Explosion and Blast-Related Injuries This page intentionally left blank Explosion and Blast-Related Injuries Effects of Explosion and Blast from Military Operations and Acts of Terrorism Editors Nabil M. Elsayed Department of Early Drug Development Celgene Corp. Summit, NJ and Department of Anatomy and Cell Biology SUNY Medical Center Brooklyn, NY James L. Atkins Division of Military Casualty Research Walter Reed Army Institute of Research Silver Spring, MD Associate Editor Nikolai V. Gorbunov Department of Scientific Research Armed Forces Radiobiology Research Institute Bethesda, MD AMSTERDAM • BOSTON • HEIDELBERG • LONDON NEW YORK • OXFORD • PARIS • SAN DIEGO SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO Academic press is an imprint of Elsevier Cover Design: Joanne Blank Cover Image: © iStockphoto Elsevier Academic Press 30 Corporate Drive, Suite 400, Burlington, MA 01803, USA 525 B Street, Suite 1900, San Diego, California 92101-4495, USA 84 Theobald’s Road, London WC1X 8RR, UK This book is printed on acid-free paper. Copyright © 2008, Elsevier Inc. All rights reserved except Chapters 2, 4, and 5. Chapters 2 and 4 are in the public domain. Chapter 5 Copyright © British Crown 2007/DSTO—published with the permission of the Controller of Her Majesty’s Stationery Office. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Science & Technology Rights Department in Oxford, UK: phone: (+44) 1865 843830, fax: (+44) 1865 853333, E-mail: [email protected]. You may also complete your request online via the Elsevier homepage (http://elsevier.com), by selecting “Customer Support” and then “Obtaining Permissions.” Library of Congress Cataloging-in-Publication Data Explosion and blast-related injuries : effects of explosion and blast from military operations and acts of terrorism / editors, Nabil M. Elsayed, James Atkins. p. ; cm. Includes bibliographical references. ISBN 978-0-12-369514-7 (hardcover : alk. paper) 1. Blast injuries. I. Elsayed, Nabil. II. Atkins, James L. [DNLM: 1. Blast Injuries. 2. Explosions. WO 820 E96 2008] RD96.7.E97 2008 362.19′719–dc22 2007045761 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 13: 978-0-12-369514-7 For all information on all Elsevier Academic Press publications visit our Web site at www.books.elsevier.com Printed in China 08 09 10 9 8 7 6 5 4 3 2 1 table of Contents List of Contributors ..............................................................................vii Preface ................................................................................................xi Introduction ........................................................................................xiii Part 1 Epidemiology of Blast and Explosion Injuries ChaPtEr 1 The Epidemiology and Triage of Blast Injuries .......................3 Richard W. Sattin, Scott M. Sasser, Ernest E. Sullivent III, and Victor G. Coronado ChaPtEr 2 Explosion Injuries Treated at Combat Support Hospitals in the Global War on Terrorism ............................41 Charles E. Wade, Amber E. Ritenour, Brian J. Eastridge, Lee Ann Young, Lorne H. Blackbourne, and John B. Holcomb Part 2 Pathology and Pathophysiology of Blast Injuries ChaPtEr 3 Pathology of Human Blast Lung Injury ...............................73 Michael Tsokos ChaPtEr 4 Neurotrauma from Explosive Blast .....................................91 Geoffrey Ling, Faris Bandak, Gerald Grant, Rocco Armonda, and James Ecklund ChaPtEr 5 Effects of Blast Injury on the Autonomic Nervous System and the Response to Resuscitation .......................105 Emrys Kirkman, Sarah Watts, Wayne Sapsford, and Marina Sawdon ChaPtEr 6 Quaternary Blast Injury: Burns ........................................143 David S. Kauvar, Michael A. Dubick, Lorne H. Blackbourne, and Steven E. Wolf i Table of Contents Part 3 Modeling and Mechanisms of Primary Blast Injury ChaPtEr 7 Multiscale Computational Modeling of Lung Blast Injuries ................................................................163 Andrzej Przekwas ChaPtEr 8 Biochemical Mechanism(s) of Primary Blast Injury: The Role of Free Radicals and Oxidative Stress .................261 Nabil M. Elsayed and Nikolai V. Gorbunov ChaPtEr 9 Inflammatory Response in Primary Blast Injury .................289 Nikolai V. Gorbunov, Ludmila V. Asher, Nabil M. Elsayed, and James L. Atkins Part 4 Global Experiences of Blast Injury and Mass Casualty Management ChaPtEr 10 Mass Casualty Events—Suicide Bombing: The Israeli Perspective ...................................................................307 Limor Aharonson-Daniel, Gidon Almogy, Hany Bahouth, Zvi Feigenberg, Yoram Kluger, Kobi Peleg, Avraham I. Rivkind, and Boaz Tadmor ChaPtEr 11 The Soviet Experience in Afghanistan 1980–1989: Abdominal Blast Injury Produced by Mine Explosions ........337 Petr G. Alisov ChaPtEr 12 Otologic Blast Trauma: Experience from Croatian War .......353 Srec´ko Branica, Krsto Dawidowsky, Nikola Šprem, and Brian McKinnon Index ................................................................................................369 Chap num List of Contributors Aharonson-Daniel, Limor, PhD. Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Israel Alisov, Petr G., MD. Department of Surgery, City Clinic, St. Petersburg, Russian Federation Almogy, Gidon, MD. Department of General Surgery, Hadassah University Hospital, Jerusalem, Israel Armonda, Rocco, MD. Department of Neurosurgery, Walter Reed Army Medical Center, Washington, DC, USA Asher, Ludmila V., MD. Division of Pathology. Walter Reed Army Institute of Research, Silver Spring, MD, USA Atkins, James L., MD, PhD. Division of Military Casualty Research, Division of Pathology. Walter Reed Army Institute of Research, Silver Spring, MD, USA Bahouth, Hany, MD. Surgery B Department and Trauma Unit, Rambam Health Campus, Haifa, Israel Bandak, Faris, PhD. Department of Neurology, F. Edward Hébert School of Medicine, Uniformed Services, University of the Health Sciences, Bethesda, MD, USA Blackbourne, Lorne H., MD. U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA Branica, Srećko, MD, PhD. Department of Otorhinolaryngology, University Hospital Center, Zagreb, Croatia Coronado, Victor G., MD, MPH. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA vii viii List of Contributors Dawidowsky, Krsto, MD, MS. Department of Otorhinolaryngology, University Hospital Center, Zagreb, Croatia Dubick, Michael, PhD. U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA Eastridge, Brian J., MD. U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA Ecklund, James, MD. Dept. of Neurosurgery, Walter Reed Army Medical Center, Washington, DC, USA Elsayed, Nabil M. PhD., FATS. Department of Early Drug Development, Celgene Corp., Summit, NJ, and Department of Anatomy, and Cell Biology, SUNY, Medical Center, Brooklyn, NY, USA Feigenberg, Zvi, MD. Medical Division, Magen David Adom, Israel Gorbunov, Nikolai V., PD. Department of Scientific Research, Armed Forces Radiobiology Institute, Bethesda, MD, USA Grant, Gerald, MD. Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA Holcomb, John B., MD. U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA Kauvar, David S., MD. U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA Kirkman, Emrys, PhD. Biophysics and Trauma (Surgical Science), Biomedical Sciences, Defence Science and Technology Laboratory (Dstl), Porton Down, Salisbury, UK Kluger, Yoram, MD, FACS. Rappaport School of Medicine, Technion, Technological Institute of Israel and Division of General Surgery B, Rambam Medical Center, Haifa, Israel Ling, Geoffrey, MD, PhD. Department of Neurology, F. Edward Hébert School of Medicine, Uniformed Services, University of the Health Sciences, Bethesda, MD, and Department of Critical Care Medicine, Neurology and Neurosurgery, Walter Reed Army Medical Center, Washington, DC, USA List of Contributors ix McKinnon, Brian J., MD. Department of Otolaryngology—Head and Neck Surgery, Medical College of Georgia, Augusta, GA, USA Peleg, Kobi, PhD, MPH. Israel National Center for Trauma and Emergency Medicine, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, and The Multidisciplinary Program for Emergency and Disaster Management, School of Public Health, Tel-Aviv University, Tel-Aviv, Israel Przekwas, Andrzej, PhD. Computational Medicine and Biology Division, CFD Research Corp., Huntsville, AL, USA Ritenour, Amber E., MD. U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA Rivkind, Avraham I., MD. General Surgery and Shock Trauma Unit, Hadassah University, Hospital, Jerusalem, Israel Sapsford, Wayne, MD. FRCS. Royal Air Force, UK Sasser, Scott M., MD. Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA Sattin, Richard W., MD. Department of Emergency Medicine, Medical College of Georgia, Augusta, GA, USA Sawdon, Marina, PhD. School for Health, University of Durham, UK. Šprem, Nikola, MD, PhD. Department of Otorhinolaryngology, University Hospital Center, Zagreb, Croatia Sullivent III, Ernest E., MD. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA Tadmor, Boaz, MD. Tel Aviv University Faculty of Medicine, School of Public Health: The Multidisciplinary Program for Emergency and Disaster Management, Tel-Aviv, Israel Tsokos, Michael, MD. Institute of Legal Medicine and Forensic Sciences, Berlin, Germany Wade, Charles E., PhD. U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA