Page 122 - Journal of Special Operations Medicine - Fall 2017

Table 3 The 10 Haddon Countermeasure Strategies, With Examples From Military Airborne Operations
Number Countermeasure Hazard Application
1 Prevent hazard creation High wind and ground impact No jumps in winds greater than 13 knots
2 Reduce amount of hazard Ground impact Larger parachute canopy size
3 Prevent hazard release Dragging on the ground after Parachute quick release
landing due to wind
4 Modify rate or distribution of hazard Ground impact Parachute landing fall; parachute ankle brace
5 Separate hazard and individual Entanglements in the air Time between jumpers (1 second) on exiting aircraft
(in space and/or time)
6 Separate hazard and individual by barrier Head impact on ground Kevlar helmet
7 Modify basic qualities of hazard Ground impact Softer landing zone
8 Make individual more resistant to damage Ground impact Higher fitness
9 Counter damage done Any Available ambulance
First aid kit
10 Stabilize, repair, rehabilitate Any Physical therapy/Rehabilitation centers

of at least 13 knots are not conducted, thus eliminating the The seventh countermeasure involves modification of the ba-
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danger. sic qualities of the hazards. This may involve modifying con-
tact surfaces by softening them or eliminating sharp edges.
The second countermeasure involves reducing the amount of In the example in Table 2, the hazard is again energy trans-
the hazard. This can be viewed as reducing the amount of the ferred to body on ground impact. Having softer and obstacle-
energy applied to the body. In the example in Table 2, the haz- free landing zones during training is an application of this
ard is the energy transferred to body when the airborne Soldier principle.
hits the ground on landing. An application of this counter-
measure is to use a parachute with a larger canopy, which will The eighth countermeasure is to strengthen the Soldier to make
reduce the force of ground impact on landing. The transition him or her more resistant to damage. At least one investiga-
in the U.S. Army from the older T-10 parachute with a 121cm tion has suggested that there is an association between higher
2
canopy to the newer T-11 parachute with a 155cm canopy is levels of aerobic fitness and injuries during airborne opera-
2
an example of this. 8,16 tions. More widely, higher levels of physical fitness appear to
6
reduce the overall incidence of injuries. Thus, in the example
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The third countermeasure involves preventing release of the in Table 3, establishing and maintaining higher aerobic fitness
energy. Once an airborne Soldier lands, he or she can be levels may reduce airborne-related injuries.
dragged on the ground by a still-inflated canopy if winds are
present. This can be avoided by “dumping” the air though the The assumption in the ninth and tenth countermeasures
use of “quick releases” on the parachute harness that connects is that injuries were not prevented, and the goal is to re-
the jumper to the parachute. duce the amount of pain and/or disability and assist with
the healing process. In the ninth countermeasure, the goal
The fourth countermeasure involves modifying the rate or spa- is to evaluate and rapidly treat the injury. In the example
tial distribution of the energy. In the example in Table 2, the in Table 3, an ambulance on the drop zone with trained
hazard is again the energy transferred to body when the air- medics and medical supplies can accomplish this. The tenth
borne Soldier hits the ground on landing. The energy can be countermeasure applies after the initial emergency period.
reduced by using a parachute landing fall that distributes the The goal here is to provide more sophisticated treatment for
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force of landing across the entire body. Also, the use of a para- the injury, perhaps in a hospital or rehabilitation unit (e.g.,
chute ankle brace (i.e., a specialized ankle brace ) absorbs physical therapy).
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some of the forces exerted on the ankle on ground impact,
thus reducing the risk of ankle sprains and fractures. 10 These countermeasures are not new. The basic principles
13
have been used in one form or another throughout military
The fifth countermeasure is to separate in space or time the history. For example, Rome applied the third countermeasure
energy being released. In the example in Table 3, the hazard by obliterating the city of Carthage in 146 BCE after many
comes from entanglements of the parachutes of two or more years of warfare. In ancient Greece, Athenians evacuated
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jumpers, which not only effects energy on ground impact but their city ahead of the oncoming Persian Army, thus applying
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can also increase injury risk from less-controlled landings. Ap- the fifth countermeasure. The Chinese applied the sixth coun-
plication of the fifth countermeasure is to have a short period termeasure by building the Great Wall to provide an impedi-
of time (e.g., 1 second) between jumpers to reduce the likeli- ment to their Northern enemies. Shields of ancient armies
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hood of high-altitude entanglements, especially when exiting protected against blunt and edged weapons and body armor
from both sides of an aircraft. 9 used today are applications of the sixth countermeasure. Fur-
ther examples of countermeasures in military situations are
The sixth countermeasure involves separating the individual shown in Table 4. 23
from the energy by using a barrier. In the example in Table 2,
the hazard is the energy that can be transmitted to head when Conclusion
the head impacts the ground (more likely in less-controlled
landings). The use of a Kevlar helmet provides a barrier to The Haddon Matrix and the 10 Countermeasure Strategies
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reduce the energy transmitted to the head. are useful instruments that provide ways to think about injury
118 | JSOM Volume 17, Edition 3/Fall 2017