Blast injuries

Blast (explosives) causes direct injury from overpressure or negative pressure from the shock wave, from particles propelled by the shock wave, and by trapping victims and causing crush injury.

Formally, there are four classes of blast injury:

• "Primary blast injury refers to tissue damage by the blast wave itself, specifically in areas with tissue-gas interfaces such as the lungs, the intestines, and the tympanic membrane.
• Secondary injury refers to penetrating or blunt injury that results from the acceleration of shrapnel or debris...
• Tertiary injuries result from acceleration-deceleration forces imposed as the blast wind propels the victim. As the body is tumbled on a rigid surface, it suffers from blunt injury, in particular closed head injury, as well as penetrating injuries as it is accelerated over sharp debris.
• A fourth mechanism includes flash and flame burns, inhalational injury, and crush injuries incurred from fires and structural collapse.

Secondary and tertiary injury overlap significantly, and both are more common than primary blast injury. However, primary blast injuries are the most severe."