BLAST INJURIES: THE EXPERIENCE OF A LEVEL 1 TRAUMA CENTER

Abstract

Background: There is a global surge in blast injuries, which are associated with high morbidity and mortality. To our knowledge, there are no guidelines for the management of blast injuries in the trauma bay.Methods: This single-center retrospective cohort study utilized data on all patients admitted to our emergency department (ED) with terror- or combat-related injuries between October 7, 2023 (Gaza Iron Swords War onset) and February 4, 2024. The primary outcome was trauma severity indicated by either an injury severity score (ISS) >15 and/or need for acute care. We also analyzed the mechanisms of injuries, focusing on those resulting from blasts.Results: Of 208 patients who were admitted following terror-and combat related injuries, 109 patients (101 males [93%], median age 24.0 years) were admitted following blast injuries. Of them, 88% were military personnel and 12% were civilians, with a median ISS of 8 [IQR:4.0-17.0]. The level of trauma was severe in 48 patients (44%). Tertiary sub-category of blast injuries (P=0.004), chest (P=0.032), abdomen (P=0.018), and lower extremities (P=0.044) injuries were significantly associated with severe trauma. Blast injuries mandated the urgent availability of specialist personnel and appropriate equipment to contend with multiple life-threatening sequelae of exposure to blasts upon the arrival of the victims to emergency services.Conclusion: Blast injuries present unique challenges in management and demand a multidisciplinary approach and specialized resources. We present an algorithm for terror- and combat-related blast injuries treated in our trauma bay. The step-by-step procedures may be applicable to any blast injury sustained under variable conditions.