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Trauma is defined as:

a sudden, unexpected, dramatic, forceful or violent event. It is the leading cause of death in the U.S. for persons 1-44 years of age, excluding suicide and homicide related deaths.


The term "Trauma Center" signifies:

a specific level of emergency medical care as defined by the American College of Surgeons- Commission on Trauma.


Trauma centers are categorized:

into five levels of care: Level I-V. Level I is the most comprehensive. Level V is the most basic.


If you are severely injured, access to care at a Level I trauma center lowers your risk of death by:



The "Golden Hour":

the idea that trauma patients have significantly better survival rates if they reach a Level I or II Trauma Center within 60 minutes of their injury.


Less than __% of the U.S. population is within one-hour travel distance from a Level I or II Trauma center.



Level I Trauma Center:

usually a university based center, research facility, or large medical center. Complete imaging capabilities 24/7. All types of specialty physicians are available on site 24 hours a day.


Level II Trauma Center:

typically has all of the same specialized care available, but is not a research or teaching hospital; some specialty physicians may not be available on site.


Level III Trauma Center:

usually located in rural, smaller communities. Does not have the full availability of specialists, but does have resources for emergency resuscitation, surgery and intensive care of most trauma pts. Has transfer agreements with Level I and/or Level II trauma centers that provide back-up resources for the care of exceptionally severe injuries.


Level IV Trauma Center:

provides the stabilization and treatment of severely injured patients in remote or rural areas where no alternative care is available.


Several types of forces that cause trauma:

blunt, penetrating, explosive and heat.


Blunt trauma:

injury incurred when the human body hits or is hit by a large outside object (as a car); includes MVA's, which includes motorcycle accidents an collision with pedestrians; falls; and aggravated assaults.


Penetrating trauma:

GSW's, stab wounds, impalement, foreign body ingestion.


Explosive trauma:

Causes injury by several mechanisms, including pressure shock waves, and high velocity projectiles.


Burn trauma:

Burns may be caused by a number of agents including fire, steam and hot water, chemicals, electricity and frostbite.


Universal guidelines during trauma:

Standard Precautions
Attention to Detail Attention to department protocol and scope of practice.


Mobile radiography was first used by:

military for treating battlefield injuries during WWI. Small portable units were carried by soldiers and set up in field locations.


If patients cannot be moved into usual routine positions:

major adaptation of CR angles and image receptor placement is required.


Patients requiring mobile radiography are often:

immobile and among the most sick. Pts may be awake and lying-in bed in traction because of a broken limb, or they may be critically ill and unconscious.


Before entering a pt's room with the machine, the radiographer should follow several important steps:

Announce your presence to the nursing staff, and ask for assistance if needed.
Determine that the correct pt is in the room.
Introduce yourself to pt and family: explain the exam.
Remove obstacles from the path of the mobile machine.


Assessing the pt's condition:

Pt's level of alertness and respiration must be assessed and then determine the extent to which the pt is able to cooperate. Pts may have varying degrees of drowsiness because of their medications or medical conditions.


Keep pt's mobility in mind:

Never move a pt or part of the pt's body without assessing the pt's ability to move, or tolerate movement. Gentleness and caution must prevail! If unsure of pt's condition, check with nursing staff or physician.


The radiographer should never move a limb that has been operated on or is broken unless:

the nurse, the physician, or sometimes the pt grants permission. Inappropriate movement of the pt by the radiographer during the exam may harm the pt.


If the pt's trunk or limb must be raised into position for a projection, the radiographer should have:

assistance so the part can be raised safely without causing harm or intense pain.


IR's must be enclosed in an appropriate, impermeable barrier in any situation in which:

it may come in contact with blood, body fluids, and other potentially infectious material. Approved procedures for disposing of used barrier must be followed.


Principle one of Trauma and Mobile radiography:

Two projections 90º to on another, with true CR-part-IR alignment; may result in two oblique views.


Exceptions with CR-part-IR alignment:

Oblique radiograph of trauma cervical spine, the IR is flat not eh table. Results in some distortion of part.


Principle two of Trauma and Mobile radiography:

Include both joints for all long bones on one IR; include entire trauma area. Make sure divergent beam does not project body part off IR.


Important considerations during trauma exams:

-Time is a critical element.
-Radiographs must be taken with minimal patient movement, requiring more manuvering of the tube and IR.
-Images must b e of high-quality on the first attempt.
-Trauma radiographers must be competent in performing mobile radiography on almost any part of the body.


Exposure factor considerations during trauma/mobile

Use shortest exposure time to minimize motion. Adjust techniques for exposures through immobilization devices and/or pathology.