Mechanisms of Injury MASTER © BASICS Education March 2019
Read the wreckage Mentally reconstruct the mechanism(s) of injury i.e. Vectors Relative masses Restraints Safety systems
Sources of Information Scene Casualty Injuries Witnesses Wreckage
Kinetic Energy Transfer of energy through body tissue leads to damage to that tissue The amount of energy available (Kinetic energy) to cause injury is a factor of mass and velocity (speed) Kinetic Energy = ½Mass x Velocity2 Hence speed has a greater impact on Kinetic energy that mass
Energy transfer
The 3 impacts 1st impact The vehicle with the object 2nd impact The occupant with the inside of the vehicle 3rd impact The internal organs with each other and the body skeleton
RTCs Frontal Side impact Roll over Rear end shunt Each produce a different pattern of injury
Large & small vehicles No crumple zones Lower limb injuries ? Seatbelts Impact with Petrol tank - # pelvis Handlebars - # femurs Other vehicles Road - friction burns
Pedestrians and pedal cyclists Adults tend to turn away to protect themselves resulting in more posterior impacts Children tend to turn to face the oncoming vehicle A history from witnesses is useful to assess the extent of the impact.
Falls from heights Fall from more than twice the height of the casualty causes serious injury Injuries dependent on Type of surface fallen onto Posture of the casualty at time of impact Part of body impacting first
Penetrating trauma Stab wounds Gunshot wounds Bullet Shotgun pellets Other objects If object still imbedded in patient, do not remove
Firearms Compression, separation and cavitation of the tissues along the tract of the object Permanent and temporary cavities formed Damage depends on the amount of energy transferred Other factors: path / yaw / fragmentation / tumble
Blast & fragmentation injury Primary Blast wave injuries Flash burns Secondary Fragmentation injuries Tertiary Blunt trauma Structural collapse Quaternary Other injuries not related to the above mechanisms e.g. crush syndrome, flash burns
Mechanisms of injury Questions?
Summary Read the wreckage Think about energy transfer Maintain high index of suspicion Communicate all relevant information
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