Impaled UXO in KIA Patients

While the Armed Forces Medical Examiners System staff is unaware of any cases where a UXO was found impaled in a deceased US soldier since 2001, it has been reported in the world literature.8,9 Since it has been recognized that many times the impaled ordnance is not identified until the patient is within a trauma treatment area of an MTF or in the OR, it again should be assumed that patients could die on the battlefield or in an MTF with unrecognized impaled ordnance. Therefore, it is recommended that all deceased individuals be screened for impaled ordnance to prevent a catastrophic situation on the ground or in the air.10 This can be accomplished by conducting a simple body cavity screening with a metal detecting wand, or an X-ray to include the torso, head, or injured extremities. If anything is found, the same precautions for a live patient should be taken to include having all nonessential people leave the threat area, notifying the local command, having security establish a perimeter, having EOD identify and remove the object, etc.