Introduction
- Importance of kinematics (2)
- Two physics laws
- Kinematics in trauma is like anamnesia in diseases-it allows us to estimate the extent of damage.
- Always rely on kinematic. Sometimes the least severe looking victims are the worst.
1) No energy is wasted.
2) m(kg)/2*v2(meter per second)=energy (joules)
Car Accident-Types of accidents and stereotypical trauma (4)
- Flip (all types possible)
- Head-on
- Upper path (head, neck, chest)
- Lower path (legs, hip) - Side
- Energy is higher (minimal shock absorption-all upper body at risk) - Back
- Whiplash (neck and spine)
Additional damage factors
3
1) Seatbelt
- Chest and stomach (check for bruising)
2)Loose objects
Unanchored objects in car (e.g. briefcase, mugs etc) can cause a lot of damage when thrown around.
3) Airbag
- If not seat belted, head and chest can be damaged.
- If airbag is too high, trauma victim can be suffocated.
Additional victims
- Motorcycle (2)
- Pedestrian (2)
Motorcycle
- Minimal protection
- Upper/Lower path, slide on side (leg damage)
Pedestrian
- Most dangerous (no protection)
- Adult vs Child
- Reaction
- Place of impact
- Path of projection
Types of injuries and causes
3
There are three types of injuries:
- Broken bones
- Torn muscle or internal organ
- Damaged blood vessels
There are three possible causes for trauma injuries: 1.Dull -Hard to diagnose and treat. 2.Penetrating -Easier to treat but not always diagnosable (e.g. bullets) 3.Blast wave -Unique kinematics
Blast wave kinematics
- Damage stages (4)
- Injuries
Damage stages:
1) Blast
2) Objects impact (rubble, shrapnel)
3) Impact into objects (floor, wall)
4) Inhalation if smoke or chemical gases
Injuries:
1) Ruptured organs and blood vessels, severed limbs, broken bones.
2) Penetrating injuries.
3) Dull injuries from impact on floor or wall.
4) Burns/asphyxiation.
Falling traumas
Factors:
- Hight (3 meters/ 3x hight of victim)
- Surface of impact
- Initial impact location (Adult-chest, Child-head)
- Obstructions in path of descent
Crush Injuries
- Pressure injuries and treatment (2)
- Important factors (3)
Injuries:
1)Compartment syndrome
(Pressure causes build up of blood within muscle membrane, loss of perfusion, muscle death)
5 P’s:
-Pain, Paralysis, Paresthesia, Pulselessness, Pallor
Treatment:
- Fixate hand level with heart (improve perfusion)
- Oxygen
2)Crush syndrome
(Pressure causes release of toxins (metabolic acidosis) and other molecules (myoglobin) that can kill a person very quickly if released into blood stream (acidosis, potassium) and also cause kidney failure (myoglobin))
Treatment:
- Before 15 minutes release pressure and treat
- After 15 minutes leave pressure and call ICU
Factors:
-Place,Time of pressure, Force of pressure
Shard Injuries
Important factors (3) Treatment (4)
Factors:
-Speed, Place, Amount
Treatment:
- Pay close attention to chest! (asherman if necessary)
- Expose entire body
- Fixate large projectiles (as in knife wounds)
- Do not remove shards!
