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Singh SK, Kumar A, Katyal S. A terrorist bomb blast, a real challenge for any tertiary care health provider. Anesth Essays Res. 2014;8(2):229-32doi: 10.4103/0259-1162.134517.
Singh, S. K., Kumar, A., & Katyal, S. (2014). A terrorist bomb blast, a real challenge for any tertiary care health provider. Anesthesia, essays and researches, 8(2), 229-32. https://doi.org/10.4103/0259-1162.134517
Singh, Shiv Kumar, et al. "A terrorist bomb blast, a real challenge for any tertiary care health provider." Anesthesia, essays and researches vol. 8,2 (2014): 229-32. doi: https://doi.org/10.4103/0259-1162.134517
Singh SK, Kumar A, Katyal S. A terrorist bomb blast, a real challenge for any tertiary care health provider. Anesth Essays Res. 2014 May-Aug;8(2):229-32. doi: 10.4103/0259-1162.134517. PMID: 25886231; PMCID: PMC4173630.
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Anesth Essays Res. 2014 May-Aug;8(2):229-32. doi: 10.4103/0259-1162.134517.

A terrorist bomb blast, a real challenge for any tertiary care health provider.

Anesthesia, essays and researches

Shiv Kumar Singh, Amit Kumar, Surabhi Katyal

Affiliations

  1. Department of Anaesthesiology, Shahid Hasan Khan Mewati Government Medical College, Nuh, Mewat, Haryana, India.
  2. Department of Obstetrics and Gynecology, Shahid Hasan Khan Mewati Government Medical College, Nuh, Mewat, Haryana, India.

PMID: 25886231 PMCID: PMC4173630 DOI: 10.4103/0259-1162.134517

Abstract

Multiple casualties and the complex set of injuries in survivors of a terrorist bomb blast poses a real challenge to health care providers. We are presenting three such cases, first case suffered a fracture of both bone lower limb bilaterally along with head injury (foreign bodies were impacted in the scalp and brain parenchyma). Following primary resuscitation, patient shifted to operation theatre after a quick computerized tomography scan and external fixator applied in general anesthesia using the rapid sequence induction. No active neurosurgical intervention was done. As this patient had acute post-traumatic stress response, he was subjected to low pressure hyperbaric oxygen therapy (pressure of 1.5 ATA for 60 min a day for 10 days) and group counseling. He had good recovery except one lost a limb because of extensive neurovascular damage due to blast. Second case had much more extensive damage involving multiple organ systems. He had blast lung, big cerebrovascular hemorrhage along with gut perforation. Despite best possible surgical and intensive care interventions, patent developed multiple organ failure and unfortunately we lost our patient. Third case was of a right sided globe rupture resulted from blast induced flying foreign bodies. After primary survey and initial resuscitation evisceration done for the damaged eye and patient later on discharged with necessary instruction (including warning signs) for follow-up.

Keywords: Advanced life support; blast lung; complex injuries; multiple casualties; terrorist

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