04-28-2004, 14:05
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#1
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Quiet Professional
Join Date: Jan 2004
Location: LA
Posts: 1,653
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Blast Injuries
Let's talk about the effects of blasts on the human form.
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Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
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NousDefionsDoc is offline
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04-28-2004, 14:10
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#2
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Quiet Professional
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Pathophysiology: Blast injuries traditionally are divided into 4 categories: primary, secondary, tertiary, and miscellaneous injuries. A patient may be injured by more than one of these mechanisms.
A primary blast injury is caused solely by the direct effect of blast overpressure on tissue. Air is easily compressible, unlike water. As a result, a primary blast injury almost always affects air-filled structures such as the lung, ear, and gastrointestinal (GI) tract.
A secondary blast injury is caused by flying objects that strike people.
A tertiary blast injury is a feature of high-energy explosions. This type of injury occurs when people fly through the air and strike other objects.
Miscellaneous blast-related injuries encompass all other injuries caused by explosions. For example, the collision of two jet airplanes into the World Trade Center created a relatively low-order pressure wave, but the resulting fire and building collapse killed thousands.
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Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
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NousDefionsDoc is offline
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04-28-2004, 14:14
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#3
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Consigliere
Join Date: Jan 2004
Location: Free Pineland (at last)
Posts: 8,767
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You want to credit that, right?
http://www.emedicine.com/emerg/topic63.htm
Here's some more:
Mortality/Morbidity:
Mortality rates vary widely. Injury is caused both by direct blast overpressure (primary blast injury) and by a variety of associated factors.
Mortality is increased when explosions occur in closed or confined spaces (eg, terrorist bus bombings) or under water. Land mine injuries are associated with a high risk of below- and above-the-knee amputations. Fireworks-related injuries prompt an estimated 10,000-12,000 ED visits in the United States annually, with 20-25% involving either the eye or hand.
Presence of tympanic membrane (TM) rupture indicates that a high-pressure wave (at least 40 kilopascal [kPa], 6 psi) was present and may correlate with more dangerous organ injury. Theoretically, at an overpressure of 100 kPa (15 psi), the threshold for lung injury, TM routinely ruptures; however, a recent Israeli case series of 640 civilian victims of terrorist bombings contradicts traditional beliefs about a clear correlation between the presence of TM injury and coincidence organ damage. Of 137 patients initially diagnosed as having isolated eardrum perforation who were well enough to be discharged, none later developed manifestations of pulmonary or intestinal blast injury. Furthermore, 18 patients with pulmonary blast injuries had no eardrum perforation.
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Roguish Lawyer is offline
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04-28-2004, 14:19
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#4
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Quiet Professional
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I wasn't finished, but thanks.
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Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
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NousDefionsDoc is offline
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04-28-2004, 14:22
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#5
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Consigliere
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Quote:
Originally posted by NousDefionsDoc
I wasn't finished, but thanks.
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Yeah, sorry. Just had to show that my google sometimes is strong. LOL
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Roguish Lawyer is offline
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04-28-2004, 14:38
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#6
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Area Commander
Join Date: Jan 2004
Location: MD
Posts: 1,012
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I'm not sure if I'm asking this correctly, but which effects are temporary and which are permanent?
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lrd is offline
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04-28-2004, 14:40
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#7
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Quiet Professional
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NP
SOAP?
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Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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04-28-2004, 14:40
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#8
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Quiet Professional
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Quote:
Originally posted by lrd
I'm not sure if I'm asking this correctly, but which effects are temporary and which are permanent?
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The affects of the blast are all injury dependent.
NDD:
Did you have a specific blast pattern or scenario in mind or just generalities?
What do you need the SOAP for? You scrubbing in? 
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"It's better to die on your feet than live on your knees."
"Its not who I am underneath, but what I do that defines me" -Batman
"There are no obstacles, only opportunities for excellence."- NousDefionsDoc
Last edited by Surgicalcric; 04-28-2004 at 14:44.
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Surgicalcric is offline
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04-28-2004, 14:56
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#9
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Quiet Professional
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Well, since the toy of choice for terrorists in the current theaters appears to be roadside IEDs, let's go with that.
Grasshopper, you will very shortly need to overcome your fear of SOAP.
So what is our SOAP for a blast from a roadside IED 5 klicks outside of Bagdad going to look like?
BTW, nice of you to volunteer.
__________________
Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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04-28-2004, 15:14
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#10
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JAWBREAKER
Join Date: Jan 2004
Location: Gulf coast
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The level of structural damage and injury caused by blast is dependent on the peak pressure(pressure decreases as you increase distance from origin), impulse length (a function of time and pressure), the overall shape of the pressure–time curve, and the elastic–plastic strength and natural period of oscillation of the structure or body.
In the human body, the shock wave/blast interacts with many types of tissues (eg, skin, fat, muscle and bone) that differ in density, elasticity and strength. Each tissue type, when interacting with a blast wave, is compressed, stretched, sheared or disintegrated by overload according to its properties.
Internal organs that contain air (sinuses, ears, lungs and intestines) are particularly vulnerable to blast.
These injuries are very difficult to diagnose. Will be interesting to hear how medics are trained to diagnose the internal injures. 
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Sacamuelas is offline
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04-28-2004, 15:14
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#11
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Consigliere
Join Date: Jan 2004
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Hey Crip:
Don't drop the SOAP.
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Roguish Lawyer is offline
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04-28-2004, 15:16
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#12
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Quiet Professional
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Nice graphic
Crip, if you haven't saved your avatar, you might want to do so in the next 30 seconds.
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Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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04-28-2004, 15:20
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#13
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JAWBREAKER
Join Date: Jan 2004
Location: Gulf coast
Posts: 1,905
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LOL......
Hey RL... since your in the medical forum AGAIN cracking jokes, you might want to be careful too. ONE good post doesn't give you a free pass for very long in here. Remember ME from your brain MRI thread??? LOL hahha
Just kidding.. Alright, lets get back to the thread's topic. This is a very serious topic for current and future medics/soldiers.
Last edited by Sacamuelas; 04-28-2004 at 15:27.
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Sacamuelas is offline
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04-28-2004, 15:21
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#14
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Quiet Professional
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For me to come up with a SOAP report for a patient I am going to need more patient/blast specific information.
Avatar has been saved for some time JIC.
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"It's better to die on your feet than live on your knees."
"Its not who I am underneath, but what I do that defines me" -Batman
"There are no obstacles, only opportunities for excellence."- NousDefionsDoc
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Surgicalcric is offline
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04-28-2004, 15:23
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#15
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Quiet Professional
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More information like what?
26y/o WM...oh wait, you're supposed to be doing it!
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Somewhere a True Believer is training to kill you. He is training with minimal food or water, in austere conditions, training day and night. The only thing clean on him is his weapon and he made his web gear. He doesn't worry about what workout to do - his ruck weighs what it weighs, his runs end when the enemy stops chasing him. This True Believer is not concerned about 'how hard it is;' he knows either he wins or dies. He doesn't go home at 17:00, he is home.
He knows only The Cause.
Still want to quit?
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NousDefionsDoc is offline
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