Blast injuries are increasingly encountered by emergency physicians due to armed conflict, terrorist attacks, and accidental explosions. While the principles of blast injury are well described in adults, children experience unique injury patterns because of their distinct anatomy, physiology, and developmental characteristics. Failure to recognize these differences may delay diagnosis of occult injuries and adversely affect outcomes. This presentation aims to provide emergency clinicians with a practical framework for recognizing and managing pediatric blast injuries. Participants will review the mechanisms of blast injury, including primary, secondary, tertiary, and quaternary blast effects, then focus on how pediatric anatomical and physiological differences influence injury patterns, clinical presentation, and emergency department management. Understanding the unique ways in which blast injuries affect children is essential for timely recognition, appropriate resource utilization, and optimal emergency care. By integrating knowledge of blast mechanisms with pediatric-specific physiology, emergency clinicians can improve diagnostic accuracy, anticipate complications, and deliver evidence-informed care in both routine practice and mass casualty incidents.

Rachelle El Helou is a dual American Board–certified physician in General Pediatrics and Pediatric Emergency Medicine. She earned her medical degree from the American University of Beirut in Lebanon and completed residency training in General Pediatrics at Children’s National Medical Center in Washington, DC, followed by fellowship training in Pediatric Emergency Medicine at Boston Children’s Hospital. She has led the successful establishment of the first Pediatric Emergency Medicine fellowship program in Lebanon in 2024, and currently serves as Program Director of the PEM Fellowship, Associate Program Director of the EM residency and Quality Director of the Pediatric ED. Her professional interests include improving and standardizing the quality of pediatric emergency care in Lebanon and building national capacity in Pediatric Emergency Medicine.