![]() Exposed areas of the victims’ body are at high risk for penetration of debris that is propelled by the explosion. Secondary blast injuries are the most common cause of mortality in victims of an explosion. Secondary blast injuries are more common than primary blast injuries. The device could be constructed with nails, metal ball bearings, screws, or other objects with the intent that they will be forcefully displaced during the blast to increase injuries to anyone in their path. In intentional explosive devices, often they are constructed with the intent to injure as many people as possible. The blast wave can carry debris a considerable distance causing injuries to anyone in its path. Secondary blast injuries account for the majority of injuries from an explosion event. The debris can be from pieces of the explosive device itself and its contents, or material located around the initial blast device at the time of the explosion. The secondary blast injuries are caused by debris that penetrates or interacts with the body surface. Secondary blast injuries are caused by debris that is displaced by the blast wind of the explosion. Victims of primary blast injuries may not initially show any obvious signs of injury. In victims with multiple presenting injuries or in incidents with multiple causalities, the injuries could be easy to miss. Victims can have chest pain, tachycardia, decreased pulse pressure, cardiac dysrhythmias and/or hypotension as a result of heart involvement. The heart can also be damaged by the blast wave. Blast eye should be considered in victims with eye pain, swelling, contusion or ecchymosis around the orbit, bleeding from the eye, decreased vision, and/or blindness. Blast brain should be considered in any victim presenting with headache, fatigue, confusion, poor concentration, amnesia, decreased level of consciousness, depression, anxiety, and/or insomnia. Solid internal abdominal organs can also be contused or lacerated however, solid organ damage occurs much less than does hollow organ damage. As with blast lung, intestinal perforation can occur acutely or may have a delayed presentation of up to 48 hours. The colon is the most common area of hemorrhage and perforation. Blast belly should be considered in any victim presenting with abdominal pain, nausea, vomiting, vomiting blood, rectal pain, testicular pain, unexplained hypovolemia, abdominal distention, and/or rigidity. In instances when the ear is over pressurized (greater than 5 psi), the bony ossicles of the ear can be dislocated, fractured and /or permanently destroyed. If there is bleeding from the ear, consider that the blast was intense enough to cause injury to the lungs and hollow organs. Blast ear should be considered in any victim that has decreased hearing or hearing loss, tinnitus, vertigo and/or bleeding from the ear. Pulmonary contusion is the most common respiratory system injury and it can be delayed in presentation up to 48 hours. If the pressure exceeds 40 psi, the victim could sustain a pulmonary contusion, pneumothorax, air embolism, interstitial parenchyma damage, and/or subcutaneous emphysema. The respiratory system can sustain significant injury, as a result of the blast wave. Blast lung should be considered in any victim that has dyspnea, cough, hemoptysis, and/or chest pain. Primary blast injuries can be subtle and have a delayed presentation. It can also cause injury to solid organs and testicular rupture. ![]() īlast belly – injury causing abdominal hemorrhage and perforation (immediate and delayed). Immediate death can also be caused by a pulmonary air embolism, severe head injury, significant internal injury, amputation, or impalement on an object. Immediate death can occur from an explosion as a result of extensive pulmonary injury with pulmonary hemorrhage causing suffocation. The four categories are based on the impact on the human body due to the blast wave, blast wind, environmental/material factors present in the area of the blast. Blast wind is the flow of superheated air that can interact with people and objects and cause injury or damage.Ĭhemical explosions cause injuries in four categories (primary, secondary, tertiary, and quaternary). In addition to the blast wave, an explosion can cause blast wind. Examples of low order explosives include – pipe bombs, gun powder, petroleum-based bombs. Low order explosions have a subsonic explosion and lack the high order explosive blast wave. High order explosives have a strong supersonic pressure wave, known as the blast wave or shock wave. ![]() Explosives are categorized as high order explosives or low order explosives. ![]()
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