Trauma to the respiratory tract is one of the primary consequences of an acute blast injury.


Types of injury:

(1) lung contusion with intra-alveolar hemorrhage and/or pulmonary edema

(2) contusion to airway (larynx, trachea, other)

(3) pneumothorax

(4) laceration with hemothorax

(5) alveolovenous fistula with air embolism (above)


Clinical signs and symptoms:

(1) cyanosis

(2) tachypnea

(3) chest pain

(4) dyspnea

(5) hemoptysis

(6) rales on auscultation (crackles)

(7) diminished breath sounds

(8) dullness to percussion



• Injury to the larynx could cause stridor and a change in voice.


If pneumothorax or hemopneumothorax develop, additional findings may include:

(1) increased resonance on percussion (over collapsed lung)

(2) diminished breath sounds (over collapsed lung)

(2) retrosternal crunch

(3) subcutaneous crepitus (with subcutaneous emphysema)

(4) tracheal deviation (away from collapsed side, if tension pneumothorax)

(5) hypotension and cardiovascular collapse


Radiographic findings:

(1) parenchymal lung infiltrates

(2) mediastinal shift (with pneumothorax)


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