Gun Shot / Blast Injury

• Primary phase: high-pressure shock wave followed by blast wind.
• Secondary phase: Surrounding objects are turned into projectiles causeing injury. Biologic projectiles (bone fragments from the bomber or surronding people) but victums at increased risk for disease transmission. Consider Hep B vaccination, anti-retroviral therapy. (Wong JML, J Trauma 2006;60:402).
• Tertiary phase: Injuries caused as victums are thrown against solid ojects.