Module 8 Review: Trauma and Injury

Introduction

• Instructor: Brian
• Purpose: Review of Module 8
• Technical Note: Camera muted due to connectivity issues

Mechanism of Injury

• Not an accurate indicator of injury severity
• Important to assess the overall patient condition
• Vehicle Conditions:
  • High index of suspicion if death of an occupant
  • Altered mental status
  • Intrusion over 12 inches on occupant side
  • Ejection from vehicle
  • Car seat found without a child may indicate ejection

Signs in Vehicle Collisions

• Altered mental status may indicate early brain injury
• Striking a fixed object at high speed can cause significant injury
• Seat belt marks indicate significant injury

Collision Dynamics

• Frontal Collision:
  • Up and over pathway: Head, neck, chest, abdomen
  • Down and under pathway: Knees, feet, femur, hips, spine
• Significant femur or pelvic fracture can result in substantial blood loss
• Rollover Collisions:
  • Complex pattern of injuries
  • Possible ejection

Penetrating Trauma

• Bullet Characteristics:
  • Drag: Factors slowing bullet down (e.g., clothing)
  • Profile: Impact point size
  • Cavitation: Tissue damage beyond bullet pathway
  • Fragmentation: Bullet breaks into pieces
• Entrance and exit wounds should be documented

Blast Injuries

• Primary Injury: Pressure effects on hollow organs
• Secondary Injury: Projectiles causing penetration
• Tertiary Injury: Blast wind causing impact with objects
• Quinary Injury: Exposure to chemicals/toxins

Scene Time and Transport

• Platinum 10 Minutes: Aim to get critically injured off the scene quickly
• Golden Hour: Surgery within 60 minutes
• Indicators for Rapid Transport:
  • Airway difficulties, respiratory arrest, brain injury, etc.

Types of Bleeding

• Arterial: Spurting, bright red
• Venous: Slow ooze, dark red
• Capillary: Slow, even flow
• Blood thinners increase risk of severe bleeding

Hemorrhagic Shock

• Symptoms: Anxiety, restlessness, pale cool skin, narrow pulse pressure
• Cycle: Blood volume loss → Decreased cardiac output → Compensatory mechanisms → Shock
• Avoid excessive IV fluids to prevent diluting clotting factors

Soft Tissue Injuries

• Contusion (Bruise): Blood vessel injury
• Hematoma: Larger blood vessel damage
• Crush Injury: Can lead to compartment syndrome

Open Wounds

• Abrasion: Superficial scraping
• Laceration: Varying depth cuts
• Avulsion: Torn tissue
• Amputation: Wrap in sterile dressing, keep cool but not frozen

Burns

• Superficial (First-Degree): Redness, no blisters
• Partial Thickness (Second-Degree): Painful, blisters
• Full Thickness (Third-Degree): Charred skin, no pain
• Rule of Nines: Estimation method for burn coverage

Skeletal System and Injuries

• Fractures:
  • Open: Breaks skin
  • Closed: Does not break skin
• Sprain vs. Strain:
  • Sprain: Joint ligament injury
  • Strain: Muscle or tendon injury

Spinal and Head Injuries

• Types of Skull Fractures:
  • Linear, depressed, open, basilar
• Brain Herniation: Downward pressure on brain stem, critical condition
• Pediatric Head Trauma: Vomiting, bradycardia, possibly linked to abuse (Shaken Baby Syndrome)

Conclusion

• Prepare for exam; contact lead instructor for questions.