Blast Lung Injury
An explosion’s initial “blast wave” (shockwave) can cause damage called blast lung. This is one of several possible primary injuries attributable to blast waves, and the most common fatal primary blast injury among survivors. Explosion blast waves exert intense pressure on the body, and most often adversely affect the ears, abdomen, and lungs, the tissue of which can be torn or burst. The extent of the damage depends on the intensity of the pressure, the density of the tissue, and other factors. Signs and symptoms of a blast lung injury may show up right away, or within a day or two. If a patient has ruptured eardrums, which indicates a high-pressure blast, there is a higher likelihood that there is also pulmonary damage. In some cases, this can cause air to enter the bloodstream, which can create air embolisms (gas bubbles). An air embolism in the heart or brain can cause a heart attack, stroke, or death.
Blast lung trauma signs and symptoms include the following:
- trouble breathing (dyspnea);
- blue skin (cyanosis), suggesting oxygen deprivation;
- low oxygen levels (hypoxemia);
- coughing up blood (hemoptysis);
- chest pain;
- alveolar wall bleeding (hemorrhages) and swelling (edema);
- visceral pleura bleeding;
- pneumothorax (collapsed);
- hemothorax (accumulation of blood in the pleural cavity).
Examples of Explosion Lung Injuries
- Two employees of a farm are inside of a room when a tank with chemicals adjacent to the room explodes. The employees suffer respiratory problems from the fumes (vapor inhalation) and are taken to the hospital.
- A person is exposed to a substantial amount of smoke during a fire and experiences a bronchial spasm. He is admitted to the hospital multiple times after having difficulty breathing.
- An employee is working near a dip tank and another worker causes an ignition of chemical vapors. The first worker suffers injuries due to inhalation of toxic substances.
- A person uses a cutting torch to cut the ends out of steel drums. When he begins cutting one of the drums, it explodes due to the residue inside the drum. The person has to be hospitalized due to lung injuries received.
- A person is blown off of a roof due to an explosion. When they hit the ground, they suffer a punctured lung and have to be taken to the hospital.
Penetrating Lung Injury
Secondary injury in a blast includes those caused by flying debris. Some objects, such as broken glass and metal, are particularly deadly.
Large debris could penetrate the lungs themselves. This is called pulmonary laceration. In most of these cases, emergency surgery is necessary to prevent death. Flying objects could also cause tracheobronchial (airway) lacerations.
Blunt Chest Trauma
In a blast, blunt chest trauma is generally a tertiary injury, which is one caused by being thrown against something. When the chest is hit on impact, it can cause a pulmonary contusion (bruising). Symptoms of a pulmonary contusion are similar to blast lung, with the addition of wheezing and low blood pressure (hypotension). People with a blunt chest trauma may also have broken ribs and other injuries to the chest and head.
Damage to Lungs from Smoke Inhalation
Smoke generated by a residential or commercial fire can contain toxic chemicals, including carbon monoxide, carbon dioxide, cyanide, hydrogen chloride, phosgene, acrolein, formaldehyde, free radicals, ammonia, sulfur dioxide, nitrogen dioxide, acetylene, methane, and benzene. It all depends on what is burning. Chemicals can cause aspiration pneumonia, which is a pulmonary infection. They can also cause chemical burns in the lungs and airways.
Smoke inhalation injuries can cause respiratory failure. “The most common cause of death in burn centers is now respiratory failure” (Demling).
When a building is blown up, part of it can fall and crush a person’s arms, legs or chest. These are serious injuries, and can result in broken bones, punctured lungs, and damage to other organs. Many times when there is a blast lung injury there is also blunt chest trauma (tertiary blast injury) and other blunt trauma injuries.
Other Blast and Explosion Injuries
Our law firm has information on other injuries:
- Centers for Disease Control and Prevention (CDC). http://www.cdc.gov/masstrauma/preparedness/primer.pdf
- Demling, Robert H. “Smoke inhalation lung injury: an update.” Eplasty 8 (2008).