Blast Injury

An explosion can injure a patient in several ways at once. The pressure wave damages air-containing organs; fragments penetrate skin and viscera; blast wind throws the body against structures; and heat, smoke, collapse, or hazardous contaminants add further injury. A small external wound does not reliably indicate a minor event. Treat every blast casualty as a multisystem trauma patient. Establish the time and distance of the explosion, whether it occurred in an enclosed space or underwater, whether the patient was trapped, and whether chemical, biological, or radiological contamination is possible. These details guide the search for occult lung, ear, abdominal, brain, crush, inhalation, and contamination-related injury. Scene safety comes before patient contact. Respond only when incident command has cleared the area, remain alert for secondary hazards, use appropriate personal protective equipment, and follow decontamination procedures when indicated. Do not delay immediately lifesaving trauma care solely because radiological contamination is possible. In Canada, the Health Portfolio Emergency Response Plan coordinates federal support to provincial and territorial partners; operational patient care follows the applicable emergency medical services, trauma-system, and facility protocols.