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Correspondence
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Volume 352:2651-2653 June 23, 2005 Number 25
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Blast Injuries

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 by DePalma, R. G.
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To the Editor: DePalma et al. (March 31 issue)1 review four patterns of injuries from explosions and offer protocol for evaluating blast injuries that is based on the presence or absence of ruptured tympanic membranes. However, as suggested in the article, tympanic-membrane perforations are found in only 60 percent of patients with clinically significant injuries, and clinically significant injuries are present in less than 30 percent of patients with tympanic-membrane perforations.2,3

We summarize our findings from our experience with more than 30 mass-casualty incidents caused by terrorist bombing. First, most persons with clinically significant blast-associated lung injury have respiratory failure . . . [Full Text of this Article]


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