Crush injuries, burns, and inhalation injuries sustained from an explosion are caused by which blast-injury category?

• A. Primary blast injuries
• B. Secondary blast injuries
• C. Tertiary blast injuries
• D. Quaternary blast injuries

Answer: (D)

Crush injuries, burns, and inhalation injuries from an explosion fall under the quaternary blast-injury category. After the initial blast overpressure, there are several other injury pathways. Primary injuries come from the overpressure affecting air-filled organs and the eardrum; secondary injuries come from flying shrapnel; tertiary injuries result from the body being thrown and impacting other objects. Quaternary injuries cover all other explosion-related effects, including burns from heat, inhalation injuries from smoke or toxic gases, and crush injuries from structural collapse or secondary events. So these types of injuries are grouped as quaternary because they arise from the broader consequences of the explosion rather than the initial blast pressure, debris impact, or body displacement.