{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T01:33:43Z","timestamp":1787621623253,"version":"build-2736575974"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Mil Health"],"accepted":{"date-parts":[[2017,8,11]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Between 2009 and 2015, 3746 children died, and 7904 were injured as a result of armed conflict within Afghanistan. Improvised explosive devices (IEDs) and explosive remnants of war accounted for 29% of child casualties in 2015. The aim of this study was to review the burden of paediatric blast injuries admitted to Camp Bastion, Afghanistan, and to investigate the hypothesis that children suffer proportionally more head injuries than adults.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>A retrospective analysis was undertaken of prospectively collected data derived from the UK Joint Theatre Trauma Registry of ambulant paediatric (aged 2\u201315 years) admissions with blast injuries at the Role 3 Field Hospital, Camp Bastion from June 2006 to March 2013. The data set included demographic information, injury profile and severity (New Injury Severity Score) and operative findings. The pattern of injuries were investigated by looking at trends in the number and severity of injuries sustained by each body region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During this period, 295 admissions were identified, 76% of whom were male, with an overall mortality rate of 18.5%. The most common blast mechanism was an IED (68%) causing 80% of fatalities. The lower extremities were the most commonly injured body region, accounting for 31% of total injuries and occurring in 62% of cases. 24.3% of children between 2 and 7 years suffered severe head or neck injuries compared with 19.8% of children aged between 8 and 15 years. 34% of head injuries were rated unsurvivable and accounted for 88% of fatalities. 77% of cases required an operation with a mean operating time of 125\u2009min. The most common first operations were debridement of soft tissues (50%), laparotomy (16%) and lower limb amputation (11%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Although paediatric blast casualties represented a small percentage of the overall workload at Camp Bastion Role 3 Medical Facility, the pattern of injuries seen suggests that children are more likely to sustain severe head, face and neck injuries than adults.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jramc-2017-000795","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T12:08:23Z","timestamp":1508760503000},"page":"151-155","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["The pattern of paediatric blast injury in Afghanistan"],"prefix":"10.1136","volume":"166","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0698-4018","authenticated-orcid":false,"given":"Daniel C","family":"Thompson","sequence":"first","affiliation":[{"name":"Defence Medical Group South, Queen Alexandra Hospital, Portsmouth, UK"},{"name":"Army Medical Service, Royal Military Academy Sandhurst, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Crooks","sequence":"additional","affiliation":[{"name":"201 (Northern) Field Hospital, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J C","family":"Clasper","sequence":"additional","affiliation":[{"name":"The Royal British Legion Centre for Blast Injury Studies, Imperial College London, London, UK"},{"name":"Defence Medical Group South East, Frimley Park Hospital, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Lupu","sequence":"additional","affiliation":[{"name":"SpR Trauma and Orthopaedics, Northern Deanery, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S A","family":"Stapley","sequence":"additional","affiliation":[{"name":"Defence Medical Group South, Queen Alexandra Hospital, Portsmouth, UK"},{"name":"Royal Centre for Defence Medicine, Queen Elizabeth Hospital, BIrmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D J","family":"Cloke","sequence":"additional","affiliation":[{"name":"201 (Northern) Field Hospital, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,10,21]]},"reference":[{"key":"2025081309350960000_166.3.151.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.5.567"},{"key":"2025081309350960000_166.3.151.2","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(13)61696-7","article-title":"Afghan civilian casualties: a grim reality","volume":"382","author":"Lancet","year":"2013","journal-title":"Lancet"},{"key":"2025081309350960000_166.3.151.3","unstructured":"United Nations Assistance Mission in Afghanistan. Annual Report 2015 Protection of Civilians in Armed Conflict, 2015:16\u201318. https:\/\/unama.unmissions.org\/sites\/default\/files\/poc_annual_report_2015_final_14_feb_2016.pdf."},{"key":"2025081309350960000_166.3.151.4","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1308\/003588412X13171221499027","article-title":"Paediatric admissions to the British military hospital at Camp Bastion, Afghanistan","volume":"94","author":"Arul","year":"2012","journal-title":"Ann R Coll Surg Engl"},{"key":"2025081309350960000_166.3.151.5","doi-asserted-by":"crossref","first-page":"189","DOI":"10.7205\/MILMED.171.3.189","article-title":"Operation enduring freedom: the 48th combat support hospital in Afghanistan","volume":"171","author":"Beitler","year":"2006","journal-title":"Mil Med"},{"key":"2025081309350960000_166.3.151.6","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31818b1e15"},{"key":"2025081309350960000_166.3.151.7","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318163b875"},{"key":"2025081309350960000_166.3.151.8","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1097\/TA.0b013e318270d3ee","article-title":"Blast injury in children: an analysis from Afghanistan and Iraq, 2002-2010","volume":"73","author":"Edwards","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"2025081309350960000_166.3.151.9","unstructured":"Gennarelli TA , Wodzin E M . Medicine. A for the A of A. Abbreviated injury scale 2005: update\u00a02008. Barrington, Ill: Association for the Advancement of Automative Medicine, 2008."},{"key":"2025081309350960000_166.3.151.10","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1097\/01.TA.0000075342.36072.EF","article-title":"The new injury severity score: A more accurate predictor of in-hospital mortality than the injury severity score","volume":"56","author":"Lavoie","year":"2004","journal-title":"J Trauma"},{"key":"2025081309350960000_166.3.151.11","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1097\/TA.0b013e3182aa2e66","article-title":"Surgical interventions for pediatric blast injury: an analysis from Afghanistan and Iraq 2002 to 2010","volume":"76","author":"Edwards","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"key":"2025081309350960000_166.3.151.12","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.160.9.972"},{"key":"2025081309350960000_166.3.151.13","unstructured":"Defence Statistics Health. Recovery rate of UK service personnel admitted to Camp Bastion field hospital. 2013 https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/280507\/recovery-rate-of-UK-service-personnel-admitted-to-camp-bastion-field-hospital.pdf"},{"key":"2025081309350960000_166.3.151.14","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-150-04-08"},{"key":"2025081309350960000_166.3.151.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.09.020"},{"key":"2025081309350960000_166.3.151.16","doi-asserted-by":"publisher","DOI":"10.1136\/adc.71.6.540"},{"key":"2025081309350960000_166.3.151.17","unstructured":"iCasualties.org. IED Fatalities. 2016 http:\/\/icasualties.org\/oef\/ (accessed 21 Sep 2016)."}],"container-title":["BMJ Military Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-2017-000795","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T16:35:18Z","timestamp":1755102918000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-2017-000795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,21]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,5,23]]},"published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1136\/jramc-2017-000795"],"URL":"https:\/\/doi.org\/10.1136\/jramc-2017-000795","relation":{},"ISSN":["2633-3767","2633-3775"],"issn-type":[{"value":"2633-3767","type":"print"},{"value":"2633-3775","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,21]]}}}