trauma

comminuted

bone is broke into more than two fragments

epiphyseal

fracture that occurs in growth section of a child's bone that may result in growth abnormalities

greenstick

incomplete fracture that passes only through the shaft of a bone; occurs in children

incomplete

fracture that doesn't run completely through the bone; nondisplaced patrial crack

oblique

broken at an angle across the bone

pathologic

fracture of weakened or diseased bone (ex. osteoporosis, infection, cancer)

spiral

fracture caused by twisting or spinning force; long, spiral shaped break in the bone

transverse

fracture straight across the bone

coup-contrecoup brain injury

a brain injury that occurs when force is applied to the head and energy transmission through brain tissue causes injury on the opposite side of original impact

traumatic aortic transection/rupture

sudden and rapid deceleration of the heart and aorta within the thoracic cavity, which may rupture the aorta and cause fatal bleeding

cavitation

when speed causes a bullet to generate pressure waves, which causes damage distant from the bullet's path; caused by rapid changes in tissue and fluid pressure that occur in tissue and fluid pressure with passage of the projectile

arterial air embolism

air bubbles in the arterial blood vessels; disturbances in vision, changes in behavior and state of consciousness, other neurologic signs; result of pulmonary blast injury

subarachnoid

beneath the arachnoid layer covering the brain

subdural

beneath the outermost covering of the brain

epidural hematoma

bleeding between the skull and dura mater (usually due to linear fracture of temporal bone

contusion

bruise; injury with bleeding below the skin but does not break it

hematoma

blood that has collected within damaged tissue or in a body cavity; when a blood vessel gets damaged and bleeds into surrounding tissues

crush syndrome

area of the body trapped for longer than 4 hours, compromising arterial blood flow; after removal there are harmful substances that secrete from the damaged area

compartment syndrome

edema and swelling result in increased pressure within a closed soft-tissue compartment; delivery of o2 and nutrients prevented

abrasion

wound of the superficial layer of skin, caused by friction; does not penetrate past dermis

laceration

jagged cut in the skin caused by a shap object or a blunt force that tears the tissue

avulsion

injury that seperates various layers of soft tissue

Commotio Cordis

trauma to chest when the heart is vulnerable, proceeds into ventricular fibrilation

RICES

for closed soft-tissue injuries: rest, ice, compression, elevation, splinting

air embolism

presence of air in veins due to open injury in neck, can lead to cardiac arrest if it enters the heart; cover with occlusive dressing

critical/severe burns

3rd degree 5% or more; 2nd degree 20% or more, and 10% of younger than 5, older than 50 yrs; 1st degree 75% or more

moderate burns

3rd degree less than 10%; 2nd degree 15-30%, 1st degree 50-75%

minor burns

3rd degree less than 2%; 2nd degree less than 15%; 1st degree less than 50%

thermal burn

caused by heat;

chemical burn

caused by a toxic substance becoming in contact with the body; remove chemical (dry brush than irrigate for 15-20 minutes)

electrical burn

have enterance + exit wounds; remove the source first! and may need to CPR

radiation burn

most gamma; first decontaminate by hazmat, then irrigate wounds and remove clothing sources

signs of hypoperfusion (head/face injury)

tachycardia; tachypnea; low blood pressure; weak pulse; cool, moist, pale skin

suspicion of spinal or brain injury

any significant blow to the face or throat

orbital fracture

indicated by one eye appearing to be lower than the other

closed head injury

brain has been injured but there is no opening to the brain

open head injury

an opening exists from the outside to the brain

raccoon eyes

bruising under the eyes; sign of skull fracture

battle sign

bruising behind one ear over the mastoid process; skull fracture sign

linear skull fracture

(nondisplaced) 80%; no deformities to skull, fracture

epistaxis

nosebleeds

depressed skull fracture

high-energy trauma to head, depression into head; bone fragmnts may be driven into brain

basilar skull fractures

from diffuse impact (falls, motor vehicle crashes); extenion of a linear fracture to the base of the skull;; signs are CSF drainage through ear, and raccoon eyes or battle sign

open skull fractures

severe force to head that may cause brain tissue to be exposed; high mortality and infection rate

primary injury

injury to brain and its associated structures

secondary injury

multitude of processes that increase the severity of primary brain injury; ex. caused by intracranial pressure, hypoxia, hypotension

motor vehicle damage of brain

compression injury (brusising) of anterior portion of the brain along with stretching or tearing of the posterior portion of the brain

signs of increased intracranial pressure

cheyene-stokes resirations, Biot (ataxic) respirations

biot respirations

irregular rate, pattern, and volume of breathing with intermittent periods of apnea

central neurogenic hyperventilation

abnormal breathing pattern associated with ICP that is characterized by deep rapid breathing

Cushing reflex

increased systolic blood pressure, decreased heart rate, irregular and decreased respirations (opposite of shock)

Subdural hematoma

accumulation of blood between the dura mater but outside of the brain; usually associated with strong deceleration forces; venous bleeding

intracerebral hematoma

bleeding in the brain tissue itself

subarachnoid hemorrhage

bleeding into subarachnoid space where CSF circulates; sudden severe headache

compression of spine

usually the result of a fall

three collisions

solid organs

bleeding concern; spleen, liver, pancreas, kidneys

hollow organs

worried about infection; stomach, gallbladder, duodenum, large intestine, small intestine, bladder

shearing injuries

can damage the aorta and vena cava

rib fractures

painful and can make breathing difficult; can lacerate blood vessels or lung tissue

flail chest

fracture of 2+ consecutive ribs in 2+ places, leaving a portion of the chest wall unstable; leads to inadequate breathing and hhypoventilation

paradoxical motion

movement of flail segment is opposite to movement of the remainder of the chest cavities

pneumothorax and tension pneumothorax

air accumulates in the chest cavity, possibly causing lung collapse; tension \= puts pressure on heart and vena cava

traumatic asphyxia

sudden compression of chest forcing blood out of organs and rupturing blood vessels; neck and face are darker than rest of body - may cause bulging eyes, distended neck veins, broken blood vessels in face; chest deformity

cardiac tamponade

direct injury to heart causing blood to flow into the pericardial sac; tough sac \= increased pressure on heart so chambers cannot fill, blood backs up into veins

cardiac tamponade symptoms

shock + narrowed pulse pressure, distended neck veins, JVD, muffled heart tones; very weak pulse, low BP, steadily decreasing pulse pressure

aortic injury symptoms

pain in chest, abdomen, or back; signs of shock; differences in blood pressure between arms

hemothorax symptoms

coughing up frothy-red blood