Blast injuries are a unique and important subset of traumatic burn injuries. Explosions can cause all types of injuries in multiple victims simultaneously, complicating triage and causing management challenges. Aggravating preparedness for these events is the fact that each event is unique, producing a wide range of injuries. According to the Centers for Disease Control and Prevention (CDC),here are a few things to expect:
- Bombs and explosions can cause unique patterns of injury seldom seen outside combat
- Half the initial casualties seek medical care over a one-hour period
- Most severely injured arrive after the less injured, who bypass EMS triage and go directly to the closest hospitals
- Most injuries involve multiple penetrating wounds and blunt trauma
- Confined space explosions (buildings, vehicles, mines) and explosions resulting in structural collapse lead to greater morbidity and mortality
- Primary blast injuries among survivors usually result from confined-space explosions
- Standard protocols apply for triage, trauma resuscitation, treatment, and transfer
For more information, please refer to the CDC information sheet here.
Radiation injuries are another unique and important subset of traumatic burn injuries. Because radioactive materials are commonplace in our society, the likelihood that an accident involving materials that are radioactive is increasing; therefore, it is important to be prepared and know how to handle these situations. Further, first responders should watch closely for signs or symptoms of exposure to radiation or chemical contamination in patients who survived an explosion.
For a primer on radiation burns, please read The Medical Management of Radiation Emergencies produced by Loyola University of Chicago.
Pediatric Terrorism and Disaster Preparedness
Children are among the most vulnerable victims to explosions or accidents; these types of disasters do not discriminate. Children cannot be treated as small adults because of significant differences in anatomy, physiology, immunology, and psychology. Therefore, it is important to incorporate the needs of children and families into disaster planning. Because of their experience, pediatricians can play a powerful role in accounting for the differences in triage, diagnosis, and management of children.
For a practical, pediatric resource, please consult the Agency for Health Care Research and Quality (AHRQ) report Pediatric Terrorism and Disaster Preparedness: A Resource for Pediatricians.