The classification of blast injuries was first described by Zuckerman in 1941 and is still widely used today. This system organizes injuries by the mechanism through which they are sustained and classifies them as primary, secondary, tertiary and quaternary. These injuries may occur in isolation or in combination with each other.
| Category | Mechanism | Typical Injuries |
| Primary | Caused by blast wave of overpressure | Tympanic membrane rupture, blast lung, intestinal hemorrhage and rupture |
| Secondary | Caused by flying debris and shrapnel | Blunt and penetrating traumatic injuries
|
| Tertiary | Due to individual being thrown by blast | Blunt and penetrating traumatic injuries
|
| Quaternary | Thermal, toxic, and asphyxiant effects | Thermal burns, chemical burns, exposure to toxins, asphyxiation
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The term quinary blast injury has also been used to describe delayed effects of explosions, such as infections, radiation exposure, and other toxic exposures.
Author: R. Gentry Wilkerson