Blast injuries can cause damage from the overpressurization wave, flying debris, being thrown by the blast wind, or secondary injuries and illnesses. The ear is often the first organ affected, with potential tympanic membrane rupture from overpressure. Lung injuries, known as blast lung, are a major cause of death and present with dyspnea, hemoptysis, and chest infiltrates on imaging. Abdominal injuries can include hemorrhage, organ perforation, and escape of contents. Secondary injuries involve penetration from debris, while tertiary injuries occur when individuals are thrown, possibly striking other objects. Management involves addressing life threats, debris removal, antibiotics, and monitoring for complications.
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
Public Awareness on Defense Against IEDs (Improvised Explosive Devices)Tariq Mahmood
World as a whole is suffering from terrorism who are using IEDs for targeting human and important installations.In order to play my part for saving our planet, this is a small contribution to share with.
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
Pedestrian injuries in road traffic accidentsMichael Kino
A Road Traffic Accident ( RTA) can be defined as, an event that occurs on a way or street open to public traffic; resulting in one or more person being injured or killed, where at least one moving vehicle is involved.
We begin an exciting series on "Revivals, Visitations and Moves of God". "Revival is a community saturated with God". We look at a few stories of revivals from Church history and respond to the call to prepare our hearts for revival.
For sermon audio, notes, slides, archives and other free resources like books, please visit our website - apcwo.org
#APCBangalore
Public Awareness on Defense Against IEDs (Improvised Explosive Devices)Tariq Mahmood
World as a whole is suffering from terrorism who are using IEDs for targeting human and important installations.In order to play my part for saving our planet, this is a small contribution to share with.
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
Pedestrian injuries in road traffic accidentsMichael Kino
A Road Traffic Accident ( RTA) can be defined as, an event that occurs on a way or street open to public traffic; resulting in one or more person being injured or killed, where at least one moving vehicle is involved.
We begin an exciting series on "Revivals, Visitations and Moves of God". "Revival is a community saturated with God". We look at a few stories of revivals from Church history and respond to the call to prepare our hearts for revival.
For sermon audio, notes, slides, archives and other free resources like books, please visit our website - apcwo.org
#APCBangalore
There are five kinds of deadly sins. Doing what is forbidden of God. Neglecting to do what is commanded. Adding to God's Word. Taking from God's Word. Substituting something else for what God has commanded.
A five-step study method - BLAST- based on activities to complete before lecture, during lecture, after lecture, to study, and to test. Primarily designed for college classes but would be applicable to any course with instructor lectures. Includes some practice and examples. Created by Coleman's Classroom.
Exploit Research and Development Megaprimer: mona.py, Exploit Writer's Swiss ...Ajin Abraham
Exploit Research and Development Megaprimer
http://opensecurity.in/exploit-research-and-development-megaprimer/
http://www.youtube.com/playlist?list=PLX3EwmWe0cS_5oy86fnqFRfHpxJHjtuyf
BLAST INJURIES, An approach towards a patient that has suffered a blast injury.Dr. RIFFAT KHATTAK
"A blast injury", is a complex type of physical trauma resulting from direct or indirect exposure to an explosion. Blast injuries range from internal organ injuries, including lung and traumatic brain injury (TBI), to extremity injuries, burns, hearing, and vision injuries. Explosions cause familiar trauma .There may be LOTS of casualties with LOTS of injuries. Secondary blast trauma is the biggest killer. The efficiency of the Emergency Response Teams, in how quickly they could identify the injuries and their ability to shift the patients the a proper healthcare facility for timely surgical interventions can save lives.
Global Medical Cures™ | Explosions & Blast Injuries
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Emergency management of oral and maxillofacial trauma including_100844.pptxNdayishimiyeSamuel1
Oral and Maxillofacial area is a crucial area for respiration, digestive, and esthetic functions. When traumatized, a backup of knowledge and skills is required to restore pleasing look and function. This ppt details how to optimize the emergency and late better outcomes of patients with oral and maxillofacial trauma.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. Blast injury
Rapid chemical conversion of a solid or
liquid into a gas with resultant energy
release.
All nuclear explosion provide thisAll nuclear explosion provide this
change in potential energy to kineticchange in potential energy to kinetic
injury in a very short period of time.injury in a very short period of time.
3.
4. Once notified of a possibleOnce notified of a possible
bombing or explosion, hospital-bombing or explosion, hospital-
based physicians should considerbased physicians should consider
immediately activating hospitalimmediately activating hospital
disaster plans, includingdisaster plans, including
preparations to care for anywherepreparations to care for anywhere
from a handful to hundreds offrom a handful to hundreds of
victims.victims.
5. Blast injury
Blast injuries in civilian populations occur as aBlast injuries in civilian populations occur as a
result ofresult of
fireworks,fireworks,
household explosions, orhousehold explosions, or
industrial accidents.industrial accidents.
Terrorist tactics may take the form ofTerrorist tactics may take the form of
letter bombs,letter bombs,
suitcase bombs,suitcase bombs,
vehicle bombs, andvehicle bombs, and
suicide bombers.suicide bombers.
6.
7.
8. BackgroundBackground
Explosions have the capability to causeExplosions have the capability to cause
multisystem, life-threatening injuries inmultisystem, life-threatening injuries in
single or multiple victims simultaneously.single or multiple victims simultaneously.
Explosions can produce classic injuryExplosions can produce classic injury
patterns from blunt and penetratingpatterns from blunt and penetrating
mechanisms to several organ systems, butmechanisms to several organ systems, but
they can also result in unique injurythey can also result in unique injury
patterns to specific organs including thepatterns to specific organs including the
lungs and the central nervous systemlungs and the central nervous system
9.
10.
11. CategoryCategory CharacteristicsCharacteristics Body Part AffectedBody Part Affected Types of InjuriesTypes of Injuries
PrimaryPrimary Results from the impact ofResults from the impact of
the over-pressurizationthe over-pressurization
wave with body surfaces. wave with body surfaces.
Gas filled structuresGas filled structures
lungs, GI tract, andlungs, GI tract, and
middle ear.middle ear.
Blast lung injuryBlast lung injury
TM ruptureTM rupture and middle earand middle ear
damage damage
Abdominal hemorrhageAbdominal hemorrhage
and perforationand perforation
ConcussionConcussion (TBI)(TBI)
SecondarySecondary Results from flying debrisResults from flying debris
and bomb fragments.and bomb fragments.
Shells Shells
Any body part may beAny body part may be
affected.affected.
Penetrating blunt injuriesPenetrating blunt injuries
Eye penetrationEye penetration
TertiaryTertiary Results from individualsResults from individuals
being thrown by the blastbeing thrown by the blast
wind.wind.
Any body part may beAny body part may be
affected.affected.
Fracture and traumaticFracture and traumatic
amputation amputation
Closed and open brainClosed and open brain
injuryinjury
Quaternary Quaternary All explosion-relatedAll explosion-related
injuries, illnesses, orinjuries, illnesses, or
diseases not due to primary,diseases not due to primary,
secondary, or tertiarysecondary, or tertiary
mechanisms. mechanisms.
Any body part may beAny body part may be
affected.affected.
BurnsBurns
Crush injuriesCrush injuries
Closed and open brainClosed and open brain
injuryinjury
breathing problems frombreathing problems from
dust, smoke, or toxicdust, smoke, or toxic
fumesfumes
12. Overview of Explosive-Related Injuries
SystemSystem Injury or ConditionInjury or Condition
AuditoryAuditory TM rupture, ossicular disruption, cochlear damage, foreignTM rupture, ossicular disruption, cochlear damage, foreign
bodybody
Eye, Orbit, FaceEye, Orbit, Face Perforated globe, foreign body, fracturesPerforated globe, foreign body, fractures
RespiratoryRespiratory Blast lung, hemothorax, pneumothorax, pulmonaryBlast lung, hemothorax, pneumothorax, pulmonary
contusion and hemorrhage.contusion and hemorrhage.
DigestiveDigestive Bowel perforation, hemorrhage, ruptured liver or spleen,,Bowel perforation, hemorrhage, ruptured liver or spleen,,
mesenteric ischemia from air embolismmesenteric ischemia from air embolism
CirculatoryCirculatory Cardiac contusion, myocardial infarction from airCardiac contusion, myocardial infarction from air
embolism, shock,, peripheral vascular injury,embolism, shock,, peripheral vascular injury,
CNS InjuryCNS Injury Concussion, closed and open brain injury, spinal cordConcussion, closed and open brain injury, spinal cord
injury,injury,
Renal InjuryRenal Injury Renal contusion, laceration, acute renal failure due toRenal contusion, laceration, acute renal failure due to
hypotension, and hypovolemiahypotension, and hypovolemia
Extremity InjuryExtremity Injury Traumatic amputation, fractures, crush injuries,Traumatic amputation, fractures, crush injuries,
15. INITIAL MANAGEMENTINITIAL MANAGEMENT
Manage as other soft tissue injuriesManage as other soft tissue injuries
Attention to foreign body removal,Attention to foreign body removal,
cleaning of wounds, and closurecleaning of wounds, and closure..
Cartilage must not be left exposed andCartilage must not be left exposed and
wounds should be closed primarilywounds should be closed primarily;;
The patient should be referred toThe patient should be referred to
SpecialistSpecialist..
16. Blast Lung InjuryBlast Lung Injury
Major cause of death in PBI’s
Clinical PresentationClinical Presentation
••Symptoms may include dyspnea,Symptoms may include dyspnea,
hemoptysis, cough, and chest painhemoptysis, cough, and chest pain..
••Signs may include tachypnea, hypoxiaSigns may include tachypnea, hypoxia
cyanosis, apnea, wheezing, decreasedcyanosis, apnea, wheezing, decreased
breath sounds, and hemodynamicbreath sounds, and hemodynamic
instabilityinstability..
••Other injuries may be presentOther injuries may be present..
17. Chest X-ray
of a victim
of
bombing
attack
showing
typical
bilateral
patchy
infiltrates in
a butterfly
distribution.
18.
19. BLI’s ManagementBLI’s Management
Diagnostic Evaluation
• Chest radiography is necessary for
anyone who is exposed to a blast.
A characteristic “butterfly” pattern may be
revealed upon x-ray.
• Arterial blood gases, computerized
tomography, and doppler
technology may be used.
• Most laboratory and diagnostic testing
can be conducted
22. Treatment of BLI
Patients with suspected or confirmed BLI should receivePatients with suspected or confirmed BLI should receive
supplemental high-flow oxygen to prevent hypoxemiasupplemental high-flow oxygen to prevent hypoxemia
If ventilatory failure occurs, patients should be intubatedIf ventilatory failure occurs, patients should be intubated..
High-flow oxygen should be administered if air embolism isHigh-flow oxygen should be administered if air embolism is
suspected, and the patient should be placed in a prone,suspected, and the patient should be placed in a prone,
semi-left lateral, or left lateral positionsemi-left lateral, or left lateral position
23. PBI - AbdomenPBI - Abdomen
Hemorrhage:
Hematoma leading to
obstruction
Upper or lower GI
bleeding
Hemoperitoneum
Escape of Contents:
Mediastinitis
Peritonitis
Mesenteric,
retroperitoneal, and
scrotal hemorrhages.
26. Management of Abd.InjManagement of Abd.Inj
Initial ManagementInitial Management
••ABCs (airway, breathing, circulation) as for allABCs (airway, breathing, circulation) as for all
trauma patientstrauma patients
••Nothing by mouthNothing by mouth
••Avoid removal of penetrating objects in emergencyAvoid removal of penetrating objects in emergency
room (operative intervention due to risk ofroom (operative intervention due to risk of
hemorrhagehemorrhage((
••Antibiotics and tetanus immunizationAntibiotics and tetanus immunization
••Serial exams and laboratory monitoringSerial exams and laboratory monitoring
••Radiological studies: plain abdominal films,Radiological studies: plain abdominal films,
computed tomography [CT] scan, Focusedcomputed tomography [CT] scan, Focused
AbdominalAbdominal
Sonography for Trauma (FASTSonography for Trauma (FAST
27. – Injuries from devices that contain foreign bodies:
• NailsNails
• RivetsRivets
• Ball bearingsBall bearings
• Nuts and bolts,Nuts and bolts,
• ShellsShells
Secondary InjuriesSecondary Injuries
29. Tertiary injuriesTertiary injuries
– Physically thrown through the air and
strike or impale themselves on objects.
– Collapsing structures.
– Other objects propelled through the air
striking the victim.
Severe head injury is a leading cause
of death in victims of blasts.
Subdural and subarachnoid
hemorrhages are the most common
findings
30. Quaternary InjuriesQuaternary Injuries
Thermal injuries
Primary or
secondary
incendiary.
– Inhalation
– Dermal
• Flash Burns
• Large body
surface area
• Shallow depth
31. Management Of Burn PTManagement Of Burn PT..
Early treatment of partial thickness burn wound consists of
mechanical debridement with wet gauzes.
Burns involving small BSA are treated with topical
antimicrobial agents, while larger areas are treated with
homografts. Homografts cover the wounds for 10–14 days
and provide protection from desiccation and infection.
32. PhysicalPhysical
HeadachesHeadaches
DizzinessDizziness
InsomniaInsomnia
FatigueFatigue
Uneven gaitUneven gait
NauseaNausea
Blurred VisionBlurred Vision
CognitiveCognitive
Attention difficultiesAttention difficulties
Concentration problemsConcentration problems
Memory problemsMemory problems
Orientation problemsOrientation problems
Signs and Symptoms of a Traumatic Brain Injury (TBISigns and Symptoms of a Traumatic Brain Injury (TBI((
Behavioral
Irritability
Depression
Anxiety
Sleep disturbances
Problems with emotional
control
Loss of initiative
Problems related to
employment, marriage,
relationships, and home
or school management
33. Blast Extremity InjuriesBlast Extremity Injuries
Traumatic amputationTraumatic amputation
Initial ManagementInitial Management
••Even when blast victims have small entrance wounds,Even when blast victims have small entrance wounds,
surgeons should maintain a low threshold for performingsurgeons should maintain a low threshold for performing
thorough debridementthorough debridement
••All open fractures are considered contaminated andAll open fractures are considered contaminated and
should receive early antibiotic treatment (first generationshould receive early antibiotic treatment (first generation
cephalosporin and/or aminoglycoside, extended spectrumcephalosporin and/or aminoglycoside, extended spectrum
penicillinpenicillin((
••Obviously contaminated wounds should be irrigated withObviously contaminated wounds should be irrigated with
sterile saline and dressed with iodophore (Betadine)-sterile saline and dressed with iodophore (Betadine)-
soaked sponges; once dressed, re-exposure should waitsoaked sponges; once dressed, re-exposure should wait
until operative explorationuntil operative exploration
34. ••Tetanus prophylaxis should be administered unlessTetanus prophylaxis should be administered unless
immunization within five years can be documentedimmunization within five years can be documented
••Extremity fractures should be splinted toExtremity fractures should be splinted to
provide mechanical stability and relieve painprovide mechanical stability and relieve pain..
Eye Injuries……
Blast eye injuries may present with a wide range of symptoms,
from minimal discomfort to severe pain or loss of vision.
Minor blast-related eye injuries include corneal abrasions,
conjunctivitis.
Eyelid lacerations, penetrating and perforating injuries to the
cornea or sclera