Blast injury - Revision history

Danbot: Add verified PubMed references (PMIDs 21456353)

2026-03-22T10:55:45Z

Add verified PubMed references (PMIDs 21456353)

← Revisión anterior		Revisión del 10:55 22 mar 2026
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	==Background==		==Background==
	*Primary blast wave increased in closed space - detonation in corner has potential to increase blast yield to 8x		*Primary blast wave increased in closed space - detonation in corner has potential to increase blast yield to 8x<ref>Plurad DS. Blast injury. Mil Med. 2011 Mar;176(3):276-82. PMID 21456353</ref>
	*Recent enhanced-blast weapons (EBW) disperses gas before explosion - larger blast wave with lower pressure amplitude that diffuses around corners		*Recent enhanced-blast weapons (EBW) disperses gas before explosion - larger blast wave with lower pressure amplitude that diffuses around corners

Rossdonaldson1: /* Video */

2024-04-17T20:13:32Z

Video

← Revisión anterior		Revisión del 20:13 17 abr 2024
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	==References==		==References==
	<references/>		<references/>

	~~==Video==~~
	~~{{#widget:YouTube\|id=4Q208UposjQ}}~~

	[[Category:EMS]]		[[Category:EMS]]
	[[Category:Trauma]]		[[Category:Trauma]]

Rossdonaldson1: /* Evaluation */

2021-11-18T20:24:36Z

Evaluation

← Revisión anterior		Revisión del 20:24 18 nov 2021
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	==Evaluation==		==Evaluation==
			[[File:Massive right hemothorax.jpg\|thumb\|[[CXR]] with large right sided hemothorax (and widened mediastinum).]]
	*[[CXR]] - butterfly distribution, bilateral patchy infiltrates		*[[CXR]] - butterfly distribution, bilateral patchy infiltrates
	*CT chest		*CT chest

Rossdonaldson1: /* Management */

2021-11-18T20:22:35Z

Management

← Revisión anterior		Revisión del 20:22 18 nov 2021
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	==Management==		==Management==
			*[[Chest tube]] for significant [[hemothorax]] and/or [[pneumothorax]]
	*[[pRBCs]] and [[FFP]] in 1:1 ratio with platelets for hemodynamically unstable patients		*[[pRBCs]] and [[FFP]] in 1:1 ratio with platelets for hemodynamically unstable patients
	*[[TM rupture]] - initial treatment supportive and enough for 75% with spontaneous healing; operative repair may be necessary for others		*[[TM rupture]] - initial treatment supportive and enough for 75% with spontaneous healing; operative repair may be necessary for others

Elcatracho: /* Injury Classifications */

2021-02-22T23:35:40Z

Injury Classifications

← Revisión anterior		Revisión del 23:35 22 feb 2021
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	\| Primary\|\|Direct effect from shockwave\|\|Sheer and stress forces\|\|[[TM rupture]], Ocular Injury, [[concussion]], blast lung		\| Primary\|\|Direct effect from shockwave\|\|Sheer and stress forces\|\|[[TM rupture]], Ocular Injury, [[concussion]], blast lung
	\|-		\|-
	\| Secondary\|\|Impact of fragments\|Penetrating trauma, amps, lacs\|\|		\| Secondary\|\|Impact of fragments\|\|Penetrating trauma, amps, lacs\|\|
	\|-		\|-
	\| Tertiary \|\|Blast propels body or large object into body\|\|[[Crush injury]] and blunt trauma\|\|Similar to MVC: Fractures, [[Pneumothorax]], Hemopneumothorax		\| Tertiary \|\|Blast propels body or large object into body\|\|[[Crush injury]] and blunt trauma\|\|Similar to MVC: Fractures, [[Pneumothorax]], Hemopneumothorax

ClaireLewis at 14:26, 19 October 2019

2019-10-19T14:26:06Z

← Revisión anterior		Revisión del 14:26 19 oct 2019
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	*Hemotympanum		*Hemotympanum
	*Ossicle injury		*Ossicle injury
	*Direct [[ocular ~~trauma~~\|ophthalmic injury]], [[foreign bodies]], or ophthalmic artery [[air embolus]]		*Direct [[ocular Trauma\|ophthalmic injury]], [[foreign bodies]], or ophthalmic artery [[air embolus]]

	===Thoracic===		===Thoracic===
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	===Musculoskeletal===		===Musculoskeletal===
	*[[~~Amputations~~]]		*[[Amputation]]s
	*[[Burns]]		*[[Burns]]

ClaireLewis at 00:59, 2 October 2019

2019-10-02T00:59:10Z

← Revisión anterior		Revisión del 00:59 2 oct 2019
Línea 46:		Línea 46:
	*Hemotympanum		*Hemotympanum
	*Ossicle injury		*Ossicle injury
	*Direct ophthalmic injury, foreign bodies, or ophthalmic artery air embolus		*Direct [[ocular trauma\|ophthalmic injury]], [[foreign bodies]], or ophthalmic artery [[air embolus]]

	===Thoracic===		===Thoracic===
	*Cardiovascular collapse (within seconds)		*[[shock\|Cardiovascular collapse]] (within seconds)
	*[[Hypotension]] due to impaired reflex that increases SVR		*[[Hypotension]] due to impaired reflex that increases SVR

	===Infectious Disease===		===Infectious Disease===
	*Transmission of disease due to penetrating trauma is rare but possible with HIV, HCV, HBV		*Transmission of disease due to penetrating trauma is rare but possible with HIV, HCV, HBV

	===Musculoskeletal===		===Musculoskeletal===
	*[[Amputations]]		*[[Amputations]]
	*[[Burns]]		*[[Burns]]

	===Markers of severe blast injury===		===Markers of severe blast injury===
	*> 10% [[TBSA]] burn		*> 10% [[TBSA]] burn
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	*[[CXR]] - butterfly distribution, bilateral patchy infiltrates		*[[CXR]] - butterfly distribution, bilateral patchy infiltrates
	*CT chest		*CT chest
	*FAST, comprehensive CT		*[[FAST]], comprehensive CT
	*Repeat clinical abdominal exams looking for peritonitis - X-rays, US, CT insensitive except in perforation		*Repeat clinical abdominal exams looking for peritonitis - X-rays, US, CT insensitive except in perforation
	*Initial CT head may not be enough - may require MRI for DAI		*Initial [[CT head]] may not be enough - may require [[MRI]] for DAI
	*Labs		*Labs
	**Consider carboxyhemoglobin and electrolytes		**Consider carboxyhemoglobin and electrolytes
	**Screening UA for significant explosions		**Screening [[UA]] for significant explosions
	**[[Burn]] labs (rhabdomyolysis, compartment syndrome, severe burns)		**[[Burn]] labs ([[rhabdomyolysis]], [[compartment syndrome]], severe [[burns]])
	**DIC labs (PT, aPTT, CBC, D-dimer, thrombin time, fibrinogen)		**[[DIC]] labs (PT, aPTT, CBC, D-dimer, thrombin time, fibrinogen)
	**[[White phosphorus]] labs ([[hypocalcemia]], [[hyperphosphatemia]], LFTs)		**[[White phosphorus]] labs ([[hypocalcemia]], [[hyperphosphatemia]], LFTs)

	==Management==		==Management==
	*pRBCs and FFP in 1:1 ratio with platelets for hemodynamically unstable patients		*[[pRBCs]] and [[FFP]] in 1:1 ratio with platelets for hemodynamically unstable patients
	*[[TM rupture]] - initial treatment supportive and enough for 75% with spontaneous healing; operative repair may be necessary for others		*[[TM rupture]] - initial treatment supportive and enough for 75% with spontaneous healing; operative repair may be necessary for others
	*Operative exploration for peritonitis		*Operative exploration for [[peritonitis]]
	*[[Air embolus]] (rare) - isolate air in apex of LV by placing patient in left decubitus, head down, feet up position		*[[Air embolus]] (rare) - isolate air in apex of LV by placing patient in left decubitus, head down, feet up position

Rossdonaldson1: Text replacement - "TBSA" to "TBSA"

2019-02-12T07:59:51Z

Text replacement - "TBSA" to "TBSA"

← Revisión anterior		Revisión del 07:59 12 feb 2019
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	*[[Burns]]		*[[Burns]]
	===Markers of severe blast injury===		===Markers of severe blast injury===
	*> 10% TBSA burn		*> 10% [[TBSA]] burn
	*Skull, facial fracture		*Skull, facial fracture
	*Penetrating injury to head or thorax		*Penetrating injury to head or thorax

ClaireLewis: /* Evaluation */

2019-02-01T20:22:16Z

Evaluation

← Revisión anterior		Revisión del 20:22 1 feb 2019
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	**Consider carboxyhemoglobin and electrolytes		**Consider carboxyhemoglobin and electrolytes
	**Screening UA for significant explosions		**Screening UA for significant explosions
	**Burn labs (rhabdomyolysis, compartment syndrome, severe burns)		**[[Burn]] labs (rhabdomyolysis, compartment syndrome, severe burns)
	**DIC labs (PT, aPTT, CBC, D-dimer, thrombin time, fibrinogen)		**DIC labs (PT, aPTT, CBC, D-dimer, thrombin time, fibrinogen)
	**White ~~phosphorous~~ labs ([[hypocalcemia]], [[hyperphosphatemia]], LFTs)		**[[White phosphorus]] labs ([[hypocalcemia]], [[hyperphosphatemia]], LFTs)

	==Management==		==Management==

Kxl328: /* Evaluation */

2018-10-24T15:38:45Z

Evaluation

← Revisión anterior		Revisión del 15:38 24 oct 2018
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	==Evaluation==		==Evaluation==
	*[[CXR]], CT chest		*[[CXR]] - butterfly distribution, bilateral patchy infiltrates
			*CT chest
	*FAST, comprehensive CT		*FAST, comprehensive CT
	*Repeat clinical abdominal exams looking for peritonitis - X-rays, US, CT insensitive except in perforation		*Repeat clinical abdominal exams looking for peritonitis - X-rays, US, CT insensitive except in perforation