10901410
Description
Flashcards by Marissa Alvarez, updated more than 1 year ago
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Created by Marissa Alvarez
over 7 years ago
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| Question | Answer |
| Define MOI (Mechanism of Injury) | refers to how a person was injured |
| What is "kinetics of trauma" and what can it predict? | The kinetic of trauma: science of analyzing mechanisms of injury -It helps you predict the kind and extent of injuries as a basis for your priority decisions regarding continuing assessment, care, and transport. |
| Trauma is nearly always the result of what? | the result of two or more bodies colliding with one another (Except for blast injuries caused by pressure waves) |
| Define Kinetics | Kinetics: the branch of mechanics dealing with movements of bodies |
| Define kinetic energy: | Kinetic energy is the energy contained in a moving body or bodies -How severely a person is injured depends on the force with which they collide with something or something collides with them and this partly depends on the kinetic energy |
| What two factors does the amount of kinetic energy a moving body has depend on? | Mass (weight) and Velocity (speed) |
| Formula for how kinetic energy in a moving body is calculated: | kinetic energy = (mass x velocity^2) DIVIDED BY (2) As the mass of a moving object is doubled, the kinetic energy is also doubled. |
| Which is a more significant factor in kinetic energy? Mass or velocity? | Velocity As velocity is doubled, the kinetic energy is quadrupled (because velocity is squared). Knowing that a high-velocity collision or injury occurred will almost certainly have caused greater injury. Gun-shot injury has greater velocity than a knife injury for example. |
| The law of inertia states: (Sir Isaac Newton) | "A body at rest will remain at rest, and a body in motion will remain in motion, unless acts upon by an outside force." |
| Define acceleration | The rate at which a body in motion increases its speed |
| Define deceleration | The rate at which a body in motion decreases its speed |
| A faster change in speed (acceleration or deceleration) results in: | more force exerted EX: Two cars of the same weight moving at the same rate of speed have equal kinetic energy. If one car gradually braked to a stop and the other stopped by hitting a telephone pole, then more force was applied to the car who hit the telephone pole because there was a greater deceleration rate. |
| Energy Changes Form and Direction | Energy traveling thought the human body is frequently interrupted (by a curved bone, a organ, etc.) Energy is then forced to change form because it can no longer travel in a straight line. The result is either blunt or penetrating injury. |
| Impacts Vehicle collision | The vehicle is suddenly stopped and gets bent out of shape |
| Impacts Body Collision | the patient comes to a quick stop on some parts of the inside of the vehicle (i.e. steering wheel) causing injury to the chest for example |
| Impacts Organ Collision | The patient's internal organs, which are all suspended in their places by tissue, come to a quick stop sometimes striking an inside surface of the body. |
| The faster a vehicle is traveling the greater the ____ _____, and the higher rate of acceleration or deceleration, the greater the ____. The greater these factors and the greater number of impacts, the greater _____ for injury. | kinetic energy force potential |
| What are common mechanisms of injury? | vehicular collision (most lethal) falls (most common, not most lethal) penetrating gunshots or stabbings explosions |
| Motor Vehicle collisions You should have a high index of suspicion if: | -a vehicle collided at high speed -death of another occupant in the vehicle -an unresponsive patient to a patient with an altered mental status -intrusion of greater than 12 inches for the occupant site (where the patient was riding) or greater than 18 inches anywhere to the vehicle -Ejection from the motor vehicle (exposed to greater transfer of energy and chance of death increases by 25 times) |
| Motor Vehicle collisions Frontal Impact | the driver will continue to move forward at the same speed the vehicle is traveling Then the driver will either go up-and-over or down-and-under the steering wheel. Up-and-over pathway: injuries to the head, neck, chests and abdomen (if unrestrained, may be ejected/partially ejected from the vehicle) Down-and-under pathway: injuries to the knees, femurs, hips, acetabulum, and spine |
| A deformed steering wheel indicates possible ___ or ___ injury. | chest or abdominal |
| The heart suffers the effect of two forces: ____ and ____. _____ force occurs when the heart is caught between the sternum and the spine, which can bruise the heart muscle. The heart is suspended by the aorta, which is attached posteriorly at the arch by a ligament. ____ force tends to pull the aorta at the ligament, which may tear or transect the aorta. | compression and shear compression shear |
| The "paper bag" syndrome results from ____ of the ___ against the steering column. | compression, chest Air, trapped in the lungs by sudden closure of the epiglottis, is compressed b/w the ribs and spine. Air compressed inside the limited areas of a lung can bruise or rupture the lung. |
| Impact marks or cracking to the windshield, also know as "___-___" marks indicates possible ____ injury. | spider-web head |
| Motor Vehicle collisions Rear-End Impact | The patient's head and neck are immediately whipped back. The body is propelled forward by the seat, while the head and neck, following the law of inertia, tend to remain at rest. |
| If a vehicle does have headrest or they are improperly positioned, the neck is hyperextended and the anterior spinal ligaments are often stretched or torn. This if often referred to as a "_____" injury. Injuries to be expected include the initial __ injury followed by either the frontal __- and __ or __- and ___ injuries once the vehicle to a complete stop and the occupant jolts forward. | whiplash neck up and over down and under |
| Motor Vehicle collisions Lateral Impact Injuries may occur? | When a vehicle is struck laterally, or directly on the side, it can be crushed inward, impinging upon the occupants. Injuries may occur to the head, neck, abdomen, and pelvis. Head and neck: vertebral fractures common, more frequent muscle tears and ligament injuries Chest and Abdomen: clavicle fracture, fractured ribs, flail segments, liver/spleen damage Pelvis: fractures of pelvis and upper femur |
| Motor Vehicle collisions Rotational and Rollover Crash | During a rollover, the vehicle hits the ground multiple times and in various places. The occupant changes direction every time the vehicle does. Multiple systems injuries are common. Ejection is common if the occupant was not restrained. Crushing injuries to ejected occupants are common. |
| Vehicle - Pedestrian Collision | When a vehicle hits a pedestrian, the extent of injury depends on how fast the vehicle was going, what part of the pedestrian's body was hit, how far the pedestrian was thrown, the surface the pedestrian landed on, and the body part that first struck the ground. Children tend to have frontal impact injuries b/c they look toward the oncoming vehicle (combo of injuries to femur, chest, abdomen, and head). An adult is most commonly going to have lateral impact injuries because they turn away from the oncoming vehicle. -fractures ot tibia/fibula, injuries to the back, chest, shoulders, arms, and abdomen -could have serious head and neck injuries |
| Restraints: A Cause of Hidden Injuries | These include airbags and seat belts. Seat belt injuries can occur to eh upper chest and abdomen. If the seat belt is worn too high, it can cause abdominal compression and spinal fracture. If worn too low, it can dislocate the hips. Air bags are most effective when used with seat belts. Frontal and side airbags do not work well in multiple collision events nor in rear-end or roll-over collisions. Head, spine, eye, facial, and arm injuries are associated with air bag deployment (significant injury being 10 inches or less). |
| Motorcycle Collisions | Wearing a helmet makes a huge difference! (w/o helmet the incidence of severe head injury and death increases by 300%) These collisions can result in multi system trauma from multiple impacts to the rider. |
| Types of Motorcycle Collisions Head-on Impact | Motorcycle tends to tip forward causing the rider to travel into the handlebars at the same speed the bike was traveling. Results in variety of injuries |
| Types of Motorcycle Collisions Angular Impact | Usually strikes a protruding object at an angle that impacts whatever body part it comes into contact with, usually breaking or collapsing in on the rider Results in severe avulsion injuries or even traumatic amputations |
| Types of Motorcycle Collisions Ejection | Ejection occurs if the rider clears the handle bars Ejection continues until a body part impacts with the object of collision, the ground, or both Boots, leather clothing, and a helmet help to protect against soft tissue damage, commonly called "road rash" and against head and facial injuries. |
| "Laying the bike down" | This is an evasive action on the part of the rider, designed to prevent ejection and separation of the driver from the bike impending collision. Abrasions can range from superficial, involving only the epidermis, to full thickness abrasions, which extend through the subcutaneous tissue and, in severe cases, to the covering bone. |
| All-Terrain Vehicles | ATV's are very problematic since they are easily tipped over. These can cause collisions similar to motorcycle collisions. |
| Falls | Falls are most common MOI. The greater the distance of the fall, the more severe the injury b/c increased height increases the velocity of the impact. Fall of 20 feet for adult Fall more than 10 feet or 2-3 times the height of the child |
| Energy travels in a ____ line until it is forced to curve. | straight |
| Feet-first Falls | A feet-first landing causes energy to travel UP the skeletal system. Fractures of the heels or fractures or dislocations of the ankles are common. (could have fractures to pelvis, femurs, and hips) If knees flexed on impact, the knees will absorb most of the impact preserving the rest of the skeletal system. If energy remains, the spine will absorb the force at every curve at the lumbar, mid thoracic, and cervical spine. |
| Falls of more than 20 feet | The internal organs are likely to be injured from deceleration forces: the liver, spleen, kidney, aorta, and heart may be affected. |
| Extending arms to break the fall can result in a fracture of the wrist bones (first point of energy dissipation) known as a ____ or "____ ____". The next points of potential injury are the elbow and shoulder. | Colles silver fork If the body is thrown backward,, the most common injuries are to the head, back, and pelvis. |
| Head-First Falls | The pattern of injury begins with the arms and extends up into the shoulders. The head may be forcibly hyperextended, hyper-flexed, or compressed, all of which can cause extensive damage to the cervical spine. |
| Penetrating Injuries | This injuries are caused by an object that cab penetrate the surface of the body such as bullets, darts, nails,, and knives. The amount kinetic injury transferred to the tissue is the greatest indicator of potential damage. |
| Penetrating Injuries Low-Velocity Injuries | A knife or other object impaled in the body exerts damage to the immediate area of impact and its underlying structures. |
| Penetrating Injuries Medium- and High- velocity injuries Damage depends on two factors! | These are generally pellets and bullets. Medium: most shotguns and handguns High: high-power, high-speed rifles such as an M16 or 30-30 Winchester Damage depends on two factors: 1) Trajectory: is the path or motion of a projectile during its travel 2) Dissipation of energy: the way energy is transferred to the human body from the force acting upon it |
| Dissipation of energy is affected by 4 factors (in the case of Medium- and High- velocity projectile injuries) | 1) Drag: the factors that SLOW a bullet down, such as wind resistance 2) Profile: the impact point of the bullet is its profile (greater size of impact point = more energy transferred) 3) Cavitation: (pathway expansion) is the cavity in the body tissues formed by a pressure wave resulting from the kinetic energy of the bullet; the hole created in the tissue sis larger than the diameter of the bullet -explain why exit wound is always larger than entry wound 4) Fragmentation: A bullet that breaks up into small pieces or releases small pieces upon impact increases the body damage (increase frontal impact area) |
| Gunshot wounds Head | Fatal wounds: 90 percent involve the head, thorax, and abdomen Head: brain tissue is compressed, GSWs to the face immediately threaten the airway |
| Gunshot wounds Chest | Chest: Lung tissue is relatively tolerant of cavitation; Pneumothorax is a common result of injury to the chest and/or lung Suspect both thoracic and abdominal injury if the entrance wound is between the nipple line and the waist. If projectile strikes diaphragm during: Exhalation: more likely to enter below the diaphragm Inhalation: more likely to enter above the diaphragm |
| Gunshot wounds Abdomen | The abdomen is often secondarily injured when the chest is injured. The air-filled and fluid-filled structures are more tolerant of cavitation than are solid organs. |
| Gunshot wounds Extremities | The extremities contain bone, muscle, blood vessels, and nerves. Circulation and motor and sensory function to the extremity may be severely or totally compromised. |
| Blast Injuries | An explosion releases tremendous amounts of heat energy, generating a pressure wave, blast winds and projection of of debris. Regardless of the cause, every explosion has three phases: primary, secondary, and tertiary. |
| Blast Injuries Primary phase injuries | are due to the pressure wave of the blast primarily affect the gas containing organs such as the lungs, stomach, intestines, inner ears, and sinuses May not be obvious externally |
| Blast Injuries Secondary phase injuries | are due to flying debris propelled by the force of the blast or blast wind these injuries are obvious most common are lacerations, impaled objects, fractures, and burns |
| Blast Injuries Tertiary phase injuries | occur when the patient is thrown away from the source of the blast injuries are the same as would be expected from ejection from a vehicle |
| The Multi-system Trauma Patient | ~90% of trauma patients have simple or single injury that involves only one body system A multisystem trauma patient has multiple injuries or involvement of more than one body system. Multiple organ injuries are considered to be multi system trauma, even though they may be part of the same body system. Carries a high incidence of morbidity and mortality |
| The Golden Period "Platinum 10 minutes" | This has been established as a parameter for emergency care because severely injured patients have the best chance of survival if intervention takes place as quickly as possible from the time of injury. The golden period is variable depending on the patient injury. The platinum ten minutes: this means that in cases of severe trauma 10 minutes is the maximum time the EMS team should devote to on-scene activities |
| High Index of Suspicion | a presumption that a patient has severe injuries if there is ANY indication at all that this is possible, which is often based on findings at the scene as to the MOI and the amount of force that may have been delivered In instances of trauma, you must evaluate and rely on the patient's assessment findings and indicators of critical injuries or instability as well as the mechanism of injury in your priority decision. |
| The Trauma System Level I | Regional Trauma Center Can manage all types of trauma 24/7 |
| The Trauma System Level II | Area Trauma Center can manage most trauma 24/7 -capable of stabilizing the trauma patient and then transferring to a higher-level center |
| The Trauma System Level III | Community Trauma Center Focuses on stabilizing the patient and then transfers to higher level center |
| The Trauma System Level IV | Trauma Facility typically small community hospital in a remote area cable of stabilizing patient and then transferring to higher-level center |
| The Golden Principles of Prehospital Trauma Care | These apply to all patients who have experienced some type of injury but especially to those with multi-system trauma or cortical injuries. |
| Special Considerations in Trauma care | 1) Your personal safety is of utmost importance when arriving on scene and throughout the entire time you are with the patient 2) Airway management and adequate ventilation and oxygenation are key elements in managing the trauma patient 3) Stop significant bleeding 4) Assessment of the trauma patient is conducted in a sequence that promotes a systematic approach tot he patient 5) Rapid transport of severely injured patient is essential to his survival 6) A backboard can serve to secure suspected fractures in an unstable patient who requires rapid transport 7) Do not develop tunnel vision and become focused on dramatic injuries or dramatic patients |
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