A patient with subcutaneous emphysema after an RDD detonation is most likely suffering from which injury?

A patient with subcutaneous emphysema after an RDD detonation is most likely suffering from which injury?

• A. Cardiac contusion
• B. Pulmonary blast injury
• C. Pneumothorax
• D. Hemothorax

Answer: (B)

Subcutaneous emphysema after a blast signals air has escaped from the lungs into soft tissues due to pulmonary barotrauma. In an explosion, the rapid overpressure primarily injures air-containing organs, with the lungs being especially vulnerable. When the lung tissue ruptures or air tracks along tissue planes, air can leak into the pleural space, mediastinum, and subcutaneous tissues, producing crepitus under the skin. This pattern points to a pulmonary blast injury, which encompasses primary lung overpressure injuries such as alveolar rupture and resultant air leaks. Cardiac contusion involves the heart and doesn’t explain air in the subcutaneous tissues. Hemothorax is blood in the chest cavity and, while it can accompany blasts, it does not by itself account for subcutaneous emphysema. Pneumothorax could cause subcutaneous emphysema, but the broader, explosion-related mechanism is best described as pulmonary blast injury.

Subcutaneous emphysema after a blast signals air has escaped from the lungs into soft tissues due to pulmonary barotrauma. In an explosion, the rapid overpressure primarily injures air-containing organs, with the lungs being especially vulnerable. When the lung tissue ruptures or air tracks along tissue planes, air can leak into the pleural space, mediastinum, and subcutaneous tissues, producing crepitus under the skin.

This pattern points to a pulmonary blast injury, which encompasses primary lung overpressure injuries such as alveolar rupture and resultant air leaks. Cardiac contusion involves the heart and doesn’t explain air in the subcutaneous tissues. Hemothorax is blood in the chest cavity and, while it can accompany blasts, it does not by itself account for subcutaneous emphysema. Pneumothorax could cause subcutaneous emphysema, but the broader, explosion-related mechanism is best described as pulmonary blast injury.