Friday, September 20 (2019); Trauma, Burns, Drowning
For a country not traditionally prone to gunshot homicide or bombing, it is not unreasonable to expect critical care trainees to only have vicarious experience of such trauma patterns. It is therefore surprising to find questions about this topic in the CICM Part II exams. In short, most of the mortality is due to primary blast injury (supersonic pressure wave travelling through hollow organs), and most of the morbidity is due to secondary blast injury (mainly shrapnel) and tertiary blast injury (getting thrown into structures, or having them collapse atop of you).Everything else (eg. burns) falls under the category of quaternary injury.