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Blast Injury: Multi-Mechanism Approach

Primary, secondary, tertiary and quaternary blast mechanisms produce different injury patterns; systemic assessment is essential.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Blast Injury: Multi-Mechanism Approach?

Blast injury is classified by four mechanisms — primary (pressure wave), secondary (shrapnel), tertiary (being thrown), quaternary (burns, smoke, psychological). Multiple combined patterns are common.

Primary blast most often affects the tympanic membrane, lungs, gastrointestinal tract and eyes. Blast lung (pulmonary contusion, haemothorax, pneumothorax), GI perforation and cerebral air embolism are serious complications.

Triage and assessment must consider polyfocal pathology; tympanic membrane examination is a screening test. CT detects extensive injuries while airway management and surgical evaluation take priority.

Symptoms

Tympanic membrane rupture and hearing loss
Chest pain and dyspnoea
Haemoptysis
Abdominal pain, nausea, vomiting
Penetrating wounds and shrapnel marks
Limb amputation
Altered mental status
Burns, open wounds and skin lacerations

Risk Factors

Confined-space explosion
Proximity to the blast
Underwater blasts (amplified effect)
Lack of hearing protection
Exposure between fragile structures
Unprotected position close to the explosive
Mass casualty triage
Military or terror operation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Observe every patient with a blast history
  • Examine ear pain and the tympanic membrane
  • New haemoptysis or chest pain
  • Abdominal signs or peritonitis
  • Late GI perforation at 24 to 48 hours
  • Airway oedema or inhalation burn

Treatment Methods

01
Airway, breathing and circulation assessment
02
Tympanic membrane examination
03
Chest radiograph or thoracic CT
04
Abdominal evaluation including eFAST
05
Resuscitation of burn area
06
Selective surgical removal of shrapnel
07
Hyperbaric oxygen for air embolism
08
Ampicillin-sulbactam wound prophylaxis
09
Psychological support

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.