b'Chapter hapterBlast InjuryAny type of explosive force involving fumes and gases can cause a serious extensive blast wound. The high forces often involve enormous heat, flame and flying particles that cause serious burns, fractures and soft tissue injury. Blasts create high pressure forces that injure the lungs and internal organs.How to RecogniseExtensive multiple soft tissue injury such as shrapnel wounds.There may be fractures and burns.Coughing up blood stained fluid.There may be bleeding from the ears and deafness.Patient is in shock.How to ManageConscious PatientAssess danger then quickly check and control any bleeding.Call Ambulance 000.Assist the patient into the most comfortable position.Check for other wounds (Secondary Survey page 86):A patient with chest wounds should be positioned sitting upright leaning forward towardthe injured side.A patient with abdominal wounds should be positioned on their back with head andshoulders raised on a pillow and knees slightly bent supported by a pillow or blanket.Burns need to be cooled and covered with non-adherent dressings.Fractures should be supported and immobilised. Loosen any tight clothing around the neck, chest and waist to reduce constriction and to help breathing.Keep the patient covered, warm and reassured.Closely monitor patient for response, airway, normal breathing while waiting for Ambulance. Do not give anything by mouth.You may moisten the lips as the patient may be complaining of thirst.If possible, remain with the patient at all times.Unconscious PatientApply DRSABCD and control any bleeding.Call Ambulance 000.Ensure the patient is in the recovery position.Check and manage other wounds.Closely monitor patient for response, airway, normal breathing while waiting for Ambulance. Bleeding 85'