A 40-year-old male was admitted to the emergency room approximately 1.5 h after sustaining a blast injury to both lower limbs. He had been resuscitated at his local accident and emergency department prior to transfer. On arrival, his pulse was 120 bpm and his blood pressure 80/40 mmHg.
Examination revealed that the patient had sustained significant blast injuries to both lower limbs with no obvious torso injuries. The left leg had sustained neurovascular damage above and below the knee with concomitant bone and soft tissue injury; there was no tissue perfusion below the knee. On the right side there was a large wound in the thigh extending anteriorly to the knee joint with profuse bleeding; bony fragments could be seen in the wound and the right foot was pale with no palpable pulses and slight reduction in sensation.
Secure an airway, commence oxygen therapy and obtain adequate intravenous (IV) access.
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