Burns by war

2021-01-30 12:00 AM

When burning creates high heat, burn for a long time, there are substances that when burned, create many toxins for the body, there are substances that cause burns and are toxic to the body.

Burns in war history

In the history of surgical fieldwork before World War I, the rate of wounded was very small.

During the German-French War from 1870-1871 there were 29 wounded soldiers.

During the Russia-Japan War, the burn rate was 0.9-1.1% of the total wounded.

World War I the burn rate of 0.04-0.6% of the total number of wounded soldiers, in France and England have organized a number of hospitals specializing in treating burns.

During World War II, burn rates increased more, in the Soviet Union: 0.5-1.5%; in Germany 0.24; in the UK 1.5%.

In each battle, the burn rate is very high such as:

Battles between fleets of floating warships hit a burn rate of 16.6% -39.5% among wounded soldiers.

Battles between tanks are up to 25-27% (British troops in North Africa), bombing fire in London May 10, 1942, burn rate to 10% of the wounded.

On August 6 and 9, 1945, the US imperialists dropped atomic bombs on the cities of Hiroshima and Nagazaki, killing 10,000 6,000 people and injuring 97,000 people compared with the total population of 42,000 people. Among these victims, the burn rate was 65% (pure or mixed burns with bone marrow and acute radiation sickness).

During the Korean War: The US uses napalm bombs, the burn rate in North Korea is 8% of the wounded.

During the war against the French in our country, the French colonialists used flamethrowers with white phosphorus and napalm bombs, the burn rate in some campaigns was 3-7%.

During the war of invasion of our country, the US imperialists increased the use of many types of incendiary weapons: napalm, white phosphorus, Tecmít, Magnesium.

Burns caused by conventional fire weapons

Some common fire weapons

Heat damage weapons have the following characteristics:

When burning creates high heat, burn for a long time, there are substances that when burned, create many toxins for the body, there are substances that cause burns and are toxic to the body.

Napan: (NP)

Ingredient: 

Gasoline 92-96%.

Aluminium soap 8-4%.

Aluminium soaps include naphthenate and aluminium palmitate, which are used to thicken gasoline from a liquid to a colloidal form. Aluminium soap can be replaced with IM (Isobutyl Methyl methacrylate) to precipitate gasoline.

Characteristics:

Flammable, flammable in large clouds with a temperature of 800-13000C, if it is mixed with magnesium and nitrate, it is called napalm pyrogen (super napan) due to heat higher than 1500-20000C. Currently, there is type of napalm B also called napalm polystyrol.        

The napalm glue sticks to the target.

Persistent burning for 5-10 minutes

For more black smoke, CO poisoning.

The density of 0.7-0.85 floating on the water surface is still burning.

White phosphorus (WP)

Uses:

Artillery shells, mortars, grenades, mines.

Bombs and safes (with symbol WP)

Characteristics:

Spontaneously ignites when exposed to oxygen and white fumes, garlic smell, in dark burns emits blue light.

Causes burns by 2 factors: Heat and acid, by the mechanism:               

4P + 5O2 - 2P2O5 generates heat 900-1200 0 C.
P2O5 + H2O HPO3, H2PO3, H3PO3 causes burns due to acid.

Tecmit (thermite) (T.H)

Composition: is a mixture of aluminium powder and iron oxide:

Al + Fe2O3 mixed with paint oil and using barium nitrate Ba (NO3) 2 as a fire point (creating a high temperature of 2000-30000C to burn Al + Fe2O3 powder. When burning, no oxygen from the air is needed because oxygen is taken in Fe2O3.

Use:  drop into cluster bombs.

Magnesium: (mg):

Used to make Magnesium bomb WWII with thermal energy up to 3000-3500 0 C.

Attention should be paid to conventional mortars, firecrackers, mines, if near the centre of the explosion, they can be injured in combination with burns caused by the fire of the explosive products or in large bomb explosions thrown by B52 aircraft. incidence of burns. But often causes superficial burns, but is still severe because it is accompanied by an explosive, burial or wound combination syndrome.

General characteristics of common war burn injuries

Location:  Mostly in the open part: face, hands (80% of cases) in the hand burns the back of the hand more than the palms, but if the burn is white phosphorus, it is often burned deep in the palms (used by wounded soldiers put out the fire).

Area, depth:  Usually has a large depth and area. Area and depth depend on the way of defences, the layout of the pit defences, the fortifications and the equipment of the army. If there are good fortifications with means of fire prevention, superficial burns are often encountered with a small burn area.

Often accompanied by combined wound:  Common burns mixed with soft wounds, fractures of extremities, blast wave syndrome. For weapons, often wound by fragments of artillery, mortars, mines, B40, B41, bombs ...

Severe and prolonged shock.

Burned wound pollution:  exuding a lot, stinking, can have maggots, easily cause septicaemia and high death, the wound is long-lasting and leaves the disabled sequelae.

Fast growing cachexia: Fastest weight loss compared to other wounded.

The burn sequelae left adversely affect the motor function, aesthetics and psychology of the injured.

Burns during nuclear war

During nuclear war, burn injuries are often combined with acute radiation sickness or other types of trauma.

Factors that cause burns include

The light radiation of the fireball.

Hot air is transmitted due to the shock wave.

Fire caught fire (house, equipment, car).

Radioactive substances (radioactive dust).

Characteristics

Burns caused by light radiation:

The majority of burns are characterized by:

Burns on parts of the body that are directly exposed to light radiation (people standing behind windows only burn the part of the body facing the window because of the light mapping in a straight line). Consequently, it is common to see only burns on one side (towards the explosive centre) of the body. Bonus burn area is not large.

Burned according to the colour of the garment, black absorbs the light energy that reaches it almost completely and white reflects the light energy almost completely, so wearing darker clothes is heavier. If wearing floral clothing, the umbrella of the damaged body colour will follow the clothing pattern.

If standing away from the centre of the explosion, clothing has a protective effect, only burns on the exposed skin.

The degree of deep burns from light radiation depends on:

The size of the nuclear weapon.

Explosion in the atmosphere, high above ground, at ground level, in water ...

Weather, terrain.

Victim's position: distance from the centre of the explosion, inside the building.

Burns caused by fire:

Clothing may catch fire if near the explosion centre.

Home equipment fire (pure fire burns).

Burns caused by radioactive dust:

Due to the fall of radioactive dust on the skin (with beta-rays, gamma rays) and symptoms:

Red skin in the first few hours, a few days followed by a latent period of several hours to a few weeks depending on the dose of radiation, then the second red skin appears, if severe, the blisters appear on the red skin, the nodule together in clumps, by itself breaks to reveal a very painful red background, then gradually turns into ulcers, rough bottom, exudate, pus, ulcers that persist for weeks to months and then go away on their own but can have a relapse.

The skin around the ulcers is disturbed with nutrition (atrophy, loss of teeth, bad scarring). Systemic fever may be accompanied by leucocytosis, lymphadenitis and burned lymphadenitis.

Combined burns with acute radiation disease:

This is the most important feature of a nuclear weapon burn. Acute radiation disease adversely affects burns and vice versa. pathology of mixed lesions has the following characteristics:

The death rate is higher.

Burn shock is more common, prolonged erectile shock, shortened weakness.

Or bleeding.

Severe blood Protide disorder.

Purulent wounds are susceptible to anaerobic infection.

The rate of septicaemia, systemic infection is high.             

Evolution at the burn:

Grade II burns can heal spontaneously if the dose of irradiated or radioactive is below 100-150R and the latent period of acute radiation disease is long.

Burns III degree (dermis) will heal longer, the progression of burn disease is determined by the severity of acute radiation disease.

Burns of degree IV, V from day 4 to 6, with a borderline of healthy and dead parts, but a small number of white blood cells and much disintegration, the formation of a borderline is slow, so necrosis falls slowly, granulation tissue is slowly formed, around the granulation tissue many new capillaries are formed, so that the granulation tissue is easy to bleed.

Because at the burn, the process of regeneration is slow, easy to bleed, and easily infected, causing the acute radiation disease to aggravate, on the contrary, the syndrome of anaemia, leukopenia, and platelets in acute radioactive disease makes burns. heavier and heavier.

Emergency care and medical treatment

Prevent and fight fire weapons at the battlefield

The pit. fortifications, traffic trenches are the best prevention, the cellar has a hatch cover, has fireproof facilities for people and vehicles and fuels.

The cellar has 2 doors, with trench traffic to easily escape when on fire. Good fire extinguishing: use water, CO2, sand, blankets, wet canvas. It is best to soak in water to turn off the fire, stamp with a wet blanket to not break the burn.

The work of wounded and treating wounded soldiers by route

Common tasks for all routes.

Anti-pain, anti-infection.

Prevention and treatment of shock, pain relief, fluid supplementation.

Handling dyspnoea, intoxication.

Selective classification.

Shipping to the following route.

Routes C and D:

No substances applied, dry ice (except for chemical burns, burns caused by white phosphorus); bandages are slightly pressed to reduce plasma drainage.

Specify degree I; No need for tape.

Degrees II, III: bandages, although in doubt, also bandage to prevent infection and cover burns.

Grade IV, V. Dry necrosis: no ice, wet necrosis: ice. Use bandages or can be wrapped with a clean cloth or cloth. If there is a wound, no matter how much burn it is. The bandage can be covered on burnt clothing that doesn't need to be removed. If taking scissors to cut gently, difficult places or stick burns left.

Bandage change at line E, F, treatment team:

In order to diagnose, examine lesions to classify.

Treatment of burns depends on the degree of damage and the cause of the burn: (chemical burns, white phosphorus burns, radiation burns).

Organizing and changing the dressing sequence:

Body search: if there is no shock, change the dressing immediately, if there is shock, apply shock.

Reduce pain before changing bandages.

Novocaine can be blocked around the kidneys, around the base of the limbs.

Before taking off the bandage, wash off sandy soil and surrounding areas with clean warm water, wipe dry.

Follow the aseptic principle and use the dressing change for each person.

During the dressing change must diagnose the depth area, classify and have a treatment plan.

Shock protection at E, F, treatment team:

Warm incubation without transport, pain relief, blocking novocaine.

Drink fluids, water first aid.

Intravenous fluids follow a protocol that monitors systemic symptoms and tests for blood and urine (arterial blood pressure, venous blood pressure, body temperature, urine, breathing rate, vomit.). .

Management of respiratory burns in the E, F, treatment team:

Phong closes the ancient sympathetic vagina, sucks phlegm. If breathing is difficult, threat of suffocation: open trachea.

Anti-infection work at E, F, treatment team:

Light burns: oral sulfamit.

Burns moderate and severe: a combination of injections and oral antibiotics.

Burns of lower extremities (deep burns polluted):

Pepper and reduce tetanus toxin - wash and change the first deep burn dressing.

Treatment of systemic poisoning, poisoning with military chemicals.

Classify wounded soldiers into 5 categories:

Type I: In urgent and urgent need: respiratory arrest, cardiac arrest, acute respiratory disturbance, acute circulatory disturbance, viable limb gangrene, acute intoxication.

Type II: very severe burns: from over 70% of the body area, active treatment, not transport far.

Type III: moderate and severe burns: burn area from 20-25% of body area or more. If there are deep burns, transfer to the skin graft surgery line for burn treatment.

Type IV: narrow superficial burns less than 5% of body area treated in the regimental level. Superficial burns that range from 5% to 20-25% of body area remain at the division line, the treatment team.

Type V: burns with mixed lesions: classified as severe, mild, according to the degree of major damage and transferred to specialized hospitals at the back level.

Organize mass transport and collection:

When many people suffer burns at the same time, it is necessary to organize a good classification, organize a private shock treatment tent for burn victims, monitor those with respiratory burns, have a toxic state level, there is mixed injury. It is necessary to organize a separate area for people with minor burns. Organize dressing crews for each area. Pay attention to hygiene and nurture care. Transportation activities need to ensure safety to prevent superinfection shock.