2) MOI Flashcards
MOI:
Energy:
Inertia:
= mech of injury how the injury happened
= Ability to do work
= law of Inertia (Newton’s 1st law) helps explain how objects in motion behave
Newton’ s 1st law:
Newtons 2nd Law:
= (inertia): body in motion will stay in motion unless acted upon an outside force “Body at rest will remain at rest unless acted upon upside force”
= “law forces at work stay in work during collision”
Kinetic energy:
Kinetic Energy form:
=energy of a object in motion (by objects mass & its velocity
= (Mass x Velocity ^2)/ 2 ½ x mv^2
Force:
Force formula:
= force related to a objects mass(weight) and/or achange in velocity
= mass x Acceleration
Biomechanic of trauma:
Occur w/ 2 forms:
= manner in which energy exchange damages human tissue
= blunt or penetrating
Faster and/or mass relation to energy:
Cavitation’s relation to speed:
Energy exchange Study of:
= more deceleration > more transfer of energy
= Faster object greater cavitation
= “kinetics of energy compact”
Forces of Blunt trauma:
Compression, Shear, Stretch
Compression blunt trauma:
Hematoma:
Contusion:
Ecchymosis:
= impact abruptly stops body part while inertia continues (hit by bat)
= artery bleed under area
= bruise cap bleed
= discoloration ID contusion
Stretch blunt trauma:
Sciwora:
= Tendons & Fibers that (tendons stronger) hold organs & other structures together are pulled & injured or torn
= spinal cord injury with out r a (kids in wreck overstretching neck)
Shear blunt trauma:
Axons shearing:
= injury occurs along edges of impacting force or at organ attachments (sudden acceleration) (liver ligament teres cuts liver) (arteriosus ligament shears middle of aorta (ductus oreriosis)
= concussion diffuse axonal injury DAI (changed pep b/c DAI)
MVC) Types of impacts:
Most common impact:
Most deadly impact:
commonly most benign impact:
= Frontal, Lateral, Oblique, Roll over, Rear
= Frontal
= Lateral (b/c less crumble zone & Seat belts offer lil protection)
= Rear
MVC) Phase 1:
Phase 2:
Phase 3:
Phase 4:
Phase 5:
= Vehicle collision (P1) deceleration
= Body collision (P2) decel/ of occupant
= Organ collision (P3) decel of internal
= 2ndary collision (P4) objects in car
= (P5) car rear end, trees,
Seat belts:
Maternal relation w/ seat belts:
Cullen’s sign:
Most common organ injuries:
SRS:
= vehicle restraints, reduced # of collision related deaths
= US #1 maternal death, hips/pelvis not ABDMN
= internal bleed abdominally
= Spleen adults Liver kids
= supplemental Restraint Systems (SRS) 1st used for front impacts, airbag inflation to cushion energy
Impact notes:
> 12inch intrusion could be critical injuries & Hybrids can electrocute
Frontal car impact:
(FCI) Restrained pathway:
(FCI) Unrestrained pathway:
= most common, Spider windshield, Pneumo b/c paper bag syndrome
= fold over, chest/ABDMN, <injuries
= Up & Over, down & under, ejection (most injuries)
Rear Car impact:
(RCI) common injuries:
= read-end, commonly most benign
= Whip lash, common C-Spine injuries
Lateral Car Impact:
more deadly impact b/c:
(LCI) body pathway & injurie:
= hit from side aka T-bone(most dealy b/c less crumble zone)
= Seat belts offer lil protection
= Coupe-Countre-Coupe injury > neck/head toward impact & body w/ impact
Oblique Car Impact:
= occurs when lateral impact is off center aka “spin/rotating”
Roll Over Car Impact:
(ROCI) injuries:
= car is flipping (high critical “drying machine”)
= Multiple impacts from hitting each part of car w/ each 1/4 rotation
Blunt T. to head & neck mortality% & w/ MVC:
= 85% mortality (Focus head neck chest abdomen)
(Blood vol/ loss) Pelvis:
Femur:
Humorous:
= 2-3Liters
= 1.5Liters per femur
= 750ml per humorous
Motorcycles often serious trauma b/c:
Frontal Moto/ pathway & Injuries:
Angular Moto/ pathway & Injuries:
Sliding Moto/ pathway & Injuries:
Ejection Moto/ pathway & Injuries:
= rider tends to absorb much of crash injuries (lots of heads injuries
= most common front dips propelling rider & handlebars catch lower
= “side swipe or lateral” impact w/ guard rails Mostly ortho-injuries
= < chances of ejections) more rashes & “most safe”
= very common, usually more serious injuries Initial Biker then Ground
Removing moto helmets:
Paramedic remove that helmet!!! For A&B,
Remove if Helmet isn’t snug &/or bad integrity
Contra: impaled through helmet & skull
AUTOPED) 1st impact:
2nd impact:
3rd impact:
Off-road injuries:
Kids Waddell’s triad:
= auto strikes body
= pedestrian thrown
= body strikes ground or object
= pop increased, usually remote areas, offer less protection,
= turn toward bumper b/c stupid, bumper hits kids pelvis & femur, chest & ABDMN hit grill, head strikes ground b/c buckethead
Falls:
Examine:
Axial loading:
FOOSH (Fall onto an outstretched hand)
Colles’ fracture:
Smith’s fracture: out
>20ft greater risk of
Aortic anyrusem to tear:
= most common blunt trauma, risk increase w/ age, sig fall 2-3x height
= height, position, surface PT landed on, physical condition of PT
= loading on axial skelton via falling (E starts heel to lumber)
= influxing wrist fractures from fall impact
= efflucing wrist fractures from fall impact “Palm out”
= internal organ damage
= pain tearing to chest shoulders back
= tearing pain from chest goes to back
Blast injuries:
Conventional bomb:
Dirty bomb:
= Effects pulmonary system significantly
= most common >Pipe bombs, fireworks, ect
= Conventional bomb w/ reactive material
Blast phases) Primary:
2ndary: flying debris hitting you
Tertiary: thrown off of feet onto something
Quaternary: misc event: tree falls on you, radioactive (dirty bomb)
Isolated blast injury:
Contra blast injury:
Underwater blasts:
= Primary: decompression of lungs
= flying debris hitting you
= thrown off of feet onto something/ground
= misc event: tree falls on you or radioactive injury(dirty bomb)
= injury same side of impact
= opposite side of impact
= enhances injury/death w/ pressure wave
Crush injuries w/ compartment syndrome occur IRL & per book:
Hyperkalemia sign:
Crush/Hyperkalemia sign:
Crush injury:
= ~ >3hrs & 4Hrs per book
= (T wave>10boxes/mountain hyperkalemia)
= Calcium-Chloride to “fool cell” then Sodium bi-carb 50mEq or 20mg Albuterol 15LPM
= Major compression of tissue causing them to open up, (releases K & acid)
Compartment syndrome:
extrems contain M.s & swelling inside self (usually benign injury but body reacts extreme) (infection)
Compartment syndrome 6 Ps) 1st
2nd
3rd
4th
5th
6th
1= Pain (always 1st) seems exaggerated from story
2= Pallor (lacking blood flow)
3= Paralysis Efferent N-Fibers damaged
4= Paresthesia afferent N-fibers pushed
5= Pressures (BP < & palpable pressure w/ palpation)
6= Pulses (dim/ gone)
Penetrating trauma:
Perforating trauma:
(3lvls of Penetrating trauma) 1st Lvl:
2nd Lvl:
3rd Lvl:
Ballistics:
Factors of bullet speed/damage:
Trajectory:
Cavitation:
Profile:
= object pierces the skin and enters the body
= object pierces through & through body
= Low velocity: knifes, swords, ect
= Medium: handguns
= High-velocity: Rifles
= study of projectiles in motion & effects on objects
= Trajectory, Drag, Cavitation, Velocity, Profile, Shape:
= curved path bullet follows after fired from a gun
= Outward motion of cavity due to projectiles speed & vacuums
= cross-section of bullet along its direction of travel
Large Vessels:
Solid Organs injuries:
Scaphoid:
Evisceration Treat:
Hallow Organs injuries:
= Carotid ex/Internal, Aorta
= vascular, Liver(lig/ teres), spleen, kidneys, pancreas, & brain
= diaphram to L
= wet dressing & wet gloves
= spill contents out usually> GI, lungs, less bleeding but more likely to get infected, compress & rebound or explode
% of all Trauma deaths:
% of GSW account for HT death:
%s of penetrating neck trauma:
%s of penetrating chest trauma are fatal:
% of great vessels injuries & due to:
minimal diameter for sucking chest wound
= 50% of all Trauma deaths is head trauma
= 35% GSW account for Head Trauma deaths
= 5-10% penetrating neck trauma (airway & neuro
= 70-80% penetrating chest fatal
= 90% all great vessels injuries due to a penetrating MOI
= At least ¾inch for penetrating Chest wounds to turn sucking
Permissive hypotensive IV therapy:
just enough fluid to get pulse used in bleeding cant control
ABDOMEN/Pelvic expanding means
massive hemorrhage can’t control
Cardiac arrhythmias and kidney damage can occur w/ crush injuries due to:
Buildup of toxins in the crushed limb
“Laying the bike down” results in
the bike absorbing much of the energy
Form/ “(mass x velocity squared)/2” equals:
Study of processes that bring forces upon human body:
When sig/ kinetic energy is applied to human anatomy:
Objects in motion & E. exchanges w/ collision:
= Kinetic energy
= Kinetics of impact
= Trauma
= Kinetics
Frontal impact MVC rarity:
Pathways of travel w/ MVC frontal impact are:
Rear-impact MVC injuries:
= most common type of impact in MVCs
= Down & under or Up & Over
= commonly limited/benign especially w/ Headrest position properly
PT involved in a frontal impact collision w/ their car hit a tree & PT was ejected from vehicle; something sig/ to remember when assessing PT:
Ejected victims experience two impacts
name of injury occurs as blunt impact abruptly halts part of the body while inertia causes the remaining anatomy to continue its motion.
= Compression blunt trauma injury
The most common & serious trauma associated w/ explosions is:
The most lethal explosions are those: That cause structural collapse
= Pulmonary injury
= That cause structural collapse
Recreating incident from evidence @ the scene will help determine:
Mental summation of anticipated injuries based on your analysis is:
= Mechanism of injury
= Index of suspicion
An injury process frequently associated with steering column impact is the “paper bag” syndrome in which the:
Driver takes a deep breath in anticipation of the collision, and lung tissue ruptures when the chest impacts the steering wheel
Child carriers should be secured in back seat b/c:
AutoPeds collision adults vs children:
= airbag inflation may push carrier into seat thus serious injury/death
= Adults tend to turn away from vehicle & children turn toward it
When a vehicle occupant strikes the vehicle’s interior, it is called a(n):
what type of trauma is when kinetic energy force, but not the object, enters the body & damages tissues:
= Body collision
= Blunt force trauma
w/ seat belts In very strong impacts, a shoulder strap may induce
chest contusions and rib fractures
Kinetics is the branch of physics dealing w/:
2 basic principles of kinetics are:
Kinematics is the branch of physics that studies:
= objects in motion & energy exchanges that occur colliding
= the law of inertia and the law of energy conservation
= “mechanics” motion of a body/system of bodies w/o consideration given to its mass or forces acting on it.
2 basic principles of kinetics are:
The law of energy conservation states that:
= Laws of energy conservation & Inertia
= Energy can neither be created or destroyed.
(Newtons laws) inertia) 1st part of 1st law
2nd Part of 1st Law:
The law of energy conservation states:
= “body stays in motion unless acted upon by an outside force.”
= “body remains in rest unless acted upon by an outside force.”
= “Energy can neither be created nor destroyed. It can only be changed from 1 form to another.” EX In an auto crash, the changing of energy from one form to another is what deforms the auto and can cause injury to the occupants
(Newtons laws) inertia) 2nd law:
force formula is summarized as:
= force is related to object’s mass (weight) & rate of its change in velocity (speed)
= Force=Mass (weight)×Acceleration (or deceleration)2
Kinetic energy:
kinetic energy formula:
Increasing mass vs. velocity directly increases what:
= energy of an object in motion (Fn. of object’s mass & its velocity)
= Kinetic energy=Mass(weight)×Velocity(speed)22
= kinetic energy > +velocity exponentially increases kinetic energy
Air bag inflation can also cause injuries:
nasal fractures, minor facial lacs, & bruises w/ small stature pep/s seated very close to steering wheel (<12Ins), or dashboard (<18Ins)
In northern waters, temps can also rapidly cause hypothermia bc:
Water draws heat from the body about 20x faster than air does
(Fall) Heart held by:
heart injured b/c:
exsanguination:
= heart is held in center of thorax by the aorta, venae cavae, & ligamentum arteriosum.
= w/ sig/ falls the heart is pulled downward w/ such force that it can tear aorta away
= draining of blood severe enough to cause death)
MOI:
mech of injury how the injury happened