Trauma

Question 1

trauma definition

Answer 1

Acute physiological/structural change happens in a person’s body when an external source of energy dissipates faster than the body can sustain and dissipate it

Question 2

mechanical energy

Answer 2

energy from motion (kinetic) or energy stored in an object (potential energy)

Question 3

chemical energy

Answer 3

found in an explosive/acid/reaction from an ingested agent or drug

Question 4

electrical energy

Answer 4

high voltage electrocution or lightning

Question 5

barometric energy

Answer 5

sudden changes in pressure

Question 6

external factors affecting injury types

Answer 6

force/energy, amount of energy and mechanisms, duration/direction of force, patient position

Question 7

internal factors affecting injury types

Answer 7

sustained when the break point of the organ is exceeded and difficult to recognize, could present with contusions, abrasions, lacerations, and punctures

Question 8

velocity

Answer 8

distance b/w an object travels per unit of time in a specific motion

Question 9

acceleration

Answer 9

rate of change of velocity

Question 10

gravity

Answer 10

downward acceleration

Question 11

first law of motion- newtons law

Answer 11

a body at rest/ motion will remain at rest/ motion unless acted upon by outside force

Question 12

second law of motion- newtons law

Answer 12

F=MA
heavier mass needs more force to change direction/stop
high-speed collisions produce deceleration of 100 ‘s- the human limit is 30G’s

Question 13

multisystem trauma

Answer 13

injuries that involve >2 body systems caused by events involving significant energy and affect the whole body

Question 14

transport considerations for trauma systems

Answer 14

patients needs/ most appropriate hospital, level of receiving facility, mode of transportation, possible transportation to landing areas if not accessible at scene

Question 15

types of trauma

Answer 15

blunt and penetrating

Question 16

types of injuries

Answer 16

shearing, avulsing, crush, compression

Question 17

injuries caused by decelerating forces

Answer 17

shearing/avulsing/rupture of organs, vasculature, nerves, soft tissues, head is vulnerable, chest to aorta injuries, abdominal blunt trauma, organs tear at point of attachment (liver, spleen, kidneys, pancreas, small intestine)

Question 18

injuries caused by external forces

Answer 18

crush/compression injuries, skull fractures, spinal cord injuries, brain swelling, fractured ribs, flail chest, abdominal injuries, pelvic fractures

Question 19

5 phases of a collision

Answer 19

deceleration of the vehicle, deceleration of occupant, deceleration of internal organs, secondary collisions, additional impacts

Question 20

types of impact patterns

Answer 20

frontal/head on (down and under), later/ side impact. rear impact (body goes forward and not head, causing whiplash), rotational ( combination of head-on and lateral), rollover (multiple impacts every roll of the car (severe injury)

Question 21

predicting types of injury

Answer 21

dependant on the look of the vehicle- indicates forces/ degree of deceleration sustained by the patient. Tire skid marks indicate whether significant energy was dissipated by breaking before the impact

Question 22

down and under pathway (frontal)

Answer 22

upper body hits the steering wheel, causing broken ribs, flail chest, pulmonary contusion, ruptured liver/spleen

Question 23

up and over pathway

Answer 23

chest/ abdomen hits the steering wheel, causing aortic tears, abdominal rupture, diaphragm rupture

Question 24

primary mechanism- blast injuries

Answer 24

damage to body caused by pressure wave generated from explosion

Question 25

secondary mechanism- blast injuries

Answer 25

damage to body resulting from being struck by flying debris

Question 26

tertiary mechanism- blast injuries

Answer 26

occurs when pt is hurled against object

Question 27

miscellaneous mechanism- blast injuries

Answer 27

burns from hot gas/fire, respiratory injury from toxic gas or crush injuries from collapses of buildings

Question 28

quinary mechanism- blast injuries

Answer 28

long term effects of chemical/radioactive/biologics from blast

Question 29

when is the first transport decision

Answer 29

2 minutes, check LOC/ABCS, and if abnormal, go

Question 30

when is the second transport decision

Answer 30

5 minutes, unstable ABCs then go

Question 31

RTS VS focused exam

Answer 31

Dangerous generalized MOI/ unconscious- RTS
Dangerous focused MOI suggesting isolated injury- focused exam on the area of injury
No significant MOI and normal initial assessment- focused exam by CC

Question 32

what is classified as a high-risk patient

Answer 32

dangerous MOI, hx of loss of consciousness, difficulty breathing, severe pain in head/neck/torso, high-risk groups- altered mental status, abnormal perfusion, abnormalities from initial assessmentst

Question 33

what is JVD

Answer 33

jugular vein distention- blood pooling from the aorta

Question 34

when would you transport after a RTS

Answer 34

altered mental status, weird respirations or circulation (shock/uncontrolled bleeding), abnormal chest exam, tender/distended abdomen, pelvic instability, bilateral femur fracture