Blast injuries are a rare event that first responders, EMS and emergency departments need to be prepared to handle. Bombs and explosion have unique patterns of injuries, and require understanding the mechanisms, evaluation, and initial treatments based on disaster medicine best practices.

These concepts are from the CDC’s website which has a lot of great material. For additional information please see: CDC Blast Injury Facts for a wealth of information.

Minneapolis New Years Morning 2014 Explosion

Key Concepts of Blast Injuries

  • Bombs and explosions can cause unique patterns of injury seldom seen outside combat – about 30% more critically injured casualties vs. ‘routine’ mass casualty events.
  • Expect half of incident casualties to seek medical care over a one-hour period (so by one hour, you probably will see no more than 50% more patients – and these will usually present more slowly).
  • Most severely injured often arrive after the less injured, who bypass EMS and go directly to the closest hospitals.
  • Predominant injuries involve multiple penetrating injuries and blunt trauma – this can be subtle!
  • Explosions in confined spaces (buildings, large vehicles, mines) and/or structural collapse are associated with greater morbidity and mortality – 49% in buses vs. 7.9% in open spaces in one study!
  • Primary blast injuries in survivors are predominantly seen in confined space exp