A 36-year-old driver was pulled from a car after it collided with a tree and the gas tank exploded.What assessment data suggest the patient suffered tissue damage consistent with a blast injury?
A) Blood pressure 82/60 mm Hg, heart rate 122 beats/min, respiratory rate 28 breaths/min
B) Crackles (rales) on auscultation of bilateral lung fields
C) Responsive only to painful stimuli
D) Irregular heart rate and rhythm

Question

Quizplus · Accepted Answer

Explosive blast energy generates shock waves that create changes in air pressure,causing tissue damage.Initially after an explosion,there is a rapid increase in positive pressure for a short period,followed by a longer period of negative pressure.The increase in positive pressure injures gas-containing organs.The tympanic membrane ruptures,and the lungs may show evidence of contusion,acute edema,or rupture.A low blood pressure and corresponding tachycardia are more suggestive of hypovolemia.Lack of response to stimuli suggests a neurological injury.An irregular heart rate and rhythm may be associated with blunt trauma to the heart (e.g.,cardiac contusion).

A 36-Year-Old Driver Was Pulled from a Car After It