PHEC - Causes of Injury Flashcards
(19 cards)
Describe the timing of trauma death
INSTANANEOUS - These occur within seconds to minutes of injury and are due to damage to the brain, spinal cord, heart and major vessels.
EARLY - These extend from the first few minutes to a few hours. Examples include airway and respiratory compromise, continuing haemorrhage and head injuries. It is in this phase, often referred to as The Golden Hour of trauma management, that properly trained individuals can save many lives.
LATE - These occur from a few hours to days/ weeks after injury. The majority are due to sepsis with associated multi-organ failure. These are influenced by patient management in the early phase.
Causes of Injury
Blunt Trauma: RTC, falls, blast injuries, crush injuries
Penetrating trauma: high and low velocity: GSW, blast injuries, shrapnel, knife wounds
Climate: Heat and cold injuries
Chemical
Burns
Other medical issues
Examples of Medical Emergencies
Airway – Anaphylaxis
Breathing – Asthma
Cardiac – MI (heart attack), cardiac arrest.
Nervous – Convulsions
Vascular – Strokes / TIA’s
Diabetes
Tropical diseases
Appendicitis
Drowning
Types / Phases of Blast Injuries
Primary: The shock wave traversing the body will cause distortion, especially of air-containing organs (blast lung, gut and tympanic membranes). Most venerable to primary blast are the ears, lungs, CNS and gastrointestinal tract.
Secondary: Bomb fragments and other projectiles causing penetrating and blunt trauma to any part of the body. Obvious injuries include laceration and fracture. Some debris can cause penetrating trauma.
Tertiary: The blast wind causes displacement of the body and its constituent parts, as well as structural damage to surrounding buildings. The rapid deceleration caused when a casualty hits a stationary object after being thrown often causes more damage, resulting in fractures, traumatic amputation and crush injuries.
Quaternary: Flash burns and psychological / all other injuries
Vehicle Collision Types
Frontal (head on) impact (down and under or up and over)
Rear end impact
Lateral or side impact
Rotational impact
Rollover
Stages of Vehicle Impact
The vehicle collides with an object or another vehicle.
The occupant collides with the inside of the vehicle.
The occupant’s internal organs collide with each other or the wall of the cavity that contains them.
Effect of Chemical Injuries
The effects of chemical agents can broadly be divided into those that cause local damage, systemic toxicity or a combination of both.
Factors affecting injuries
caused by rounds:
Mass and velocity
Shape and stability
Tissue density
Length of wound track
Contamination
Range (distance fired from)
Effects of GSWs
Rounds enter the body causing crushing injury to the tissue.
The surrounding tissues, organs and structures are damaged due to the energy produced from the velocity.
May not always produce an exit wound
Fragmentation Injuries
Caused by, bombs, shells, grenades, other explosives
Each fragment crushes its own path through tissue leading to extensive damage.
Tissues weaken due to multiple fragment paths
Fragments often stay inside the body and can cause further damage every time a casualty is moved.
Factors affecting injuries caused by fragments:
Mass and velocity
Shape and stability
Tissue density
Length of wound track
Cavitations
Contamination
Effects of Crush Injuries
Occur when a crushing or compressive force is applied to the body
Overlying skin may remain intact
The degree of injury will depend on the amount of pressure applied and the time it is under pressure
Caused by – Entrapment from collapsed structures, vehicles or earth.
Often results in – Amputation, Cardiac arrest, fracture and Renal failure
Heat Illness Treatment
Move to cool environment
Spray or Lightly cover in TEPID water
Assess airway breathing and circulation
Cool the casualty
Fan
Strip Layers
Give fluids
Prevention is key. The key to preventing heat illness is the effective assessment and management of risk by commanders.
Heat Illness Definition
The term heat illness refers to spectrum of illness which includes heat exhaustion and heat stroke. Individuals who become incapacitated as a result of a rise in core body temperature due to environmental factors and / or physical exertion.
Heat Illness Symptoms
Collapse or LOC, Fitting or Seizures, Staggering / loss of coordination, Impaired judgement
Inappropriate or unusual behaviour, Anxiety/Agitation, Confusion, Pins and Needles, Headache, Weakness or fatigue, Nausea / vomiting, Disturbed vision, Thirst, Hyperventilation, Diarrhoea, Cramps / muscle spasms
Hypothermia Moderate Symptoms
Uncontrolled shivering, saying they feel cold, cold to touch, loss of dexterity, loss of insight, cold pale hands and feet, mild confusion, disorientation or irritability
Hypothermia Severe Symptoms
NOT shivering, reduced level of consciousness or unresponsive, confused, irrational or clumsy, slurred speech, slow irregular pulse, may appear dead
Hypothermia Treatment
Reduce environmental influences, warm drinks if able to drink, remove wet clothing, lie on insulated surface, cover with blankets, use re-warming kits as available, if unconscious move into recovery position and monitor, evacuate / refer on
Effects of Burns
Burn injuries are caused by contact between energy and living cells
The source of the energy may be thermal, chemical, electrical or radiation
High temperature combustion from modern explosives.
Specific types of weapons are designed to inflict burn injury, for example, flame-throwers and napalm munitions.
Secondary ignition of fuel and lubricants.
Inhalation of the toxic products of combustion.
