Eardrum Perforation in Explosion Survivors: Is It a Marker of Pulmonary Blast Injury?☆,☆☆,★,★★
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INTRODUCTION
Terrorist bombings have become an increasing international problem threatening civilian communities worldwide. Injuries incurred in such explosions were until recently a topic of interest mainly to military physicians. Considering the increasing incidence of terrorist bombings in many countries, the typical injuries are apt to challenge medical care providers who are unaccustomed to coping with such trauma in civilian populations.
Traditionally, 4 mechanisms of injury are implicated in trauma
METHODS AND MATERIALS
Between April 6, 1994, and March 4, 1996, 11 terrorist explosions occurred in Israel, injuring a total of 770 persons, 145 of whom died. Depending on geographic location, survivors were evacuated to 17 hospitals throughout Israel (range, 1 to 6 hospitals per incident). All 11 attacks were executed by suicide terrorists who either carried the bomb on their garments or drove booby-trapped vehicles. The bombs were self-made and incorporated various explosive materials, occasionally including
RESULTS
A total of 770 persons were injured in the 11 explosions, 145 (18.8%) of whom died. Of the latter group, 123 were found dead at the scene of the explosion and 22 died from their injuries after admission to the hospital. Of the 647 persons who were admitted to hospitals, 193 (29.8%) were diagnosed as having sustained primary blast injuries, including 142 with isolated eardrum perforation and 51 with other forms of primary blast injuries.
The average age of those who sustained primary blast
DISCUSSION
The reported proportion of primary blast injuries among all types of blast injuries ranges from 2% to 76%, depending on the magnitude of the explosive charge and on-scene characteristics.4, 5 The majority of persons affected by primary blast injuries have merely perforated eardrums; life-threatening blast injuries are less common. We investigated the fate of explosion survivors in whom the only primary blast injury was eardrum perforation. We assumed that perforated eardrums may indicate a more
Acknowledgements
We wish to acknowledge all the faithful physicians and nurses who worked days and nights during these difficult times in Israel.
References (8)
Primary blast injuries
Ann Emerg Med
(1986)The pathogenesis of blast injury and its management
Br J Hosp Med
(1988)- et al.
Casualties from terrorist bombings
J Trauma
(1983) Dysbarism
Cited by (0)
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From the Department of Urology, Asaf-Harofe Medical Center,Tel-Aviv University, Zerifin*;and the Department of Urology‡and Office of the Assistant Director,§ Hadassah Medical Center, The Hebrew University, Jerusalem, Israel.
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Address for reprints:Dr Dan Leibovici, Department of Urology, Asaf-Harofe Medical Center, Zerifin 70300, Israel.
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0196-0644/99/$8.00 + 0
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