Trauma Summary - Chapter 27 Trauma Overview Mechanism of Injury(MOI how person was injured Kinetics of Trauma predict the kind and extent of injuries as

Trauma Summary - Chapter 27 Trauma Overview Mechanism of...

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Chapter 27: Trauma Overview - Mechanism of Injury (MOI) – how person was injured - Kinetics of Trauma – predict the kind and extent of injuries as a basis for your priority decisions regarding continuing assessment, care, and transport o Trauma nearly always the result of 2 or more bodies colliding with each other - Kinetics – branch of mechanics dealing with movements of bodies - Kinetic Energy – body in motion kinetic energy = mass X velocity X velocity / 2 - Law of Inertia – Body in motion will remain in motion unless outside force acts on it o The faster rate of deceleration exerts more force Impacts o Vehicle Collision – vehicle comes to a quick stop o Body Collision – patient comes to a quick stop because of part of the vehicle o Organ Collision – Organs come to a stop by hitting the inside of the body High Index of Suspicion o Death of another occupant o Unresponsive patient or Altered Mental Status o Intrusion of Greater that 12 inches for occupants site or 18 in any other part of the vehicle o Ejection from the vehicle – chances of death increases 25X - Frontal Impact – Unrestrained = Up & Over Direction (head, neck, chest, & abdomen) or Down & Under (knees, femurs, hips, acetabulum, & spine) o Head collision look for spider web on windshield o Paper bag syndrome results from compression of chest against the steering wheel - Rear-End Impact – neck hyperextends and anterior spinal ligaments stretched or torn = whiplash o Lateral – skull thinnest at temporal bone, vertebrae not supposed to bend laterally, clavicle broken - Rollover/Rotational – Multisystem injuries, ejection is common, crushing injuries common - Vehicle - Pedestrian – Child turns towards car and usually gets ran over by same car, adult turns away and most impact is on the side. - Seat Belts – too low = dislocated hips; too high = abdominal compression & spinal fracture - Air Bags – most prone to injury = old adults, short adults (< 5’2”), infants and children less than 12 y/o o SCIWORA – spinal cord injury without injury to vertebrae - Motorcycle – head on = ejection, angular = multisystem and amputation, Laying it down = abrasions - Falls – Adult severe = 20ft, child severe = 2 or 3 X height or 10ft o Feet First – spinal injury along with leg injuries, internal organs affected, silver fork/Colles is split in wrist on impact o Head First – hyperextended, hyper flexed, or compressed - Penetrating o Low Velocity – Knife o Medium-High Velocity – Bullets Trajectory – path or motion of projectile Dissipation of energy – way energy transferred to human body with force acting on it High Velocity/Medium Energy = small area of damage High Velocity/High Energy = large area of damage and exploded limb/shattered bone Drag = slow down; Profile = impact size; Cavitation = expansion from pressure; Fragmentation = bullet breaks up; Gunshot wounds = 90% to head, thorax, or abs - Blast – Primary = Pressure of wave; Secondary = flying debris; Tertiary = patient thrown - Multisystem Trauma – high incidence of morbidity and mortality - Golden Period
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