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DD,

PBI (pulmonary blast injury) - Lung
 Pulmonary contusion
– Worse on side of approach of blast waves in open air.
– Bilateral and diffuse when victim is located in confined space.
 Degree of pulmonary pathology is proportional to the velocity of chest wall displacement.

 PBI to lung is referred to as blast lung.
 Greater incidence in confined spaces
 Major cause of death in PBI’s
 Alveolar membranes torn
 Minimal to massive hemorrhage with hemothorax or air emboli

 Treatment similar to Pulmonary Contusion.
 Studies have shown no long term effects
 Generally normal after 1 year
PBI - Hypotension
 Bradycardia and hypotension without hemorrhage.
– Blast loads directly at the chest cause a unique vagal nerve-mediated form of cardiogenic shock without compensatory vasoconstriction.
– Occurs within seconds and resolves over 1 – 2 hours.
PBI – Arterial Air Embolus (AAE)
 Hemopneumothoraces, traumatic emphysema, and alveolovenous fistulas from stress-induced tears of air-tissue interfaces.
 Lead directly to bronchopleural fistulas or Arterial Air Embolus (AAE).
PBI - AAE
 AAE to the brain or head may be the most common cause of rapid death caused solely by PBI in immediate survivors.
 May be precipitated by positive-pressure ventilation (PPV).
 Often occurs at the moment of PPV.

hi swatsurgeon

what is REFERENCES, ther is a lot of new things in the post i have to read up on.
u must make a book som day.

one Q: can a BVM make a AAE in a blast lung?


Frank Hansen

the txt link dont work?
F

sorry, here is that pressure/injury curve again...
as far as references......that will take some digging time but I'll try to put something together.

Ied tactics getting better/shockwave injuries/treating compound fractures
 

This is a very good thread!
Great topic!
Have you ever heard of or treated broken bones from the shockwave of a blast?
It seems with the concussive force that is emitted from such explosives like IEDs, Mines, RPG's, and other mixed explosives, that they could easily break bones with the shockwave if they go off relatively near someone.

I once had an opportunity, or rather, responsibility to treat a compound fracture.
It was on a boy scout outing and we were rappeling, this guy was heading down the face and dropped way too fast for about the last 15 feet. His calf snapped in half and was protruding from his skin. We got the leg relatively straight and immediately applied pressure to stop the bleeding. We stopped the bleeding fairly quickly, but were ill prepared to set or mend the fracture at all, we made a migshift stretcher and carried him down the mountain (Mt. Si). We then drove him to the nearest hospital. He was just fine. It took him a good long while to heal and at times now he still has a limp. Sucks for him.

Just thought I'd mention that, first aid has been something I've been interested in.

The tactics being used for these explosives is becoming ever more intelligent, i.e.,
soldiers get out of a vehicle after a IED goes of, a second goes off injuring the soldiers. With an enemy growing more intelligent, the role of the medic and combat surgeon are more vital than ever. And for those of you who are Medics or Trioge doctors, I bow to you, for you have all my respect for your integral role in this nations military.

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