Explosion and Blast-Related Injuries (eBook)

Front Cover 1
Explosion and Blast-Related Injuries 4
Copyright Page 5
Table of Contents 6
List of Contributors 8
Preface 12
Introduction 14
Part 1: Epidemiology of Blast and Explosion Injuries 18
Chapter 1: The Epidemiology and Triage of Blast Injuries 20
Introduction 21
Methodological Issues 25
Mechanisms And Consequences of Blast-Related Injury 28
Morbidity And Mortality 37
Conclusion 47
Disclaimer 49
References 49
Chapter 2: Explosion Injuries Treated at Combat Support Hospitals in the Global War on Terrorism 58
Introduction 59
Explosion Characteristics 61
Explosion Injuries 63
Explosion Statistics 64
Unique Injuries 66
Demographics of Explosions in Military Patients 68
Injuries 69
Anatomical Distribution of Injuries 72
Age 73
Gender 74
Injury Severity 74
Procedures 76
Hemostatic Resuscitation 76
Clinical Lessons Learned 78
Summary 80
References 80
Part 2: Pathology and Pathophysiology of Blast Injuries 88
Chapter 3: Pathology of Human Blast Lung Injury 90
Introduction 90
Injuries caused by explosives—a short overview 91
Pathological features of traumatic lung injury not due to primary blast effects 95
Blast lung injury 99
Concluding remarks 104
References 105
Chapter 4: Neurotrauma from Explosive Blast 108
IntroductIon 108
Types Of Traumatic Brain Injury 109
Severity Of Traumatic Brain Injury 110
Prevalence 111
Mechanisms Of Injury 112
Blast Mechanics 113
Blast Injury 113
Clinical Management 114
Blast Concussive Injury 117
Conclusion 119
Disclaimer 119
References 119
Chapter 5: Effects of Blast Injury on the Autonomic Nervous System and the Response to Resuscitation 122
Introduction 122
Primary Blast Injuries 125
Secondary Blast Injury 141
Tertiary Blast Injury 147
Summary 150
Disclaimer 151
References 151
Chapter 6: Quaternary Blast Injury: Burns 160
Introduction 160
Epidemiology 161
Pathophysiology 166
Radiant Heat 167
Treatment 169
Conclusion 173
Disclaimer 174
References 174
Part 3: Modeling and Mechanisms of Primary Blast Injury 178
Chapter 7: Multiscale Computational Modeling of Lung Blast Injuries 180
Introduction 181
Multiphysics, And Multiscale Approaches In Modeling Blast Injury 190
Modeling Explosion Blast—Human Body Dynamics And Biomechanics 204
Blast Wave Lung Injury Model 237
Summary and Conclusions 267
Disclaimer 270
References 270
Chapter 8: Biochemical Mechanism(s) of Primary Blast Injury: The Role of Free Radicals and Oxidative Stress 278
Introduction 279
Methods 285
Results and Discussion 290
Conclusions 296
Acknowledgments 299
Disclaimer 299
References 299
Chapter 9: Inflammatory Response in Primary Blast Injury 306
Introduction 306
Model of Blast Lung Trauma 307
Systemic Cardiopulmonary Alterations in Shock Wave Induced Injury 309
Systemic and Local Inflammation in Shock Wave Induced Pulmonary Trauma 311
Summary 316
Acknowledgments 319
Disclaimer 319
References 319
Part 4: Global Experiences of Blast Injury and Mass Casualty Management 322
Chapter 10: Mass Casualty Events—Suicide Bombing: The Israeli Perspective 324
Introduction 325
Mechanism of Injury in Bomb Explosions 326
Characteristics of the Primary Blast Injuries on Specific Organs 329
Limb Amputation 331
Causes of Immediate Death 331
Forensic Studies 331
Site of the Explosion and the Wounding Potential 332
The Multidimensional Injury Pattern 332
Blast Injuries: Prehospital Management 333
Triage 336
Triage and Control in a Level 1 Trauma Center 339
The Epidemiology of Trauma Casualties 343
Discussion 346
Conclusion 347
Summary 348
References 348
Chapter 11: The Soviet Experience in Afghanistan 1980–1989: Abdominal Blast Injury Produced by Mine Explosions 354
Introduction: Land Mines in the Soviet–Afghan War 354
Mine Explosion and the Heart 357
Mine Explosion and the Lung 358
Mine Explosion and the Central Nervous System 358
Mine Explosion and Septic Shock 359
Mine Explosion and Organs of the Abdominal Cavity 359
Land Mine Injury Management 363
Conclusions 368
Disclaimer 368
References 368
Chapter 12: Otologic Blast Trauma: Experience from Croatian War 370
Introduction 370
War-Related Blast Injury of the Middle Ear 372
War-Related Blast Injury of the Inner Ear 379
Summary 382
References 383
Index 386