Disposition of Patients Following Exposure to Blasts

Patients may be considered for discharge if they have normal oxygen saturations and a normal chest x-ray, even in the presence of perforation of the eardrum [4].

Patients who physically felt the impact of a blast wave and those who sustained loss of consciousness following an explosion should be admitted for observation, probably for at least 24 hours [4].

All patients will need to be discharged with written and verbal advice regarding:

  • Symptoms of other blast injuries
  • Symptoms that should prompt return to the ED
  • Who to contact in the case of emergency
  • If and when to return for a follow up

Monitoring and reassessment of injuries

Patients with evidence of blast lung, but not initially requiring critical care, must be admitted and closely monitored for any deterioration, preferably with continuous oxygen saturation monitoring.

Patients with abdominal primary blast injury may need emergent laparotomy. If this is not necessary they are best admitted under the surgical team for regular reassessment of their haemodynamic status and abdominal examination, any deterioration of which should prompt repeat imaging of the abdomen or exploratory surgery.

Above all, patients with any sign of primary blast injury must be reassessed regularly for any deterioration.

Post a comment

Leave a Comment