Chapter 24-trauma Overview

Question 1

Trauma emergencies

Answer 1

Occur as a result of force applied to the body

Question 2

Medical emergencies

Answer 2

Include illnesses or conditions; not caused by an outside force

Question 3

Index of suspicion

Answer 3

Your awareness and concern for potentially underlying unseen injuries

Question 4

Mechanism of injury (MOI)

Answer 4

The way in which traumatic injuries occur, it describes the forces acting on the body that causes injury

Question 5

What are the three concepts of energy typically associated with injury? Not including thermal energy)

Answer 5

Potential energy, kinetic energy, and the energy of work

Question 6

Work

Answer 6

Force acting over a distance

Question 7

Kinetic energy

Answer 7

The energy of a moving object

Question 8

What is the kinetic energy formula

Answer 8

KE = 1/2 mass x velocity

Question 9

How to find the force of something

Answer 9

F= mass x velocity

Question 10

Potential energy

Answer 10

The product of mass, force of gravity, and height and is mostly associated with the energy of falling objects

Question 11

Mustisystem trauma

Answer 11

An injury to more than one body system

Question 12

Blunt trauma

Answer 12

The result of force to the body that causes injury without any penetrating of the soft tissues or internal organs of cavities

Question 13

What are the three collisions involved in a car crash

Answer 13

The first collision is a vehicle against another object, the second collision is the passenger against the interior of the car, the third collision is the passengers internal organs against the solid structures of the body

Question 14

Coup contrecoup brain injury

Answer 14

Compression injury to the anterior and posterior part of the brain

Question 15

Significant moi’s are suggested by what findings

Answer 15

• death of an occupant in the vehicle
• sever deformity of the vehicle or intrusion in the vehicle
• severe deformities to the frontal part of the vehicle, with or without intrusion
• moderate intrusion in lateral crash
• severe damage from the rear
• crashed in which rotation is involved
• ejecction from the vehicle

Question 16

What three Likely areas of injury can a significant MOI and condition of vehicle suggest

Answer 16

A. The knees can strike the dashboard, resulting in hip dislocation or fracture
B. Serious chest and abdominal injuries can occur from the steering wheel
C. Head and spinal injuries can occur from collision with the window

Question 17

What injuries do rear end crashes typically cause?

Answer 17

Whiplash

Question 18

What injury can happen from a lateral car crash? (T bone)

Answer 18

The passenger can get a lateral whiplash injury in the shoulders and the head moves towards intrusion

Question 19

Car vs pedestrian

Answer 19

Often results in broken bones, but may also have serious unseen injuries to underlying body systems.
Estimate speed of the vehicle, then whether the patient was ejected, the surface landed on, and what distance or if the patient was pulled under the vehicle
Multi system injuries are common

Question 20

Car vs bike

Answer 20

Examine position and damage of bicycle.

If Helmet is damaged, expect head/spinal trauma

Question 21

Car vs motorcycle

Answer 21

Make sure to undergo cervical spine checking

Examine the motorcycle, the distance of skid on the road, the car, and the helmet

Question 22

What are the four types of motorcycle impacts?

Answer 22

• head on crash
• angular crash; usually results in direct crushing injury between motorcycle and secondary force to the lower extremities
• ejection: can suffer from sever road rash to bone
• controlled crash: the biker lays the bike down to ultimately avoid injury

Question 23

How many feet of a fall is considered significant

Answer 23

20 feet

Question 24

What two things are considered a significant moi for a child

Answer 24

1. Falls of greater then 10 feet (2 to 3 times the height)

2. Medium to high speed vehicle crash (>25 mph)

Question 25

When a patient falls, what factor should you account for?

Answer 25

The height of the fall The type of surface struck The part of the body that hit first, followed by the path of energy displacement

Question 26

Trajectory

Answer 26

The path the projectile takes

Question 27

Cavitation

Answer 27

A phenomenon in which speed causes a bullet to generate pressure waves, which caused damage distance from the bullets path

Question 28

Drag

Answer 28

Air resistance

Question 29

What are signs and symptoms of blunt or penetrating trauma to the neck? What would the index of suspicion be?

Answer 29

``` Noisy or labored breathing Increased respiratory rate Swelling of the face or neck Altered gag reflex Decreasing/low Glasgow, scale Rapid weak pulse Decreasing/low blood pressure ``` IOS: * significant bleeding or foreign bodies in the upper or lower airway, causing obstruction * be alert for airway compromise

Question 30

What would the signs and symptoms be for significant chest wall blunt trauma from motor vehicle crashes, car versus pedestrian, and other crashes (as well as penetrating trauma) What would the IOS be?

Answer 30

``` Significant chest pain Shortness of breath Increased respiratory rate Asymmetric chest wall movement Subcutaneous emphysema Presence of JVD Rapid, weak pulse or decreasing/low blood pressure Loss of peripheral pulses during inspiration Narrowing pulse pressure's IOS: *cardiac or pulmonary contusions * pneumothorax or hemothorax * broken ribs, causing respiratory compromise ```

Question 31

Signs and symptoms of any significant blunt force trauma from motor vehicle crashes or penetrating injuries Along with index of suspicion

Answer 31

Blunt or penetrating trauma to the neck, chest, abdomen, or groin Blows to the head sustain doing motor vehicle crashes, falls, or other incidents, producing loss of consciousness, altered mental status, inability to recall events, combativeness, or changes in speech patterns Difficulty moving extremities, headache, especially with nausea and vomiting Rapid weak pulse, and decreasing/low blood pressure IOS: injuries in these regions may tear and cause damage to the large blood vessels located in these body areas, resulting in bad bleeding Be alert to the possibility of bruising to the brain and bleeding in and around the brain tissue

Question 32

Signs and symptoms and index of suspicion of any significant blunt or penetrating trauma from falls or a significant height

Answer 32

*Severe back and or neck pain, history of difficulty moving extremities, loss of sensation or tingling in extremities * decreasing GCS * rapid, weak pulse IOS: injury to the bones of the spinal column of the spinal cord

Question 33

Describe primary blast injuries

Answer 33

These injuries are due entirely to the blast itself: damage to the body happens by the pressure wave generated by the explosion

Question 34

Secondary blast injuries

Answer 34

Damage to the body results from being struck by flying debris such as shrapnel from the device or from glass or splinters which may have been set in motion by the explosion

Question 35

Tertiary blast injuries

Answer 35

These injuries occur when the patient is hurled by the force of the explosion against a stationary object

Question 36

Quaternary blast injuries

Answer 36

This category of miscellaneous injuries includes burns from hot gases, respiratory injury from healing toxic gases, suffocation, poisoning, medical emergencies incurred as a result of the explosion, crush injuries, contaminations of wounds

Question 37

Tim panic membrane

Answer 37

The eardrum, the thin membrane in the middle ear that transmit sound vibrations to the internal ear. This can be damaged in blast injuries and you can use it to help you triage patients

Question 38

Pulmonary blast injuries

Answer 38

Pulmonary trauma resulting from short range exposure to the destination of explosives The patient may report tightness or pain in the chest and may cough up blood and have tachapnia or other signs of respiratory distress. Subcutaneous emphysema can be detected over the chest through palpation

Question 39

Arterial air embolism

Answer 39

Air bubbles in the arterial blood vessels

Question 40

Level one trauma center

Answer 40

Original resource center in general he serves large cities are heavily populated areas. Level one facilities must be capable of providing every aspect of trauma care from prevention through rehabilitation

Question 41

Level two trauma facility

Answer 41

Typically located in less populated areas. Level two centers are expected to provide initial definitive care, regardless of injury severity. These facilities can be academic institutions or public/private community facilities.

Question 42

Level III trauma center

Answer 42

Able to provide prompt assessment, resuscitation, and stabilization of injured patients in emergency operations

Question 43

Level IV trauma center

Answer 43

Able to provide advanced , Life-support before transportations to a higher level trauma center

Question 44

Trauma score

Answer 44

Calculator number from 1 to 16. It takes into account the Glasgow coma scale score, respiratory rate, respiratory expansion, systolic blood pressure, and capillary refill

Question 45

Glasgow, scale: Eyeeye-opening, verbal, motor

Answer 45

``` Eye opening *spontaneous: 4 * Voice: 3 * pain stimulation: 2 *none: 1 VERBAL * oriented conversation: 5 * confused conversation: 4 * inappropriate words: 3 * incomprehensible sounds: 2 *none: 1 MOTOR: * obeys commands: 6 * localizes pain: 5 * with drawls from pain: 4 * abnormal flexion 3 Abnormal extension 2 None: 1 ```

Question 46

Revised trauma score

Answer 46

Commonly used for patients with head trauma because it's a weighted to compensate for major head injury without multi system injury or a major physiological changes

Question 47

Revised trauma score

Answer 47

GCS: 13-15. SBP. > 80 9MMHG. RR 29 bpm