The recent increase in terrorist bomb attacks on urban civilian targets in Europe and the USA has emphasized the need for all relevant health provision team members to become familiar with the pathophysiology and treatment of the resulting injuries. This chapter focuses on blast injuries, considers recent advances in ventilation strategies for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), and describes how this has been applied in the treatment of the severe blast injuries patient. Smoke, hot gas, or chemical inhalation injury are the most common cause of acute deterioration in lung function in burn injury patients and should always be suspected. Pulmonary contusion is a common lesion occurring in patients sustaining severe blunt chest trauma. The diagnosis of traumatic lung injury is usually made clinically with confirmation by chest radiography. Blunt thoracic trauma can result in significant morbidity in injured patients.

For acutely injured patients multiple physical, financial, social, medical, and legal post-trauma concerns exist that may limit the ability to focus exclusively on the psychological sequelae of the trauma. Injured patients treated within trauma care systems are at high risk for developing post-traumatic stress disorder (PTSD). Acute care mental health services research programs aim to address the mental health needs of populations of injured patients presenting for treatment in the acute care medical setting. Recent investigation suggests that emergency department heart rate alone has only modest specificity and sensitivity for the prediction of chronic PTSD symptoms. Mental health professionals have been observed to converge on the scene of mass disasters. Rather than immediately preparing for early intervention targeting post-traumatic stress, newly arriving mental health professionals could be assigned as care managers to injured patients triaged through acute care settings.