8/8/2019 Essential Facts

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8/8/2019 Essential Facts

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Fluidmanagementsimilartopulmonarycontusion;ensuretissueperusionbutavoidvolumeoverload

Endotrachealintubationormassivehemoptysis,impendingairwaycompromiseorrespiratoryailure

Considerselectivebronchialintubationorsignicantairleaksormassivehemoptysis

Positivepressuremayriskalveolarruptureorairembolism

Promptdecompressionorclinicalevidenceopneumothoraxorhemothorax

Considerprophylacticchesttubebeoregeneralanesthesiaorairtransport

Airembolismcanpresentasstroke,MI,acuteabdomen,blindness,deaness,spinalcordinjury,claudication

HighfowO2;prone,semi-letlateral,orletlateralposition

ConsidertranserorhyperbaricO2therapy

Abdominal Injury

Gas-lledstructuresmostvulnerable(esp.colon)

Bowelperoration,hemorrhage(smallpetechiaetolargehematomas),mesentericshearinjuries,solidorganlacerations,and

testicularrupture

Suspectinanyonewithabdominalpain,nausea,vomiting,hematemesis,rectalpain,tenesmus,testicularpain,unexplained

hypovolemia Clinicalsignscanbeinitiallysubtleuntilacuteabdomenorsepsisisadvanced

Ear Injury

Tympanicmembranemostcommonprimaryblastinjury

Signsoearinjuryusuallyevidentonpresentation(hearingloss,tinnitus,otalgia,vertigo,bleedingromexternalcanal,otorrhea)

Other Injury

Traumaticamputationoanylimbisamarkerormulti-systeminjuries

Concussionsarecommonandeasilyoverlooked

Considerdelayedprimaryclosureorgrosslycontaminatedwounds,andassesstetanusimmunizationstatus

Compartmentsyndrome,rhabdomyolysis,andacuterenalailureareassociatedwithstructuralcollapse,prolongedextrication,

severeburns,andsomepoisonings

Considerpossibilityoexposuretoinhaledtoxins(CO,CN,MetHgb)inbothindustrialandterroristexplosions

Signicantpercentageosurvivorswillhaveseriouseyeinjuries

Disposition Nodenitiveguidelinesorobservation,admission,ordischarge

Dischargedecisionswillalsodependuponassociatedinjuries

Admit2ndand3rdtrimesterpregnanciesormonitoring

Closeollow-upowounds,headinjury,eye,ear,andstress-relatedcomplaints

Patientswithearinjurymayhavetinnitusordeaness;communicationsandinstructionsmayneedtobewritten

This fact sheet is part of a series of materials developed by the Centers for Disease Control and Prevention (CDC)

on blast injuries. For more information, visit CDC on the Web at:www.emergency.cdc.gov/BlastInjuries

April2008