BLAST INJURIES
Mohammed Issa Mohammed Saleh;
Abstract
Physicians are increasingly faced with the possibility of caring people injured in explosions. Explosions have four mechanisms of injury thatmay be combined, adding to the complexity and lethality ofinjury to victims. In addition, it must be bornein mind that bomb blasts could also be used todisperse radiological agents.
Although most blast-relatedinjuries can be managed in a similar manner to typical penetrating or blunt traumatic injuries, injuriescaused by the blast pressure wave itself cannot.The blast pressure wave affects mainly air–tissue interfaceswithin the body, and the pulmonary, gastrointestinal, and auditory systems are at greatest risk. Of these, blast lung injury is the mostchallenging to treat. The clinical picture is a mix of ARDSand air embolism, and the institution of positive pressureventilation couldcause a systemic arterial air embolism.Abdominal primary blast injury may be clinically silent until complications are advanced. Auditory primary blast injuries areeasily overlooked and are a source of significantmorbidity. In addition to the devastating effects of theblast pressure wave and the ensuing flying projectiles, crush injuryand compartment syndrome magnify the inflictedinjuries.
Acute care providers who are most likely to be the first receivers of injuredpeople, have an urgent responsibility to know andunderstand the diagnostic and management issuesunique to blast injuries.
Although most blast-relatedinjuries can be managed in a similar manner to typical penetrating or blunt traumatic injuries, injuriescaused by the blast pressure wave itself cannot.The blast pressure wave affects mainly air–tissue interfaceswithin the body, and the pulmonary, gastrointestinal, and auditory systems are at greatest risk. Of these, blast lung injury is the mostchallenging to treat. The clinical picture is a mix of ARDSand air embolism, and the institution of positive pressureventilation couldcause a systemic arterial air embolism.Abdominal primary blast injury may be clinically silent until complications are advanced. Auditory primary blast injuries areeasily overlooked and are a source of significantmorbidity. In addition to the devastating effects of theblast pressure wave and the ensuing flying projectiles, crush injuryand compartment syndrome magnify the inflictedinjuries.
Acute care providers who are most likely to be the first receivers of injuredpeople, have an urgent responsibility to know andunderstand the diagnostic and management issuesunique to blast injuries.
Other data
| Title | BLAST INJURIES | Other Titles | الإصابات الناتجة عن الانفجارات | Authors | Mohammed Issa Mohammed Saleh | Issue Date | 2014 |
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