Contingency: the likely spectrum of injuries based upon a review of three recent undeveloped theatres of operations--CORPORATE, TELIC 1 and HERRICK 4.

Contingency operations are by their nature unpredictable and high-risk, with undeveloped logistical support, and medical provision is no exception. Can the contingency experiences of the last three decades help to predict the type of casualties that may be seen in future contingency operations? By reviewing published casualty statistics available from Operations CORPORATE, TELIC 1 and HERRICK 4 it can be demonstrated, unsurprisingly, that gunshot wounds and blast injuries dominate battle injuries, but that disease non-battle injuries also constitute a significant draw on medical provision, particularly gastrointestinal illness in hot environments. Planning for medical support for future contingency operations should anticipate this. Disease non-battle injuries have the potential to render a large proportion of a force combat-ineffective, requiring preventative measures to avoid overwhelming the available medical facilities. When operations occur in populated areas civilian casualties are likely to pose difficulties to medical support, due to issues with onward evacuation and a wider case mix, such as paediatrics.