Trauma overview Chapter 27 Flashcards
Kenetic energy equation
Mass x velocity squared/2
What is the more significant factor. Mass or velocity
Velocity
types of impacts in a vehicle collision
in order
- Vehicle collision
- Body collision
- Organ collision
what are your high index of suspicion in a MVA
- Death of another occupant of the vehicle
- Unresponsive
- AMS
- Intrusion greater than WHAT? 12 inches…good job
- Ejection from the vehicle
- Vehicle telemetry data consistent with a high risk of injury
Up and over frontal impact potential injuries
- Head
- Neck
- Chest
- Abdomen
Down and under frontal impact potential injuries
- Knees
- Femur
- Pelvis
- Spine
what two organs take the most damage when the abdomen hits the steering wheel or dashboard
Are they solid or hollow?
- Liver
- Spleen
- Solid
Paper bag injury
Air compressed inside the limited areas of a lung can rupture the lung when the chest hits the steering wheel
Starburst
What is it indicitive of
Not the candy!
The pts head hit the windsheild and was unrestrained
Multisystem trauma patient
What does that mean
Multiple injuries or involvement or more than one body system
Morbidity
Define
Ilness or injury
Mortality
Define
Death or chance of death
Golden hour
Time frame
in what situation would this pertain to?
- 1hour
- Full trauma
Platinum 10 minutes
Why is this significant?
- Maximum time devoted on scene for a full trauma
- Some patients need definitive care in less than an hour to survive
Pattern of injury for a child in a pedistian vs car MVA
- Children turn towards the vehicle
- Typically go under the vehicle
- Gonna see more hip. chest, abdomen, and head injuries
Pattern of injury for adults vs car MVA
- Typically turn away from the vehicle
- See more spine, rib, tib fib fractures, and femur fractures
- Typically go up and over the vehicle
Indications for platinum 10 minutes and rapid transport
Hold onto your seat there is a shit ton (26)
- Airway occlusion or difficulty in maintaining a patent airway
- Respiratory rate <10 or >29
- Inadequate tidal volume
- Hypoxia
- Respiratory distress, failure, apnea
- Suspected skull fracture
- Flail chest
- Suspected pneumothorax, hemothorax, or tension pneumo
- Pelvic fracture
- Two or more proximal long bone fractures
- Crushed or mangled extremity
- Uncontrolled external hemorrhage
- S/S of shock
- Significant external blood loss with controlled hemorrhage
- Glasgow coma score of 13 or less
- AMS
- Seizure activity
- Sensory or motor deficit
- Any penetrating trauma
- Amputation of an extremity proximal to the finger
- Multisystem trauma
- Open or depressed skull fracture
- Suspected brain injury
- Paralysis
- Trauma in a patient with significant medical history
Level one regional trauma center
What kind of cases can they manage?
- All types of trauma 24/7
Level two area trauma center
What cases can they manage?
- Can manage a vast majority of trauma and surgical capabilities
- Can stabalize trauma patients before transfering them to a level 1 trauma center
Level three Community trauma center
What cases can they manage
- Some surgical capabilities but not really what they do
- they manage the trauma and stabalize serious injuries before transfering them to a higher level center
Level four trauma facility
What cases can they handle?
- Typically a small community hospital in a remote area capable of stabalizing seriously injured trauma patients and then transferring to a higher level center
4 key factors for high velocity (bullets) injuries
- Drag
- Profile
- Cavitation
- Fragmentation
Drag
Define
- the factors that slow a bullet down such as wind resistance
Profile
Define
- The impact point of the bullet is its profile. The greater the size of the impact point the more energy is transferred
Cavitation
Define
- How big is the hole in the body
Fragmentation
Define
- A bullet that breaks up into small pieces or releases small pieces upon impact creating a larger injured area
