Trauma Overview and Mechanism of Injury Flashcards
Kinematics
The process of predicting injury patterns that can result from the forces and motions of energy.
Blunt Trauma
An injury produced by the wounding forces of compression and change of speed, both of which can disrupt tissue.
Incident phase
The phase of trauma that refers to the trauma event.
Cavitation
A temporary or permanent opening produced by a force that pushes body tissues laterally away from from the track of a projectile.
Acceleration
An increase in the velocity of a moving object.
Deceleration
A decrease in the velocity of a moving object.
Penetrating trauma
An injury produced by crushing and stretching forces of a penetrating object that results in some form of tissue disruption.
Post incident phase
The phase of trauma where emergency care is delivered to injured patients
Pre-incident phase
The phase of trauma that refers to the prevention of intentional and unintentional trauma deaths.
Trauma center
A specialized hospital distinguished by the immediate availability of specialized personnel, equipment, and services to treat most severe and critical injuries.
The Golden Hour
The first hour after severe injury. In this period, surgical intervention for the trauma patient can enhance survival and reduce complications.
Immediate death
Occurs within seconds or minutes of injury. Lacerations of the brain, brainstem, upper spinal cord, heart, aorta, or other large vessels.
Early death
Occurs within the the first 2 to 3 hours after injury. Result from major head injury, hemopneumothorax, ruptured spleen, lacerated liver, pelvic fracture, or other injuries resulting in significant blood loss.
Late deaths
Occurs days or weeks after the injury. Result from sepsis, infection, or multiple organ failure
Ground transportation
Used if the appropriate facility can be reached within a reasonable time. Reasonable time is defined as definitive care within 60 minutes after the injury.
Aeromedical transportation
Used if the time needed needed to transport a patient by ground to an appropriate facility poses a threat to the patients survival and recovery.
Weather, road, or traffic conditions would seriously delay the patients access to definitive care.
Critical care personnel and equipment are needed to adequately care for the patient during transportation.
Newton’s first law of motion
An object, whether at rest or in motion, remains in that state unless acted upon by an outside force.
Conservation of energy law
Energy cannot be created or destroyed; it can only change form. (Energy can take mechanical, thermal, electrical, chemical, and nuclear forms.)
Newton’s second law of motion
Force (F) equals mass (M) multiplied by acceleration (a) or deceleration (d):
F=M X a or F = M X d
Kinetic energy
Kinetic energy equals half the mass multiplied by the velocity squared
The paramedic should consider the following when evaluating the trauma patient:
Mechanism of injury
Force of energy applied
Anatomy
Energy
The three impacts in an MVC
First impact the vehicle strikes an object
Second impact the occupant collides with the inside of the car
Third the internal organs collide inside the body
Forward collision
The sum of the speeds of both vehicles is the velocity that produces damage
Rear end collision
The difference between the two speeds is the damaging velocity
Head deceleration injury
Brain moves inside head until compressed by skull. Blood vessels attached to brain and skull Can be torn causing intracranial hemorrhage. Brain tissue can be bruised, crushed, or lacerated
Thoracic deceleration injury
Aorta affixed by aortic valve in descending portion of aortic arch by the ligamentum arteriosum. Aorta may be sheared at level of ligamentum arteriosum attachment. Transection and dissection of through to internal lining intima and media of aorta can cause cardiac tamponade
Abdominal deceleration injury
Kidneys most commonly affected. Kidneys can shear away from vascular pedicle attachments. Mesenteric tears, liver separation from midpoint at vascular and hepatic duct pedicle, and tear of splenic capsule.
Compression head injury
Open fracture, closed fracture, and bone fragment penetration (depressed skull fracture). Brain contusion and laceration.
Thoracic compression injury
Fractured ribs, sternum, and open pneumothorax. Paper bag effect from lung rupture due to large inhalation and compression of full lungs causes alveolar rupture.
Aortic valve rupture, cardiac dysrhythmias, myocardial contusion, or atrioventricular rupture.
Abdominal compression injury
Solid organ rupture, vascular organ hemorrhage, and hollow organ perforation. Commonly ruptured bladder and laceration to spleen, liver and kidneys. Rupture or herniation of diaphragm.
Auto-pedestrian injury
First impact vehicle hits pedestrian.
Second pedestrian hits hood of vehicle.
Third pedestrian strikes ground or other object
Blast injuries
Primary, secondary, tertiary, and quaternary
Primary blast injury
Result from sudden changes in environmental pressure. Thermal injuries and damage to gas containing organs. Common injuries to ears, lungs, CNS, and GI tract.
Secondary blast injuries
Result from being struck by flying debris. High velocity missile-type injuries (shrapnel).
Tertiary blast injuries
Occur when victims are propelled through space by an explosion and strike a stationary object.
Quaternary blast injuries
Burns, radiation injuries, crush injuries, asthma, COPD or other problems from dust, smoke, or toxic gases. Also angina, hyperglycemia, and hypertension.
Vertical falls
Paramedic should evaluate three things:
The distance fallen
The body position of the patient on impact
The type of landing surface struck
Severe injuries from a fall
(15-20) feet or 3 times the height of the person who fell
Adult falls from more than 15 feet
Usually falls on feet causing bilateral calcaneus fractures
Child falls
Usually land head first because of its size and weight.
