EXPLOSIONANDBLASTINJURIES

MechanismsofInjury
Outline
Injurydefinitions
BombInjurythreatmodel
Agent
Host
Environment
Specificexamples
Review
VideoclipTNT
Injurydefinitions
Primary:blastwave
Secondary:projectilefragments
Tertiary:contactwithobjects(blunt)
Quaternary:burnsandtoxins
Bomb
Size & weight
Explosive choice
Purpose & Source
Delivery system
Adulterants
Tactic
Human
Age, sex, & weight
Fitness, PPE
Nutrition, health
Access to care
Open Space, Confined Space,
Structural Collapse
Reflecting or Shielding surfaces
Building and non-structural debris
Air and liquid hazards
BombInjuryThreatModel
Lee-Davis
Agent
500lbsbombriggedasIED
AntiTankMineencasedinconcreteand
commanddetonatedviaremotecontrol
ArtilleryshellsriggedasIEDs
Explosives
Chemicalcompoundthatisabletorelease
storedenergyintheformofrapidlyexpanding
gases
HighOrderExplosives(HE)
TNT,ammoniumnitratefueloil,C4
Blastwave
Primaryblastinjury
LowOrderExplosive(LE)
Propellants(blackpowder,pyrotechnics)
Noblastwave
Rareprimaryblastinjury
Highexplosives
Storedenergyisreleasedrapidly
Detonation
Examples:TNTanddynamite
PRESSURE
TIME
(microseconds)
PEAK
OVERPRESSURE
POSITIVE PHASE OVERPRESSURE DURATION
0 ATM
Zero
Atmosphere
Pressure
Horrocks, CL. Blast Injuries: Biophysics,
Pathophysiology and Mnaagement Principles.
Idealizedblastoverpressurewaveform
seenonlyinhighorderexplosives(HE)
NEGATIVE PHASE
VACUUM
Zero ATM
Detonation
Nuclearvideo
Lowexplosives
Storedenergyisreleasedslowly
Combustionordeflagration
Examples:gunpowder,fuel
Noblastwaveoroverpressurization
Injuryresultsfrom:
Thermalburns,
Ballistic(shrapnel)
Suffocation(fumesandtoxins)
Host
Age
Sex
Height
Medicalhistory
Accesstocare
Environment
Openspace
Enclosedorconfinedspace
Structuralcollapse
Underwater
Openspace
Potentialforshrapnel
totravelalarge
distance(>100m)
Lessprimaryblast
injuries
Enclosedspace
Increasedmortality
Increasedblastpressure
Complicatedrescue
Structuralcollapse
Increasedmortality
fromprimaryblast
waveaswellasfrom
tertiaryand
quaternaryinjuries
Crushsyndrome
Whoisthis?
Whereisthis?
Highexplosives
Storedenergyisreleasedrapidly
Detonation
Examples:TNTanddynamite,andANFO!
Review
Blastsoccurfromvariouscauses,including
intentionalcauses
Highexplosivesdetonate
Lowexplosivescombustordeflagrate
Review
Highexplosiveblastscauseasupersonicblast
wave,whichisapressurewavethattravels
aheadoftheothereffects(heatand
fragments)andcausesPRIMARY blastinjury.
Review
BothHighandloworderexplosionscause
fragmentationandpenetratinginjury,known
asSECONDARY injury
Review
Bothhighandloworderexplosionscanthrow
peopleintoobjects,throwobjectsinto
people,orcausestructuralcollapse,causing
TERTIARY injury
Review
Explosionscauseheatinjury(burns)and
createtoxicproducts(carbonmonoxide,
cyanide,etc)thatcauseQUATERNARY injury
Review
Thepatternofinjuryispredictablegiven
knowledgeof:
Agent
Host
Environment
Questionsorcomments?