Missile And Blast Injuries

Question 1

What is a missile injury?

Answer 1

Wounds caused by sharp projectile objects that pierce the skin, such as bullets or shrapnel.

Question 2

What is a blast injury?

Answer 2

Injury caused by pressure waves from explosions affecting internal organs without necessarily having an entry wound.

Question 3

What are common causes of missile and blast injuries?

Answer 3

Explosives, firearms, military conflicts, terrorist attacks.

Question 4

What are the velocity classifications of missile injuries?

Answer 4

Low velocity (<340m/s), Medium velocity (340-610m/s), High velocity (610-1100m/s).

Question 5

What is ballistic trauma?

Answer 5

Trauma caused by high-velocity projectiles like bullets, including entrance and exit wounds.

Question 6

What is permanent cavitation in missile injuries?

Answer 6

Direct tissue destruction along the missile’s path, leaving a permanent cavity.

Question 7

What is temporary cavitation in missile injuries?

Answer 7

A shockwave-induced expanding tissue cavity that leads to secondary tissue damage.

Question 8

What is ‘blast lung’?

Answer 8

Pulmonary barotrauma caused by a primary blast wave, leading to potential delayed respiratory symptoms.

Question 9

What are primary blast injuries?

Answer 9

Injuries caused by overpressure waves affecting gas-filled organs like the lungs, ears, and intestines.

Question 10

What are secondary blast injuries?

Answer 10

Injuries caused by debris or projectiles from an explosion leading to penetrating or blunt trauma.

Question 11

What are tertiary blast injuries?

Answer 11

Injuries caused by physical displacement of the body due to a blast wave, leading to blunt trauma or fractures.

Question 12

What are quaternary blast injuries?

Answer 12

Burns, toxic exposure, crush injuries, and exacerbation of pre-existing conditions due to an explosion.

Question 13

What is the ATLS primary survey approach?

Answer 13

A: Airway & C-spine, B: Breathing, C: Circulation, D: Disability (GCS/AVPU), E: Exposure, F: Fluids.

Question 14

What are common symptoms of blast lung?

Answer 14

Chest pain, dyspnea, cough, hypoxia, bilateral infiltrates on chest X-ray.

Question 15

What injury is commonly associated with tympanic membrane rupture?

Answer 15

Hearing loss, tinnitus, dizziness.

Question 16

What is the recommended imaging for missile injuries?

Answer 16

X-rays, CT scans, MRI for assessing soft tissue and bone damage.

Question 17

What are the steps in managing missile injuries?

Answer 17

Hemostasis, wound debridement, stabilization of fractures, revascularization if needed.

Question 18

Why is a second-look wound debridement necessary?

Answer 18

To assess for necrosis, infection, and ensure better wound healing.

Question 19

What is the initial management of blast injuries?

Answer 19

Airway management, oxygen therapy, hemorrhage control, and stabilization.

Question 20

What are potential complications of missile injuries?

Answer 20

Loss of limbs, blindness, deafness, chronic wounds, contractures, PTSD.

Question 21

What psychological condition is common after blast injuries?

Answer 21

Post-traumatic stress disorder (PTSD).

Question 22

What investigations are commonly done for blast injuries?

Answer 22

CBC, FBS, EUCr, wound swab, biopsy, audiometry, radiographic imaging.

Question 23

What clinical conditions may result from brain injury due to blast waves?

Answer 23

Headache, dizziness, confusion, loss of consciousness.

Question 24

Why is hemorrhage control critical in missile injuries?

Answer 24

Uncontrolled bleeding can lead to shock and death.

Question 25

How is fluid resuscitation managed in blast trauma?

Answer 25

IV fluids are administered to maintain hemodynamic stability.

Question 26

Why are gastrointestinal injuries concerning in blast trauma?

Answer 26

Perforation or hemorrhage may lead to peritonitis and sepsis.

Question 27

What is the purpose of group and save in trauma management?

Answer 27

To prepare blood for potential transfusion.

Question 28

What factors determine the extent of tissue damage in missile injuries?

Answer 28

Velocity, trajectory, projectile shape, and tissue characteristics.

Question 29

Why are high-velocity gunshot wounds more severe?

Answer 29

They transfer more kinetic energy, causing greater cavitation and tissue destruction.

Question 30

How do blast injuries cause ophthalmic trauma?

Answer 30

High-pressure waves and debris may lead to corneal abrasions, globe rupture, or retinal detachment.

Question 31

What is the significance of rotational motion in gunshot injuries?

Answer 31

Bullets may tumble or oscillate, increasing tissue damage along their path.

Question 32

What are the primary organs affected by primary blast injury?

Answer 32

Lungs, ears, gastrointestinal tract, brain.

Question 33

What are the principles of surgical intervention in missile injuries?

Answer 33

Debridement, wound closure, fracture fixation, vascular repair if necessary.

Question 34

What is the primary concern in treating penetrating abdominal trauma?

Answer 34

Peritoneal contamination and organ injury requiring surgical exploration.

Question 35

Why is rehabilitation important in blast injuries?

Answer 35

To restore function, improve mobility, and provide psychological support.

Question 36

What is the role of prosthetics in missile injuries?

Answer 36

Prosthetics help restore limb function after amputations.

Question 37

How does blast overpressure cause brain injury?

Answer 37

Rapid pressure changes lead to stress and shear forces causing cerebral edema and hemorrhage.

Question 38

What is the butterfly pattern in chest radiographs?

Answer 38

Bilateral hilar infiltrates seen in blast lung injuries.

Question 39

Why is the tympanic membrane sensitive to blast waves?

Answer 39

It is a thin, gas-filled structure that ruptures under rapid pressure changes.

Question 40

What is the difference between direct and indirect tissue damage in gunshot wounds?

Answer 40

Direct damage is from bullet impact, while indirect damage results from cavitation and shockwaves.

Question 41

What are the characteristics of low-velocity missile injuries?

Answer 41

Localized tissue damage with minimal cavitation effects.

Question 42

What role do antibiotics play in missile injury management?

Answer 42

Prevent infections, especially in contaminated wounds.

Question 43

How does crush injury occur in blast trauma?

Answer 43

Structural collapse or heavy debris traps and compresses body parts, leading to ischemia and necrosis.

Question 44

What is the importance of occupational therapy in blast injury rehabilitation?

Answer 44

Helps patients regain independence and adapt to functional limitations.

Question 45

How does amputation affect a patient’s rehabilitation process?

Answer 45

Requires prosthetic fitting, physiotherapy, and psychological adjustment.

Question 46

What is the AVPU scale used for?

Answer 46

Assessing neurological status: Alert, Verbal response, Pain response, Unresponsive.

Question 47

Why is revascularization necessary in some missile injuries?

Answer 47

Restores blood flow to prevent ischemic damage and limb loss.

Question 48

What type of fractures are common in tertiary blast injuries?

Answer 48

Long bone fractures, pelvic fractures, spinal injuries.

Question 49

Why is delayed presentation of blast lung concerning?

Answer 49

Pulmonary edema and respiratory failure can develop hours after injury.

Question 50

What are the long-term effects of blast-related brain injuries?

Answer 50

Cognitive deficits, memory loss, chronic headaches, PTSD.

Question 51

What is the purpose of an emergency thoracotomy in gunshot trauma?

Answer 51

To control hemorrhage, relieve cardiac tamponade, or repair major vessels.

Question 52

Why is tympanic membrane rupture a marker for blast exposure?

Answer 52

It indicates exposure to significant overpressure, even in the absence of external wounds.

Question 53

What is the purpose of wound swabs in missile injuries?

Answer 53

To detect and guide treatment of bacterial infections.