Blast Injuries
 

Let's talk about the effects of blasts on the human form.

Pathophysiology: Blast injuries traditionally are divided into 4 categories: primary, secondary, tertiary, and miscellaneous injuries. A patient may be injured by more than one of these mechanisms.

A primary blast injury is caused solely by the direct effect of blast overpressure on tissue. Air is easily compressible, unlike water. As a result, a primary blast injury almost always affects air-filled structures such as the lung, ear, and gastrointestinal (GI) tract.

A secondary blast injury is caused by flying objects that strike people.

A tertiary blast injury is a feature of high-energy explosions. This type of injury occurs when people fly through the air and strike other objects.

Miscellaneous blast-related injuries encompass all other injuries caused by explosions. For example, the collision of two jet airplanes into the World Trade Center created a relatively low-order pressure wave, but the resulting fire and building collapse killed thousands.

You want to credit that, right?

http://www.emedicine.com/emerg/topic63.htm

Here's some more:

Mortality/Morbidity:

Mortality rates vary widely. Injury is caused both by direct blast overpressure (primary blast injury) and by a variety of associated factors.

Mortality is increased when explosions occur in closed or confined spaces (eg, terrorist bus bombings) or under water. Land mine injuries are associated with a high risk of below- and above-the-knee amputations. Fireworks-related injuries prompt an estimated 10,000-12,000 ED visits in the United States annually, with 20-25% involving either the eye or hand.

Presence of tympanic membrane (TM) rupture indicates that a high-pressure wave (at least 40 kilopascal [kPa], 6 psi) was present and may correlate with more dangerous organ injury. Theoretically, at an overpressure of 100 kPa (15 psi), the threshold for lung injury, TM routinely ruptures; however, a recent Israeli case series of 640 civilian victims of terrorist bombings contradicts traditional beliefs about a clear correlation between the presence of TM injury and coincidence organ damage. Of 137 patients initially diagnosed as having isolated eardrum perforation who were well enough to be discharged, none later developed manifestations of pulmonary or intestinal blast injury. Furthermore, 18 patients with pulmonary blast injuries had no eardrum perforation.

I wasn't finished, but thanks.

Yeah, sorry. Just had to show that my google sometimes is strong. LOL

I'm not sure if I'm asking this correctly, but which effects are temporary and which are permanent?

NP

SOAP?

The affects of the blast are all injury dependent.


NDD:

Did you have a specific blast pattern or scenario in mind or just generalities?

What do you need the SOAP for? You scrubbing in? :D

Well, since the toy of choice for terrorists in the current theaters appears to be roadside IEDs, let's go with that.

Grasshopper, you will very shortly need to overcome your fear of SOAP.

So what is our SOAP for a blast from a roadside IED 5 klicks outside of Bagdad going to look like?

BTW, nice of you to volunteer.

The level of structural damage and injury caused by blast is dependent on the peak pressure(pressure decreases as you increase distance from origin), impulse length (a function of time and pressure), the overall shape of the pressure–time curve, and the elastic–plastic strength and natural period of oscillation of the structure or body.

In the human body, the shock wave/blast interacts with many types of tissues (eg, skin, fat, muscle and bone) that differ in density, elasticity and strength. Each tissue type, when interacting with a blast wave, is compressed, stretched, sheared or disintegrated by overload according to its properties.

Internal organs that contain air (sinuses, ears, lungs and intestines) are particularly vulnerable to blast.

These injuries are very difficult to diagnose. Will be interesting to hear how medics are trained to diagnose the internal injures. :munchin

Hey Crip:

Don't drop the SOAP.

Nice graphic

Crip, if you haven't saved your avatar, you might want to do so in the next 30 seconds.

LOL......

Hey RL... since your in the medical forum AGAIN cracking jokes, you might want to be careful too. ONE good post doesn't give you a free pass for very long in here. Remember ME from your brain MRI thread??? LOL hahha

Just kidding.. Alright, lets get back to the thread's topic. This is a very serious topic for current and future medics/soldiers.

For me to come up with a SOAP report for a patient I am going to need more patient/blast specific information.

Avatar has been saved for some time JIC.

More information like what?

26y/o WM...oh wait, you're supposed to be doing it!

:munchin