Primary Blast Injury

This case illustrates the classic injury pattern seen in primary blast injury. Primary blast injury, caused only by high-order explosives, is the result of the blast wave’s compressive effect on tissue. Effects are greatest at the tissue-air interface. Ear damage is the most common and pulmonary injury is the most lethal. Gastrointestinal injury and brain injury are also common. Traumatic amputations due to primary blast injury were extremely rare in survivors prior to Operations Iraqi and Enduring Freedom. Primary blast injury is usually associated with secondary, tertiary, and quaternary blast injuries. Blast victims require a meticulous approach because the dramatic nature of the obvious soft tissue injuries may distract even experienced trauma providers from focusing on more lethal occult injuries.