Primary blast injury: update on diagnosis and treatment.

BACKGROUND : Injuries from combat and terrorist explosions are increasing worldwide. As such, physicians can expect to treat more patients with complex and unique patterns of injury produced not only by fragments and blunt trauma, but also by high-pressure air expanding from the detonation center. DISCUSSION : Tissue damage from the blast wave or primary blast injury can be an important cause of occult trauma to the ocular, aural, pulmonary, cardiovascular, musculoskeletal, and neurologic systems. Awareness of the extensive corporal effects of the blast wave is an essential prerequisite to diagnosis. SUMMARY : This article focuses on the incidence, risk factors, diagnosis, management, and screening for primary blast injury.