Situations:
(1) industrial explosion (fireworks factory, etc)
(2) accident at a storage location (warehouse, firing range, etc)
(3) military-related
(4) terrorist event
(5) mining
Clinical features of gunpowder burns:
(1) severe burns because of the high thermal temperatures involved.
(2) associated with inhalation injury due to hot and toxic gases (vaporized metal, sulfur, nitrates, chlorates, etc) released. Many patients develop severe edema of the airways.
(3) may be associated with blast or crush injury, especially if the explosion occurred in a confined space.
Management requires:
(1) early and aggressive management of burns including prompt fluid resuscitation with physiologic monitoring
(2) early and aggressive management of serious non-burn injuries
(3) early and aggressive management of the airway, often with tracheostomy and mechanical ventilation
(4) operations for less serious injuries may need to be delayed if there is serious inhalation injury
