Blast injury

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Blast injury is a syndrome (set of symptoms) resulting from an explosion. This is an injury caused by the impact of a pressure/shock wave on the human body. The essence of an explosion is a rapid transformation of energy (chemical, nuclear, etc.) which leads to a rapid increase in temperature and gas pressure at the site of the explosion and the expansion of the explosion waste products into the surroundings.

Injuries[edit | edit source]

The energy of a propagating shock wave is released whenever it passes through an acoustic impedance interface. Typically at the interface soft tissue - air or soft tissue - bone. The extent of injury depends on the intensity and duration of exposure.

Primary injuries
  • Caused by a pressure wave (gas, liquid, solid substance).
  • They occur most often when a person is close to the source of the explosion (land mine).
  • Most effected are organs that contain air (first middle ear injury manifests itself, then the lungs (contusion, bleeding, alveoli damage), the intestine (injury manifests itself after several hours), ...)
  • The brain is also traumatized.
  • A primary injury is characterized by the absence of external injuries so the severity and extent of the injuries are often unrecognized or underestimated.
Secondary injuries
  • The remains of objects that are thrown into the surroundings by the explosion play their role here.
  • This includes penetrating and perforating trauma with visible bleeding or bleeding into internal organs. The presence of shrapnels significantly complicates treatment.
Tertiary injuries
  • This is an injury to the extent of amputation caused by a strong hit of air or the impact of the human body against an obstacle. Often accompanied by penetrating injuries.
Indirect injuries
  • Arising in a different context (e.g. building collapses, being trampled by a crowd), burns, crush syndrome.

Distance from the epicenter[edit | edit source]

  1. epicenter - devastating, fatal injuries
  2. primary zone – pressure wave effecting the middle ear or lungs
  • in an open space: the shock wave propagates spherically, reflects off the ground and standing objects; overpressure is followed by a wave of underpressure and rapid normalization of pressure ratios
  • in a closed space: the pressure wave is reflected and the overpressure lasts longer, the proportion of primary injuries increases; on the contrary, the proportion of shrapnel injuries decreases due to obstacles (e.g. bus seats)
  • immersion blast syndrome (propagation of a pressure wave in a liquid)
    • especially abdominal contusion with intestine ruptures, eyeball contusions
  • solid blast syndrome (propagation of a pressure wave in a solid environment)
    • multiple fractures of the limbs (for those who were standing at the time of the explosion), pelvis and spine (for those who were sitting)

Injury to individual organs[edit | edit source]

  1. ear – perforation of the eardrum with possible hearing damage
  2. lungs – rupture of the alveolocapillary membrane accompanied by bleeding and air embolization into the arteries of the brain and heart; emphysema and pneumothorax can also occur
  3. heart – the injury may subsequently be accompanied by heart rhythm disorders
  4. GIT – contusion or perforation of the intestinal wall
  5. limbs – amputation of peripheral parts of limbs
  6. muscles - crush syndrome and subsequent rhabdomyolysis

Treatment of injured in the explosion[edit | edit source]

  • surgical treatment – ​​where indicated (fractures, intestinal ruptures, etc.)
  • otherwise conservative procedure
    • ensuring breathing (intubation, cricothyrotomy, oxygen therapy) and blood circulation (cardiotonics, shock treatment)
    • prevention and treatment of pulmonary complications (antibiotics)

Links[edit | edit source]

Related articles[edit | edit source]

Sources[edit | edit source]

Literature[edit | edit source]

  • JANOVSKÝ, B. – MAKOVIČKA, D. Protivýbuchová ochrana staveb : Šíření a útlum vzdušných rázových vln [online]. [cit. 2011-02-09]. <http://pvoch.cvut.cz/ke_stazeni/>.
  • ZEMAN, Miroslav. Chirurgická propedeutika. 2. edition. Grada, 2000. ISBN 80-7169-705-2.
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