First Responders: Clinical Care of Blast Trauma in the Prehospital Setting

Abstract

Blast trauma care in the prehospital setting focuses on the same treatment priorities as for any trauma patient. Primary blast injuries as a result of blast wave effects on the body pose a unique injury pattern that may not readily manifest at the time of prehospital encounter, so Emergency Medical Services (EMS) providers need to remain vigilant over the possible presence of primary blast injuries, consider factors that increase their likelihood, and report those factors to later treaters. The focus on correcting life-threatening conditions found during the primary survey occurs in the same fashion as with non-blast trauma patients. However, given the operational concerns, prehospital providers may have to take a tactical approach to the primary survey with increased focus on immediate life-threatening hemorrhage control. Once exsanguinating hemorrhage is identified and controlled, the provider can return to airway, breathing, circulation, and hypothermia management. Rapid triage, stabilization, and transport to appropriate definitive trauma care will ensure the best possible outcomes from blast poly-trauma.