Cinematics

Question 1

Introduction

• Importance of kinematics (2)
• Two physics laws

Answer 1

• Kinematics in trauma is like anamnesia in diseases-it allows us to estimate the extent of damage.
• Always rely on kinematic. Sometimes the least severe looking victims are the worst.

1) No energy is wasted.
2) m(kg)/2*v2(meter per second)=energy (joules)

Question 2

Car Accident-Types of accidents and stereotypical trauma (4)

Answer 2

1. Flip (all types possible)
2. Head-on
   - Upper path (head, neck, chest)
   - Lower path (legs, hip)
3. Side
   - Energy is higher (minimal shock absorption-all upper body at risk)
4. Back
   - Whiplash (neck and spine)

Question 3

Additional damage factors

3

Answer 3

1) Seatbelt
- Chest and stomach (check for bruising)

2)Loose objects
Unanchored objects in car (e.g. briefcase, mugs etc) can cause a lot of damage when thrown around.

3) Airbag
- If not seat belted, head and chest can be damaged.
- If airbag is too high, trauma victim can be suffocated.

Question 4

Additional victims

• Motorcycle (2)
• Pedestrian (2)

Answer 4

Motorcycle

• Minimal protection
• Upper/Lower path, slide on side (leg damage)

Pedestrian

• Most dangerous (no protection)
• Adult vs Child
  
  1. Reaction
  2. Place of impact
  3. Path of projection

Question 5

Types of injuries and causes

3

Answer 5

There are three types of injuries:

1. Broken bones
2. Torn muscle or internal organ
3. Damaged blood vessels

There are three possible causes for trauma injuries:
1.Dull
-Hard to diagnose and treat. 
2.Penetrating
-Easier to treat but not always 
diagnosable (e.g. bullets) 
3.Blast wave
-Unique kinematics

Question 6

Blast wave kinematics

• Damage stages (4)
• Injuries

Answer 6

Damage stages:

1) Blast
2) Objects impact (rubble, shrapnel)
3) Impact into objects (floor, wall)
4) Inhalation if smoke or chemical gases

Injuries:

1) Ruptured organs and blood vessels, severed limbs, broken bones.
2) Penetrating injuries.
3) Dull injuries from impact on floor or wall.
4) Burns/asphyxiation.

Question 7

Falling traumas

Answer 7

Factors:

• Hight (3 meters/ 3x hight of victim)
• Surface of impact
• Initial impact location (Adult-chest, Child-head)
• Obstructions in path of descent

Question 8

Crush Injuries

• Pressure injuries and treatment (2)
• Important factors (3)

Answer 8

Injuries:
1)Compartment syndrome
(Pressure causes build up of blood within muscle membrane, loss of perfusion, muscle death)
5 P’s:
-Pain, Paralysis, Paresthesia, Pulselessness, Pallor

Treatment:

• Fixate hand level with heart (improve perfusion)
• Oxygen

2)Crush syndrome
(Pressure causes release of toxins (metabolic acidosis) and other molecules (myoglobin) that can kill a person very quickly if released into blood stream (acidosis, potassium) and also cause kidney failure (myoglobin))

Treatment:

• Before 15 minutes release pressure and treat
• After 15 minutes leave pressure and call ICU

Factors:
-Place,Time of pressure, Force of pressure

Question 9

Shard Injuries

Important factors (3)
Treatment (4)

Answer 9

Factors:
-Speed, Place, Amount

Treatment:

• Pay close attention to chest! (asherman if necessary)
• Expose entire body
• Fixate large projectiles (as in knife wounds)
• Do not remove shards!