Explosives and Blast Injuries

Overview

Explosions can cause unique patterns of injury seldom seen outside combat.

Most injuries among survivors involve standard penetrating and blunt trauma. Blast lung is the most common fatal injury among initial survivors.

Explosions in confined spaces (mines, buildings, or large vehicles) and/or structural collapse generally cause more injuries and death than open space blasts.

Half of all initial casualties will seek medical care over a one-hour period. This can be useful to predict demand for care and resource needs. Expect an "upside-down" triage - the most severely injured arrive after the less injured, who bypass EMS triage and go directly to the closest hospitals.

Background

Explosions can produce unique patterns of injury seldom seen outside combat. When they do occur; they have the potential to inflict multi-system life-threatening injuries on many persons simultaneously.

The injury patterns following such events are a product of the composition and amount of the explosives involved, the surrounding environment, the distance between the casualty and the blast, and any intervening protective barriers or environmental hazards.

Few U.S. health professionals have experience with explosive-related injuries. This section introduces information relevant to the care of casualties from explosives and blast injuries. As the risk of terrorist attacks increases in the U.S., it is necessary to understand the type of injuries associated with explosions and must be prepared to assess and treat the people injured by them.