Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-26T23:33:05.170Z Has data issue: false hasContentIssue false
  • English
  • Français

Injuries From Explosions: More Differences Than Similarities Between Various Types

Published online by Cambridge University Press:  06 May 2022

Michael Rozenfeld Open the ORCID record for Michael Rozenfeld [Opens in a new window] ,
Kobi Peleg ,
Irina Radomislensky ,
Morel Ragoler ,
Moran Bodas  and
Israel Trauma Group (I.T.G.)
Michael Rozenfeld*
Affiliation:
Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute, Tel HaShomer, Israel
Kobi Peleg
Affiliation:
Tel-Aviv University, Faculty of Medicine, School of Public Health, Tel-Aviv, Israel
Irina Radomislensky
Affiliation:
Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute, Tel HaShomer, Israel
Morel Ragoler
Affiliation:
Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute, Tel HaShomer, Israel
Moran Bodas
Affiliation:
Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute, Tel HaShomer, Israel Tel-Aviv University, Faculty of Medicine, School of Public Health, Tel-Aviv, Israel
*
Corresponding author: Michael Rozenfeld, Email: micahelr@gertner.health.gov.il.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To compare injury patterns of different types of explosions.

Methods:

A retrospective study of 4508 patients hospitalized due to explosions recorded in the Israel National Trauma Registry between January 1997 and December 2018. The events were divided into 4 groups: terror-related, war-related, civilian intentional explosions, and civilian unintentional explosions. The groups were compared in terms of injuries sustained, utilization of hospital resources, and clinical outcomes.

Results:

Civilian intentional and terror-related explosions were found to be similar in most aspects except for factors directly influencing mortality and a larger volume of severely injured body regions among terror-victims. Comparisons between other groups produced some parallels, albeit less consistent. Civilian intentional explosions and civilian unintentional explosions were different from each other in most aspects. The latter group also differed from others by its high volume of life-threatening burns and a higher proportion of children casualties.

Conclusions:

While consistent similarities between explosion casualties exist, especially between victims of intentional civilian and terror-related explosions, the general rule is that clinical experience with a type of explosion cannot be directly transferred to other types.

Keywords

burnsexplosionsinjury patternsinjury severity
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e154
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Injuries and Violence: The Facts. Geneva: World Health Organization (WHO). Published 2014. https://www.who.int/news-room/fact-sheets/detail/injuries-and-violence#:~:text=Key%20facts,traffic%20injuries%2C%20homicide%20and%20suicide. Accessed May 1, 2021.Google Scholar
Rozenfeld, M, Givon, A, Peleg, K. Violence-related versus terror-related stabbings: significant differences in injury characteristics. Ann Surg. 2018;267(5):965-970.CrossRefGoogle ScholarPubMed
Almogy, A, Kedar, A, Bala, M. When a vehicle becomes a weapon: intentional vehicular assaults in Israel. Scand J Trauma Resusc Emerg Med. 2016;24:149.CrossRefGoogle ScholarPubMed
DePalma, RG, Burris, DG, Champion, HR, Hodgson, MJ. Blast injuries. N Engl J Med. 2005;352:1335-1342.CrossRefGoogle ScholarPubMed
Reade, MC. Blast injury: what to expect in civilian vs. military context. ICU Manag. 2015;4:163-166.Google Scholar
Champion, HR, Holcomb, JB, Young, LA. Injuries from explosions: physics, bio-physics, pathology, and required research focus. J Trauma. 2009;66:1468-1477.Google Scholar
Almogy, G, Luria, T, Richter, E, et al. Can external signs of trauma guide management? Lessons learned from suicide bombing attacks in Israel. Arch Surg. 2005;140:390-393.CrossRefGoogle ScholarPubMed
Tadmor, B, Feigenberg, Z, Aharonson-Daniel, L, et al. Mass casualty events—suicide bombing: the Israeli perspective. In: Elsayed, Nabil M PhD, Atkins, JL, eds. Explosion and Blast-Related Injuries. Academic Press; 2008; pp. 307-335.Google Scholar
Rozenfeld, M, Givon, A, Shenhar, G, et al. A new paradigm of injuries from terrorist explosions as a function of explosion setting type. Ann Surg. 2016;263(6):1228-1234.CrossRefGoogle ScholarPubMed
Aharonson-Daniel, L, Peleg, K; ITG. The epidemiology of terrorism casualties. Scand J Surg. 2005;94:185-190.CrossRefGoogle ScholarPubMed
Peleg, K, Jaffe, DH; Trauma Group, Israel. Are injuries from terror and war similar? A comparison study of civilians and soldiers. Ann Surg. 2010;252(2):363-369.CrossRefGoogle ScholarPubMed
Byard, RW. Lethal explosions in a non-terrorist civilian setting. Med Sci Law. 2018;58(3):156-158.CrossRefGoogle Scholar
Noji, EK, Lee, CY, Davis, T, Peleg, K. Investigation of Federal Bureau of Investigation bomb-related death and injury data in the United States between 1988 and 1997. Mil Med. 2005;170:595-598.CrossRefGoogle ScholarPubMed
Kosashvili, Y, Loebenberg, MI, Lin, G, et al. Medical consequences of suicide bombing mass casualty incidents: the impact of explosion setting on injury patterns. Injury. 2009;40:698-702.CrossRefGoogle ScholarPubMed
Frykberg, ER. Medical management of disasters and mass casualties from terrorist bombings: how can we cope? J Trauma. 2002;53:201-212.CrossRefGoogle ScholarPubMed
Bala, M, Willner, D, Keidar, A, et al. Indicators of the need for ICU admission following suicide bombing attacks. Scand J Trauma Resusc Emerg Med. 2012;20:19.CrossRefGoogle ScholarPubMed
Peleg, K, Rozenfeld, M. Dealing with terror-related mass casualty events: principles and lessons learned. Notfall + Rettungsmedizin. 2015;18(4):285-292.CrossRefGoogle Scholar
Miller, A, Epstein, D, Givon, A, et al. Injuries from civilian under-vehicle improvised explosive devices: an analysis of the Israeli National Trauma Registry during the years 2006–2020. Eur J Trauma Emerg Surg. 2021. https://doi.org/10.1007/s00068-021-01739-4, Published June 26, 2021.Google Scholar
Patel, JN, Tan, A, Dziewulski, P. Civilian blast-related burn injuries. Ann Burns Fire Disasters. 2016;29(1):43-46.Google ScholarPubMed
Kulla, M, Maier, J, Bieler, D, et al. Civilian blast injuries: an underestimated problem? Unfallchirurg. 2016;119:843-853.CrossRefGoogle ScholarPubMed
Boissiere, F, Bekara, F, LucaPozner, V, et al. Thermal and chemical burns caused by e-cigarette battery explosions. Ann Chir Plast Esthet. 2020;65(1):24-30.CrossRefGoogle ScholarPubMed
Mohan, A, Nolan, GS, Jain, A. Firework-related blast injury to the hand and treatment algorithm. BMJ Case Rep. 2019;12(10):e231804.CrossRefGoogle Scholar
Almogy, G, Belzberg, H, Mintz, Y, et al. Suicide bombing attacks: update and modifications to the protocol. Ann Surg. 2004;239(3):295-303.CrossRefGoogle ScholarPubMed
Peleg, K, Savitsky, B; Trauma Group, Israeli. Terrorism-related injuries versus road traffic accident-related trauma: 5 years of experience in Israel. Disaster Med Public Health Prep. 2009;3(4):196-200.CrossRefGoogle ScholarPubMed
de Faber, JT, Kivelä, TT, Gabel-Pfisterer, A. National studies from the Netherlands and Finland and the impact of regulations on incidences of fireworks-related eye injuries. Ophthalmologe. 2020;117(Suppl 1):36-42.CrossRefGoogle ScholarPubMed