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From the US Department of Veterans Affairs, James A. Haley Veterans' Hospital in Tampa, Fla, and the Defense and Veterans Brain Injury Center (formerly the Defense and Veterans Head Injury Program) in Tampa; also the University of South Florida in Tampa, Departments of Internal Medicine (Scott, Scholten), Psychiatry (Vanderploeg), and Psychology (Belanger,Vanderploeg).

Address correspondence to Heather Belanger, PhD, James A. Haley Veterans' Hospital, Physical Medicine and Rehabilitation–117, 13000 Bruce B. Downs Blvd, Tampa, FL 33612-4745. E-mail: Heather.Belanger{at}va.gov

Civilians and military personnel alike are increasingly being exposed to explosives in war zones and other regions of political conflict and, consequently, they are suffering associated blast-related polytrauma (multiple complex injuries). Although acute, emergency-based medical care for patients with blast-related trauma has been well described, postacute clinical management—which is of greatest interest to primary care physicians and rehabilitation specialists—has not been well discussed or researched. The authors offer a description of the common injuries seen in patients with blast-related polytrauma, as well as a conceptual model of a potential evaluation and treatment strategy in the postacute setting. Although medical evaluation of a patient typically proceeds in a sequential manner based on primary symptoms, the authors advocate a parallel approach to patient evaluation based on mechanism (cause) of injury. Such an approach relies on knowledge of the typical physical and psychological sequelae associated with a particular mechanism of injury to guide patient assessment and treatment. The authors highlight the mechanism-of-injury approach used with patients who have blast-related polytrauma at the Veterans Health Administration's (VHA) Veterans Affairs Medical Center in Tampa, Fla, site of one of the VHA's four Polytrauma Rehabilitation Centers.