Blast Injuries

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Question 1 of 10

1. Question
Which of the following statements are correct regarding the cause of particular blast injuries?
- Primary blast injuries are caused by the blast over-pressure
- Secondary blast injuries are caused by the effects on the body of missiles displaced by blast winds
- Tertiary blast injuries are caused by fire, inhalational injury or structural collapse
- Quaternary blast injuries are caused by the impact against structures when patients are displaced by the blast winds
Question 2 of 10

2. Question
Which of the following factors should alert the emergency physician to an increased likelihood of the presence of primary blast injury?
- A suicide bombing
- The presence of flash burns
- An open-air bombing
- Wearing personal protective equipment (PPE)
- An underwater explosion
Question 3 of 10

3. Question
Which of the following statements regarding primary blast injury of the ear are correct?
- The ear is the organ most likely to be damaged by primary blast injury following exposure to an explosion
- Rupture of the tympanic membrane is rare at over-pressures below 15 psi
- Absence of tympanic membrane rupture is a good indicator as to the absence of other primary blast injuries
- Deafness following exposure to blast is usually permanent
- All patients exposed to a blast should undergo otoscopic examination
- Management of rupture of the tympanic membrane is expectant
Question 4 of 10

4. Question
Which of the following statements regarding patients with blast lung are correct?
- Intubation should be performed early in order to prevent deterioration
- The chest radiographs are most likely to show a butterfly distribution of opacification
- A fall in peripheral oxygen saturation is a late sign
- Permissive hypercapnia increases morbidity
Question 5 of 10

5. Question
Which of the following abnormalities may be found on the chest radiograph of a patient with isolated primary blast injury of the lung (blast lung)?
- Pneumothorax
- Perihilar opacification in a butterfly distribution
- Multiple rib fractures
- Haemothorax
- Subcutaneous emphysema
Question 6 of 10

6. Question
Which of the following statements are correct regarding abdominal primary blast injury?
- It is rare
- It commonly affects the solid organs such as the liver and spleen
- If affecting the luminal GI tract, perforation is most common at the ileocaecal junction
- It is more common following open air blasts than underwater blasts
- It causes abdominal pain, nausea, haematemesis and malaena
- It may be differentiated from secondary or tertiary abdominal blast injury on using FAST
Question 7 of 10

7. Question
Which of the following statements are correct regarding management of primary blast-injured patients in the ED?
- Patients should be managed in accordance with standard trauma management guidelines
- ST elevation following blast injury should be treated with oxygen, analgesia and nitrates
- To protect blast-injured lungs, intubation and ventilation should be avoided in patients with reduced level of consciousness
- Rhesus-negative pregnant women should receive anti-D immunoglobulin within 72 hours of a blast
Question 8 of 10

8. Question
Which of the following statements are correct regarding primary blast injuries?
- Skull fracture can occur in the absence of a direct blow
- Primary blast injury to the globe is unlikely to be found in survivors
- Fractures of the teeth are usually single
- Mandibular fractures following primary blast injury are usually vertical and bilateral
Question 9 of 10

9. Question
Which of the following statements are correct regarding disposition of patients from the ED following exposure to a blast?
- Some patients may be discharged directly from the ED
- Patients with ruptured tympanic membranes need to be admitted to hospital
- Patients who felt the blast wave hit them should be admitted to hospital
- Patients with a normal CT in the presence of abdominal pain may be discharged home from the ED
Question 10 of 10

10. Question
Which of the following are recognised long-term complications of primary blast injury?
- Cholesteatoma
- Restrictive lung defect
- Emotional and behavioural impairment
- Deafness
- Visual field defects
- Tinnitus

Blast Injuries – Post Test

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