1. Primary blast injury
2. Secondary blast injury
3. Tertiary blast injury
4. Quaternary blast injury / Miscellaneous
1. Primary blast injury- (Blast wave)
• Injuries caused by the blast wave itself
• Affecting air-filled structures-
Eardrum (most sensitive) > Lung > GIT (most common in underwater blast)
2. Secondary blast injury- (Flying objects / Projectiles / Missiles)
Injuries caused by flying debris or projectiles (metal particles).
Marshall triad: Refers to the presence of all three types of mechanical injuries (see below) at the same anatomical site- (PYQ: INICET Nov 2024)
• Abrasion
• Contusion
• Laceration
(Mnemonic: ACL ligament of knee)
|
Blast Injury Type |
Due to |
|
Primary |
Blast wave |
|
Secondary |
(Flying objects / Projectiles / Missiles) |
|
Tertiary |
Victim displacement, Blunt force trauma |
|
Quaternary |
Miscellaneous |
3. Tertiary blast injury- (Victim displacement, Blunt force trauma)
• Injuries caused by the person being thrown by the blast wind against the solid objects.
• Blunt & penetrating trauma combination.
• A person with low body weight is at a higher risk because they are more easily affected by the force of blast winds.
Examples:
• Fractures
• Traumatic amputation
• Coup-contrecoup injury
4. Quaternary blast injury- (Miscellaneous)
Injuries caused by the overall environmental effects or other factors (burns, toxic exposure).
Examples:
• Fire - Burns
• Building collapse- Asphyxiation, crush injuries
• Exposure to hazardous chemicals, radiation