trauma-ppt Flashcards
ppts what is trauma
Trauma is an injury to human tissues and organ s resulting from the transfer of energy from the environment
what causes injury
Injuries are caused by some form of energy that is beyond the body’s resilience to tolerate *
what does the trimodal distribution of trauma pt deaths look like
% of who dies when
50% in first hr (often on scene)
25% in first 4hrs (often in emerg)
25% in the weeks 1-5 after initial injury (often in ICU)
common causes of death in first hr after trauma
hemmorhage
shock
…
common causes of death in first 4hrs after trauma
hypovolemia airway obstruction (generally d/t unconscious pt)
common cause of death in 1-5wks after trauma
Die from infection, multiple organ dysfx syndrome (from being ischemic, anaerobic metb)
what is the definitive treatment of multiple trauma pts
surgery
when are diagnostics a priority of pt care
when they give useful info for Tx
how do you calculate the impact force
Impact Force = weight x speed
eg weight of car x speed in km you were going
falls > than __ft can be fatal
why?
12 ft
risk of traumatic dissection of thoracic aorta
acceleration/deceleration injuries are a form of what type of force
blunt
what is a risk if going >50km/h in a vehicle and crashing or stopping abruptly
- when the heart goes forward it creates shearing forces, primarily above the heart, shears on aorta. The heart also bounces back. The aorta has multi layers and they can come apart.
- MVA >50km/h have high risk of shearing aortic dissection
what kind of injuries or organs might be caused by sudden accel/decel
- damage to liver, heart, aorta, head injury
- the liver and heart are heavy and htey move in the body cavity more
why can blunt force trauma often go without being properly treated
blunt forces often have no visible, outer evidence of injury
what are the forms of energy that can cause injury
what is another biomechanism of energy that causes cellular damage
Energy Mechanical Thermal Chemical Electrical Radiant
-hypoxia
if a pt was in a car accident what kind of injuries from compression might they sustain?
what reaction might the person have in this situation and what organs could it affect?
The lap belt comes up around abdm and can pop bowel up through diaphragm
people tend to hold their breath and clamp their glottis shut, this creates a seal on the lungs and can contribute to a pneumothorax when suddenly compressed
what structures do rotational injuries often occur to
limbs generally also head/neck/spine, trunk
when a structure is rotated although it might not break or show external signs of damage what might happen and why is this dangerous
the internal strs are damged–>inflm or the damage doesnt allow perfusion–>hypoxia
what causes more damage to the structures around it, a sharp or dull penetrating object
dull as it pulls the tissues surrounding it
when are penetrating accidents often missed
when the object that entered the person was thin and fine
are bullet wounds generally in a straight line
no, theyre designed to spin within the person
what basic questions should you ask yourself about your trauma pt and their accident
how much energy, what kind of injury, what organs affected
why might some trauma pts not show their injury until many hours after
Sympathetic system will activate. Alpha adrenergic receptors—triage body organs and send blood to most important organs (heart, brain). A lot of your organs dont have blood going to them, youre not hypovolemic although you might present with cold hands etc
if your pt has a skull laceration that is barely bleeding should you be worried
yes, this means they had a lot of force to their head and their brain might have been affected or inflm might follow
