If you fall down from a big height and land on your feet… regarding energy transfer, why does your back hurt and not just your feet? You didnt hit your back. Explain
The legs absorb much of the energy but that energy is transferred to the spine. The potential energy is converted into kinetic and that turns to work the work of bringing the body to stop
If you take a blunt force injury to the head… you have nausea/vomiting, dizziness, severe headache… What potentially lethal thing could be going on in a closed head causing these symptoms?
Bleeding and increased ICP.
What are the most common mechanism of injuries for blunt trauma
Vehicular crashes and falls
What is 3rd collision? What injuries are caused in 3rd collision
: It’s where the internal organs collide within the walls of the body cavity after the body stops moving and injury includes TBI
Review rapid trauma score. What would a GCS of 13, a systolic of 80, and RR of 8 have for an RTS
GCS = 4 SPB = 3 RR = 2 = 9
What are the symptoms of a serious pelvic fracture? What can you apply to treat hypovolemia in pelvic fractures that could save their life
Tachycardia, pelvic pain shock, it will give when you palpate , hypotension, leg rotation/length difference, bleeding
Use a pelvic binder to control the hemorrhage
: You bandage slow bleeding. It does not appear severe. But some bleeding is noted through the bandage after a while
Apply another dressing on top
If the spleen is injured in blunt trauma, it can cause referred pain to the left shoulder. What is referred pain and what presentation would you expect to find when assessing the abdomen of this serious internal spleen injury?
Referred pain is pain felt in a different place from the actual injury source.
When assessing the abdomen you might find pain/tenderness, guarding, rigidity, distention, and signs of shock
Is capillary bleeding serious bleeding? What does the book say. Do you need to treat capillary bleeding in the primary usually or would it be acceptable to treat other serious injuries and delay capillary bleeding until you are in the secondary assessment
It is not serious bleeding and you can treat in the secondary assessment
When tissue is injured, how does the blood respond to that area
Body responds with vasoconstriction, platelets stick together and then it clots
What is epistaxis and what are the concerns that epistaxis may cause
It is a nosebleed . Concerns = nausea/vomiting and airway compromise/aspiration - HPB
What are the rules of 9 for children with burns
Head = 12, each arm 9, anterior and posterior torso = 18 , each leg 16.5 , perineum 1
Energy related to Falls
: Potential energy = mass x force of gravity x height and mostly associated with the energy of falling objects
Blunt Head Trauma (What would happen
would happen?)
A: Could cause skull fracture, brain bleed, cerebral edema, increased ICP
Difference between Blunt trauma and Penetrating
: Blunt is the impact on the body , Penetrating injury caused by objects that pierce the surface of the body
First Collision, 2nd collision, ** 3rd Collision (HINT: what injuries occur in each
First = vehicle into another object, 2nd passenger against the interior of the car – lower extremity fractures like rib, head trauma, 3rd internal organs against the solid structure of the body = compression injury to the brain and tension injury of the posterior portion of the brain, aorta rupture
What would fix an open book pelvic fracture in the back of your ambulance
A pelvic binder for fractures and treat for shock
slow bleed vs serious bleed
slow bleed = direct presure, dressing, reassess and add dressing if needed
Serious Bleed – direct pressure, would packing, tourniquet when indicated , rapid transport
What two large organs cause the most internal bleeding in blunt abdominal trauma
Liver in RUP and Spleen LUQ
What type of injuries should you treat in the primary?? What traumatic injuries are life threatening?
Treat any life threatening traumatic like severe external bleeding first then airway obstruction, sucking chest would, shock, major head injury
Know the bleeding cascade. What happens to the blood and blood vessels @ the site of the injury and hemorrhage
vessels constrict – platelets form – cots forms
Know the rule of 9’s for pediatric burns
Baby = Head = 18, each arm 9, anterior and posterior torso = 18 , each leg 13.5 , perineum 1.
Read about impaled objects. Do we remove them typically? When would you remove it
No, we don’t remove them , remove only if it obstructs the airway, prevents CPR
palm method for amount of burned area
Palm = 1% TBSA
Use the patient’s hand to estimate the burn size
Example a If a burn is the size of 5 of their palms = 5% tbsa
