Challenges in management of blast injuries in Intensive Care
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Introduction
A high intensity bomb blast exploded in Delhi on 7 September 2011. Four of the most severely injured were shifted to Intensive Care Unit (ICU) of our Trauma center after primary resuscitation by a team of advanced trauma life support providers in the emergency department (ED).

Case
A 34-year-old male with decreased level of consciousness (Glasgow Coma Scale = 6), obstructed breathing, hypotension, right hemothorax and compound fracture in bilateral both bones of lower limbs and right humerus was managed in the ED with tracheal intubation, intercostal drain (ICD) insertion (500 ml of blood) and intravascular administration of crystalloids, colloids, blood products and inotropes (dopamine and noradrenaline).

Minimal peritoneal fluid collection was reported on Focused Assessment Sonography in Trauma (FAST); computed tomography (CT) abdomen confirmed right ileal injury. A large (7.2 cm × 3.7 cm) parietal hematoma and fracture right temporal bone was reported on CT head....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271281/
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