Chapter 12: Traumatic Disease

Trauma Level 1

Primary hospitals are this kind. Must treat 1200 admissions or 240 major trauma patients per year with a response time of 15 minutes from patient arrival. Total Care for All Injuries. 24-hour in-house coverage by general surgeons and prompt availability.

Leadership in continuing education for team members and research. Located in large metropolitan areas, they serve as both primary and tertiary care institutions.

Trauma Level 2

The most common trauma facilities are serving as community trauma centers. Can handle the majority of trauma cases and transport patients to level 1 when necessary. 24-hour immediate coverage by general surgeons. In smaller cities and towns, they provide a valuable service.

Trauma Level 3

Located in remote rural areas and serving communities that do not have a trauma 2 center. Demonstrated ability to provide prompt assessment and stabilize or resuscitate in emergency operations. The key component is 24 hr coverage by medical physicians with a 30 min response time. They have formal transfer agreements if they need more care at another center.

Trauma Level 4

ability to provide advanced trauma life support before transfer of individuals to a higher trauma center. Have basic emergency department facilities to implement ATLS protocols and 24 hr lab coverage. Transfer to other centers formal agreements.

Trauma leading cause of death in what age group

Injury is one of the leading causes of death. Trauma is third. Trauma is the leading cause of death in ages 1 and 44 years.

accounted for 31.8% of all deaths aged 1-9 in 2018. 40.6% of deaths were 10-24. 34.6% were 25-44 years old.

Compression Fracture

A fracture produced by compression. They are the most frequent type of injury involving a vertebral body.

Damage limited to the upper portion of the vertebral body, the anterior margin. Generally occur in T or L vertebrae. The most common sites are T11-T12 in the T spine and T12-L1 at the thorocolumbar juncture. Hangman fracture- fracture of the arch of C2. Sometimes called traumatic spondylosis.

Concussion

Brief loss of consciousness as a result of a blow to the head. 18% of high school brain injury deaths. Characterized by headache, vertigo, and vomiting.

Nonunion Fracture

The most serious complication is this. Refers to a fracture in which healing does not occur and the fragments do not join. Often seen in fractures of the scaphoid carpal bone. Lack of vascularization.

Open Fracture

A fracture in which the bone ends penetrate the soft tissue and skin, creating an opening to the exterior of the body. Leaves an open route for bacteria to enter. Lead to infection, or osteomyelitis.

Spiral/oblique Fracture

Complete, noncomminuted fracture.

Salter-Harris System

Growth plate fractures are classified according to severity and involvement of epiphysis. I is least severe and VI being most severe. Healed injuries of this may change the length of the bone.

Atelectasis

Loss of air in lung resulting from a partial or total collapse of a lung.

Pneumothorax

An accumulation of free air or gas in the pleural space that compresses the lung tissue. Penetrating chest trauma, such as stab wounds, gunshots, fractured ribs, etc. Occurs frequently in tall hyposthenic males.

Radiographically, it appears as a strip of radiolucency devoid of lung markings. A collapse of 30% or less is usually treated by bed rest and needle aspiration.

Shoulder Dislocation (luxation)

A bone is out of its joint and not in contact with its normal articulation. Most commonly dislocate anteriorly. Other than truama, seizure disorders and electric shock are the major causes of these. In fact, a posterior one may be a first sign of a seizure disorder.

Bennett’s Fracture

fracture and dislocation of the first carpometacarpal joint. Common in basketball players and skiers.

Boxer’s Fracture

when the fifth metacarpal (ocassionaly 4th) fractures as a result of a blow to or with the hand. It is the most common metacarpal fracture and may be immobilized with or without reduction, as it is difficult to maintain this reduction.

Colles Fracture

Fracture through the distal inch of the radius. An avulsion fracture of the ulnar styloid process occurs in more than half of all these. This is the MOST COMMON WRIST FRACTURE, and it usually results from falling on hand (FOOSH). The external sin contour looks like a “dinner fork.”the

Pott’s Fracture

a fracture affecting one or both of the malleoli, often caused by a traumatic stress on the ankle joint.

Coup lesion

A contusion formed on the side of the head where trauma occurs is called a

open

A fracture of the skeletal system in which the bone has penetrated the skin is termed

Fatique

Fractures that occur at sites of maximal strain on a bone, usually in connection with unaccustomed activity, are classified as _______fractures.

Malunion

A fracture that heals in a faulty position is termed a

Anteriorly

shoulder dislocations are most commonly displaced:

Avascular necrosis commonly affects the

Atelectasis

“Incomplete expansion of a lung as a result of partial or total collapse” describes

pneumoperitoneum

Penetrating chest trauma could lead to a

Erect PA position during expiration

Demonstration of a pneumothorax is best accomplished by making exposure with the person in the

Duodenum

Which portion of the GI system most frequently damaged by blunt trauma to the abdomen

pneumoperitoneum

The “football sign” generally indicates which pathology

CT

Which imaging modality is recommended by the ACR for demonstration of a cervical spinal injury?

shaken baby syndrome

severe type of physical abuse that affects childs ’s head and neck. Whiplash.