CL Horrocks. Blast Injuries: Biophysics, Pathophysiology and Management Principles.

Introduction Explosions are physical, chemical or nuclear reactions that involve the rapid release of considerable amounts of energy. Their deleterious effects on living organisms are embodied by the term blast injury. The incidence of injuries resulting from explosions has increased throughout the twentieth century. This has been caused in part by industrial expansion. More significant has been the proliferation of explosive weapons and their increased use world-wide. Injuries caused by explosions are not confined to the battlefield. The International Committee of the Red Cross has estimated that throughout 70 countries, at least 2,000 people (predominantly civilians) are killed or injured every month by anti-personnel mines. From 1990 to 1995, 15,700 criminal bombing incidents were recorded in the United States by the Federal Bureau of Investigation (FBI).These resulted in the deaths of 355 persons and injuries to 3176. Explosions caused by industrial accidents and terrorist devices are infrequent, but unpredictable events in developed countries. Therefore, civilian doctors may be required to deal with large numbers of blast injured subjects with little warning in chaotic and difficult circumstances. An understanding of the mechanisms of these injuries and their management is useful to all physicians. Explosions and the injuries caused by them are the subjects of this paper.