Pressure wave intensity declines with the cubed root of distance from the explosion.Distance between the victim and the blast.hard flat surface, impaled on object, etc.) Tertiary injuries are determined by what surface casualty strikes (e.g.Solid surfaces reflect blast waves, therefore, a person standing next to a wall may suffer increased primary blast injury due to reflections, while someone standing behind solid cover may experience less injury.Explosions leading to structural collapse and entrapment produce more orthopedic injuries and can cause crush injuries and compartment syndrome longer extrication time increases mortality.in a building, bus, mine) or underwater have the highest associated mortality Injuries can include fractures, amputations, lacerations, dislocations, and any type of soft tissue injury.Responsible for the majority of casualties and mortality in many explosions.Terrorist bombers often place screws or other debris in/around bombs.Military explosives are designed to fragment to maximize damage (shrapnel).Debris that is displaced by the blast wind of the explosion and penetrates or interacts with the body surface.Amount and composition of the explosive material (e.g.The extent and pattern of injuries are the result of several factors:

What factors affect the Severity of Blast Injuries? A casualty may be injured by one or several mechanisms. What are the Types/Categories of Blast Injuries?īlast injuries (from high-order explosives) are generally categorized as primary to quaternary. Refers to the flow of superheated air that can interact with people and objects and cause injury or damage.Refers to the pressure differentials (over- and under-pressurization) created by an explosion.What is the difference between a Blast Wave and Blast Wind? What is the difference between High-order and Low-order explosives? Unexploded ordnance: undetonated military explosive devices contaminating abandoned battlefields.

Improvised: small quantities, devices used outside of their intended purpose.

Manufactured: implies standard, military-issued, mass-produced weapons.

Non-accidental: deliberately set or detonated.

industrial accidents (factory and mining operations, fuel transportation/storage) we will review the basic pathophysiology, sequelae, and management of blast injuries.įor other topics related to Military Medicine, please see our posts on Damage Control Resuscitation, TCCC and Recent Updates, Prolonged Field Care, Inhalation Injuries, Abdominal Stab Wounds, and Resuscitative Thoracotomy. The majority of injuries resulting from explosions are similar to those we encounter in our everyday trauma practice, though there are specific injuries to look out for and some injuries unique to blasts. Once notified of a possible bombing or explosion, Emergency Physicians should immediately consider activating hospital disaster and contingency plans. The biggest potential challenge in managing blast injuries is the creation of large numbers of simultaneous critically ill casualties. Blast injuries resulting from explosions have the capacity to cause life-threatening multisystem injuries in multiple victims simultaneously.

Barotrauma explosives