Ch25: Trauma Overview

Question 1

index of suspicion

Answer 1

awareness that unseen life-threatening injuries may exist

Question 2

work

Answer 2

force applied over a distance

w = fd

Question 3

kinetic energy

Answer 3

energy of a moving object

KE = 1/2mv^2

Question 4

where is the kinetic energy of a moving vehicle transferred to in a motor vehicle crash?

Answer 4

the work of stopping that vehicle, e.g. damage to the frontal part

Question 5

does mass or velocity of an object have a greater impact on the injury to a person?

Answer 5

velocity!! as v is squared in the KE equation

Question 6

potential energy

Answer 6

energy of a fall e.g. gravitational`

Question 7

newton’s first law of motion

Answer 7

objects at rest will stay in rest and objects in motion will stay in motion until there is an external force applied

Question 8

newton’s second law

Answer 8

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

Question 9

how do seatbelts and airbags work according to newton’s second law

Answer 9

they slow down the acceleration rate, generating less force on the person

Question 10

multisystem trauma

Answer 10

trauma that affects multiple body systems

Question 11

you should maintain a high index of suspicion for _____ injuries in blunt trauma patient

Answer 11

internal

Question 12

types of motor vehicle crashes

Answer 12

head-on
rear-end
T-bone
rotational (spins)
rollover

Question 13

3 types of collisions experienced in every vehicle crash

Answer 13

1. collision between car and external object e.g. tree
2. collision between passenger and car
3. collision of passenger’s internal organs against skeletal structure

Question 14

coup-contrecoup injury

Answer 14

force or contusion caused by impact of the brain inside the skull on the other side of original impact

Question 15

be careful of ____ during rapid extrication if you observe that the airbags have not inflated in a vehicle crash

Answer 15

airbag deployment

Question 16

possible contact points and injuries in a head-on collision

Answer 16

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

Question 17

whiplash

Answer 17

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

Question 18

passengers only wearing a lap seatbelt have a greater risk of injury in the ____ and ____ spine

Answer 18

thoracic and lumbar

Question 19

why are rollover/rotational crashes so dangerous?

Answer 19

rolling over increases risk of second and third collision

Question 19

most common life-threatening event in rollover crashes

Answer 19

when the person is ejected from the vehicle

Question 20

4 types of motorcycle crashes

Answer 20

head-on
angular
ejection
controlled

Question 21

what is considered a significant MOI for a child who has fallen?

Answer 21

3m or 2-3 times their height

Question 22

children often land on their head when they fall. why is this?

Answer 22

they are top-heavy

Question 23

what is considered a significant MOI for a child in a car crash?

Answer 23

> 25 mph or 40 kph

Question 24

what is considered a significant MOI for an adult who has fallen?

Answer 24

20 feet, 6m

Question 25

cavitation

Answer 25

speed from a bullet in the body generates pressure waves that affect organs at a distance

Question 26

permanent cavitation

Answer 26

the actual bullet trajectory

Question 27

temporary cavitation

Answer 27

caused by the stretching of tissues due to pressure change

Question 28

what kinds of tissues are better at tolerating stretch

Answer 28

high-elasticity tissue like muscle vs. low-elasticity tissue like liver

Question 29

what index of suspicion should you have for neck trauma

Answer 29

spinal injury
FBAO
airway compromise
vascular trauma - e.g. carotid arteries (major bleeding)

Question 30

what index of suspicion should you have for chest trauma

Answer 30

broken ribs (RESP COMPROMISE)
pneumothorax
hemothorax
tension pneumothorax
pneumohemothorax
cardiac/pulmonary contusion

Question 31

what index of suspicion should you have for any trauma from vehicle accidents

Answer 31

spinal injury
brain injury, contusion and bleeding
ICP
chest trauma and injury
abdomen trauma
knee trauma –> transfer of energy to pelvis injury

Question 32

what index of suspicion should you have for any trauma from fall accidents

Answer 32

spinal column injury (bones)
spinal cord injury (nervous)
calcaneous injury

Question 33

primary blast injury

Answer 33

caused by blast wave itself

Question 34

secondary blast injury

Answer 34

caused by flying objects like missile or shrapnels being propelled by blast force

Question 35

tertiary blast injury

Answer 35

caused by impact with another object

Question 36

quarternary blast injury

Answer 36

injuries of other causes such as toxic inhalation, burns

Question 37

what organs are most affected by a blast wave

Answer 37

hollow organs

Question 38

tympanic membrane

Answer 38

EARDRUM!
thin semitransparent membrane in ear

Question 39

under what condition should you NOT give a patient supplemental oxygen to prevent worsening of pneumothorax

Answer 39

no positive pressure ventilation

Question 40

3 Priorities of Pre-Hospital Trauma Care

Answer 40

1. Hemorrhage: direct pressure –> tourniquet
2. Airway & breathing + spinal immobilization
3. Shock therapy: keep patient warm

Question 41

what is the RTS score

Answer 41

Scale to evaluate head trauma

Revised Trauma Score
1. GCS Score
2. Systolic BP
3. RR

Question 41

what is the ACS-COT

Answer 41

American College of Surgeons - Committee on Trauma