Anesthesia Care in Blast Injury

Abstract

Anesthetic management of blast injury poses one of the most formidable clinical scenarios that the anesthesia practitioner may encounter. Massive tissue destruction, hemorrhage and hypovolemic shock, traumatic airway injury, blast-related lung injury, and blast-related thermal injury are among some of the devastating elements that may confront the anesthesiologist in treatment of blast casualties. While blast injury in civilian settings represents a relatively rare event, a larger share of experience has been learned from theaters of armed conflict. In the recent and ongoing conflicts in Afghanistan, Iraq, and Syria, blast injuries have constituted most of the casualties. The following review of relevant literature on this subject addresses some of the most clinically challenging aspects of the anesthetic management of blast injury, to include dismounted complex blast injury, hypovolemic shock, coagulopathy, blast-induced traumatic airway injury, blast-related lung injury, and blast-induced thermal injury.