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Blast injury — DIPIMC MCQ

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HardPre-Hospital TraumaBlast injuryDIPIMCDipIMC

Following an explosion at an industrial site, a casualty is found conscious with ruptured tympanic membranes, breathlessness with frothy sputum, and abdominal pain, but no external wounds. Which category of blast injury best explains this presentation?

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Correct answer: D — Primary blast injury from the pressure wave

Primary blast injury results from the blast pressure wave acting on gas-filled structures, classically producing tympanic membrane rupture, blast lung (dyspnoea with frothy sputum) and hollow-viscus injury, often without external wounds. Secondary injury is from fragments, tertiary from bodily displacement, and quaternary from burns and inhalation. Crush injury follows entrapment. Pearl: an apparently uninjured blast casualty with ruptured eardrums warrants a high index of suspicion for blast lung.

Reference: ATACC; JRCALC Clinical Guidelines