Clinical Pearl: What injuries do you see after an explosion?
爆炸事故会造成什么样的损伤？

• Explosions can cause a complex series of injuries, which may includesubtle or delayed findings. Repeated evaluations, such as serialabdominal exams, may be required.
• 爆炸事故会造成一系列的复合伤，包括潜在的或迟发的。需要包括系列腹部检查的重复性评价。

• Blast injuries are divided into 4 categories:

• 冲击伤分为四类：

o Primary blast injuries: Injury from blast wave over-pressure. Found in gasfilled structures (ear, lung, hollow organs)
o 原发性冲击伤： 由冲击波直接对含有气 体的结构造成的损伤，如耳，肺，和空腔脏器。

o Secondary blast injuries: Injury from thrown objects (primarilypenetrating trauma, but may blunt)

o 二级冲击伤：由飞来的物体造成的外伤（主要是穿透伤，也可造成钝挫伤）。

o Tertiary blast injuries: Injuries from patient being thrown by blast wave (blunt trauma)

o 三级冲击伤：由于病人被气流波飞出后造成的外伤。

o Miscellaneous (quaternary) blast injuries: Injuries from other causes,such as burns, crush injuries, rhabdomyolysis, and toxic chemicals.

o 其它（四级）冲击伤：由其它原因所造成的外伤，如烧伤，挤压伤，横纹肌溶解症，和毒性化学物质。

• The most common primary blast injury is tympanic membrane rupture.
• 最常见的原发性冲击伤是鼓膜破裂。

Reference: http://emergency.cdc.gov/masscasualties/blastessentials.asp