1. Principles of Trauma

2. Objectives Define: Kinematics, Mechanism of Injury, Index of Suspicion
Compare and Contrast high and low velocity injuries
Compare and Contrast the 5 MOIs
Describe the role of a trauma center in improving the survival of a trauma patient
Describe the management of a trauma patient in outdoor or wilderness settings

3. Kinematics
The branch of mechanics that studies the movement of body segments without consideration given to its mass or the forces making it move
KE=(1/2)mv2

4. Mechanism of Injury
The Force that Produced the injury, its intensity and direction
Types of Force:
Direct
Twisting
Forced Flexion or Hyperextension
Indirect

5. What are the Final/Fabulous Five?

6. 1. Penetrating Injury
An injury that breaks the skin and damages underlying structures
High-Velocity Wounds: faster than 2,000 ft/sec.
Low-Velocity Wounds: slower than 2,000 ft/sec.

7. 2. Blunt Kinetic energy doesn’t break skin
Causes bruised tissue, internal
bleeding, broken bones, organ
damage

8. 3. Blast Injury Primary: Massive pressure wave striking the body
Secondary: Airborne objects that strike the body
Tertiary: Body is thrown into other objects
Quaternary: Other blast related factors
minute 1:25

9. 4. Rotational
Direction of kinetic energy through the body that is not compatible with normal range of motion

10. 5. Crush
Body part caught between two or more objects

11. Three Phases of Injury
1. Pre-Injury Phase: Events and Conditions leading up to the injury
2. Injury Phase: Period during which energy is transferred through a patients body
3. Post- injury Phase: when energy transfer complete

12. Post-Injury Phase Golden Hour: first hour
Three peaks when traumatic death generally occurs:
First seconds to minutes following a catastrophic injury
First minutes to an hour following a critical injury
Days to weeks following initial injury

13. Trauma Centers
Level I: 24 hour, in-house trauma surgeons as well as prompt availability of all major surgical subspecialties, anesthesia, etc. must have ongoing research and surgical residency program
Level II: Level I without research or residency
Level III: Trauma surgeon available, not every subspecialist
Level IV and V: Trained Trauma nurses and a physician available. Basic resuscitative measures