Influence of vagal injury on acute traumatic reaction after blast injury

Ball of Death: A Fatal Case Report on Accidental Death of a Child After Crude Bomb Explosion

ABSTRACT

Crude bombs are country-made explosive weapons, usually prepared from locally available materials such as firecrackers or explosives used in mines. These are generally concealed inside the fruits, such as jackfruit, pineapple, and watermelon, to kill wild boars or other animals by poachers in India. Occasionally, crude bombs are remodeled resembling fruit or a ball and placed on the fields, where animals usually raid their crops. Such crude bombs may result in accidental explosions and contribute to the death of unintended targets, including humans. Despite these sporadic incidents reported in media, scientific data are lacking. Here, we report a young child who sustained injuries after an accidental explosion of such a crude bomb. It exploded when the child apparently mistook it for a ball and grasped it firmly while playing with his brother. This case is the first to report the accidental death of a child after the crude bomb's fatal explosion to the best of our knowledge. This report also briefly overviews the emerging menace of crude bombs in India.

Autonomic responses to blast overpressure can be elicited by exclusively exposing the ear in rats

Blast overpressure has become an increasing cause of brain injuries in both military and civilian populations. Though blast's direct effects on the cochlea and vestibular organs are active areas of study, little attention has been given to the ear's contribution to the overall spectrum of blast injury. Acute autonomic responses to blast exposure, including bradycardia and hypotension, can cause hypoxia and contribute to blast-induced neurotrauma. Existing literature suggests that these autonomic responses are elicited through blast impacting the thorax and lungs. We hypothesize that the unprotected ear also provides a vulnerable locus for blast to cause autonomic responses. We designed a blast generator that delivers controlled overpressure waves into the ear canal without impacting surrounding tissues in order to study the ear's specific contribution to blast injury. Anesthetized adult rats' left ears were exposed to a single blast wave ranging from 0 to 110 PSI (0-758 kPa). Blast exposed rats exhibited decreased heart rates and blood pressures with increased blast intensity, similar to results gathered using shock tubes and whole-body exposure in the literature. While rats exposed to blasts below 50 PSI (345 kPa) exhibited increased respiratory rate with increased blast intensity, some rats exposed to blasts higher than 50 PSI (345 kPa) stopped breathing immediately and ultimately died. These autonomic responses were significantly reduced in vagally denervated rats, again similar to whole-body exposure literature. These results support the hypothesis that the unprotected ear contributes to the autonomic responses to blast.