Strategies for pre-hospital and early in-hospital management for explosion injuries

Lianyang ZHANG; Yang LI

doi:10.16016/j.1000-5404.202006240

您当前的位置：

首页 >

文章列表页 >

Strategies for pre-hospital and early in-hospital management for explosion injuries

Expert Review | 更新时间：2026-01-09

- Strategies for pre-hospital and early in-hospital management for explosion injuries
- Journal of Third Military Medical University Vol. 42, Issue 18, Pages: 1771-1776(2020)
- 作者机构：
  
  400042 重庆，陆军军医大学(第三军医大学)大坪医院战创伤医学中心，创伤、烧伤与复合伤国家重点实验室
- 作者简介：
- 基金信息：
  
  the General Program of Military Logistic Scientific Research(CS317L015);the Project of National Military Standards(8WS19B021)
- DOI：10.16016/j.1000-5404.202006240
  CLC： R459.7; R642; R826.5
- Received：28 June 2020，
  
  Revised：2020-07-06，
  
  Published：30 September 2020
- 稿件说明：
移动端阅览
Lianyang ZHANG, Yang LI. Strategies for pre-hospital and early in-hospital management for explosion injuries[J]. Journal of Third Military Medical University, 2020, 42(18): 1771-1776.
DOI：

Lianyang ZHANG, Yang LI. Strategies for pre-hospital and early in-hospital management for explosion injuries[J]. Journal of Third Military Medical University, 2020, 42(18): 1771-1776. DOI： 10.16016/j.1000-5404.202006240.

摘要

爆炸伤常见于战争、暴恐袭击和爆炸事故中，特有的多维致伤机制导致爆炸伤伤情复杂、危重，常出现批量伤员，救治难度大。医护人员常缺乏救治经验，从而导致救治不规范、效果不佳。本文介绍爆炸伤的五型分类法，以及爆炸伤院前和院内急救策略

并阐述耳、胃肠道、心、四肢、眼和脑等脏器爆炸伤的早期救治要点。

Abstract

Explosion injuries are common in wars

terrorist attacks and explosion accidents. The unique multi-dimensional mechanisms of explosion injuries result in complex and critical conditions of injuries and often causes mass casualties

which can be difficult to manage. As few health professionals have sufficient experience with explosion injuries

the management of such injuries still awaits standardization to improve the outcomes of the patients. Herein we introduce the concept of 5-type classification of blast injuries and summarize the strategies for pre-hospital management and early treatment of the patients

with elaboration of the key points in the early treatment of the injuries of the ears

gastrointestinal tract

heart

limbs

eyes and brain.

关键词

Keywords

references

LENHART M K, SAVITSKY E. Combat casualty care: lessons learned from OEF and OIF. San Antonio: Borden Institute, 2012.

WILKERSON G R, LEMON C, FALCONE R E. Blast injuries. Trauma Rep, 2016, 17(3): 1-19.

杨策, 蒋建新, 杜娟, 等. 2000年至2015年国内174起爆炸事故冲击伤诊治分析.中华诊断学电子杂志, 2016, 4(1): 36-40. DOI: 10.3877/cma.jissn.2095-655X.2016.01.011

YANG C, JIANG J X, DU J, et al . Analysis of the current situation of diagnosis and therapy in Chinese severe explosion accidents over the past 15 years. Chin J Diagn Electron Ed, 2016, 4(1): 36-40. DOI: 10.3877/cma.jissn.2095-655X.2016.01.011.

MATHEWS Z R, KOYFMAN A. Blast injuries. J Emerg Med, 2015, 49(4): 573-587. DOI: 10.1016/j.jemermed.2015.03.013.

黎檀实, 姜保国, 吕发勤, 主译.院前创伤生命支持(军队第8版).北京: 人民军医出版社, 2017: 634-661.

LI T S, JIANG B G, LYU F Q. Pre-hospital trauma life support. 8th Edition. Beijing: the People's Military Medical Press, 2017: 634-661.

KLUGER Y, NIMROD A, BIDERMAN P, et al . The quinary pattern of blast injury. Am J Disaster Med, 2007, 2(1): 21-25. DOI: 10.5055/ajdm.2007.0005.

张连阳.灾难爆炸伤医学救援进展.解放军医学杂志, 2015, 40(9): 689-692.

ZHANG LY. Progress in disaster medical rescue for blastinjury. Med J Chin PLA, 2015, 40(9): 689-692. DOI: 10.11855/j.issn.0577-7402.2015.09.01.

KAHN C A, SCHULTZ C H, MILLER K T, et al . Does START triage work? an outcomes assessment after a disaster. Ann Emerg Med, 2009, 54(3): 424-430.e1. DOI: 10.1016/j.annemergmed.2008.12.035.DOI: 10.11855/j.issn.0577-7402.2015.09.01.

GORDON W, TALBOT M, FLEMING M, et al . High bilateral amputations and dismounted complex blast injury (DCBI). Mil Med, 2018, 183(suppl_2): 118-122. DOI: 10.1093/milmed/usy082.

GODDARD N V, EVRIVIADES D.Successful use of intrapelvic quikclot in life-threatening blast injury. Trauma Case Rep, 2017, 8(12): 59-62. DOI: 10.1016/j.tcr.2017.10.021.eCollection 2017 Dec.

THOMPSON D C, CROOKS R J, CLASPER J C, et al . The pattern of paediatric blast injury in Afghanistan. BMJ Mil Health, 2020, 166(3): 151-155. DOI: 10.1136/jramc-2017-000795.

HARRISON C D, BEBARTA V S, GRANT G A. Tympanic membrane perforation after combat blast exposure in Iraq: a poor biomarker of primary blast injury. J Trauma, 2009, 67(1): 210-211. DOI: 10.1097/TA.0b013e3181a5f1db.

XYDAKIS M S, BEBARTA V S, HARRISON C D, et al . Tympanic-membrane perforation as a marker of concussive brain injury in Iraq. N Engl J Med, 2007, 357(8): 830-831. DOI: 10.1056/NEJMc076071.

ZHENG X F, ZHU F, FANG H, et al . Management of combined massive burn and blast injury: a 20-year experience. Burns, 2020, 46(1): 75-82. DOI: 10.1016/j.burns.2018.11.010.

PIZOV R, OPPENHEIM-EDEN A, MATOT I, et al . Blast lung injury from an explosion on a civilian bus. Chest, 1999, 115(1): 165-172. DOI: 10.1378/CHEST.115./.165.

CLANCY K, VELOPULOS C, BILANIUK J W, et al . Screening for blunt cardiac injury. J Trauma Acute Care Surg, 2012, 73: S301-S306. DOI: 10.1097/ta.0b013e318 270193a.

WEBSTER C E, CLASPER J, STINNER D J, et al . Characterization of lower extremity blast injury. Mil Med, 2018, 183(9/10): e448-e453. DOI: 10.1093/milmed/usx126.

QUINONES P M, MENTZER C, WHITE C, et al . Manag-ement of mangled extremity from shotgun blast injury. Am Surg, 2016, 82(8): e200-201.

LIU Y Y, FENG K, JIANG H, et al . Characteristics and treatments of ocular blast injury in Tianjin explosion in China. BMC Ophthalmol, 2020, 20: 185. DOI: 10.1186/s12886-020-01448-3.

DOUGHERTY A L, MACGREGOR A J, HAN P P, et al . Visual dysfunction following blast-related traumatic brain injury from the battlefield. Brain Inj, 2011, 25(1): 8-13. DOI: 10.3109/02699052.2010.536195.

YEH D D, SCHECTER W P. Primary blast injuries: an updated concise review. World J Surg, 2012, 36(5): 966-972. DOI: 10.1007/s00268-012-1500-9.

BOCHICCHIO G V, LUMPKINS K, O'CONNOR J, et al . Blast injury in a civilian trauma setting is associated with a delay in diagnosis of traumatic brain injury. Am Surg, 2008, 74(3): 267-270.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

No data

Related Author

No data

Related Institution

No data

⁰