Casualties from Terrorist Bombings

Disaster Medicine: Conventional Terrorist Bombings

“…4 The intensity and duration of this pressure depends on the volume of the enclosed structure, and the degree of venting through the doors and windows. 14 The blast loading on a human being is the amount of force exerted on the body and is affected by the body position in relation to the blast wave. If the maximum overpressure and duration of the positive incident overpressure remain constant and the presence of projectiles ignored, the incidence of physical injury and mortality will be greater when a person is oriented with the long axis of their body perpendicular (oriented side-on) and near a reflecting surface.…”

“…13,14,17,19,20 A person in danger of an impending underwater blast should float on the surface instead of treading water. Fortunately, water greatly reduces the effective range of any fragments propelled from the blast.…”

“…23 This is because persons close enough to sustain such injuries from air blasts are likely killed immediately by the secondary and tertiary effects or by massive air embolism from primary blast injury. 4,14 Other lung injuries include pneumothorax, hemothorax, traumatic lung cysts, interstitial emphysema, pneumomediastinum, and subcutaneous emphysema. Chest wall damage, including rib fractures, is not usually seen in the absence of other pulmonary trauma.…”

“…Fine particles of dust may be embedded within the skin producing a discoloration called "dust tattooing." 14 The head and neck are the most frequently injured regions of the body, followed by the extremities. 28 Clothing and footwear provide a protective effect against soft tissue injuries to the covered areas of the body.…”

“…The incidence of head injuries from terrorist bombings ranges from 10.8 -63%. 5,14,21,28,33 Mortality rates for bombing can be deceptive. The casualties should be broken down into immediate on-scene mortality, number of critically injured survivors (ISS >15), and overall mortality in hospitalized survivors.…”