Mechanisms of Injury and Trauma Systems

Question 1

Name a few airbag injury patterns

Answer 1

• Abrasions to face, arms and hands
• Burns to eyes and face

Question 2

What is

MOI criteria for transfer to a Trauma Center

Answer 2

• Adult falls more than 20 feet or 3x height
• Children falls >10 feet or <10ft with LOC
• High-risk auto crash
• Intrusion into passenger compartment
• Ejection
• High-risk injury
• Pedestrian/bicyclist thrown
• Burns with other trauma
• 2 or more long bone fractures

EMS provider judgment; When in doubt, transfer to a Trauma Center

Question 3

What are

Special Considerations in trauma patients

Answer 3

• Age > 55 yrs old
• Systolic BP < 110mmHg in age > 65yrs old
• Use of anticoagulants
• Pregnancy
• Burns with trauma

Question 4

Why is Pain Management important in trauma patients?

Answer 4

So that there isn’t a massive catecholamines dump

Question 5

What is

Don Juan Syndrome

Answer 5

When jumping down to the ground, energy is transferred to the heels, legs, pelvis, chest, T12-L1 and L2

Fact: children younger than 3 have fewer injuries from falls greater than three stories than children and adults

Question 6

What is

Newton’s First Law of Motion

Answer 6

A body at rest will remain at rest unless acted on by an outside force

Question 7

What is

Newton’s Second Law of Motion

Answer 7

Force = mass x acceleration

Question 8

What are

The 5 phases of Deceleration

Hint: during collision

Answer 8

• Vehicle decelerates
• Occupant decelerates
• Internal Organs decelerate
• Secondary Collisions
• Post-Secondary Collisions

Question 9

List

Possible injury patterns of Head-On/Frontal Impact

Answer 9

• Brain
• Scalp
• Tracheal
• Sternal/Rib Fractures
• Pneumo/Hemothorax
• Femoral Fracture
• Ruptured Spleen, Liver, Bowel, Diaphragm
• Dislocated: Knee, Hip
• Pericardial Tamponade
• Myocardial Contusion

Question 10

List

Possible injury patterns of Side Impact/Lateral Impact

Answer 10

• Fractured: Hip, Clavicle, Humerus, Ribs, Cervical Spine
• Lacerations
• Contusions
• Brain Injury

Question 11

List

Possible injury patterns of Rear-End Collision

Answer 11

• “Whiplash”
• Deceleration injuries
• Tearing inside skull (Diffuse Axonal Injury)

Question 12

What is

Waddell’s Triad

Answer 12

the order in which a pediatric is hit by a vehicle

1. Pelvis collides with the bumper
2. Chest and Abdomen hit the hood/grill
3. Head hits the vehicle and then the ground

Question 13

Define

Penetrating Trauma

Answer 13

When an object punctures the skin and tissues/organs

Question 14

What determines the severity of a stab wound?

Answer 14

• Anatomic Area
• Depth
• Length
• Angle

Question 15

True or False

The most important factor in the severity of a Gunshot Wound (GSW) is the type of tissue the projectile passes through.

Answer 15

TRUE

Question 16

What do you need to check for with a Gunshot Wound (GSW)?

Hint: Bullet Travel

Answer 16

Exit Wound

Question 17

What is cavitation?

Answer 17

the pressure waves from a projectile push tissues lateral and in front of the projectile

Question 18

What are the 5 different effects of blast injuries?

Answer 18

• Primary - pressure wave
• Secondary - flying debris
• Tertiary - thrown into surrounding objects
• Quaternary - heat generated from the explosion
• Quinary - biologic, chemical, or radioactive contaminants

Question 19

Fill in the Blank

If a blast injury occurs and there is rupture of the ______ membrane, have a high suspicion for other blast injuries

Answer 19

Tympanic​

Question 20

What 3 objective data is utilized to calculate the Revised Trauma Score (RTS)?

Answer 20

• Systolic Blood Pressure
• GCS
• Respiratory Rate

Question 21

Which patient(s) meet criteria for transport to a Trauma Center?

1. Adult that fell 15 feet
2. Auto crash with ejection
3. Patient with bilateral tib/fib fractures
4. Auto crash with death in same passenger compartment

Answer 21

Answer: 2 3 and 4

1. Adults falls >20 feet qualify for transport to a Trauma Center

Question 22

List

Capabilities of a Level I Trauma Center

Answer 22

• 24-hour in-house surgeons
• Provides speciality care (neuro, orthopedics, anesthesiology)

Capable of providing care for every possible injury

Question 23

What are the Capabilities of Level II Trauma Center?

Answer 23

• 24-hour immediate coverage of surgeons
• Tertiary care (cardiac, microvascular, hemodialysis)

Able to INITIATE definite care for all injuries

Question 24

What are the Capabilities of Level III Trauma Center?

Answer 24

• 24-hour coverage by emergency medicine physicians
• Developed transfer agreements to higher level of care

Provides prompt assessment, resuscitation, and stabilization or all injured patients

Question 25

What are the Capabilities of Level IV Trauma Center?

Answer 25

Basic emergency and implements ATLS

Provides Advanced Trauma Life Support (ATLS) before transfer to a higher care