Suicide Bombers Form a New Injury Profile

Aharonson‐Daniel, Limor; Klein, Yoram; Peleg, Kobi

doi:10.1097/01.sla.0000225355.06362.0f

Cited by 75 publications

(44 citation statements)

References 18 publications

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“…These projectiles can result in a myriad of consequences, ranging from superficial to lethal wounds, depending on their velocity and shape (9). These fragments generally fly with great force and can cause occult penetrating wounds concealed by hair or clothing (76). These victims may walk in to the ED apparently well, yet have penetrating injuries that can threaten their life (76).…”

Section: Clinical Implications Of Secondary Blast Injurymentioning

confidence: 99%

Blast Injuries

Mathews¹,

Koyfman²

2015

The Journal of Emergency Medicine

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Section: Clinical Implications Of Secondary Blast Injurymentioning

confidence: 99%

Blast Injuries

Mathews¹,

Koyfman²

2015

The Journal of Emergency Medicine

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“…This high rate is probably related to the suicide bombing, which contributed to the relatively severe injuries requiring more abdominal, vascular and neurosurgical procedures compared with the other forms of trauma. 11,12 None of the imaged patients had evidence of blast lung. As a unique injury pattern of bomb explosion, blast lung injury is a major cause of immediate death and morbidity in patients who are critically ill. 13 Furthermore, primary blast lung prevalence has been reported to be significantly higher in patients injured in a confined-space explosion than in those injured in an open-space explosion.…”

Section: Discussionmentioning

confidence: 99%

Imaging features of blast injuries: experience from 2015 Ankara bombing in Turkey

Yazgan¹,

Aksu²

2016

BJR

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Objective: To present the radiological features of blastrelated injuries in the victims of the 10 October 2015 Ankara bombing and emphasize the importance of imaging. Methods: This retrospective descriptive study included a total of 28 patients who underwent CT scan or radiographic imaging within 6 h after the bombing on 10 October 2015. CT scans and plain radiographs were evaluated regarding mechanisms of injuries. Injuries were categorized as primary, secondary, tertiary and quaternary. The number of shrapnel and distribution of injuries were noted. Injury Severity Score (ISS) was used to rank the severity of the injury. Results: Primary blast injuries consisted of only tympanic membrane rupture. A high rate of patients (21/28 patients) in the study group suffered from secondary blast injuries. Tertiary injuries were detected in only three patients. Of the severely injured patients, five had abdominal injuries, three had thoracic injuries and six had extremity injuries. ISS was significantly higher in patients with thoracic and abdominal injuries. Conclusion: Our results after the suicide bomb attacks showed that the most common injury pattern was secondary blast injury. The torso was the most commonly injured body region, followed by the extremities. This specific injury pattern requires the use of immense radiological imaging. Hence, radiologists should be aware of the mechanisms and spectrums of blast-related injuries. Advances in knowledge: Both the unique injury pattern and the following chaos make blast-related injuries a challenge in terms of triage, diagnosis and management. Radiologists should be familiar with the wide spectrum of these unique injuries. INTRODUCTION Mechanisms of injuryThe patterns of blast-related injuries are categorized according to the basic effect of explosion (Table 1). This categorization provides a valuable theoretical framework for understanding blast injuries. However, various mechanisms occur together and victims usually have complicated injuries.1,2 Primary injuries occur secondary to the direct effect of changes in the atmospheric pressure caused by the blast wave, which is an intense over-pressurization impulse created by the explosion. Gas-filled structures such as the middle ear, lung and the gastrointestinal tract are most susceptible. Secondary blast injuries result from flying debris and fragments. They can be seen in any part of the body and are considered to be the most common cause of explosion-related injuries. Fragments would be metallic (shrapnel) or non-metallic. Furthermore, bony fragments from other individuals can be encountered. Tertiary blast injuries occur when the victim body is thrown over by the blast wind producing blunt or penetrating trauma. Quaternary blast injuries are caused by burns, toxic inhalation and exposure to radiation.

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“…This was seen in the Madrid, Israeli and Bali bombings. [2,[5][6] Mass-casualty triage has developed from a wartime necessity to a civilian tool to ensure that constrained medical resources are directed to the greatest use for most of people. Several primary and secondary triage tools have been developed, including Simple Treatment and Rapid Transport (START), JumpSTART, Care Flight Triage, Triage Sieve, SaccoTriage Method, Secondary Assessment of Victim Endpoint (SAVE), and Pediatric Triage Tape.…”

Section: Discussionmentioning

confidence: 99%

Bombings specific triage (Bost Tool) tool and its application by healthcare professionals

Jaiswal

Verma

Kole

2015

World Journal of Emergency Medicine

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BACKGROUND: Bombing is a unique incident which produces unique patterns, multiple and occult injuries. Death often is a result of combined blast, ballistic and thermal effect injuries. Various natures of injury, self referrals and arrival by private transportation may lead to "wrong triage" in the emergency department. In India there has been an increase in incidence of bombing in the last 15 years. There is no documented triage tool from the National Disaster Management Authority of India for Bombings. We have tried to develop an ideal bombing specifi c triage tool which will guide the right patients to the right place at the right time and save more lives. METHODS:There are three methods of studying the triage tool: 1) real disaster; 2) mock drill; 3) table top exercise. In this study, a table top exercise method was selected. There are two groups, each consisting of an emergency physician, a nurse and a paramedic. RESULTS:By using the proportion test, we found that correct triaging was significantly different (P=0.005) in proportion between the two groups: group B (80%) with triage tool performed better in triaging the bomb blast victims than group A (50%) without the bombing specifi c triage tool performed.CONCLUSION: Development of bombing specifi c triage tool can reduce under triaging.

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Suicide Bombers Form a New Injury Profile

Cited by 75 publications

References 18 publications

Blast Injuries

Blast Injuries

Imaging features of blast injuries: experience from 2015 Ankara bombing in Turkey

Bombings specific triage (Bost Tool) tool and its application by healthcare professionals

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