Solid Metal Chemical and Thermal Injury Management.

The article focuses on white phosphorus (WP) injuries, a combined chemical and thermal hazard commonly encountered in military conflicts due to WP's widespread use in munitions and smoke screens. It details WP's unique injury characteristics, including spontaneous ignition upon air exposure, and emphasizes the importance of early decontamination through aqueous irrigation or immersion to prevent ongoing burns and systemic toxicity. The review highlights acute management strategies suitable for both resource-rich and austere environments, the need for specialized burn care, and the potential for severe delayed systemic effects and chronic complications such as jaw osteonecrosis. It also underscores gaps in current Tactical Combat Casualty Care guidelines regarding WP and calls for enhanced education and protocols for military clinicians at all levels.