Chapter 25: Trauma Overview

Key Concepts

• Understanding the basics of energy and its effects on the human body.
• General injury patterns from different types of impacts, falls, and penetrating trauma.
• Application of physics laws in trauma assessment.
• Critical thinking in predicting injuries and adjusting the index of suspicion based on scene analysis.
• Common injury patterns to major body systems.

Importance of Trauma

• Leading cause of death for people under 44 in the US.
• Trauma results from physical forces; distinct from medical emergencies.
• Evaluation of the mechanism of injury (MOI) is crucial for identifying potential serious injuries.
• Index of suspicion: awareness and concern for potential unseen serious injuries.

Energy and Trauma

• Types of Energy:
  • Potential Energy
  • Kinetic Energy
  • Energy of Work
• Energy cannot be created or destroyed, only transformed.
• Kinetic energy involves mass and velocity; potential energy involves mass, gravity, and height.

Mechanisms of Injury (MOI)

• Non-Significant MOI: Injury to an isolated body part or minor falls.
• Significant MOI:
  • Multi-system trauma
  • Falls from heights
  • Motor vehicle/motorcycle crashes
  • Pedestrian vs. car accidents
  • Gunshot wounds

Traumatic Injury Types

• Blunt Trauma: Force causes injury without penetration.
• Penetrating Trauma: Objects pierce the body, causing damage to internal structures.

Blunt Trauma Specifics

• Common in vehicle crashes and falls.
• Motor vehicle crashes involve three collisions: vehicle, body, and organs.
• Types of crashes include frontal, rear-end, lateral, rollover, and rotational.

Penetrating Trauma Specifics

• Low energy (e.g., knife wounds) and high/medium velocity (e.g., gunshot wounds).
• Important concepts: Cavitation, temporary and permanent cavitation injuries.

Blast Injuries

• Types of Blast Injuries:
  • Primary: From the blast wave.
  • Secondary: From flying debris.
  • Tertiary: From body displacement.
  • Quaternary: Other injuries from the explosion (e.g., burns, inhalation injuries).

Multi-System Trauma

• Involves multiple body systems, requiring rapid intervention and transport.

Pre-Hospital Trauma Care

• Ensure safety of self, crew, and patient.
• Manage life threats and maintain spinal protection.
• Transport rapidly to appropriate facilities.

Patient Assessment

• Focus on serious MOI and chief complaints.
• Address injuries to head, neck, throat, chest, and abdomen.

Transport and Hospitalization

• Decisions based on trauma center capabilities and distance.
• Consider air transport for remote or critically injured patients.

Quiz Review Highlights

• Kinetic energy relates to weight and speed.
• Non-intact windshield can indicate head injury in car crashes.
• Aortic rupture could result from high-speed frontal impacts.
• Steering wheel deformity linked to blunt chest trauma.
• Whiplash common in rear-end impacts; ejection in rollovers.
• Road drag in motorcycle ejections.
• Internal damage can exceed external appearances in stab wounds.
• Tertiary injury likely in building explosion scenarios.

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