Prepping communities: Explosives Flashcards
What are some newer explosive devices?
Enhanced blast weapons, improvised explosive devices
What is an explosive event?
Conversion of a solid or liquid explosive material into gas causing energy release
What is the degree of blast injury based on?
Size of charge, distance, surrounding environment
What occurs when a blast is reflected by a solid surface?
Magnified many times
What should be done in detection during an explosive event?
Not typical or predictable
Used mostly by terrorists
What does the incident commander do when there is an explosive event?
Should manage traumatic and explosive events like any other disaster
What should be done in security and safety in an explosive event?
Scene must be secured and perimeter established, safety hazards must be relayed to incident commander
What types of hazards should be assessed?
Downed power lines, fire, debris, blood, structural instability
Who must be communicated with is the support part of an explosive event?
The trauma and burn team/center
What types of injuries can you see from a blast?
Primary, secondary, tertiary, quaternary, quinary
What are the characteristics to a primary blast injury?
Unique to explosions with high explosives, causes damage to air filled organs
Blast lung, TM rupture in ear, abd injury, brain injury
What will a pressure differential show in a primary blast injury?
Tear is alveolar walls, disruption of alveolar-capillary interface
What are the signs of a primary blast injury
Difficulty to complete a sentence in one breath, rapid/shallow respiration, poor chest wall expansion, dec breath sounds, wheezing/hemoptysis, cutaneous emphysema
What would the x-ray of someone suffering from over-pressurized lung from a primary blast injury look like?
“Butterfly” pattern
What can occur from a system air embolism from a primary blast injury?
Vascular obstruction, chest pain, focal neurological deficits, blindness, tongue blanching, cutis marmorata
Most related to sudden deaths in the first hour
What is the treatment for a pulmonary blast injury (primary)?
Spontaneous respiration preferred, supplemental O2, airway pressure must be more than vascular, lung isolation, unilateral intubation
What is a secondary blast injury?
Penetrating trauma caused by accelerations of shrapnel or blast debris
What are some characteristics of secondary blast injuries?
Possible small entrance wound and requires a detailed exam
What is a tertiary blast injury?
Displacement of body or structural collapse
Describe compartment syndrome.
Ecchymosis, tenderness, swelling, pain with passive motion, hypotension and shock, numbness and flaccid paralysis, may have loss of distal pulses
Describe crush syndrome.
Traumatic rhabdomyolysis, release intracellular toxins, potentially toxic when circulated through blood
How is crush syndrome treated?
Treat hyperkalemia, treat w/ iV glucose and insulin is cardiotoxic, beta-2 agonist, exchange resin. dialysis
Early, agressive treatment, IV normal saline, refer/perform fasciotomy if there is compartment syndrome
What is a quaternary blast injury?
All explosions related the burns and burn related injuries, environmental toxins, exacerbation of underlying illness
What is a quinary blast injury?
Purposeful addition of agents; chemical, biological, nuclear
What should you be aware of during triage in a blast injury?
Tympanic membrane rupture - they can’t hear you
CT pts of head, thorax, abs should go to OR
What are the treatment ABCs?
Airway (burns and hemorrhage), breathing (pneumothorax), and circulation (possible tourniquet use)
What is the parkland formula?
Adults: 2-4 mLs LR x kg body weight X TBSA; first half in 8 hours rest over 16 hrs
Less than 10: 3-4 mls LR x kg body weight x TBSA
In treatment ABCs, there is a D which stands for…
Disability; needs neurological exam, consider psychological impact of disaster
In treatment ABCs, the E stands for…
Exposure, elimination, environmental control;
Allow for exam, hypothermia, warm IV fluids, removal from outside
What should be done for evac in an explosive event?
Benefit most from rapid, orderly scene, balance flow of pts
What occurs in the recovery stage after an explosive event?
Starts when casualties have been removed, analyze post-incident
