Name a few airbag injury patterns.
- abrasions to face, arms and hands
- burns to eyes and face
What are the MOI criteria for transfer to a Trauma Center?
- adult falls more than 20 feet or 3x height
- children fall >10 feet or <10 ft with LOC
- high-risk auto crash:
intrusion into passenger compartment and ejection from vehicle - high-risk injury
- pedestrian/bicyclist thrown
- burns with other trauma
- two or more long bone fractures
EMS provider judgment; When in doubt, transfer to a Trauma Center.
What are the special considerations in trauma patients?
- > 55 yrs old
- Systolic BP of < 110mmHg in age > 65yrs old
- Use of anticoagulants
- Pregnancy
- Burns with trauma
What is the importance of pain management in trauma patients?
Reduces the physiological stress response, minimizing a massive catecholamine dump.
Define:
Don Juan syndrome
When jumping down to the ground, energy is transferred to the heels, legs, pelvis, chest, T12-L1 and L2.
Fact: children younger than 3 years have fewer injuries from >3-story falls compared to older children and adults.
Define:
Newton’s First Law of Motion
A body at rest will remain at rest unless acted on by an outside force.
Define:
Newton’s Second Law of Motion
Force = mass x acceleration
F = ma
What are the five phases of deceleration?
Hint: during collision
- Vehicle decelerates
- Occupant decelerates
- Internal organs decelerate
- Secondary collisions
- Post-secondary collisions
List
Possible injury patterns of head-on/frontal impact.
- brain
- scalp
- tracheal
- sternal/rib fractures
- pneumo/hemothorax
- femoral fracture
- ruptured spleen, liver, bowel, diaphragm
- dislocated: knee, hip
- pericardial tamponade
- myocardial contusion
List
Possible injury patterns of side impact/lateral impact.
- fractures of the hip, clavicle, humerus, ribs, cervical spine
- lacerations
- contusions
- brain injury
List
Possible injury patterns of rear-end collision.
- whiplash
- deceleration injuries
- tearing inside the skull (diffuse axonal injury)
Define:
Waddell’s Triad
The order in which a pediatric is hit by a vehicle.
- Pelvis collides with the bumper.
- Chest and abdomen hit the hood/grill.
- Head hits the vehicle and then the ground.
Define:
penetrating trauma
When an object punctures the skin and tissues or organs.
What determines the severity of a stab wound?
- anatomical area
- depth
- length
- angle
True or false.
The most important factor in the severity of a gunshot wound (GSW) is the type of tissue the projectile passes through.
True
What do you need to check for with a gunshot wound (GSW)?
Hint: bullet travel
exit wound
What is a cavitation?
The pressure waves from a projectile push tissues laterally and in front of the projectile.
What are the five different effects of blast injuries?
- Primary - pressure wave
- Secondary - flying debris
- Tertiary - thrown into surrounding objects
- Quaternary - heat generated from the explosion
- Quinary - biologic, chemical, or radioactive contaminants
Fill in the blank:
If a blast injury occurs and there is rupture of the ______ membrane, maintain a high suspicion for other blast injuries.
tympanic
What three objective data is utilized to calculate the Revised Trauma Score?
RTS
- Systolic blood pressure;
- GCS;
- Respiratory rate
Which patient(s) meet criteria for transport to a Trauma Center?
- Adult that fell 15 feet
- Auto crash with ejection
- Patient with bilateral tibia/fibula fractures
- Auto crash with death in same passenger compartment
2, 3 and 4
Note: Adults who fall more than 20 feet qualify for transport to a Trauma Center.
What are the capabilities of a Level I Trauma Center?
- 24-hours in-house surgeons
- Specialty care (neuro, orthopedics, anesthesiology)
Capable of providing care for every possible injury.
What are the capabilities of a Level II Trauma Center?
- 24-hours immediate coverage of surgeons
- Tertiary care (cardiac, microvascular, hemodialysis)
Able to initiate definite care for all injuries.
What are the capabilities of a Level III Trauma Center?
- 24-hours coverage by emergency medicine physicians
- Developed transfer agreements to higher level of care
Provides prompt assessment, resuscitation, and stabilization of all injured patients.
