IED Blast Injury in Japan

SavageGlow · #1 ● 04-03-2023, 08:00 PM

Source:

A 64-year-old man with no known medical history was admitted to our hospital’s emergency department because of a blast injury he sustained from an IED while walking in a park. At the scene, four people were injured and triaged, one of them as black (Category 0) and the others as red (Category I). One of the patients, who had been triaged as "red," was placed on a backboard, immobilized, and transported by ambulance to our emergency department.

On presentation, the patient was alert and well-oriented, and his mental state registered 15 on the Glasgow Coma Scale. His blood pressure was 154/80 mmHg, his pulse was 78 beats per minute, his respiratory rate was 20 per minute, and his oxygen saturation was 97% (with an oxygen flow of 10 L per minute supplied by a nonrebreathing mask). He had multiple small wounds on his left side (Figure 1).

He complained of hearing difficulty in his right ear and paresthesia in his left upper limb. As a part of the primary and secondary surveys, we performed a radiographic examination and computed tomography (CT) scanning. Multiple fragments of foreign bodies were found in his wounds, but none of them had penetrated the peritoneal, pleural, and cranial cavities (Figure 2).

A left tympanic membrane rupture was suspected but not visualized on otoscopic examination. As wound contamination was not so evident, we performed postexposure prophylaxis using tetanus toxoid. We determined the patient’s Injury Severity Score (ISS) to be 11 and his Revised Trauma Score (RTS) to be 7.841.

In the operating room, all wounds were well irrigated and debrided, and foreign bodies were removed as far as possible. The patient’s postoperative course was mostly uneventful. His paresthesia persisted, and a CT myelography on hospital day nine revealed a left brachial plexus injury. On hospital day 37, the patient was moved to another hospital for further rehabilitation.

IED blasts are rare in Japan. I wonder if this gentleman was a victim in this incident in which a suicidal individual blew himself up in a park and injured multiple people in the process.

I’m almost sure he was. Per this article: “A 64-and 58-year-old man were seriously injured in the blast while a 14-year-old junior high school student was left with minor injuries” as well as the death of the 72-year-old suicide victim. Our patient in this report is 64…