Operational and Medical Management of Explosive and Blast Incidents, 1st ed. 2020

This book provides a comprehensive overview of the medical and operational management of blast and explosive incidents affecting civilian populations. It incorporates global lessons learned from first responders, emergency medicine providers, surgeons, intensivists, and military specialists with deep experience in handling blast injuries from point of injury through rehabilitation.  

The book begins with background and introductory information on blast physics, explosion types, frequency, and perspectives from the military. This is followed by a section on prehospital management focusing on medical and trauma responses, triage, psychological consequences, and operational considerations. It then examines the roles of the emergency department and ICU with chapters on planning and training, surge capacity, resilience, management of common injury types, contamination, and ventilator strategies.  The next section covers surgical treatment of a variety of blast injuries such as thoracoabdominal, extremity and vascular, and orthopedic injuries. The book then discusses medical treatment of various injury patterns including lung, abdominal, extremity, and traumatic brain injury. The final section of the book covers post-hospital considerations such as rehabilitation, mental health, and community resilience. Throughout, case studies of recent incidents provide real-life examples of operational and medical management.

Operational and Medical Management of Explosive and Blast Incidents is an essential resource for physicians and related professionals, residents, nurses, and medical students in emergency medicine, traumatic surgery, intensive care medicine, and public health as well as civilian and military EMS providers.

Part I. Introduction

Chapter 1. Scope and Scale of the Problem   

Chapter 2. Blast Physics and Biophysics 

Chapter 3. State of the Science – Blast Injury Pathophysiology

Chapter 4. Operational Considerations: Review of Contemporary Data

Chapter 5. Civilian Hospital and Healthcare System Preparedness (Location, Preparedness, 

Chapter 6. Military Trauma System Response to Blast MCI                                   

Chapter 7. The Modern Explosive Threat: Improvised Explosive Devices

Chapter 8. Interagency Collaboration and Maturation – The United Kingdom Experience

Chapter 9. Case Study: The Madrid Train Bombing of March 11, 2004

Chapter 10. Scope of the Problem and Operational Considerations                            

Chapter 11. Lessons in Prehospital Trauma Management During Combat

Chapter 12. First Responders: Clinical Care of Blast Trauma in the Prehospital Setting

Chapter 13. The Explosive Mass Casualty: Prehospital Incident Management and Triage

Chapter 15. Risk-Related Zones of Prehospital Operations

Chapter 16. Tactical Emergency Medical Support (TEMS)

Chapter 17. Case Study: Ptimary Blast Injury in a Field Setting 

Chapter 18. Case Study: 2013 Boston Marathon

Chapter 19. Emergency Department Response to Explosive Incidents: Scope of the Problem and 

Operational Considerations                                                 

Chapter 20. Emergency Medicine: Combat Lessons Learned                                         

Chapter 22. The Role of Blood Products in Damage Control Resuscitation in Explosion-Related Trauma 

Chapter 23. Pediatric Considerations 

Chapter 24. Organization, Operations, Management, and Their Role in Surge Capacity and Mass Casualty Incidents 

Chapter 25. Case Study: Emergency Department Response to the Boston Marathon Bombing                                      

Chapter 26. Case Study: Management of Blast Incidents in Israel

Part IV. Surgical Management 

Chapter 27. Scope of the Problem and Operational Considerations: Logistics, Surge Capacity, Organizing a Response, Sustainment Issues, Resource Utilization                                                      

Chapter 28. Combat Lessons Learned

Chapter 30. Anesthesia Care in Blast Injury       

Chapter 31. Vascular Injuries                                     

Chapter 32. Management of Thoracoabdominal Blast Injuries

Chapter 33. Genitourinary Injuries 

Chapter 34. Management of Orthopaedic Blast Injuries

Chapter 35. Reconstructive Plastic Surgery in Blast and Burn Injuries

Chapter 36. Pediatric Blast Injuries

Chapter 37. Case Study: Boston Bombings, a Surgeon’s View

Part V. ICU Management 

Chapter 38.  ICU Management of Blast Victims: Scope of the Problem and Operational 

Considerations

Chapter 40. ICU Management: Extended Resuscitation Considerations

Chapter 41. Case Study from Afghanistan:  Dismounted Complex Blast Injury

Part VI. Special Considerations

Chapter 42. Chemical, Biological, Radiological, or Nuclear Event (CBRNE): Prehospital and 

Hospital Management

Chapter 43. Burn Management                    

Chapter 44. Wound Management

Chapter 45. Psychological Consequences: Responders and Community

David W. Callaway, MD, MPA

Director, Division of Operational and Disaster Medicine

Associate Professor, Emergency Medicine

Carolinas Medical Center

Charlotte, NC 

Jonathan L. Burstein, MD

Beth Israel Deaconess Medical Center

Harvard Medical School

Boston, MA