EMT Terrorism Response and Disaster Management Practice Test

Blast pulmonary edema and impaired oxygen exchange point to injury of the lungs themselves. In a primary blast event, the pressure wave most directly affects gas-filled organs, with the lungs being the most vulnerable. This damage disrupts the alveolar-capillary barrier, causing fluid to leak into the airspaces and creating pulmonary edema that reduces the efficiency of oxygen transfer, leading to hypoxemia. Clinically you’d expect sudden shortness of breath and respiratory distress after an explosion, with potential diffuse edema on imaging. The other organs listed—liver, spleen, intestines—can be injured in blasts, but they don’t cause the edema and oxygenation problems that originate in the lungs. So, injury to the lungs best explains blast pulmonary edema and impaired oxygen exchange.