In the aftermath of bombings at the Boston marathon on April 15, the Centers for Disease Control and Prevention (CDC) has alerted health professionals that its website on mass casualty event preparedness and response contains extensive information for them, their patients, and the general public.
The website's section for health professionals offers a primer on explosion and blast injuries, which aren't commonly seen outside of combat. For example, high-order explosives produce a supersonic overpressurization shock wave that can cause serious lung and abdominal injuries without any apparent external wounds. Signs of blast lung—apnea, bradycardia, and hypotension—usually are evident at the initial evaluation but have been reported as late as 48 hours afterward. Ear injuries and concussions may be easily overlooked, and patients with serious eye injuries sometimes don't seek treatment for days, weeks, or even months after the event.