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

4. KE=(1/2)mv2
Law of Conservation of Energy
Stopping Distance

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

6. Five Major MOIs Blunt Injury Penetrating Injury Rotational Injury
Crush Injury
Blast Injury

7. Penetrating Injury
An injury that breaks the skin and damages underlying structures
High-Velocity Wounds: Object is moving faster than 2,000 ft/sec. ex: high-powered hunting rifles and military weapons
Low-Velocity Wounds: Object is moving slower than 2,000 ft/sec. ex: hand guns and stab wounds.

8. 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

9. Three Phases of Injury
Pre-Injury Phase: Events and Conditions leading up to the injury
Injury Phase: Period during which energy is transferred through a patients body
Index of Suspicion: When evaluating a patient who has sustained a trauma, the initial impression of what could be injured and how bad the injury is based on mechanism of injury

10. Post-Injury Phase Begins as soon as energy transfer is complete
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

11. 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