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Response to Acts of Terrorism
Published in Robert A. Burke, Counter-Terrorism for Emergency Responders, 2017
“Blast lung” is a direct consequence of the high-order explosives (HE) over-pressurization wave. It is the most common fatal primary blast injury among initial survivors. Signs of blast lung are usually present at the time of initial evaluation, but they have been reported as late as 48 hours after the explosion. Blast lung is characterized by the clinical triad of apnea, bradycardia, and hypotension. Pulmonary injuries vary from scattered petechiae to confluent hemorrhages. Blast lung should be suspected for anyone with dyspnea, cough, hemoptysis, or chest pain following the blast exposure. Blast lung produces a characteristic “butterfly” pattern on chest x-ray. A chest x-ray is recommended for all exposed persons, and a prophylactic chest tube (thoracostomy) is recommended before general anesthesia or air transport is indicated if blast lung is suspected.
The Medical Management of Military Injuries
Published in Melanie Franklyn, Peter Vee Sin Lee, Military Injury Biomechanics, 2017
Damian Keene, Peter Mahoney, Johno Breeze, Arul Ramasamy
The benefits of prolonged permissive hypotension in blast injury have been questioned. Animal studies have demonstrated it cannot be maintained indefinitely and a point will be reached where the physiological effects of shock cannot be reversed, resulting in death (Garner et al. 2010). A hybrid technique has been demonstrated to overcome this: permissive hypotension is allowed for the first 60 minutes, a normal blood pressure is targeted after this point by the administration of blood products irrespective of haemorrhage control (Watts et al. 2015).
Biomechanics of Chest and Abdomen Impact
Published in Joseph D. Bronzino, Donald R. Peterson, Biomedical Engineering Fundamentals, 2019
David C. Viano and Albert I. King
FIGURE 14.3 Biomechanics of chest injury by a crushing injury mechanism limited by tolerable compression at Cmax = 35%, a viscous injury mechanism limited by the product of velocity and extent of deformation at VCmax = 1.0 m/s, and a blast injury mechanism for shock wave loading.
Numerical assessment of the human body response to a ground-level explosion
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
Piotr W. Sielicki, Tomasz Gajewski
Depending on the blast injury cause, the world literature classifies injuries as primary, secondary, tertiary and quaternary (Yeh and Schecter, 2012; Mathews and Koyfman, 2015). Primary injuries are caused directly by a blast wave propagated in a gas; therefore, organs containing air, such as the tympanic membranes (eardrums), lungs, and bowels are vulnerable to this type of injury (Tan et al., 2015; Gupta and Przekwas, 2015; Unified Facilities Criteria, 2008). It should be stated that body armour does not protect against this type of injury (Dionne et al., 2018). Secondary injuries are caused by flying objects in the surrounding environment, such as glass or metal pieces (bolts and nails) (Szymczyk et al., 2017). Stab and gunshot types of wounds are usually classified as secondary injuries. Tertiary injuries include the effects of human body translation due to collisions with hard objects, such as walls, furniture, cars, and so on (Eskridge et al., 2012). Structural collapse injuries also belong to this group. Quaternary injuries are classified as effects not categorised previously, such as burns, psychological trauma, or harmful radiation (Gupta and Przekwas, 2015). To conclude, primary injuries are the most detrimental to human health. Thus, this article focuses on the numerical analysis of the human body and corresponding harmful over-pressures and accelerations resulting from a blast wave on eardrums, lungs, and the pelvis.
Computational modeling of blast induced whole-body injury: a review
Published in Journal of Medical Engineering & Technology, 2018
Arnab Chanda, Christian Callaway
A blast is a destructive wave of highly compressed air spreading outwards from an explosion, which may cause varying degrees of traumatic injury to the human body [1,2]. Blast-induced injuries can be of three major types: primary, secondary and tertiary. A primary blast injury [3] is caused by the direct impact of a blast wave on the human body, which may cause bone fractures, muscle ruptures and irreparable damage to internal organs. A primary blast wave also carries an extreme amount of heat energy, which may cause severe skin burns. A secondary blast injury [4] is caused by debris or shrapnel propelled by the explosion on or into the body, which may severely damage the skin or the sensory organs. A tertiary blast injury [4] involves the transmission of excessive stresses on the body causing it to fling onto a solid structure such as a building. Based on the intensity of a blast, all three types of blast injury may be accompanied with traumatic amputation of one or more body parts and heavy fatal bleeding.