US Department of Defense
Advancing Blast Injury Research to Protect and Heal Those Who Serve

Blast Injuries in Focus

Hearing/balance injuries

Blast-related Hearing and Balance Injuries

Hearing injuries impede communication, reduce situational awareness, hinder threat detection, and ultimately impair safety and mission effectiveness of the Service Member. Peripheral hearing loss, central auditory processing deficits, tinnitus, and vestibular impairment are among the damage associated with blast exposure. Even in relatively mild cases of blast-related auditory injury, initial symptoms of pain, tinnitus, hearing loss, dizziness, and/or disorientation can threaten individual and military unit effectiveness. Although these initial symptoms and deficits may dissipate over hours or days, blast overpressure can tear the ear drum, fracture delicate middle ear bones, and disrupt hearing by blocking the ear canal with blood, debris, or foreign bodies. If left untreated, some blast-related injuries may lead to permanent impairment. Read more...


Blast-related Hemorrhage

Hemorrhage is the leading cause of preventable death on the battlefield and is directly associated with many types of blast injuries, (e.g., abdominal bleeding and perforation, and traumatic amputations). Approximately 25% of these causalities could have been prevented if timely, more effective approaches to hemorrhage control were available closer to the point of injury. One of the greatest priorities in trauma care is to control massive bleeding immediately; this priority has driven the re-emergence of tourniquets in the Iraq and Afghanistan theaters of operation. Hemorrhage is also associated with secondary complications that include shock, inflammation, coagulopathy, and severe hypotension and tissue hypoxia, which contribute to poor injury outcomes, especially for those with other injuries (i.e., traumatic brain injury (TBI)). Advanced resuscitative treatment of hemorrhage within the first hour after injury, the 'golden hour', is the most effective strategy for treating preventable combat casualties due to bleeding. Read more here


Blast-related Extremity Injuries

Extremity trauma injuries accounted for 70 percent of total battle injuries from 2003 to 2015. Blast-related extremity injuries have a high infection rate, with extensive soft tissue damage, volumetric muscle loss, nerve damage, and complex scarring. Some of these injuries result in one or more amputations. The management of Service Members with amputations or complex extremity injuries requires a comprehensive, coordinated, and multidisciplinary healthcare team throughout the continuum of care, using the latest practices in medical/surgical interventions, prosthetic and orthotic technology, and rehabilitation management. Read more here


Blast-related Traumatic Brain Injuries

Blast-related TBI is commonly caused by the secondary and tertiary blast mechanisms. The existence of brain injuries caused by the primary mechanism of blast alone, without secondary or tertiary head impacts, is a topic of continuing debate within the scientific community. Read more here and here...


Blast-related Ocular and Vision Injuries

Eye injuries in combat have dramatically increased due to the use of improvised explosive devices (IEDs). In contrast to peacetime eye injuries, many combat eye injuries are bilateral and frequently occur in association with other head and neck trauma or polytrauma. Multiple factors account for the disproportionately high number of eye injuries given the overall size of the eye and its representative proportion of total body surface area: the required preferential exposure of the eye in order to see and fight; limited eye armor or protection; the unique susceptibility of the eye to injury by small fragments; and the changing nature of armaments and preferred weapons, (e.g., IEDs). Read more...

Last modified: 03-Apr-2023