1. Trauma

2. Trauma Leading cause of death for people under 40
Occurs as a result of physical forces applied to the body
Blunt forces
Penetrating forces

3. Mechanism of Injury
The way in which forces act on the body to to cause an injury
Kinetic energy- the energy of a moving object, and is the relationship of mass (weight) and velocity (speed)
Kinetic Energy = mass/2 x velocity2
If weight doubles energy doubles
If speed doubles energy quadruples

4. Mechanism of Injury
Knowledge of different types of MOI’s allow us to predict injuries
A high index of suspicion for multisystem trauma and unseen injuries in the following situations
Falls from heights
Motor vehicle and motorcycle crashes
Car vs pedestrian / bicycle / motorcycle
Gunshot wounds / stabbings

5. Blunt Trauma Vehicle collisions 3 impacts Vehicle strikes something
Passenger impacts interior of vehicle
Passengers organs impact solid structures in body

6. Vehicular Crashes Frontal Collisions Rear end Collisions
Deceleration injuries
Rear end Collisions
Whiplash injuries
Lateral Collisions (T Bone)
Rollover Crashes
Injuries unpredictable due to multiple impacts
Restained vs Unrestrained
Partial or full ejection

7. Vehicular Crashes Car vs Pedestrian Car vs Bicycle Car vs Motorcycle
Usually presents with graphic injuries but be alert for unseen injuries
Car vs Bicycle
Similar findings as pedestrian
May be wearing a helmet
Car vs Motorcycle
Lay down vs impact with larger object
Protective equipment (helmet, leather clothing)

8. Situations that indicate Trauma
Death of other vehicle occupant
Severe damage to the vehicle
Severe damage to front or rear
Moderate damage to laterally
Rotational or rollover
Patient with altered mental status
Ejection

9. Concerns with MVC’s Speed Safety equipment
Seat belts
SRS systems
Did safety systems deploy or were they used.

10. Falls How far did they fall
15 feet or 3 x persons height considered significant
What part of body impacted ground (head vs feet)
What was ground surface ( cement, grass)

11. Penetrating Trauma Low velocity/ knife or ice pick
Medium / High velocity
Hand gun
Rifle
Shot gun
Military weapons
Try to get as much info as possible about weapon for hospital.

12. Blast Injuries Primary blast injuries- pressure wave from blast
Disruption of blood vessels
Rupture of major organs (especially hollow organs)
Secondary blast injuries – injuries caused by being struck by flying debris
Tertiary blast injuries – occurs when persons body is thrown back
Miscellaneous injuries – burns, inhalation injuries

13. Multisystem Trauma Injuries to head Bleeding or bruising to the brain
Swelling in the brain causes pressure against skull
All signs may not be evident early in assessment conditions may deteriorate with time
Frequent reassessment is crucial

14. Multisystem Trauma Injuries to neck and throat
Life threatening injuries possible
Trachea
Major blood vessels
Cervical spine

15. Multisystem Trauma Injuries to chest Lungs Heart Great Vessels
Pneumothorax
Tension Pneumothorax
Heart
Contusion
Tamponade
Great Vessels
Rib Fractures

16. Multisystem Trauma Abdomen Solid organs Hollow Organs
Liver, Spleen, Pancreas, Kidneys
Hollow Organs
Stomach, Large and Small intestine, urinary bladder
Organs very vascular risk for internal bleeding high

17. Main Priorities of Trauma Care
Scene Safety/ appropriate resources
MOI / high degree of suspicion
Identify and manage life threats
Try to limit on scene time to 10 minutes “the platinum 10 minutes”
Give receiving facility a “heads up”
Transport considerations (ground vs air)
Secondary assessment and non life threat treatments enroute
Reassess every 5 min