Blunt Trauma

1、blunt trauma introduction to blunt trauma kinetics of blunt trauma types of trauma blunt trauma explosion other blunt trauma sections most common cause of trauma death and disability energy exchange between an object and the human body, without intrusion through the skin introduction to blunt trauma

2、 kinematics process of examining the scene to determine potential injuries that result from the forces of motion moi mechanism of injury description of the mechanical and physiological changes that result in anatomical or functional damage of tissue index of suspicion based on the moi and kinetics p

3、redict expected injuries kinetics of blunt trauma inertia “a body in motion will remain in motion unless acted upon by an outside force.” “a body at rest will remain at rest unless acted upon by an outside force.” conservation of energy “energy can neither be created nor destroyed. it is only change

4、d from one form to another.” kinetic versus potential energy kinetic energy energy in motion double weight = double energy double speed = quadruple energy speed is the greatest determinant kinetics of blunt trauma 2 )()( 2 speedvelocityweightmass ke force emphasizes the importance of rate at which a

5、n object changes speed (acceleration or deceleration) kinetics of blunt trauma onacceleratimassforce blunt closed injury indirect injury to underlying structures transmission of energy into the body tearing of muscle, vessels and bone rupture of solid organs organ injury ligamentum teres penetrating

6、 open injury direct injury to underlying structures types of trauma 44,000 people die each year on us highways events of impact vehicle collision body collision organ collision secondary collisions objects inside vehicle strike occupant additional injuries vehicle receives a second impact blunt trau

7、ma: automobile crashes inertia and mvcs restraints seatbelts occupant slows with the vehicle shoulder and lap belts must be worn together injuries if worn separately airbags (srs) reduce blunt chest trauma cause: hand, forearm, if lower density is adjacent to higher density surface tissue of denser

8、tissue is disrupted- “spalling” as wave transverses the walls of the alveoli (high density), they rupture as the wave encounters the air within the alveoli (low density); massive destruction of alveoli and diffuse hemorrhage in lung implosion pressure wave passes through the lung, it forces blood ou

9、t of the vascular space and into the alveoli wave of high pressure is followed by wave of low pressure allowing alveoli to expand rapidly with further tearing of the lung parenchyma, atelecasis, hemorrhage secondary injury results from flying debris created by the explosion and carried by blast wind

10、s injuries are typically severe and penetrating due to high ke of projectiles tertiary injuries blast winds are sufficient force to cause victims to become human missiles victim strikes the ground associated injuries injuries resulting from changes in the environment as a consequence of the explosio

11、n fire; burns combustion of toxic products; poisoning leaks of toxic chemicals; asphyxiation explosion pressure wave structural collapse blast wind burns projectiles personnel displacement blast injury phases primary: heat of the explosion secondary: trauma caused by projectiles tertiary: personnel

12、displacement and structural collapse blast injury assessment be alert for secondary device initial scene size-up important establish incident command system (ics) evaluate for secondary hazards injury patterns rupture of air or fluid filled organs lung: late manifestation (heat or agricultural great force to soft tissue and bones tissue stretching and compression extended pressure results in anaerobic metabolism distal to compression return of blood flow, toxins to entire body severe hemorrhage due to severe damaged blood vessels care prolonged crush medications sodium