Sometimes the extent of moderate or severe damage caused by bTBI (explosive blast traumatic brain injury)is difficult to determine at first, doctors have told specialists. Severe facial trauma can prevent reliable neurological examination, especially when it comes to examining the pupils for reaction. Specialized tools are often necessary to even make triage decisions that could save lives.
The chaos of war only compounds the difficulty in making decisions when it comes to severe injury. When a doctor or other medical professional is used to medical centers in the United States, where there are adequate resources and help in the form of other professionals near at hand, it can be very difficult to work on a battlefield where everything is in short supply, but the number of patients is much greater.
Difficult decisions have to be made in such environments, experts have learned. It isn’t uncommon for a great number of severely injured patients to arrive at the same time. Efficient triage is essential for the best use of limited resources. There may be few health care providers, no operating rooms or CT scanners, and not many blood products to go around. It may even be impossible to evacuate patients to a better facility. The whole idea behind triage is take resources that may not be adequate and stretch them out to their best possible use to help the largest number of patients. They must be stabilized and their lives preserved until they can be evacuated into a better circumstance.
Skull fracture can be a result of this kind of trauma. Hospitals and doctors in The Bronx and Brooklyn are always on the alert for this kind of injury.