WEEK 1

Question 1

INJURY

Answer 1

Occurs when an external source of energy dissipates more rapidly than the body’s ability to tolerate it.

Question 2

ENERGY SOURCES

Answer 2

Energy sources includes kinetic, chemical, electrical thermal and radiation sources

Question 3

NATURE OF INJURY

Answer 3

Causes of injury may be accidental or intentional (struck by an object, cut by a knife, falls, exposure to fire or toxic chemicals, suicide attempts)

Question 4

TRAUMA INJURIES (FOUR TYPES)

Answer 4

Suicide
Transport accidents
Falls
Assault

Question 5

INJURIES EARLY CHILDHOOD

Answer 5

Near-drowning & drowning major causes of injury & death

Question 6

INJURIES YOUNG ADULTHOOD

Answer 6

Self-harm & road crashes are primary causes of injury

Question 7

INJURIES ELDERLY

Answer 7

Falls are most common cause of injury or death

Question 8

VSS HEART RATE

Answer 8

80-100 BPM

Question 9

VSS RESPIRATORY RATE

Answer 9

12-20/ MIN

Question 10

VSS SP02

Answer 10

95%

Question 11

VSS TEMPERATURE

Answer 11

36.5 - 37.2 C

Question 12

VSS BLOOD PRESSURE

Answer 12

120/80

Question 13

VSS BLOOD GLUCOSE LEVELS

Answer 13

4 mmol/L - 8 mmol/L

Question 14

MECHANISM OF INJURY (MOI)

Answer 14

MOI is used to determine types of injuries and patterns of injuries in trauma patients and is useful for screening and assessing potential of occult injuries

Question 15

HIGH RISK MOI FACTORS

Answer 15

Ejected for vehicle 
Fall above 3m 
Explosions 
High impact RTC 
Vehicle rollover 
Entrapped for 30+ min

Question 16

BLUNT TRAUMA MOI (LIST 5)

Answer 16

Acceleration
Deceleration 
Compression  
Shearing
Direct force

Question 17

BLUNT TRAUMA MOI ACCELERATION

Answer 17

Occur when moving object strikes a stationary or slower moving body (i.e. blow from a blunt object)

Question 18

BLUNT TRAUMA MOI DECELERATION

Answer 18

Occur when moving body hits a solid or slower moving object (reverse of acceleration)

Question 19

BLUNT TRAUMA MOI COMPRESSION

Answer 19

Occur with a squeezing inward pressure applied to the tissues

Question 20

SHEARING

Answer 20

Shearing forces can cause organs (e.g. liver & heart) to pull away or fold around muscles & ligaments that secure them in position (internal bleeding)

Question 21

DIRECT FORCE

Answer 21

?

Question 22

FALLS MOI

Answer 22

Mechanism of injury is vertical deceleration

Severity and type of injury associated with distance or height of the fall, area of body impact, landing surface and whether the fall was broken on the way down.

Question 23

PENETRATING TRAUMA MOI

Answer 23

Injuries caused by a foreign object penetrating or entering the body

Penetrating object creates energy that dissipates into the surrounding tissue

Extent of damage dependant on object used, amount of force behind object, distance from the victim to the weapon, type of tissue penetrated

Question 24

BLASTS INJURIES MOI

Answer 24

Primary injuries → pressure waves

Secondary injuries → fragments and nearby debris in air

Tertiary injuries result from person being displaced either onto ground or objects

Resulting in = Avulsion, amputation, fractures, penetrating injuries, crush injuries, burns etc.

Question 25

INHALATION INJURIES MOI

Answer 25

Carbon monoxide poisoning, upper airway injury and lower airway injury May be result of CO poisoning, thermal injury and chemical damage Contributes significantly to early mortality following burn trauma

Question 26

MOTOR VEHICLE CRASH THREE PHASES MOI

Answer 26

1. Vehicle impacts with another object 2. Deceleration of occupant → compression, blunt, penetrating or shearing trauma 3. Internal structures continue to move until they collide with another internal structure, or vasculature, muscles or ligaments suddenly restrain them - Different damage occurs with each point of impact - Consider size of occupant – blunt force impact on a child will affect a greater surface area

Question 27

PATTERNS OF INJURY (POI)

Answer 27

POI data is gathered by thorough assessment of the patient. Energy transference and mechanism of impact need to be taken into account.

Question 28

TRAUMA EPIDEMIOLOGY

Answer 28

Trauma epidemiology allows for understanding of the clinical & public health problem ``` LOOKS AT: A specific group of people What injuries they have sustained How serious these injuries are How the injuries are being managed What could be changed in these circumstances to afford better patient outcomes ```

Question 29

STATE TRAUMA SYSTEMS

Answer 29

Works to have the right patient delivered to the right hospital in the shortest time Enhanced retrieval & transfer services Trauma triage & transfer protocols

Question 30

MAJOR TRAUMA SERVICE (MTS)

Answer 30

These hospitals are the designated adult and paediatric major trauma service for the State These are the highest level trauma facilities in the state They are the preferred destinations for a major trauma patient if within 45 minutes transport time.

Question 31

METROPOLITAN TRAUMA SERVICE (MeTS)

Answer 31

The preferred destinations for major trauma patients who are >45 minute transport window to a major trauma centre.

Question 32

RURAL/REGIONAL TRAUMA SERVICE

Answer 32

If the Major Trauma Service is > 45 minutes transport time then the patient should be to the highest level Regional Trauma Service.

Question 33

PRIMARY CARE SERVICES

Answer 33

If the nearest Regional Trauma Service is > 45 minutes transport time then the patient should be taken to the nearest Primary/Local hospital.

Question 34

HOSPITAL DESTINATION

Answer 34

Ambulance Operations Centre must be notified to ensure consideration for early secondary transport.

Question 35

PRE-HOSPITAL MANAGEMENT OF THE TRAUMA PATIENT

Answer 35

Paramedics play an important role in initial assessment, treatment and accessing the most appropriate ongoing care for the patient

Question 36

PRE-HOSPITAL HELP FOR PARAMEDICS

Answer 36

Ambulance operational resources (personnel, surface ambulance services) Clinical Coordination Centre/Retrieval Services Queensland Ambulance clinical resources (ICP/ACP/CCP/MICA/HARU/Dr) Community resources (first aid) Aero medical resources (air ambulance and retrieval services) Ancillary medical facilities (local facilities) Receiving hospitals (where is the appropriate definitive care)