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Blast injuries in children: a mixed-methods narrative review
  1. John Milwood Hargrave1,
  2. Phillip Pearce2,
  3. Emily Rose Mayhew3,
  4. Anthony Bull3,
  5. Sebastian Taylor4
  1. 1 South Thames Foundation School, Royal Army Medical Corps, London, UK
  2. 2 Centre for Blast Injury Studies, Imperial College London, London, UK
  3. 3 Department of Bioengineering, Imperial College London, London, UK
  4. 4 Global Child Health Programme, Royal College of Paediatrics and Child Health, London, UK
  1. Correspondence to Dr Emily Rose Mayhew; e.mayhew{at}


Background and significance Blast injuries arising from high explosive weaponry is common in conflict areas. While blast injury characteristics are well recognised in the adults, there is a lack of consensus as to whether these characteristics translate to the paediatric population. Understanding blast injury patterns in this cohort is essential for providing appropriate provision of services and care for this vulnerable cohort.

Methods In this mixed-methods review, original papers were screened for data pertaining to paediatric injuries following blasts. Information on demographics, morbidity and mortality, and service requirements were evaluated. The papers were written and published in English from a range of international specialists in the field.

Results Children affected by blast injuries are predominantly male and their injuries arise from explosive remnants of war, particularly unexploded ordinance. Blasts show increased morbidity and mortality in younger children, while older children have injury patterns similar to adults. Head and burn injuries represent a significant cause of mortality in young children, while lower limb morbidity is reduced compared with adults. Children have a disproportionate requirement for both operative and non-operative service resources, and provisions for this burden are essential.

Conclusions Certain characteristics of paediatric injuries arising from blasts are distinct from that of the adult cohort, while the intensive demands on services highlight the importance of understanding the diverse injury patterns in order to optimise future service provisions in caring for this child blast survivor.

  • paediatric
  • blast
  • trauma
  • conflict
  • outcomes

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  • Contributors JMH was responsible for the analysis of the data and the writing of the main body of the work. AB and ERM made substantial contributions to the concept of the work. AB supervised the design and analysis of the bioengineering material used by JMH. PP and JMH acquired and sorted the medical journal articles for relevance to the field. PP oversaw the analysis for tables and figures and substantially contributed to the general supervision of the overall project. ERM contributed the Introduction and Conclusion text material. AB, ST, PP and ERM gave extensive critical revisions for important intellectual and technical content and approved the final version of the draft. All authors have agreed to be accountable for all aspects of the work. ERM is the corresponding author and is responsible for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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