bastion_classification_lower_limb: Bastion Classification of Lower Limb Blast Injuries

In cliot: Clinical Indices and Outcomes Tools

Bastion Classification of Lower Limb Blast Injuries

Description

Classifies lower limb injuries caused by blasts (e.g., Improvised Explosive Devices/IEDs) based on the most proximal level of injury. This classification system aids in communicating injury severity, anticipating resource needs (surgical consultations), and guiding hemorrhage control (tourniquet viability).

Usage

bastion_classification_lower_limb(injury_level, segmental_injury = 0,
                                  abdominal_injury = 0, genital_perineal_injury = 0,
                                  pelvic_ring_injury = 0, upper_limb_injury = 0)

Arguments

injury_level	Numeric (1-5). The most proximal extent of the injury. 1: Injury confined to the foot. 2: Injury involving the lower leg (permits effective below-knee tourniquet). 3: Injury involving proximal lower leg or thigh (permits effective above-knee tourniquet). 4: Proximal thigh injury (prevents effective tourniquet application). 5: Any injury with buttock involvement.
segmental_injury	Numeric (0 or 1). Presence of potentially viable tissue distal to the most proximal injury (Segmental Injury). (1 = Yes).
abdominal_injury	Numeric (0 or 1). Associated intraperitoneal abdominal injury. (1 = Yes).
genital_perineal_injury	Numeric (0 or 1). Associated genitalia or perineal injury. (1 = Yes).
pelvic_ring_injury	Numeric (0 or 1). Associated pelvic ring injury. (1 = Yes).
upper_limb_injury	Numeric (0 or 1). Associated upper limb injury. (1 = Yes).

Value

A list containing:

Bastion_Class	The determined Bastion Class (1-5).
Description	Anatomical description of the class.
Tourniquet_Guide	Guidance on the feasibility of tourniquet application.
Associated_Injuries	List of associated complications present.

References

Jacobs N, Rourke K, Keene D, et al. Lower limb injuries caused by improvised explosive devices: proposed 'Bastion classification' and prospective validation. Injury. 2012;43(9):1442-1446. doi:10.1016/j.injury.2012.05.001

Examples

# Example 1: Class 3 Injury
# Proximal lower leg injury (Level 3), with upper limb injury
bastion_classification_lower_limb(3, 0, 0, 0, 0, 1)

# Example 2: Class 5 Injury
# Buttock involvement (Level 5), with abdominal and pelvic injury
bastion_classification_lower_limb(5, 0, 1, 0, 1, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.