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Primary blast lung injury — DIPIMC MCQ

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HardPre-Hospital TraumaPrimary blast lung injuryDIPIMCDipIMC

Following an explosion, a casualty complains of breathlessness and is coughing up blood. He has bilateral ruptured tympanic membranes but no external chest wound. Oxygen saturations are 88 percent.

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Correct answer: D — Give supplemental oxygen with cautious ventilation and transport, anticipating primary blast lung injury.

Ruptured eardrums with respiratory symptoms after a blast suggest primary blast lung injury, managed with oxygen, judicious ventilation that avoids the high pressures that risk air embolism and barotrauma, and rapid transfer. Aggressive ventilation and fluid overload can worsen the lung injury. Tympanic rupture is a marker of significant blast exposure rather than a trivial finding.

Reference: ATACC Guidelines