64. Primary and Secondary Blast injuries

Question 1

Primary blast injury - Clinical Presentation

Answer 1

Eardrum perforation

ARDS fluid from the smallest blood vessels in the lungs starts to leak into the alveoli.
The lungs become smaller and stiffer and it becomes hard to breath. The amount of oxygen in the blood falls.
This is called hypoxemia

Pneumothorax

Hypoxia

Bilateral diffuse infiltrates such as pus, blood, or protein are found in lung parenchyma

Question 2

Primary blast injury - Treatment

Answer 2

Emergency endotracheal treatment and ventilatory support

Question 3

Secondary blast injury - Definition

Answer 3

enetrating trauma from fragments of bomb

Penetrating trauma results in deep soft tissue wounds and profuse bleeding.

Before taking patient to OR – pack the wounds with gauze before surgery.

Question 4

Secondary blast Injury - Clinical presentation

Answer 4

profuse bleeding

superficial skin lacerations

lethal visceral wounds

Question 5

Secondary blast injury - Diagnostic investigations

Answer 5

X-ray

CT

Physical examination to determine depth of penetration

Question 6

Secondary Blast Injury - treatment

Answer 6

Debridement of wound + removal of embedded foreign fragments