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- p. 12projectile’s kinetic energy and more specifically its velocity (Kinetic Energy = ½ (Mass) x Velocity). Particles distributed by blast explosions also create permanent and temporary cavities. Figure A-1. Two areas of projectile-tissue interaction Explosive munitions injure through ... mechanisms a person is exposed to depends on their distance from the explosion, with persons closer to blasts being exposed to more mechanisms of injury. (See Figure 2 below.) Primary blast injuries occur from a pressure wave known
- p. 3surgeon has an appreciation for the phenomenon of wound evolution and weapon ballistics. Military assault rifles and proximity blasts cause large areas of cavitation because the kinetic energy transfer exceeds the area of tissue destruction by the projectile ... questionably viable but progress to necrosis over the subsequent 24-72 hours from microvascular thrombosis and ischemia. Blast wounds are heavily contaminated with environmental debris and, sometimes, foreign tissue from other blast victims. Furthermore, regional vascular injury, tourniquet
- p. 4general, leave the wound open until arrival at the definitive care facility. It is recognized that unstable blast injury patients with multiple fragmentation injuries over much of their bodies may not be able to undergo thorough debridement ... prior to dressing application.4 The need for repeat serial inspection and wound debridement cannot be over-emphasized. Unstable blast injury patients with multiple fragmentation injuries may not receive thorough debridement of all wounds at initial operation
- p. 13Nuclear, and Environmental Injuries) and are managed as outlined in CBRNE guidelines. Figure A-2. Four mechanisms of blast injury Virtually every organ is susceptible to injury from blast explosions and many of these injuries, particularly hollow viscus
- Agressions collectives par armes de guerre — conduites à tenirMinistères de l'Intérieur, des Armées et de la Santé
- p. 154étale de la simple fatigue auditive qui a parfois récupéré avant l’arrivée aux urgences, jusqu’au blast auri- culaire. Ce dernier doit être recherché par l’urgentiste. Il peut tout d’abord provoquer des lésions du système ... patient à une onde pressionnelle élevée (> 1 bar). De ce fait, il doit faire rechercher des signes de blast laryngo-trachéal et pulmonaire, qui peuvent engager le pronostic vital à court terme. Le seuil pressionnel de rupture
- p. 55onde de pression, ou onde de choc ou souffle de l’explosion ; ces lésions sont dites de blast et peuvent comprendre : – des lésions orthopédiques allant jusqu’à l’amputation traumatique provoquée par l’onde de choc. Pour certains ... lésions font partie des lésions secondaires, – un blast pulmonaire provoquant contusion pulmonaire et épanchement pleural sans spécificité, – un blast digestif qui peut donner des lésions immédiates des organes pleins et des organes creux mais aussi des hématomes parfois
- p. 155sang dans le conduit auditif externe (CAE), obturant ce dernier, provoquant une surdité et compliquant l’otoscopie. Un blast auriculaire peut alors facilement être diagnostiqué à tort. Il est important d’éliminer une fracture du rocher ... jours. En cas de contre-indication aux corticoïdes, l’avis de l’ORL peut être demandé. Suspicion de blast auriculaire Dans ce cas, l’avis de l’ORL doit être demandé, car l’examen clinique, notamment otoscopique
- p. 57Quantifying Gunshot Wound Components, Journal of Trauma, 1985, 25(6): 522-529. §§ Pasquier P., Lenoir B., Debien B., « Blast, lésions par explosions », in EMC Anesthésie Réanimation, Volume 10, no 4, octobre 2013. §§ Lindsey D., The Idolatry of Velocity
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- p. 15military rifles are much higher than civilian handguns which may lead to cavitation and surrounding devitalized tissue. Additionally, blasts can create four to five different classes of injury to the brain and other organ systems complicating management.75 ... Primary blast injury: blast overpressure from pressure waves. 2. Secondary blast injury: penetrating fragmentation injuries. 3. Tertiary blast injury: displacement of the casualty or blast debris that falls on the casualty. 4. Quaternary blast injury: injury from
- p. 315propage en milieu liquide, les lésions toucheront plutôt les organes pleins (foie, rate, cerveau, yeux). Les lésions de blast peuvent être immédiates et évidentes ; elles peuvent aussi être inapparentes et se manifester de façon retardée, parfois plus ... apparemment indemne, qui s’est trouvée à proximité d’une victime blessée, doit être considérée comme suspecte de blast, même si elle ne se plaint de rien et fera l’objet d’un bilan. Autres types de lésions
- p. 321foudre est une décharge électrique entre le nuage et la terre. Le foudroyé est possiblement électrisé, polytraumatisé, blasté, brûlé et hypotherme. Risque Le risque de foudroiement est majeur lorsque la distance ente le sol et la base ... dire, quand son pas est long (cela explique que l’exposition est majeure pour les quadrupèdes). Conséquences possibles • Blast : l’onde de choc précédant le tonnerre peut être responsable d’un blast aérien (tympans) ; • Traumatisme
- p. 314milieu ambiant dans toutes les directions sous la forme d’une onde de choc. Les lésions de « blast » désignent l’ensemble des lésions anatomiques générées à la suite d’une forte explosion. Mécanismes L’explosion initiale, l’onde ... tout ou partie de ces mécanismes en fonction de son éloignement de l’origine de l’explosion : • le blast primaire : Ce sont des lésions provoquées par l’onde de choc. Elles peuvent se produire à l’air libre
- p. 217indirect) qui entraîne des lésions des gros vaisseaux abdominaux, du foie ou de la rate ; • d’une explosion (blast). Risques & Conséquences La gravité du traumatisme abdominal est due à l’atteinte des organes abdominaux avec apparition
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- OMS / CICR — Basic Emergency Care (cahier du participant)OMS · CICR · IFEM
- p. 60injuries) that can limit blood flow to the muscles and nerves (compartment syndrome). Did the person sustain a blast injury? Blast injuries (from explosions) can involve all systems of the body, especially the hollow organs. Common blast injuries ... ears. Patients involved in explosions need to be checked carefully and repeatedly because these injuries are easily missed. Blasts may also be associated with foreign bodies in the skin and eyes, burns or chemical injury, and toxin
- p. 70have many systemic problems related to muscle damage and should always be handed over to an advanced provider. Blast injury • Injury to air-filled organs (such as lung, stomach and bowel) • Delayed symptoms of tachypnoea, hypoxia, chest pain ... loss, ringing in the ears, pain, ear bleeding • Other injuries, burns, exposure to chemicals or toxins An explosive blast can cause injuries in three ways: 1. Visible injuries from shrapnel (fragments of metal released by an explosive device
- p. 228Burn injury Assess size and calculate fl uid needs, give IV fluids and oxygen, monitor for airway oedema. Blast injury Give oxygen, treat burns as below, give IV fluids, monitor closely for delayed effects of internal injury. REMEMBER ... height) • Gunshot or stabbing • Explosion or fire in an enclosed space. • Penetrating injuries to head, neck or torso • Blast or crush injuries • Flail chest • Two or more large bone fractures, or pelvic fracture • Spinal injury • Limb paralysis • Amputation
- p. 9High Bilateral Amputations and Dismounted Complex Blast Injury CPG ID: 22 Guideline Only/Not a Substitute for Clinical Judgment 9 Refer to JTS Acute Extremity Compartment Syndrome and the Role of Fasciotomy in Extremity War Wounds CPG for further ... various levels from transtibial to very high transfemoral levels. These are often associated with extremely complex soft tissue blast wounds that include the perineal and gluteal region (see Figure 1). In addition to lower extremity amputations, these injury
- p. 14High Bilateral Amputations and Dismounted Complex Blast Injury CPG ID: 22 Guideline Only/Not a Substitute for Clinical Judgment 14 3. Patients in the population of interest resuscitated by MTP. 4. Patients in the population of interest who undergo ... Tactics 101: 026. Cordon and Search Operations. Armchair General 2. Dismounted Complex Blast Injury. Report of the Army Dismounted Complex Blast Injury Task Force, 18 June 2011 . 3. Shackelford SA, Del Junco DJ, Powell-Dunford
- p. 4High Bilateral Amputations and Dismounted Complex Blast Injury CPG ID: 22 Guideline Only/Not a Substitute for Clinical Judgment 4 B A C K G R O U N D The Dismounted Complex Blast Injury (DCBI) injury ... procedure. An ad hoc committee was established that produced a DCBI report, Report of the Army Dismounted Complex Blast Injury Task Force, which influenced changes in military tactics and demonstrates the criticality and power of rapid cycling
- p. 12High Bilateral Amputations and Dismounted Complex Blast Injury CPG ID: 22 Guideline Only/Not a Substitute for Clinical Judgment ... myonecrosis. Patients are at risk for invasive fungal infection if three of the following factors are present: Dismounted blast injury Above knee immediate amputation Extensive perineal/genitourinary/rectal injury Ultra massive transfusion of >20 units in the first 24 hours
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- p. 5conventional Hepatitis B vaccine. The risk of transmission for human immunodeficiency virus (HIV) is considered very low after blast injury and generally warrants no action.17 However, in the case of penetrating blast injury in a highly endemic region ... through the AD.VI.S.OR hotline. Hepatitis C (HCV) prophylaxis is not recommended, but testing can be considered in penetrating blast injury at the time of injury and at two, four, and six months.20 Healthcare Bloodborne Pathogen Exposure: Staff caring
- p. 50and/or emergencies associated with pediatric and geriatric patients) • Multi-system trauma (S,S) • Multi-system trauma (F,F) • Blast injuries (F,F) • Multi-system trauma (C,F) • Blast injuries (F,F) • Multi-system trauma (C,C) • Blast injuries
- ASPR TRACIE — Triage et soins sur les lieux d'un afflux massifASPR TRACIE (HHS)
- p. 15research to address the gaps in knowledge that exist regarding tourniquet use. Lesperance, R.N. and Nunez, T.C. (2015). Blast Injury: Impact on Brain and Internal Organs. (Abstract only.) Critical Care Nursing Clinics of North America ... Based on a literature review, the authors discuss some key points for the immediate care of blast injury victims. Specifically, they note that these patients should be treated as having multisystem trauma and managed according to Advanced Trauma
- p. 24patients with severe injuries and found the following injuries in patients: soft tissue and musculoskeletal injuries (85%), ear blast injury (67%), blast lung injury (63%), and head trauma
- p. 5patients with severe injuries and found the following injuries in patients: soft tissue and musculoskeletal injuries (85%), ear blast injury (67%), blast lung injury (63%), and head trauma (52%). Hirsch, M., Carli, P., Nizard
- p. 13patients with severe injuries and found the following injuries in patients: soft tissue and musculoskeletal injuries (85%), ear blast injury (67%), blast lung injury (63%), and head trauma
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- p. 6patients who underwent ERT at a single Role 3 facility in Afghanistan.9 The mechanisms were again all blast and gunshot wounds, and the overall survival rate was 22%. Although there were no survivors among patients with traumatic arrest ... survivors also had an explosive/blast mechanism. This work suggests that ERT may improve the outcomes in primary extremity blast injuries who were in extremis at arrival. RECOMMENDATIONS A recommended algorithm for ERT in traumatic arrest in the combat
- p. 6engineered to disperse radioactive material but without a fission or fusion reaction. Improvised explosive device Main concern is blast effects. Radiation exposure to only those close to blast. Radioactive dust and smoke could have some health effects Explosive
- p. 7Requires nuclear fission or fusion. Designed to deliver a nuclear detonation at either full or partial yield. Nuclear blast High level of external radiation exposure, blast /and thermal injury, and subsequent radiation contamination exposure through fallout Bomb dropped
- p. 194THORACOSTOMY CLINICAL INDICATIONS: Suspect a tension pneumothorax and treat when a casualty has significant torso trauma or primary blast injury and one or more of the following: • Severe or progressive respiratory distress or tachypnea, absent or markedly decreased ... gauge or a 10-gauge, 3.25-inch needle / catheter • If a casualty has significant torso trauma or primary blast injury and is in traumatic cardiac arrest: decompress both sides of the chest before discontinuing treatment. Clean area
- p. 10Axial load to head o High speed collision, rollover, or ejection from any motorized vehicle o Explosion or blast injury o Trauma resulting in temporary amnesia/loss of consciousness
- p. 23inhalation / carbon monoxide / cyanide toxicity) • Are there other traumatic injuries associated? • Any spinal immobilization needed? (fall from height, blast etc.) Differential Diagnosis • Cardiac arrest • Environmental exposure • Seizure • Burns (chemical, electrical, thermal, radiation) • Multiple trauma • Carbon monoxide toxicity Treatment
- p. 36spinal cord injury: o Blunt trauma to head or neck o Injury associated with high energy transfer (e.g., blast, motor vehicle) o Fall from greater than standing height o Fall directly onto head / neck o History of back
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- p. 6conventional) has particular utility in the identification of more subtle vascular injuries (e.g., traumatic pseudoaneurysm, arteriovenous fistula) following blast injury.15 In some instances, revision of at-risk repairs is necessary when bypasses are identified as having a stenosis ... signs such as history of significant hemorrhage, injury proximity to major vessels (fracture pattern, dislocation, penetrating wound, or blast injury), bruising or hematoma or question regarding the presence or absence of a palpable pulse require another diagnostic test
- IFRC — International First Aid, Resuscitation and Education Guidelines 2020IFRC — Global First Aid Reference Centre
- p. 409Retrieved from: https://doi.org/10.1016/j.injury.2017.10.025 Reavley, P., Bree, S., Horne, S., & Mayhew, E. (2019). Paediatric Blast Injury Field Manual. The Paediatric Blast Injury Partnership; Save the Children International; Imperial College London. https://www.savethechildren.org.uk/content/dam/gb/reports/pbip_blastinjurymanual_2019.pdf Savage, E., Forestier
- p. 442violence. ICRC. Full article: https://www.icrc.org/en/doc/assets/files/other/icrc_002_0870.pdf Reavley, P., Bree, S., Horne, S., & Mayhew, E. (2019). Paediatric Blast Injury Field Manual. The Paediatric Blast Injury Partnership; Save the Children International; Imperial College London. Full article: https://www.savethechildren.org.uk/content/dam/gb/reports/pbip_blastinjurymanual_2019.pdf
- p. 40force or violence • effects of disorganised healthcare, society and necessities (food, shelter, water) to responders. The Pediatric Blast Injury Field Manual (Reavley et al., 2019) has specific target audiences, including bystanders and medical personnel. The first section
- p. 195alert to the risks they face from weapons and aggression. • In the event of a gunshot, blast or knife injury on someone wearing a ballistic vest, the first aid provider should consider the potential for blunt force trauma
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- p. 2brain within the cranial vault which results in injury to brain tissue. TBI may be closed (blunt or blast trauma) or open (penetrating trauma).1 Signs and symptoms of TBI are highly variable and depend on the specific
- p. 3pain 2 – Extension to pain 1 – No response Red Flags Witnessed loss of consciousness Two or more blast exposures within 72 hours Unusual behavior or combative Unequal pupils Seizures Repeated vomiting Double vision or loss of vision Worsening
- p. 23function associated with treatment Implement definitive care when possible Types of Wounds Abrasion Burn Puncture Laceration Gunshot Blast Crush injury Telemedicine Large or complex wounds Associated injury to bone, blood vessel, tendon, nerve Penetrating chest or abdominal wound
- USFA / FEMA — Pompiers et EMS en tuerie de masseU.S. Fire Administration (FEMA)
- p. 4trauma care. Providing appropriate protective gear to personnel exposed to risks. Considering fire hazards secondary to the initial blast if improvised explosive devices (IEDs) are used. Considering secondary devices at main and secondary scenes. Determining how transportation
- JTS — Prolonged Casualty Care GuidelinesJoint Trauma System (DoD)
- p. 26brain within the cranial vault which results in injury to brain tissue. TBI may be closed (blunt or blast trauma) or open (penetrating trauma).13 Signs and symptoms of TBI are highly variable and depend on the specific
- TCCC Guidelines — 1er mai 2026CoTCCC / Joint Trauma System
- p. 3necessary. 1. Suspect a tension pneumothorax and treat when a casualty has significant torso trauma or primary blast injury and one or more of the following: 1. Severe or progressive respiratory distress 2. Severe or progressive tachypnea
- p. 4needle and leave the catheter in place. 5. If a casualty has significant torso trauma or primary blast injury and is in traumatic cardiac arrest (no pulse, no respirations, no response to painful stimuli, no other signs
- p. 5Bleeding 1. A pelvic binder should be applied for cases of suspected pelvic fracture: Severe blunt force or blast injury with one or more of the following indications: Pelvic pain Any major lower limb amputation or near amputation
- p. 6casualty has signs or symptoms of significant TBI or has altered mental status associated with blast injury or blunt trauma: 1. Administer 2 gm of tranexamic acid via slow IV or IO push as soon as possible
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