WARFARE INJURIES

BLAST INJURIES
AND
CRITICAL CARE
Dr Shahzad Alam Shah
Assistant Prof. Laparoscopic Surgery
FJMC/SGRHL

Blast Injuries
A blast injury is a complex type of physical
trauma resulting from direct or indirect
exposure to an explosion
Blast injuries usually manifest in a form of
polytrauma, i.e. injury involving multiple
organs or organ systems.
PRIMARY INJURIES
Primary injuries are caused by blast
overpressure waves, or shock waves
SECONDARY INJURIES

Secondary injuries are due to bomb fragments
and other objects propelled by the explosion

TERTIARY INJURIES
Displacement of air by the explosion creates a
blast wind that can throw victims against solid
objects
Blast Injury
Mechanism
The magnitude of damage due the blast wave
is dependent on:
1) the peak of the initial positive pressure wave
2) the duration of the overpressure;
3) the medium in which it explodes;
4) the distance from the incident blast wave; and
5) the degree of focusing due to a confined area or
walls.
CRITICAL CARE

CRITICAL CARE
Intensive-care medicine or critical-care
medicine is a branch of medicine concerned
with the provision of life support or organ
support systems in patients who are critically
ill and who usually require intensive
monitoring.

Florence Nightingale

Overview
Patients requiring intensive care may require
support for
hemodynamic instability
airway or respiratory compromise
acute renal failure,
potentially lethal cardiac arrhythmias,
multiple organ failure, more commonly referred
to now as multiple organ dysfunction syndrome.
Intensive monitoring after major surgery

Intensive Care Unit
Organ systems
Intensive care usually takes a system by system approach to
treatment, rather than the SOAP (subjective, objective, analysis,
plan) approach of high dependency care

The nine key IC systems are (alphabetically):
cardiovascular system,
central nervous system,
endocrine system,
gastro-intestinal tract
hematology,
microbiology (including sepsis status),
renal (and metabolic),
respiratory system
Oval Silicon Resuscitator
for manual ventilation
Endotracheal Tube
Nasogastric Tube
Intravenous Fluid Therapy
Blood Transfusions
Dialysis Machine
Equipment and systems
Common equipment in an intensive-care
unit (ICU) includes

Mechanical ventilation to assist breathing through an
Endotracheal tube
Intravenous lines
Nasogastric tubes,
Suction pumps,
Drains and
Catheters;
Drugs
Intensive care unit
An intensive care unit (ICU), critical care unit
(CCU), intensive therapy unit, or intensive
treatment unit (ITU) is a specialized
department in a hospital that provides intensive-
care medicine.
TYPES
Specialized types of ICUs include:
Neonatal intensive-care unit (NICU)
Pediatric intensive-care unit (PICU)
Coronary care unit (CCU)
Medical Surgical intensive-care unit (MSICU)
Surgical intensive-care unit (SICU)
Trauma Intensive care Unit (TICU)
Mobile Intensive Care Unit (MICU)

Pattern of Injury