Ch25: Trauma Overview Flashcards
index of suspicion
awareness that unseen life-threatening injuries may exist
work
force applied over a distance
w = fd
kinetic energy
energy of a moving object
KE = 1/2mv^2
where is the kinetic energy of a moving vehicle transferred to in a motor vehicle crash?
the work of stopping that vehicle, e.g. damage to the frontal part
does mass or velocity of an object have a greater impact on the injury to a person?
velocity!! as v is squared in the KE equation
potential energy
energy of a fall e.g. gravitational`
newton’s first law of motion
objects at rest will stay in rest and objects in motion will stay in motion until there is an external force applied
newton’s second law
f = ma
force is highly dependent on acceleration = how fast a vehicle comes to a stop
the quicker the deceleration, the higher the force on the person
how do seatbelts and airbags work according to newton’s second law
they slow down the acceleration rate, generating less force on the person
multisystem trauma
trauma that affects multiple body systems
you should maintain a high index of suspicion for _____ injuries in blunt trauma patient
internal
types of motor vehicle crashes
head-on
rear-end
T-bone
rotational (spins)
rollover
3 types of collisions experienced in every vehicle crash
- collision between car and external object e.g. tree
- collision between passenger and car
- collision of passenger’s internal organs against skeletal structure
coup-contrecoup injury
force or contusion caused by impact of the brain inside the skull on the other side of original impact
be careful of ____ during rapid extrication if you observe that the airbags have not inflated in a vehicle crash
airbag deployment
possible contact points and injuries in a head-on collision
face & head strike the windshield
–> head or spinal cord injury
chest or abdomen hit the steering wheel
knees hitting dashboard
–> energy transfer to pelvis causing hip fracture or dislocation
whiplash
injury to the neck that happens because of the neck bending forcibly forward and then backward, or vice versa. usually happens during a rear-end accident
passengers only wearing a lap seatbelt have a greater risk of injury in the ____ and ____ spine
thoracic and lumbar
why are rollover/rotational crashes so dangerous?
rolling over increases risk of second and third collision
most common life-threatening event in rollover crashes
when the person is ejected from the vehicle
4 types of motorcycle crashes
head-on
angular
ejection
controlled
what is considered a significant MOI for a child who has fallen?
3m or 2-3 times their height
children often land on their head when they fall. why is this?
they are top-heavy
what is considered a significant MOI for a child in a car crash?
> 25 mph or 40 kph
what is considered a significant MOI for an adult who has fallen?
20 feet, 6m
cavitation
speed from a bullet in the body generates pressure waves that affect organs at a distance
permanent cavitation
the actual bullet trajectory
temporary cavitation
caused by the stretching of tissues due to pressure change
what kinds of tissues are better at tolerating stretch
high-elasticity tissue like muscle vs. low-elasticity tissue like liver
what index of suspicion should you have for neck trauma
spinal injury
FBAO
airway compromise
vascular trauma - e.g. carotid arteries (major bleeding)
what index of suspicion should you have for chest trauma
broken ribs (RESP COMPROMISE)
pneumothorax
hemothorax
tension pneumothorax
pneumohemothorax
cardiac/pulmonary contusion
what index of suspicion should you have for any trauma from vehicle accidents
spinal injury
brain injury, contusion and bleeding
ICP
chest trauma and injury
abdomen trauma
knee trauma –> transfer of energy to pelvis injury
what index of suspicion should you have for any trauma from fall accidents
spinal column injury (bones)
spinal cord injury (nervous)
calcaneous injury
primary blast injury
caused by blast wave itself
secondary blast injury
caused by flying objects like missile or shrapnels being propelled by blast force
tertiary blast injury
caused by impact with another object
quarternary blast injury
injuries of other causes such as toxic inhalation, burns
what organs are most affected by a blast wave
hollow organs
tympanic membrane
EARDRUM!
thin semitransparent membrane in ear
under what condition should you NOT give a patient supplemental oxygen to prevent worsening of pneumothorax
no positive pressure ventilation
3 Priorities of Pre-Hospital Trauma Care
- Hemorrhage: direct pressure –> tourniquet
- Airway & breathing + spinal immobilization
- Shock therapy: keep patient warm
what is the RTS score
Scale to evaluate head trauma
Revised Trauma Score
1. GCS Score
2. Systolic BP
3. RR
what is the ACS-COT
American College of Surgeons - Committee on Trauma
