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Trauma and Trauma Systems > Mechanism of injury > Flashcards

Mechanism of injury Flashcards

1
Q

introduction

A
  • trauma is primary cause of death and disability between ages 1-44 years
  • analyzing a trauma scene is a vital skill
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2
Q

trauma

A

-injury occurs when an external source of energy affects the body beyond its ability to sustain and dissipate the energy

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3
Q

forms of energy

A
  • different forms of energy produce different kinds of trauma
  • mechanical energy
  • chemical energy
  • electrical energy
  • barometric energy
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4
Q

biomechanics

A

Study of physiology and mechanics of living organisms

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5
Q

kinetics

A

Study of the relationship among speed, mass, direction of force, and physical injury caused by these factors

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6
Q

mechanism of injury (MIO)

A
  • physical cause of the injury
  • what happens outside the body
  • assessment of how energy was introduced to the body
  • suggest which organs/systems may be affected
  • can direct assessment and treatment
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7
Q

biomechanics of trauma

A
  • explains the physical results of the MOI

- what happens inside the body

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8
Q

factors affecting types of injury

A
  • Ability of body to disperse energy delivered
  • Force and energy
  • duration and direction
  • position of victim
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9
Q

force and energy: factors affection types of injury

A

− Size of object
− Velocity
− Acceleration or deceleration
− Affected body area

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10
Q

duration and direction: factors affecting types of injury

A

− The larger the area of force dissipation, the more pressure is reduced to a specific spot.

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11
Q

impact resistance

A
  • impact resistance of body parts has a bearing on types of tissue disruption
  • organs that have has inside are easily compressed
  • liquid containing organs are less compressible
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12
Q

understand the effects of forces to help assess the mechanism of injury (MOI)

A
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13
Q

velocity (V)

A

distance per unit of time

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14
Q

acceleration (a)

A

rate of change of velocity

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15
Q

gravity (g)

A

downward acceleration imparted to any object moving toward earth

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16
Q

kinetic energy

A

1/2 (mass x velocity^2)

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17
Q

kinetics

A
  • the KE of a car in motion that stops suddenly must be transformed or applied to another object
  • other factors that will affect energy dissipation in a crash include:
  • vehicles angle of impact
  • differences in sizes of the 2 vehicles
  • restraint status and protective gear of occupants
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18
Q

law of conservation of energy

A

-energy can neither be created nor destroyed

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19
Q

energy dissapation

A
  • process by which KE is transformed into mechanical energy

- protective devices can manipulate the way in which energy is dissipated

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20
Q

newtons first law of motion

A

-a body at rest will remain at rest unless acted on by an outside force

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21
Q

newtons second law of motion

A
  • the force of an object can exert is the product of its mass times its acceleration
  • f= ma
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22
Q

force

A
  • force = mass (weight) x acceleration (or deceleration)

- deceleration and acceleration can be measured in numbers of g force

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23
Q

blunt trauma

A

-injuries in which tissues are not penetrated by external object

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24
Q

motor vehicle crashes

A
  • 5 phases of trauma
  • phase 1- deceleration of the vehicle
  • phase 2- deceleration of occupant
  • phase 3- deceleration of internal organs
  • phase 4- secondary collisions
  • phase 5- additional impacts received by the vehicle
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25
Q

impact patterns: frontal or head on impacts

A
  • front end of the car distorts
  • passengers decelerate at same rate as vehicle
  • abrupt deceleration injuries are produced by a sudden stop of a body forward motion
  • unrestrained occupants usually follow one of 2 trajectories:
  • down and under pathway
  • up and over pathway
26
Q

impact patterns: lateral or side impacts

A
  • impart energy to the near side occupant
  • seat belt offer little protection
  • the body is pushed in 1 direction, while the head moves towards the impacting object
27
Q

-impact patterns: rear impacts

A
  • have the most survivors
  • whiplash injury is common
  • energy is imparted to the front vehicle
28
Q

impact patterns: rotational or quarter panel impacts

A
  • occurs when a lateral crash is off center

- the vehicle forward motion stops, but the side continues in rotational motion

29
Q

impact patterns: rollovers

A
  • patients may be ejected
  • patients may be struck hard against the interior of the vehicle
  • worst scenario bc no protection
30
Q

restrained vs unrestrained occupants

A
  • seat belts stop the motion of an occupant traveling at the same speed as the vehicle
  • associated injuries include cervical fractures and neck sprains
31
Q

air bags

A
  • have reportedly reduced deaths in direct frontal crashes by about 30%
  • can also result in secondary injuries:
  • direct contact
  • chemicals
32
Q

motorcycle crashes

A
  • any structural protection afforded to victims is derived from protective devices worn by the rider
  • helmet
  • leather or abrasion resistant clothing
  • boots
  • attention should be given to:
  • deformity of motorcycle
  • side damaged
  • distance of skid
  • deformity of objects or vehicles
  • helmet deformity
33
Q

four types of motorcycle impact

A
  • head on impact
  • angular impact
  • ejected
  • laying the bike down
34
Q

when helmet should be removed

A
  • helmet should be removed carefully if:
  • airway management techniques cannot be performed with the helmet in place
  • helmet should be cut if it cannot be removed without further deformation
35
Q

3 predominant MOIs for pedestrains

A
  • 1st impact- auto strikes body with its bumpers
  • 2nd impact- adult is thrown on hood and/or grille of vehicle
  • 3rd impact- body strike the ground or some other object
36
Q

waddell triad

A
  • pattern of injuries in children and people of short stature
  • bumper hits pelvis and femur
  • chest and abdomen hit grille
  • head strikes vehicle and ground
  • more likely to go under, hit head on ground, or hit grille
37
Q

falls from heights

A
  • severity of injuries impacted by:
  • height
  • position
  • surface
  • physical condition
38
Q

penetrating trauma

A
  • involves disruption of skin and tissues in a focused area
  • low velocity- caused by sharp edges
  • medium and high velocity- object might flatten out, tumble, or ricochet
  • middle- handgun
  • high- riffle
39
Q

most common penetrating injury

A

-caused by firearms

40
Q

stab wounds

A
  • severity depends on:
  • anatomic area involved
  • depth of penetration
  • blade length
  • angle of penetration
41
Q

gunshot wounds

A
  • the most important factor for seriousness of wound is type of tissue involved
  • entry wound is characterized by the effects of the initial contact and implosion
  • severity depends on:
  • type of firearm
  • velocity of projectile
  • physical design/size of projectile
  • distance of victim from muzzle
  • type of tissue struck
42
Q

handgun wounds

A
  • revolver holds 6-10 rounds of ammunition
  • pistol holds up to 17 rounds of ammunition
  • accuracy is limited
43
Q

shotguns

A
  • fire round pellets

- shallower

44
Q

rifles wounds

A
  • fire single projectile at a very high velocity
  • impart a spin for accuracy
  • longer barrel = more accurate
  • can go further into the body
  • high velocity
45
Q

deformation/tissue destruction: gunshot wounds

A
  • deformation/tissue destruction is based on:
  • density
  • compressibility
  • missile velocity
  • missile fragmentation
46
Q

projectile creates a permanent cavity

A

-may be straight line or irregular pathway

47
Q

pathway expansion

A

-tissue displacement that results from low displacement sonic pressure

48
Q

missile fragmentation

A

-projectile sends off fragments that create paths through tissues

49
Q

exit wounds

A
  • exit wounds occur when projectile energy is not entirely dissipated
  • size depends on energy dissipated and degree of cavitation
  • exit wound is larger, can be burns, more surface area
50
Q

wounding potential

A
  • wounding potential depends on:
  • powder charge
  • size and number of pellets
  • dispersion of the pellets
  • range at which the weapon was fired
  • barrel length (long = more accuracy)
  • type of choke at the end of the barrel
  • shorter barrel -> more dispersion
51
Q

when assessing gunshot wounds

A
  • obtain weapon used, range fired, bullet used
  • look for powder residue around the wound
  • entrance and exit wounds
52
Q

primary blast injuries

A
  • damage is caused by pressure wave generated by explosion
  • close proximity to the origin of the pressure wave carries a high risk of injury or death
  • can rupture membranes and affect organs
53
Q

-secondary blast injuries

A
  • result from being struck by flying debris
  • a blast wind occurs
  • flying debris may cause blunt and penetration injuries
  • most common
  • b
54
Q

tertiary blast injuries

A
  • occur when a person is hurled against stationary, rigid objects
  • ground shock
  • amputations, broken bones, penetrations
55
Q

ground shock

A

-physical displacement when the body impacts the ground

56
Q

quaternary blast injury

A
  • occur from the miscellaneous events that occur during an explosion
  • may include:
  • burns
  • respiratory injury
  • crush injury
  • entrapment
57
Q

quinary blast injuries

A
  • caused by biologic, chemical, or radioactive contaminants added to an explosive
  • associated with dirty bombs
58
Q

physics of an explosion

A
  • speed, duration, and pressure of the shock wave are affected by:
  • size of the explosive charge
  • nature of surrounding medium
  • distance from explosion
  • presence or absence of reflecting surface
59
Q

explosion is more damaging in closed spaces

A

true

60
Q

blast pressures cause destruction at

A
  • interface between tissues of different densities

- interface between tissues and trapped air

61
Q

tissue at risk

A
  • air containing organs are more susceptible to pressure changes (lungs) -> primary blast
  • junctions between tissues of different densities and exposed tissue are prone
  • the ear is most sensitive (pressure)
  • primary pulmonary blast injuries occur as contusions and hemorrhages
  • if there is any reason to suspect lung injury in a blast victim -> administer oxygen
62
Q

assessment/management of blast injuries

A
  • if scene safety cannot be ensured, evacuate until advised that it is safe
  • assess for other hazards
  • form a general impression as you approach
  • assess breath sounds frequently
  • examine for the presence of DCAP-BTLS
  • establish a baseline pulse oximetry value

Trauma and Trauma Systems (18 decks)

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