Wightman J M, Gladish S L
Center for Disaster and Humanitarian Assistance Medicine, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799, USA.
Ann Emerg Med. 2001 Jun;37(6):664-78. doi: 10.1067/mem.2001.114906.
Powerful explosions have the potential to inflict many different types of injuries on victims, some of which may be initially occult. Flying debris and high winds commonly cause conventional blunt and penetrating trauma. Injuries caused by blast pressures alone result from complex interactions on living tissues. Interfaces between tissues of different densities or those between tissues and trapped air result in unique patterns of organ damage. These challenge out-of-hospital personnel, emergency physicians, and trauma surgeons to specifically seek evidence of these internal injuries in individuals with multiple trauma, adjust management considerations to avoid exacerbation of life-threatening problems caused by the blast wave itself, and ensure appropriate disposition of these patients in possible mass-casualty situations. Knowledge of the potential mechanisms of injury, early signs and symptoms, and natural courses of these problems will greatly aid the management of blast-injured patients.
强烈爆炸有可能对受害者造成多种不同类型的伤害，其中一些伤害最初可能并不明显。飞溅的碎片和狂风通常会导致传统的钝性和穿透性创伤。仅由爆炸压力造成的伤害是由活组织上的复杂相互作用导致的。不同密度组织之间或组织与 trapped air 之间的界面会导致独特的器官损伤模式。这些情况对院外急救人员、急诊医生和创伤外科医生提出了挑战，他们需要特别留意多发伤患者出现这些内伤的证据，调整管理思路以避免因爆炸波本身而加重危及生命的问题，并在可能发生大规模伤亡的情况下确保对这些患者进行妥善安置。了解这些损伤的潜在机制、早期体征和症状以及这些问题的自然病程将极大地有助于对爆炸伤患者的管理。 （注：原文中“trapped air”不太明确准确含义，可能是“被困空气”之类，这里按字面翻译）
