Blast injury with particular reference to recent terrorist bombing incidents.

The aetiology of primary blast lung is discussed with reference to the biodynamics of blast injury, and the clinical and pathological features of the condition are described. An analysis of casualties from bomb blast incidents occurring in Northern Ireland leads to the following conclusions concerning the injuries found in persons exposed to explosions: (1) there is a predominance of head and neck trauma, including fractures, lacerations, burns, and eye and ear injuries; (2) fractures and traumatic amputations are common and often multiple; (3) penetrating trunk wounds carry a grave prognosis; and (4) primary blast lung is rare. A comparison of four bombing incidents in England in 1973 and 1974 shows how the type and severity of injury are related to the place in which the explosion occurs. The administrative and clinical aspects of the management of casualties resulting from terrorist bombing activities are discussed.