2-2 Military Acute Care & Cause of Injury

Question 1

Describe scene management approach

Answer 1

This is an all inclusive approach to the management of military casualties that aims to take into consideration the identification and elimination of all matters relating to any incident

Question 2

Describe casualty management

Answer 2

• S-A-F-E
• Quick history/look
• Cat haem
• Airway
• Breathing
• Circulation
• Disability
• Environment and exposure

Question 3

Explain timing of trauma death

Answer 3

• Instantaneous - 0-10mins
• Early - 2hrs
• Late days - later

Question 4

Define

Answer 4

SAFE - Send for help, Assess for further danger, Find and free the casualty rom the danger if there is a risk to life or remove the danger from the casualty, Evaluate the casualties (triage, traps)

CSCATTT - Command and control, Safety, Comms, Assessment, Triage, Treatment, Transport

ATMIST - Age, Time of injury/time on scene, MOI, Injuries sustained, signs and symptoms (AVPU, resp rate, pulse, pupils), Treatment so far

METHANE - My c/s, Exact location, Type of incident, Hazards, Access, Number & severity of casualties, Emergency services present or required

Question 5

Describe a 9liner

Answer 5

A 9liner provides the information needed to request CASEVAC. A MIST report is given at handover between each successive level of care.

Question 6

What are the stages of impact in an RTC?

Answer 6

1. The vehicle collides with another object or vehicle
2. The unrestrained occupant collides with eh inside of the vehicle
3. The occupants internal organs collide with each other or the wall. The cavity that contains them

Question 7

Describe a frontal or head on impact

Answer 7

An unrestrained occupant will follow one of two paths. Down and under or up and over

Question 8

Explain whiplash

Answer 8

A low headrest can act as a pivot point causing whiplash when a vehicle is hit from the rear. A head on collision can result in the occupants head hitting the windscreen. If the windscreen is damaged then assume a C spine injury.

Question 9

Describe the pathophysiology of missile injury

Answer 9

A missile is any object propelled forward by and external force. Primary missiles originates from the source of the energy such as bullets. Secondary missiles are particles picked up by the blast wave or the passage of the primary missile.

Question 10

Explain factors Affecting missile flight

Answer 10

• Size
• Shape
• Weight
• Velocity
• Oscillation
• Cavitation

Question 11

Describe kinetic energy transfer

Answer 11

• Low energy transfer wounds
• Medium energy transfer wounds
• High energy transfer wounds
• Permanent cavitation
• Temporary cavitation

Question 12

Describe the effects of blast injuries

Answer 12

Primary - Shockwave
Secondary - Bone fragments and projectiles
Tertiary - blast wind displaces body
Quaternary - Flash burns, physiological sequelae

Question 13

Describe the effects of burns

Answer 13

Can be caused by high temp combustion or secondary ignition of fuel. Weapons designed to inflict burn injury. Can be complicated by inhalation which can take several hours to develop.

Question 14

Describe the effects of crush injury

Answer 14

Damage to muscles cells releasing myoglobin into circulation. Myoglobin blocks renal tubes causing renal failure. Casualty mate require fluid rises prior to release of crush and may require amputation on scene.