, HC, GD, NG and DNN. The final manuscript was approved by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Data availability statement No data are available. There has been no data collection for this article.

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