Chapter 24-Trauma

Question 1

define index of suspicion

Answer 1

an awareness and concern for potentially serious underlying and unseen injuries

Question 2

What is trauma/when does it occur?

Answer 2

It occurs when tissue is exposed to levels of energy higher than what it can withstand

Question 3

What are the three types of energy that can be associated with injuries?

Answer 3

kinetic, potential, and work

Question 4

What is work?

Answer 4

Force applied over a certain distance

Question 5

What is kinetic energy?

Answer 5

Energy possessed by a moving object

Question 6

______ energy becomes _____ during a motor vehicle crash

Answer 6

Kinetic energy –> work of stopping the vehicle and passengers

Question 7

What has a larger impact on the damage caused by a moving object? Its mass or speed?

Answer 7

Speed

Question 8

Define blunt trauma

Answer 8

Trauma that results from an object making contact with the body

Question 9

What are the two most common causes of blunt trauma?

Answer 9

Motor vehicle crashes and falls

Question 10

What are the different types of motor vehicle crashes?

Answer 10

Frontal, rear-end, lateral, spin, and rollover

Question 11

What are the three crashes associated with motor vehicle crashes?

Answer 11

Vehicle with exterior object, passenger with vehicle interior, and organs colliding with rigid body structures such as bones

Question 12

What are some things associated with the first type of collision that should raise your index of suspicion?

Answer 12

Crushed vehicle exterior, intrusion into the passenger compartment, seats torn from their mounts, and collapsed steering wheel

Question 13

What are common injuries resulting from the second type of collision?

Answer 13

Head trauma, lower extremity fractures, and broken ribs

Question 14

What are some examples of injuries resulting from the third type of collision?

Answer 14

Brain colliding with skull, heart colliding with sternum

Question 15

What are some things to look for with frontal crashes?

Answer 15

Whether passengers were wearing their seat belts, whether the airbag deployed, whether the seat belts caused pelvic or abdominal injuries

Question 16

What is a common result of rear-end crashes?

Answer 16

Whiplash, causing c-spine damage

Question 17

What are common injuries associated with lateral crashes?

Answer 17

Lateral whiplash of head, shoulders, thorax, and upper extremities towards side of impact, fractures in lower extremities, pelvis, and ribs, and lateral injuries to chest and abdomen

Question 18

What is the most serious MOI associated with rollover crashes?

Answer 18

ejection

Question 19

Instead of identifying all entry and exit wounds associated with penetrating trauma, what should you focus on?

Answer 19

How many penetrations there are and the length of the penetrating object(s)

Question 20

What’s the problem with frangible bullets?

Answer 20

They’re designed to fragment into many pieces upon impact with the body, which increases the damage

Question 21

What is cavitation?

Answer 21

When the speed of a bullet causes it to generate pressure waves that have a ripple effect throughout the body and cause damage to tissue far from the trajectory of the bullet

Question 22

Which is often worse, entry or exit bullet wounds?

Answer 22

Exit, because of cavitation

Question 23

What is a key piece of information you should obtain regarding penetrating wounds/GSWs?

Answer 23

The type of weapon used

Question 24

What are your priorities in cases with multi-system trauma?

Answer 24

• Your safety
• Call additional help
• MOI
• c-spine
• ABCs
• shock treatment/bleeding
• Limit on-scene time to 10 min

Question 25

What features does a Level I trauma center have?

Answer 25

• 24-hour coverage by general surgeons
• Care in specialties
• Cardiac, hand, pediatric, and microvascular surgery
• Prevention, public education, cont. edu.
• Quality assessment
• Research

Question 26

What features does a Level II trauma center have?

Answer 26

• 24-hour coverage by general surgeons
• Care in specialties
• Prevention, public education, cont. edu.
• Quality assessment

Question 27

What are features of a Level III trauma center?

Answer 27

• 24-hour coverage by physicians and availability of general surgeons
• Transfer agreements with Levels I & II centers
• Quality assessment
• Prevention, public education, cont. edu.

Question 28

What are features of a Level IV trauma center?

Answer 28

• Basic emergency department coverage and 24-hour lab coverage
• Agreements for transfers
• Quality assessment
• Prevention, public education, cont. edu.