After the Boston Bombing and Texas Explosion, Don't Ignore Minor Injuries

April 19, 2013— -- In the aftermath of traumatic events, such as the Boston Marathon bombing or the explosion at a Texas fertilizer plant, it's not only those with the most serious wounds who need treatment.

It's just as important for those with seemingly minor physical injuries, or psychological trauma, to get medical care too.

While the bombs in Boston will be remembered for the three deaths and the serious and devastating wounds they inflicted, some of which required limb amputation, experts said the two explosions could have also compromised the hearing of numerous spectators who have not yet sought medical care.

After the bombing, the Massachusetts Eye and Ear Infirmary released a symptom checklist on its website for those who may have suffered ear damage in Monday's bombing. It recommends that anyone with blood draining from the ears, facial droopiness or weak facial muscles, among other symptoms, seek treatment, as they could possibly have a punctured eardrum.

Dr. Thomas Scalea, the physician-in-chief at the Shock Trauma Center at the University of Maryland Medical System, said people exhibiting symptoms should make an appointment with their primary care physician.

"The safe thing is if you have symptoms, you should be seen. They all [were hit with] concussive force injury," said Scalea, referring to victims of the Boston Marathon bombings.

Scalea also said that those who were knocked over in the blast or briefly knocked out when they fell to the ground could have suffered a mild traumatic brain injury similar to a football player who is knocked out from a tackle.

"It's a milder form, but people get post-concussive syndrome," said Scalea. "That can happen after a single mild brain injury."

Post-concussive syndrome can manifest itself in forgetfulness, inability to retain information or even a change in personality. Scalea emphasized that the symptoms can manifest themselves even in those who didn't suffer severe physical injuries from the initial blast.

"People shouldn't feel embarrassed to seek medical attention because they aren't missing a leg," said Scalea. "It's important to seek medical care for their problems. Untreated, those problems can get complicated as well."

In the days and weeks after a traumatic event, experts caution that survivors could also start showing symptoms of post-traumatic stress disorder as they begin to "process the event" and get back to the their daily lives.

Dr. Joan Anzia, a psychiatrist who specializes in disaster psychology at Northwestern University in Chicago, said that she expected a percentage of survivors near the Boston Marathon bombings to exhibit signs of PTSD.

"It's a betrayal trauma. It disrupts the idea of who you can trust," said Anzia, who said events understood to be an "act of God" tended to be less traumatic.

While there is no way to tell who will develop PTSD, Anzia said that those who disassociated from the attacks in Boston or from the explosion in Texas might have more difficulty in coping with emotions in the future.

"Numbing, shutting down and confusion -- when [those] take over, it can be very disruptive," said Anzia. "If you see people after the event who can't remember what happened or they seem spaced out, it's a warning sign that they may need treatment to recover."

Anzia said it was important for those who are exposed to a frightening or distressing event to retreat to a place of safety and surround themselves with a support system composed of family and friends. She also emphasized that physical symptoms brought on by fear and panic were normal reactions.

"It's normal to feel your heart rate go up. ... You may feel very sad [and] frightened and feel not safe," said Anzia. "Most people will recover with time."