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Blast Injury Basics: A Primer for the Medical Speech-Language Pathologist

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If medical care requiring more than 30 days is needed, soldiers are transferred to a U.S. military hospital-Walter Reed Army Medical Center, National Naval Medical Center (WRAMC), or Brooke Army Medical Center, which specializes in burn treatment. Soldiers who will not return to combat and still require rehabilitation will next be seen at a VA Hospital and ultimately a civilian/community-based facility.

Patients who survive blast injury may incur traditional open head brain injury (secondary effects), closed head brain injury (tertiary effects), and brain injury from the primary "blast over-pressurization" phenomenon (cerebral contusion). Indirect brain injury due to resulting air embolism (and stroke) may also result from blast over-pressurization (incidence unknown). Blast over-pressurization exposure adds significant complexity to the profile of blast cases with TBI, which may prove to be an important research area.

Because of exposure to traumatic events, the loss of health and independence, and bodily disfigurement that blast cases may encounter, these cases are at risk for a host of psychiatric disorders, including Post-Traumatic Stress Disorder (PTSD). Many PTSC symptoms overlap with symptoms of TBI, especially mild brain injury: headache, dizziness, irritability, decreased concentration, memory problems, fatigue, visual disturbances, sensitivity to light and noise, judgment problems, anxiety, and depression. Similarities in the behavioral characteristics of patients with TBI and/or PTSD can complicate the rehabilitation team's diagnostic assessment effort.

The road to recovery for individuals who have incurred blast injuries is a long and complicated one. Medical SLPs must prepare to provide clinical services and to serve as community re-entry advocates for survivors of blast injury.

 Successful community reintegration will require the intervention of medical and rehabilitation professionals who are knowledgeable, committed, and caring.I challenge you to explore this emerging area further to determine the role that you can play in facilitating restoration and wholeness to returning soldiers and others who have survived the ravages of blast injury.


Gloriajean Wallace is a medical speech-language pathologist and professor in the Department of Communication Sciences and Disorders aat the University of Cincinnati. Contact her at


From Blast Injury Basics: A Primer for the Medical Speech-Language Pathologist by G.L. Wallace. The ASHA Leader, 11(9), 26-28. Copyright 2006 by American Speech-Language-Hearing Association. Reprinted with permission. All rights reserved.


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