Blast injuries in children: a mixed-methods narrative review
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John Milwood Hargrave1, Phillip Pearce2, Emily Rose Mayhew3
1South Thames Foundation School, Royal Army Medical Corps, London, UK.
Insights
Pediatric blast injuries differ from adult patterns, with younger children facing higher mortality from head and burn injuries. Understanding these distinct patterns is crucial for optimizing care for child blast survivors.
Area of Science:
- Trauma surgery
- Pediatric emergency medicine
- Military medicine
Background:
- Blast injuries are prevalent in conflict zones, with established adult injury patterns.
- Paediatric blast injury characteristics are not well-defined, necessitating further research.
- Understanding paediatric blast injuries is vital for effective care and service provision.
Purpose of the Study:
- To review and synthesize existing literature on paediatric blast injury characteristics.
- To identify demographic, morbidity, mortality, and service requirement patterns in children affected by blasts.
- To compare paediatric blast injury patterns with those observed in adult populations.
Main Methods:
- A mixed-methods review of original English-language papers.
- Screening of papers for data on paediatric injuries following explosive blasts.
- Evaluation of data including demographics, morbidity, mortality, and service needs.
Main Results:
- Paediatric blast injuries predominantly affect males and often result from explosive remnants of war.
- Younger children exhibit higher morbidity and mortality, particularly from head and burn injuries.
- Older children present with injury patterns similar to adults, but children disproportionately require extensive medical services.
Conclusions:
- Paediatric blast injury characteristics are distinct from adult patterns, especially in younger children.
- The significant service demands highlight the need for specialized provisions for child blast survivors.
- Optimizing future service provisions requires a comprehensive understanding of diverse paediatric blast injury patterns.
Background And Significance:
Blast injuries arising from high explosive weaponry is common in conflict areas. While blast injury characteristics are well recognised in the adults, there is a lack of consensus as to whether these characteristics translate to the paediatric population. Understanding blast injury patterns in this cohort is essential for providing appropriate provision of services and care for this vulnerable cohort.
Methods:
In this mixed-methods review, original papers were screened for data pertaining to paediatric injuries following blasts. Information on demographics, morbidity and mortality, and service requirements were evaluated. The papers were written and published in English from a range of international specialists in the field.
Results:
Children affected by blast injuries are predominantly male and their injuries arise from explosive remnants of war, particularly unexploded ordinance. Blasts show increased morbidity and mortality in younger children, while older children have injury patterns similar to adults. Head and burn injuries represent a significant cause of mortality in young children, while lower limb morbidity is reduced compared with adults. Children have a disproportionate requirement for both operative and non-operative service resources, and provisions for this burden are essential.
Conclusions:
Certain characteristics of paediatric injuries arising from blasts are distinct from that of the adult cohort, while the intensive demands on services highlight the importance of understanding the diverse injury patterns in order to optimise future service provisions in caring for this child blast survivor.
