Explosive Blasts: A Primer on a Multidimensional Mechanism of Injury

  • Raymond Fang


Explosive blasts caused 78% of US battle injuries sustained in support of Operations Iraqi Freedom and Enduring Freedom. These multidimensional injuries can create multiple, complex injuries in the same patient, or a cohort of simultaneously injured patients, and oftentimes require multidisciplinary treatment. Injuries incurred from explosive blasts are categorized by four mechanisms of injury:
  • Primary blast injuries are those resulting from the casualty’s exposure to the blast wave following a high-explosive detonation.

  • Secondary blast injuries are caused by energized debris from the explosion striking the casualty and causing penetrating wounds and/or blunt injuries.

  • Tertiary blast injuries result from the casualty being propelled by the force of the blast wind.

  • Quaternary blast injuries include all other injuries, illnesses, or diseases related to the explosion and not included by the preceding three categories.

Understanding basic blast physics and pathophysiology will assist clinicians caring for casualties injured by explosive blasts in not only military but also civilian settings.


Barotrauma Blast injuries Military medicine Traumatic brain injuries Wounds and injuries 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA

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