The impact of a shrapnel injury depends on two factors: speed with which it hits the body and the body part it strikes. Priyanka reports.
The toll of victims' at Delhi's high court blast on September 7 rose to 14 after another patient succumbed to his injuries at the Ram Manohar Lohia hospital on Thursday. There are still about 34 injured being treated at the hospital, while three are being treated at the All India Institute of Medical Sciences trauma center. Most of the injured are nursing shrapnel induced injuries.
When a bomb explodes, it throws out shrapnel's and other constituent objects with a vigorous force. It strikes people around it, causing injuries of varying degrees. Rediff.com spoke to a senior doctor at the AIIMS trauma center to find out the impact of powerful shrapnel hits on the human body in a bomb blast and how it is treated.
Shrapnel could be pellets, nails or tiny sharp objects, less than the size of a peanut. As the name suggests, shrapnel causes a 'sharp injury'. "The impact of a shrapnel injury on human body depends on two factors: the speed with which it hits the body and the body part that it hits," explained a senior doctor at the AIIMS trauma center.
If shrapnel hits a bone, it will completely shatter it and break in into several pieces, but if it misses the bone and is still as quick as a bullet, it might enter the human body from one end and exit from another. However, if it reaches the body at a lower velocity, when the person is standing at a distance from the main area of explosion, it enters the body and gets stuck in the areas it hits.
"If shrapnel strikes the head of a person, it is unlikely it will exit, because the bones are very hard. If it hits the chest, which is a big cavity, it loses its high speed by the time it reaches the other end of the body, and is most likely to get stuck in the cavity. But if it hits the hand of a person it is most likely to exit. Thus, the same shrapnel can cause different types of injuries," the doctor explained.
Three patients are currently being treated at AIIMS trauma center; all three of them have different types of shrapnel induced injuries. Shrapnel hit the first patient, Deepak Bhatt, in the inner thigh and hit the bone directly. It was at such high speed that it exited the body and shattered the bone into pieces. He was lucky as the shrapnel did not damage the blood vessels and nerves in the leg, and missed them by half a centimeter. But the bone bore the brunt of the direct hit and is beyond repair. There were 4-5 big bony pieces floating that had to be removed.
Another patient, Vipin Gautam, was hit by shrapnel in the leg; it, however, damaged his blood and nerve vessels. The doctor reveals that when the patient was brought to the AIIMS trauma center, there was no nerve or blood supply to the limb. It was not possible to repair it and an amputation had to be performed. However, the doctor added that he would be the first one to be discharged. The remaining two patients will easily take 5 to 6 months to recover fully.
B N Thakur was hit by shrapnel on his feet and it made a huge crater before exiting. He did not lose his feet because there was no injury to the nerve or the blood vessels, but he has suffered bone loss. After 3-4 surgeries and six months of recuperation, the doctor is confident the patient should be able to walk. The doctor said that all three injuries were in the legs of the patients and were hence not life-threatening.
"Had the same shrapnel hit the abdomen, chest or heart, the patient wouldn't have survived. Also, there are many pellets in the arms of Thakur, but it does not matter how many pellets are lodged in a patient's body, a thousand or more. What matters is where in the patient's body they are lodged.
If the minutest of pellet is lodged in the eye or in the joints or is causing direct pressure on the nerves, it has to be removed. It all depends on how important it is to remove the pellets. But if it settles in an area in the chest where there is no structure, then it is a different matter altogether. A number of bullet injuries are treated similarly, not all of the pellets are taken out. It is not possible to take out each every pellet; it is not even advisable," the doctor said.
But doesn't that cause life-long pain to the patient? "But we do let implants stay in the body lifelong, don't we," asks the doctor.
The doctor said that it usually takes 3 to 4 operations and grafting, and another 5 to 6 months to fix the damage caused by shrapnel injuries. It also depends on how early patients are brought in for treatment.
