ABC of major trauma. Blast and gunshot injuries.

The incidence of blast and gunshot injuries is increasing throughout the world. This article deals with management problems that are specific to these injuries. * Chest-examine for signs of respiratory failure and pneumothorax of which may be delayed for up to 48 hours. Such -perform chest radiography to exclude pneumothorax: examine damage, from which survival is possible, may baseline appearance of lung fields, for signs of the adult respiratory distress occur in up to 5% of those injured by explosions. syndrome, and for free gas under the diaphragm The clinical presentation is similar to that of the * Abdomen-examine for local peritonitis and bowel sounds adult respiratory distress syndrome, with * Central nervous system -examine for abnormal signs increasing respiratory failure and radio-opacity of * Funduscopy for air emboli lung fields, but is coupled in some cases with air * External auditory meati for perforated tympanic membranes entering the circulation, producing small arterial * Olfactory function (for medicolegal compensation) air emboli, which in turn may produce secondary