Mechanisms of Injury and Trauma Systems

Question 1

Name a few airbag injury patterns.

Answer 1

• abrasions to face, arms and hands
• burns to eyes and face

Question 2

What are the MOI criteria for transfer to a Trauma Center?

Answer 2

• adult falls more than 20 feet or 3x height
• children fall >10 feet or <10ft with LOC
• high-risk auto crash:
  intrusion into passenger compartment and ejection from vehicle
• high-risk injury
• pedestrian/bicyclist thrown
• burns with other trauma
• two or more long bone fractures

EMS provider judgment; When in doubt, transfer to a Trauma Center.

Question 3

What are the special considerations in trauma patients?

Answer 3

• > 55 yrs old
• Systolic BP of < 110mmHg in age > 65yrs old
• Use of anticoagulants
• Pregnancy
• Burns with trauma

Question 4

What is the importance of pain management in trauma patients?

Answer 4

Reduces the physiological stress response, minimizing a massive catecholamine dump.

Question 5

Define:

Don Juan syndrome

Answer 5

When jumping down to the ground, energy is transferred to the heels, legs, pelvis, chest, T12-L1 and L2.

Fact: children younger than 3 years have fewer injuries from falls greater than three stories than children and adults.

Question 6

Define:

Newton’s First Law of Motion

Answer 6

A body at rest will remain at rest unless acted on by an outside force.

Question 7

Define:

Newton’s Second Law of Motion

Answer 7

Force = mass x acceleration

F = ma

Question 8

What are the five phases of deceleration?

Hint: during collision

Answer 8

1. Vehicle decelerates
2. Occupant decelerates
3. Internal organs decelerate
4. Secondary collisions
5. Post-secondary collisions

Question 9

List

Possible injury patterns of head-on/frontal impact.

Answer 9

• Brain
• Scalp
• Tracheal
• Sternal/Rib Fractures
• Pneumo/Hemothorax
• Femoral Fracture
• Ruptured Spleen, Liver, Bowel, Diaphragm
• Dislocated: Knee, Hip
• Pericardial Tamponade
• Myocardial Contusion

Question 10

List

Possible injury patterns of side impact/lateral impact.

Answer 10

• fractured: hip, clavicle, humerus, ribs, cervical spine
• lacerations
• contusions
• brain injury

Question 11

List

Possible injury patterns of rear-end collision.

Answer 11

• “whiplash”
• deceleration injuries
• tearing inside the skull (diffuse axonal injury)

Question 12

Define:

Waddell’s Triad

Answer 12

The order in which a pediatric is hit by a vehicle.

1. Pelvis collides with the bumper.
2. Chest and abdomen hit the hood/grill.
3. Head hits the vehicle and then the ground.

Question 13

Define:

penetrating trauma

Answer 13

When an object punctures the skin and tissues or organs.

Question 14

What determines the severity of a stab wound?

Answer 14

• anatomic area
• depth
• length
• angle

Question 15

True or false.

The most important factor in the severity of a gunshot wound (GSW) is the type of tissue the projectile passes through.

Answer 15

True

Question 16

What do you need to check for with a gunshot wound (GSW)?

Hint: bullet travel

Answer 16

exit wound

Question 17

What is a cavitation?

Answer 17

The pressure waves from a projectile push tissues lateral and in front of the projectile.

Question 18

What are the five different effects of blast injuries?

Answer 18

1. Primary - pressure wave
2. Secondary - flying debris
3. Tertiary - thrown into surrounding objects
4. Quaternary - heat generated from the explosion
5. Quinary - biologic, chemical, or radioactive contaminants

Question 19

Fill in the blank.

If a blast injury occurs and there is rupture of the ______ membrane, maintain a high suspicion for other blast injuries.

Answer 19

tympanic

Question 20

What three objective data is utilized to calculate the Revised Trauma Score?

RTS

Answer 20

• Systolic blood pressure
• GCS
• Respiratory rate

Question 21

Which patient(s) meet criteria for transport to a Trauma Center?

1. Adult that fell 15 feet
2. Auto crash with ejection
3. Patient with bilateral tib/fib fractures
4. Auto crash with death in same passenger compartment

Answer 21

2, 3 and 4

Note: Adults who fall more than 20 feet qualify for transport to a Trauma Center.

Question 22

What are the capabilities of a Level I Trauma Center?

Answer 22

• 24-hours in-house surgeons
• Specialty care (neuro, orthopedics, anesthesiology)

Capable of providing care for every possible injury.

Question 23

What are the capabilities of a Level II Trauma Center?

Answer 23

• 24-hours immediate coverage of surgeons
• Tertiary care (cardiac, microvascular, hemodialysis)

Able to initiate definite care for all injuries.

Question 24

What are the capabilities of a Level III Trauma Center?

Answer 24

• 24-hours coverage by emergency medicine physicians
• Developed transfer agreements to higher level of care

Provides prompt assessment, resuscitation, and stabilization or all injured patients.

Question 25

What are the capabilities of a Level IV Trauma Center?

Answer 25

basic emergency and implements ATLS

Provides Advanced Trauma Life Support (ATLS) before transferring to a higher level of care.

Question 26

Where’s the best place to enhance your trauma care skills in preperation to become a paramedic?

Answer 26

Brainscape’s EMT “Component 8: Care for the Trauma Patient” Flashcards