Blast Injury in Ibadan: A consultant emergency physician’s narrative and recommendation

It was a distressing moment on the night of January 16, 2024 when an accidental massive dynamite explosion hit the Old Bodija area of Ibadan, Nigeria with far-reaching impact reported in close and remote areas from the site of blast. As the incident commander, an emergency response was activated in the University College Hospital and other peripheral health facilities to provide both pre-hospital and in-hospital care to distressed victims with top-notch coordination of quality emergency medical services delivered using a locally adapted field triage guidelline, mass casualty incident management system and the ‘METHANE’ protocol to provide rescue response, effective field triage, sorting, transport, treatment, and rehabilitation of the patients admitted for emergency care at various facilities. The national guideline on field triage, 2021 was the game changer which was locally adapted and practically implemented! Many of the victims had varying degrees of blast injury ranging from depressed skull fractures with surface collections (epidural and subdural hematomas), early post-traumatic seizures, tympanic membrane rupture, multiple long bone fracture, to compromised airways requiring cardiorespiratory support, emergency blood transfusion services, neurocritical care, surgical operations, and rehabilitation provided by specialist physicians, surgeons, residents, nurses,  medical and nursing students, and other volunteer workers. The role of national field triage policy document( 2021 revision) that was appropriately implemented  influenced the blast disaster management and mass casualty incident response in the low-and middle-income country-Nigeria. The clinical outcome recorded was excellent and remarkable. Specialist emergency physicians, trauma surgeons and others on the emergency medical services team need to be conversant with the provisions of the document for application based on local needs. I recommend the policy document by Newgard et al. 2022 to specialist emergency physicians of my sort and other  providers of emergency care in developing climes as an effort to domesticate global best practices in their respective localities and to birth better outcomes in the events of mass casualty incidents and disasters that strike without notice. Also, a paper by Michalski et al. 2024 is recommended for advancing prehospital care in LMICs.  The message is for you and I to strengthen the siamese twins of pre-and in-hospital care in our climes so as to advance on-site and in-hospital emergency care in our communities. Let the theme for the  Emergency Medicine Day ( May 27, 2025) resonate to all and sundry so that we can jointly echo the theme:  ” We are proud to provide your emergency care…”