The military type have a characteristic and brutal shock wave pattern associated with them.
The shock wave smashes into the victim causing multi organ damage much of which is not immediately apparent. It may be a simple shockwave or if the victim in in an enclosed area a complex multiple shockwave. They both cause multi-system injuries. The mechanism are described as spallation, implosion and inertia.
It has been classified as having four main elements
Immediate Primary Injuries
The place that is most vulnerable to blast injury is where a solid organ contains or meets a hollow gas filled space; a vulnerable interface. This does not exclude other parts of the body.
Long term Effects
Where does all this start ? The obvious suggestion must be at he moment of injury.
The so-called “unexpected survivors” appear to age more quickly, develope hypertension, coronary artery disease and chronic kidney disease sooner than their peers.
They may suffer long term PAIN which is especially challenging to manage.
There are the obvious long term effects of blast injury – missing limbs, deafness, shortness of breath.
What of conditions that have only been widely recognised since the wars in Iraq and Afghanistan. – Heterotrophic Ossification ? Muscle, tendons and blood vessels which progressively become ossified and turn into bone requiring yet more surgery.
There are less obvious consequences that are a consequence of Traumatic Brain Injury (TBI) ?
It is not all over and done with once the damaged limb is removed.
One of the injured from the battle at Mirbat died a few months later in the UK.
On arrival in the FST he had a shattered lower right jaw from what was probably a bullet from an AK-47; up to 1500ft lbs of muzzle energy at 2,500 ft per second.
There was considerable rumour about the cause of his death including malaria but the one that has most currency is that it was a portion of tooth blasted deep into a lung. The tooth fragment may have contributed but it is not unreasonable to suggest that the blast wave of the bullet hitting his upper respiratory tract caused damage throughout his lungs whch eventually proved to be fatal and that attributing it simply to the tooth fragment is possibly over-simplistic.
There are a number of articles in the Journal of the Royal Army Medical Corps which deal with both actual blast injuries from “Ireland to Afghanistan” and the experimental investigation of blast injuries in the UK at Porton Down