Trauma Overview and Mechanism of Injury

Question 1

Kinematics

Answer 1

The process of predicting injury patterns that can result from the forces and motions of energy.

Question 2

Blunt Trauma

Answer 2

An injury produced by the wounding forces of compression and change of speed, both of which can disrupt tissue.

Question 3

Incident phase

Answer 3

The phase of trauma that refers to the trauma event.

Question 4

Cavitation

Answer 4

A temporary or permanent opening produced by a force that pushes body tissues laterally away from from the track of a projectile.

Question 5

Acceleration

Answer 5

An increase in the velocity of a moving object.

Question 6

Deceleration

Answer 6

A decrease in the velocity of a moving object.

Question 7

Penetrating trauma

Answer 7

An injury produced by crushing and stretching forces of a penetrating object that results in some form of tissue disruption.

Question 8

Post incident phase

Answer 8

The phase of trauma where emergency care is delivered to injured patients

Question 9

Pre-incident phase

Answer 9

The phase of trauma that refers to the prevention of intentional and unintentional trauma deaths.

Question 10

Trauma center

Answer 10

A specialized hospital distinguished by the immediate availability of specialized personnel, equipment, and services to treat most severe and critical injuries.

Question 11

The Golden Hour

Answer 11

The first hour after severe injury. In this period, surgical intervention for the trauma patient can enhance survival and reduce complications.

Question 12

Immediate death

Answer 12

Occurs within seconds or minutes of injury. Lacerations of the brain, brainstem, upper spinal cord, heart, aorta, or other large vessels.

Question 13

Early death

Answer 13

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.

Question 14

Late deaths

Answer 14

Occurs days or weeks after the injury. Result from sepsis, infection, or multiple organ failure

Question 15

Ground transportation

Answer 15

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.

Question 16

Aeromedical transportation

Answer 16

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.

Question 17

Newton’s first law of motion

Answer 17

An object, whether at rest or in motion, remains in that state unless acted upon by an outside force.

Question 18

Conservation of energy law

Answer 18

Energy cannot be created or destroyed; it can only change form. (Energy can take mechanical, thermal, electrical, chemical, and nuclear forms.)

Question 19

Newton’s second law of motion

Answer 19

Force (F) equals mass (M) multiplied by acceleration (a) or deceleration (d):

F=M X a or F = M X d

Question 20

Kinetic energy

Answer 20

Kinetic energy equals half the mass multiplied by the velocity squared

Question 21

The paramedic should consider the following when evaluating the trauma patient:

Answer 21

Mechanism of injury
Force of energy applied
Anatomy
Energy

Question 22

The three impacts in an MVC

Answer 22

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

Question 23

Forward collision

Answer 23

The sum of the speeds of both vehicles is the velocity that produces damage

Question 24

Rear end collision

Answer 24

The difference between the two speeds is the damaging velocity

Question 25

Head deceleration injury

Answer 25

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

Question 26

Thoracic deceleration injury

Answer 26

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

Question 27

Abdominal deceleration injury

Answer 27

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.

Question 28

Compression head injury

Answer 28

Open fracture, closed fracture, and bone fragment penetration (depressed skull fracture). Brain contusion and laceration.

Question 29

Thoracic compression injury

Answer 29

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.

Question 30

Abdominal compression injury

Answer 30

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.

Question 31

Auto-pedestrian injury

Answer 31

First impact vehicle hits pedestrian.
Second pedestrian hits hood of vehicle.
Third pedestrian strikes ground or other object

Question 32

Blast injuries

Answer 32

Primary, secondary, tertiary, and quaternary

Question 33

Primary blast injury

Answer 33

Result from sudden changes in environmental pressure. Thermal injuries and damage to gas containing organs. Common injuries to ears, lungs, CNS, and GI tract.

Question 34

Secondary blast injuries

Answer 34

Result from being struck by flying debris. High velocity missile-type injuries (shrapnel).

Question 35

Tertiary blast injuries

Answer 35

Occur when victims are propelled through space by an explosion and strike a stationary object.

Question 36

Quaternary blast injuries

Answer 36

Burns, radiation injuries, crush injuries, asthma, COPD or other problems from dust, smoke, or toxic gases. Also angina, hyperglycemia, and hypertension.

Question 37

Vertical falls

Answer 37

Paramedic should evaluate three things:

The distance fallen

The body position of the patient on impact

The type of landing surface struck

Question 38

Severe injuries from a fall

Answer 38

(15-20) feet or 3 times the height of the person who fell

Question 39

Adult falls from more than 15 feet

Answer 39

Usually falls on feet causing bilateral calcaneus fractures

Question 40

Child falls

Answer 40

Usually land head first because of its size and weight.