Summary of the T1 category critical patients
| Casualty no/theatre | Critical criteria | Mechanism | ISS | Shock index | Injury | Treatment | Transfusion | Outcome |
|---|---|---|---|---|---|---|---|---|
| 1/Mali | Airway compromised; external haemorrhage | GSW to face | 43 | 0.9 | Major mandible open fracture; dorsal seton wound | DCS: tracheotomy; mandible external fixation; DID | No | Transferred |
| 2/Mali | Respiratory distress; haemorrhagic shock | GSW to thorax, leg, arm and forearm | 50 | 1.6 | Haemothorax; lung parenchymal injuries; axillary and lower extremity wounds | DCS: damage control thoracotomy: lung parenchymal suture and explorative pericardotomy; axillary exploration; DID | 4 PRC, 3 FDSP | Transferred |
| 3/Mali | Haemorrhagic shock; septic shock | GSW to legs and neck | 45 | 0.8 | Complex tibial opened fracture; zone 2 seton neck wound | DCS: orthopaedics damage control: external fixation and fasciotomies; DID | ||
| Secondary thigh amputation | 6 PRC, 3 FDSP | Transferred | ||||||
| 4/Mali | GCS <7; neurologic shock | GSW to head | 75 | 0.7 | Opened skull fracture with cerebral penetration; cerebral coning; enucleation | Decompressive craniectomy | No | Perioperative death |
| 5/Mali | Peritonitis | GSW to abdomen | 29 | 0.9 | Colonic perforation; retroperitoneal haematoma | Definitive laparotomy with ileocaecal resection; DID | No | Transferred |
| 6/Mali | Haemorrhagic shock | Fragment to abdomen, neck and lower extremity; blast | 29 | 0.7 | Grade 3 hepatic laceration; tibial open fracture; zone 1 neck wound; tympanic rupture | Definitive laparotomy; neck exploration; external fixation; DID | No | Transferred |
| 7/CAR | Suspected intra abdominal penetration | Fragment to hands, perineum and groin; blast | 22 | 0.5 | Multiple fragment wound to the abdomen, perineum, hands and thigh; blast; tympanic rupture | Explorative laparotomy; staged DID | No | Transferred |
| 8/CAR | Airway compromised; respiratory distress | Fragments to face and leg | 50 | 1.2 | Complex facial wound; tension pneumothorax; complex open leg fracture | DCS: chest tube; tracheotomy; orthopaedic damage control: bilateral external fixation; DID | 2 PRC | Death |
| 9/CAR | Haemorrhagic shock | GSW to groin | 35 | 1.6 | Femoral vein laceration; femoral open fracture | DCS: damage control laparotomy: femoral vein ligation; external fixation; DID | 2 PRC, 2 FDSP, 1L FWB | Transferred |
| 10/CAR | Respiratory distress | Fragment to thorax and arm | 45 | 0.7 | Pneumothorax; humeral artery injury | Chest tube; humeral artery venous graft; DID | No | Transferred |
CAR, Central African Republic; DCS, damage control surgery; DID, debridement, irrigation and dressing; FDSP, freeze-dried secured plasma; FWB, fresh whole blood; GCS, Glasgow score; GSW, gunshot wound; ISS, Injury Severity Score; PRC, packed red cells.