Injuries from Suicide Bombs
In some countries the possibility that surgeons would have to treat patients injured in a suicide bomb attack is a daily risk. Because of this, the classification and treatment of injuries has been highly developed. Detonation of a suicide bomb device causes injuries in four different ways.
Primary blast injury is due to the rapid outward movement of the shock wave. This causes ruptured middle ear
structures and the lethal blast lung injury, which can initially present in a patient as mild shortness of breath with deterioration to full respiratory failure within minutes to hours. Almost all victims of suicide bombs on buses die of primary blast injury.
Secondary blast injury occurs when the victims are hit by penetrating missiles that are propelled by the blast. This is most common with the small sharp objects packed around the bombs. The most common area injured with secondary blast injury is the head. This injury is typical in crowded marketplaces or nightclubs.
Tertiary blast injury occurs when the victim’s body is displaced or thrown and strikes a wall or car. These injuries are similar to what is seen in motor vehicle crashes and include fractures, ruptured spleens, and occasionaly aortic injuries. These injuries occur in restaurants and nightclubs.
Quartenary blast injury are burn injuries. They are more common in closed spaces, but can occur in up to 5% of suicide bomb attacks in the outside spaces.
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