Chapter 2.3 Types of injury Flashcards

1
Q

Trauma-related injury (4) types that you can experince

A
  • Blunt trauma
  • Penetrating trauma
  • Thermal trauma
  • Blast trauma
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2
Q

BLUNT TRAUMA

A

Common examples; assault, acceleration and de-escalation forces e.g. collisions and falls

  • The more force the greater the damage
  • More distance of energy transfer the more likely a diminish the extent of injury may occur.
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3
Q

Falls

  • principles & considerations
  • types of injury
  • how it happened
  • surface?
A

Principles; acceleration and de-escalation forces & Newton’s laws of motion

  • When the patient falls and collides with the ground this is WHEN transfer of energy occurs.

*Point of impact is the MAJOR point of transfer e.g. head, hip, arm. What took the force?

*Type of surface. Carpet and grass help to absorb the energy better than concrete or tiles.

*Bone is less flexible than soft tissue
- air-filled organs may rupture
- solid organs may fracture

  • if a person is pushed or knocked over the ACCELARTION increases, causing additional transfer of energy = greater impact.
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4
Q

What is a significant injury in a pead?

A

occurs @ x3 of the childs height

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5
Q

MVA ; impacts

A

1st - when the vehicle collides with the object

2nd - after the initial impact. The occupants continue to move in original direction until they collide with the interior of the vehicle

3rd - when the internal structures collide with the body cavity. the organs meet resistance from the structures that encapsulate them.

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6
Q

How do we work out the survivability of an accident?

A

Determine the velocity and stopping distance.

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7
Q

What to think about when determining injuries from an MVA?

A
  • rate
  • stopping distance
  • deployment of safety mechamuims
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8
Q

What to think about when determining injuries from an MVA?

A
  • rate
  • stopping distance
  • deployment of safety mechanisms
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9
Q

What to think about when determining injuries from an MVA?

A
  • rate
  • stopping distance
  • deployment of safety mechanisms
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10
Q

AIRBAGS - things to note

A

Chemicals used to preserve and deploy airbags can cause corneal abrasions and minor skin burns. this is due to rapid inflation.

*Thus, eye injuries may result and are a particular concern for patients wearing glasses.

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11
Q

Mechanisms of injury and potential injury patterns in MVCs

(7)

A
  1. Up & Over pathway - when the head and chest lead the way over the steering wheel.
  2. Down and under the pathway - under the steering wheel. Pelvis, tib/fib and knee. can occur when the seatbelt is secured ABOVE the pelvis.
  3. Lateral (T-bone). Shoulder, elbow and pelvis. Closer to injury high risk. Can also cause sheer injury e.g AAA
  4. Rotational. When struck and then struck again and turned around.
  5. Rear. can be similar to frontal as thrown into the front of the car
  6. Rollover - can cause all of the injury patterns mentioned
  7. Ejection - can cause all of the injury patterns mentioned
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12
Q

What is the most serious point of an ejection MVA

A

Increases the likely hood of a fatality

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13
Q

Motorcycle accidents or other motorized vehicles: what kinda of injury.
- low side
- high side
- head on
- lateral

A
  • Low side crash; abrasions, shoulder, clavicle, lateral head and clavicle injuries.
  • A high-side crash; injuries included in low plus conditions of the surface and speed.
  • Head on; handle bars = femur and pelvis injuries. Then head, neck, chest and extremities.
  • Lateral or angular; crush injuries, shoulder, head
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14
Q

Vechile vs pedestrian
- adult & pead

A

Catapulted onto the hood / and or windshield.

Peads - thrown from the vehicle or under the vehicle due to size

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15
Q

Penetrating trauma - define

A

Any foreign object that enters through the skin barrier is considered penetrating.

Involved the victim’s internal organs, causing hemodynamic instability (shock) and increased risk of infection.

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16
Q

Organs involved in penetrating trauma

A

Small bowel (50%)
Large bowel (40%)
Liver (30%)
Intra-abdominal vascular system (25%)

17
Q

Bullet related considerations

A

KE = Mv2 /2.

Kinetic energy = KE
projectile mass = m
bullet velocity = v

*Bullets travel at their fastest when leaving the muzzle of a firearm. They are slowed by the effect of drag when they enter the air.

18
Q

bullets - deviation and direction

A

Direction = rotational axis
Deviation = Yaw (wobble)

19
Q

Full metal jacket bullet

A

Full metal jacket - Made of heavy metal that covers the bullet from base to tip

e.g assault rifles

Cause - minimal tissue deformation on impact. “snow storm” pattern on xray

20
Q

Types of bullets (4)

A
  1. full metal jacket
  2. soft nose
  3. hollow point
  4. frangible
21
Q

Soft nose bullet

A

Non-jacketed

The impact is designed to expand on impact. although they are designed to expand they are less likely to penetrate through the body.

22
Q

Hollow nosed bullet

A

They have a hollow cavity in the tip and jacket and are designed to produce maximal energy transfer on impact, they are forced back once entering

“mushroom effect”

Used by police and hunters

23
Q

Frangible bullets

A

deigned to break apart they impact a surface harder than the bullet.

Causes multiple fragment paths.

24
Q

Cavitation (from a bullet)

  • AIR FILLED + SOLID & Taking force
A

As indicated by the KE equation. increased velocity of a projectile causes more damage than increases mass.

Thus a bullet passes through the skin at high pressure causing a cavity

*Air-filled organs e.g. lungs and stomach are elastic and can thus tolerate high-velocity cavitation relatively.

  • Solid organs e.g. liver, kidney will shear.
25
Q

Cavitation in a car accident (temporary)

A

When the unrestrained driver hits the steering wheel a temporary cavity is created.

26
Q

Blast trauma: speed of sound? what elements

A

This occurs when energy in the form of light, heat or/and sound is released rapidly.

  • Pressure expands outwards in ALL directions… this is FASTER than the speed of sound
27
Q

Blast trauma injuries

A

BLUNT & PENETRATING TRAUMA

  • chemical
  • thermal
  • physical
  • radioactive

+++ Internal haemorrhage

28
Q

Effects of explosions on the human body - PRIMARY

A

IMPACT
* Direct blast

MECHANISM OF INJURY
* Direct tissue damage/blast to the body
* Gas-filled environment = > risk
* complex stressors

TYPES OF INJURY
* blast lung (pulmonary barotrauma)
* tympanic mebrance rupture)
* Abdo perf and hemorrhage
* eye rupture
* TBI

29
Q

Effects of explosions on the human body - SECONDARY

A

IMPACT
*projectiles propelled by the explosion

MECHANISM OF INJURY
*primary fragments from exploding weapons and shrapnel
* other debris from the environment

TYPES OF INJURY
* penetrating ballistic (fragmentation) or bullet injuries
*eye penetration
*closed and open brain injury

30
Q

Effects of explosions on the human body - TERITARY

A

IMPACT
*Results from individuals being thrown by the blast wind onto a hard surface

MECHANISM OF INJURY
* displacement of the body and structural collapse

TYPES OF INJURY
*whole or partial body translocation from being thrown against a hard surface.
- blunt/penetrating trauma
*fractures
* traumatic amputations

31
Q

Effects of explosions on the human body - QUATERNARY

A

IMPACT
All explosion-related injuries, illnesses or diseases not caused by primary/secondary or tertiary mechanisms

MECHANISM OF INJURY
*burns
* metals
*septic syndromes

TYPES OF INJURY
* burns
* crush
* asthma, COPD
*angina
* HTN or hyperglycemia

32
Q

Effects of explosions on the human body - QUINARY

A

IMPACT
Associated with exposure to hazardous materials from radioactive, biological or chemical components of a blast.

MECHANISM OF INJURY
*bacteria
* Chemicals
*radiation
*tissue from a bystander

TYPES OF INJURY
* depends

33
Q

Overview of explosion-related injuries (plus systems effected)

A
  1. auditory (circulatory system)
  2. eye/orbit / face (CNS)
  3. respiratory (renal)
  4. digestive (extremity)