Toxin-Blast Composite Injury

Abstract

The so-called toxin-blast composite injury refers to simultaneous and secondary effects of shock wave and toxin on the body. Such injuries are characterized by difficulties in diagnosis and capturing the best treatment opportunity, which is why they are difficult to treat. Toxin-blast composite injuries constituted quite a large portion of the victims in the extra-large aluminum powder explosion in Kunshan on August 2, 2014, and the explosion at a Tianjin hazardous chemical storage warehouse on August 12, 2015, and fatality counts were high. For such instances, rapid emergency response and the proper medical care are vital. In the new century, people have been increasingly concerned about new military revolution spearheaded by advanced science and technology-empowered forces and the various impacts on future warfare arising from this revolution. In particular, people have realized that the widespread adoption of special weapons in modern hi-tech warfare is causing injuries, which constitute a series of new challenges for the development of military medicine across the globe. From the Gulf War and the Kosovo War, to the conflicts in Iraq and Syria, modes of battle such as long-distance strikes, precision-guided strikes, non-contact warfare, and beyond visual range (BVR) combat are continuously evolving. There have been broad applications of weaponry such as missiles, depleted uranium bombs, thermobaric weapons, joint direct attack munitions (JDAM), graphite bombs and fuel-air explosives, and the likes of laser weapons, microwave weapons, infrasonic weapons, weather warfare, electromagnetic pulse (EMP) weapons, new types of nuclear, biological and chemical weapons, binary chemical weapons, and neutron bombs have quietly emerged. Therefore, modern and tech-driven localized conflicts are characterized by high rates of injuries and deaths, extensive weapon effective duration, and complicated injury mechanisms, with increases in new types and forms of injuries that are harder to treat. Modern and tech-driven warfare affects traditional frontline rescue methods, and it is mandatory to renew understandings about certain issues in frontline medical care and engender a shift in philosophy. In future warfare, medical care and equipment must be on the same level as the frontline of battlefield, which would enhance medical treatment quality and reduce deaths, injuries, and subsequent disabilities, while relatively sound medical care support can provide a sort of mental support for combatants, helping stabilize their psyche. The nature of the concept of “injury” is rapidly changing. Under the current circumstances, medicine worldwide, in particular military medicine, the concept of “injury” is changing by leaps and bounds! The future is challenging tradition, and all notions and aspects from military-civilian, peace time–war time, philosophy, and principle to system, model, and academic discipline are all undergoing revolutions! The current international landscape is rather complicated, the world is not truly existing in peace and localized conflicts continue to erupt everywhere. The September 11 attacks shocked the world, and composite blast injuries were the most common among victims. In recent years, gas explosions in mines, explosions from explosives, explosions from car bombs, composite injuries from chemical weapons, poisoning from toxic gas accompanied by crushing injury, composite injuries from modern warfare and weapons, fires in recreational facilities and composite injuries from other accidents (with the majority being toxin-blast composite injury) have been occurring in higher frequency across the globe. At times, medical care personnel, or even those specializing in emergency medicine, have been shown unequipped to deal with these injuries, missing the best opportunity for treatment that might end up being lifelong regrets. At present, the international medical community is increasingly prioritizing studies and subjects related to treatment of toxin-blast composite injury. However, reports have pointed out that there is still a lack of effective methods for dealing with toxin-blast composite injury, and there are not any specialized antidotes or medicines for this type of composite injury. This is a great concern since toxin-blast composite injury could happen not merely during times of war but also in times of peace. Thus, toxin-blast composite injury is hard to handle in emergency situations or for clinical physicians, with the crux of the matter being difficult in diagnosis and capturing best opportunity for treatment. Therefore, actively performing basic and clinical care research programs on toxin-blast composite injury is a matter of great urgency.