Missile And Blast Injuries Flashcards
What is a missile injury?
Wounds caused by sharp projectile objects that pierce the skin, such as bullets or shrapnel.
What is a blast injury?
Injury caused by pressure waves from explosions affecting internal organs without necessarily having an entry wound.
What are common causes of missile and blast injuries?
Explosives, firearms, military conflicts, terrorist attacks.
What are the velocity classifications of missile injuries?
Low velocity (<340m/s), Medium velocity (340-610m/s), High velocity (610-1100m/s).
What is ballistic trauma?
Trauma caused by high-velocity projectiles like bullets, including entrance and exit wounds.
What is permanent cavitation in missile injuries?
Direct tissue destruction along the missile’s path, leaving a permanent cavity.
What is temporary cavitation in missile injuries?
A shockwave-induced expanding tissue cavity that leads to secondary tissue damage.
What is ‘blast lung’?
Pulmonary barotrauma caused by a primary blast wave, leading to potential delayed respiratory symptoms.
What are primary blast injuries?
Injuries caused by overpressure waves affecting gas-filled organs like the lungs, ears, and intestines.
What are secondary blast injuries?
Injuries caused by debris or projectiles from an explosion leading to penetrating or blunt trauma.
What are tertiary blast injuries?
Injuries caused by physical displacement of the body due to a blast wave, leading to blunt trauma or fractures.
What are quaternary blast injuries?
Burns, toxic exposure, crush injuries, and exacerbation of pre-existing conditions due to an explosion.
What is the ATLS primary survey approach?
A: Airway & C-spine, B: Breathing, C: Circulation, D: Disability (GCS/AVPU), E: Exposure, F: Fluids.
What are common symptoms of blast lung?
Chest pain, dyspnea, cough, hypoxia, bilateral infiltrates on chest X-ray.
What injury is commonly associated with tympanic membrane rupture?
Hearing loss, tinnitus, dizziness.
What is the recommended imaging for missile injuries?
X-rays, CT scans, MRI for assessing soft tissue and bone damage.
What are the steps in managing missile injuries?
Hemostasis, wound debridement, stabilization of fractures, revascularization if needed.
Why is a second-look wound debridement necessary?
To assess for necrosis, infection, and ensure better wound healing.
What is the initial management of blast injuries?
Airway management, oxygen therapy, hemorrhage control, and stabilization.
What are potential complications of missile injuries?
Loss of limbs, blindness, deafness, chronic wounds, contractures, PTSD.
What psychological condition is common after blast injuries?
Post-traumatic stress disorder (PTSD).
What investigations are commonly done for blast injuries?
CBC, FBS, EUCr, wound swab, biopsy, audiometry, radiographic imaging.
What clinical conditions may result from brain injury due to blast waves?
Headache, dizziness, confusion, loss of consciousness.
Why is hemorrhage control critical in missile injuries?
Uncontrolled bleeding can lead to shock and death.
How is fluid resuscitation managed in blast trauma?
IV fluids are administered to maintain hemodynamic stability.
Why are gastrointestinal injuries concerning in blast trauma?
Perforation or hemorrhage may lead to peritonitis and sepsis.
What is the purpose of group and save in trauma management?
To prepare blood for potential transfusion.
What factors determine the extent of tissue damage in missile injuries?
Velocity, trajectory, projectile shape, and tissue characteristics.
Why are high-velocity gunshot wounds more severe?
They transfer more kinetic energy, causing greater cavitation and tissue destruction.
How do blast injuries cause ophthalmic trauma?
High-pressure waves and debris may lead to corneal abrasions, globe rupture, or retinal detachment.
What is the significance of rotational motion in gunshot injuries?
Bullets may tumble or oscillate, increasing tissue damage along their path.
What are the primary organs affected by primary blast injury?
Lungs, ears, gastrointestinal tract, brain.
What are the principles of surgical intervention in missile injuries?
Debridement, wound closure, fracture fixation, vascular repair if necessary.
What is the primary concern in treating penetrating abdominal trauma?
Peritoneal contamination and organ injury requiring surgical exploration.
Why is rehabilitation important in blast injuries?
To restore function, improve mobility, and provide psychological support.
What is the role of prosthetics in missile injuries?
Prosthetics help restore limb function after amputations.
How does blast overpressure cause brain injury?
Rapid pressure changes lead to stress and shear forces causing cerebral edema and hemorrhage.
What is the butterfly pattern in chest radiographs?
Bilateral hilar infiltrates seen in blast lung injuries.
Why is the tympanic membrane sensitive to blast waves?
It is a thin, gas-filled structure that ruptures under rapid pressure changes.
What is the difference between direct and indirect tissue damage in gunshot wounds?
Direct damage is from bullet impact, while indirect damage results from cavitation and shockwaves.
What are the characteristics of low-velocity missile injuries?
Localized tissue damage with minimal cavitation effects.
What role do antibiotics play in missile injury management?
Prevent infections, especially in contaminated wounds.
How does crush injury occur in blast trauma?
Structural collapse or heavy debris traps and compresses body parts, leading to ischemia and necrosis.
What is the importance of occupational therapy in blast injury rehabilitation?
Helps patients regain independence and adapt to functional limitations.
How does amputation affect a patient’s rehabilitation process?
Requires prosthetic fitting, physiotherapy, and psychological adjustment.
What is the AVPU scale used for?
Assessing neurological status: Alert, Verbal response, Pain response, Unresponsive.
Why is revascularization necessary in some missile injuries?
Restores blood flow to prevent ischemic damage and limb loss.
What type of fractures are common in tertiary blast injuries?
Long bone fractures, pelvic fractures, spinal injuries.
Why is delayed presentation of blast lung concerning?
Pulmonary edema and respiratory failure can develop hours after injury.
What are the long-term effects of blast-related brain injuries?
Cognitive deficits, memory loss, chronic headaches, PTSD.
What is the purpose of an emergency thoracotomy in gunshot trauma?
To control hemorrhage, relieve cardiac tamponade, or repair major vessels.
Why is tympanic membrane rupture a marker for blast exposure?
It indicates exposure to significant overpressure, even in the absence of external wounds.
What is the purpose of wound swabs in missile injuries?
To detect and guide treatment of bacterial infections.
