Chapter 2.3 Types of injury Flashcards
Trauma-related injury (4) types that you can experince
- Blunt trauma
- Penetrating trauma
- Thermal trauma
- Blast trauma
BLUNT TRAUMA
Common examples; assault, acceleration and de-escalation forces e.g. collisions and falls
- The more force the greater the damage
- More distance of energy transfer the more likely a diminish the extent of injury may occur.
Falls
- principles & considerations
- types of injury
- how it happened
- surface?
Principles; acceleration and de-escalation forces & Newton’s laws of motion
- When the patient falls and collides with the ground this is WHEN transfer of energy occurs.
*Point of impact is the MAJOR point of transfer e.g. head, hip, arm. What took the force?
*Type of surface. Carpet and grass help to absorb the energy better than concrete or tiles.
*Bone is less flexible than soft tissue
- air-filled organs may rupture
- solid organs may fracture
- if a person is pushed or knocked over the ACCELARTION increases, causing additional transfer of energy = greater impact.
What is a significant injury in a pead?
occurs @ x3 of the childs height
MVA ; impacts
1st - when the vehicle collides with the object
2nd - after the initial impact. The occupants continue to move in original direction until they collide with the interior of the vehicle
3rd - when the internal structures collide with the body cavity. the organs meet resistance from the structures that encapsulate them.
How do we work out the survivability of an accident?
Determine the velocity and stopping distance.
What to think about when determining injuries from an MVA?
- rate
- stopping distance
- deployment of safety mechamuims
What to think about when determining injuries from an MVA?
- rate
- stopping distance
- deployment of safety mechanisms
What to think about when determining injuries from an MVA?
- rate
- stopping distance
- deployment of safety mechanisms
AIRBAGS - things to note
Chemicals used to preserve and deploy airbags can cause corneal abrasions and minor skin burns. this is due to rapid inflation.
*Thus, eye injuries may result and are a particular concern for patients wearing glasses.
Mechanisms of injury and potential injury patterns in MVCs
(7)
- Up & Over pathway - when the head and chest lead the way over the steering wheel.
- Down and under the pathway - under the steering wheel. Pelvis, tib/fib and knee. can occur when the seatbelt is secured ABOVE the pelvis.
- Lateral (T-bone). Shoulder, elbow and pelvis. Closer to injury high risk. Can also cause sheer injury e.g AAA
- Rotational. When struck and then struck again and turned around.
- Rear. can be similar to frontal as thrown into the front of the car
- Rollover - can cause all of the injury patterns mentioned
- Ejection - can cause all of the injury patterns mentioned
What is the most serious point of an ejection MVA
Increases the likely hood of a fatality
Motorcycle accidents or other motorized vehicles: what kinda of injury.
- low side
- high side
- head on
- lateral
- Low side crash; abrasions, shoulder, clavicle, lateral head and clavicle injuries.
- A high-side crash; injuries included in low plus conditions of the surface and speed.
- Head on; handle bars = femur and pelvis injuries. Then head, neck, chest and extremities.
- Lateral or angular; crush injuries, shoulder, head
Vechile vs pedestrian
- adult & pead
Catapulted onto the hood / and or windshield.
Peads - thrown from the vehicle or under the vehicle due to size
Penetrating trauma - define
Any foreign object that enters through the skin barrier is considered penetrating.
Involved the victim’s internal organs, causing hemodynamic instability (shock) and increased risk of infection.
Organs involved in penetrating trauma
Small bowel (50%)
Large bowel (40%)
Liver (30%)
Intra-abdominal vascular system (25%)
Bullet related considerations
KE = Mv2 /2.
Kinetic energy = KE
projectile mass = m
bullet velocity = v
*Bullets travel at their fastest when leaving the muzzle of a firearm. They are slowed by the effect of drag when they enter the air.
bullets - deviation and direction
Direction = rotational axis
Deviation = Yaw (wobble)
Full metal jacket bullet
Full metal jacket - Made of heavy metal that covers the bullet from base to tip
e.g assault rifles
Cause - minimal tissue deformation on impact. “snow storm” pattern on xray
Types of bullets (4)
- full metal jacket
- soft nose
- hollow point
- frangible
Soft nose bullet
Non-jacketed
The impact is designed to expand on impact. although they are designed to expand they are less likely to penetrate through the body.
Hollow nosed bullet
They have a hollow cavity in the tip and jacket and are designed to produce maximal energy transfer on impact, they are forced back once entering
“mushroom effect”
Used by police and hunters
Frangible bullets
deigned to break apart they impact a surface harder than the bullet.
Causes multiple fragment paths.
Cavitation (from a bullet)
- AIR FILLED + SOLID & Taking force
As indicated by the KE equation. increased velocity of a projectile causes more damage than increases mass.
Thus a bullet passes through the skin at high pressure causing a cavity
*Air-filled organs e.g. lungs and stomach are elastic and can thus tolerate high-velocity cavitation relatively.
- Solid organs e.g. liver, kidney will shear.
