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-method 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. Patient and public involvement
statement: No patients or members of the public were involved in this review.
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 to 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 highlights the
importance of understanding the diverse injury patterns in order to optimise future service
provisions in caring for this the child blast survivor.