Trauma - Chapter 25

Nonsignificant MOI

Injury to an isolated body part

A fall without the loss of consciousness

Significant MOI

Injury to multiple body systems

Fall from heights + vehicle crashes + gunshot wounds + stabbings

Blunt Trauma

Force to the body that causes injury without penetrating soft tissues or internal organs

Be alert to skin discoloration and pain.

Motor vehicle crashes and falls are the most common MOIs.

Maintain a high index of suspicion for hidden injuries

Penetrating Trauma

Causes injury by objects that pierce the surface of the body and damage soft tissues and internal organs

Frontal Crashes

Evaluate the restraint system (seatbelt)

Injuries can occur if the seatbelt is worn improperly

Rear-end Crashes

Known to cause whiplash-type injuries (especially if there is not headrest)

Lateral Crashes

Suspect lateral chest and abdomen injuries on the side of impact

possible fractures of the lower extremities

organ damage from the third collision

Primary Blast Injuries

These are due entirely to the blast itself

Damage to the body is caused by the pressure wave generated by the explosion

Secondary Blast Injuries

Damage caused by flying debris from the blast

Tertiary blast injuries

The victim is hurled by the force of the explosion against a stationary object

Quaternary (miscellaneous) blast injuries

Burns from hot gases/fires started by the blast

Respiratory injury from inhaling toxic gases

Crush injury from collapse of buildings

Index of suspicion

Your awareness and concern for potentially serious underlying and unseen injuries.

mechanism of injury

The way traumatic injuries occur.

Describes the forces acting on the body that cause injury

Car vs Object Crash

Car against another car, tree, or object

By assessing the vehicle, you can often determine the MOI.

Passenger vs Inside of Car Crash

Passenger against the interior of the car

Common passenger injuries include lower extremity fractures, flail chest, and head trauma.

Organs vs Body crash

Passenger’s internal organs against solid structures of the body

Internal injuries may not be as obvious as external injuries but are often the most life threatening

Frontal Crash

Suspect injuries to extremities (second) and internal organs (third)

Supplemental restrain systems can cause harm such as the seatbelt/airbags

Rear-end crash

Known to cause whiplash-type injuries

Lateral Crashes

Very common cause of death associated with vehicle crashes

Lateral whiplash + chest + abdomen injuries + possible fractures of lower extremities, pelvis, and ribs

Organ damage from third collision

Rollover Crashes

Injuries depend on whether the passenger was restrained.

Most common life-threatening event is ejection or partial ejection of the passenger from the vehicle.

Rotational Crashes

Rotation of the vehicle provides opportunities for the vehicle to strike objects such as utility poles

Car vs Pedestrian

Injuries are often graphic and apparent + can also be serious unseen injuries

Should determine → speed of vehicle + whether patient was thrown + surface patient landed on + whether patient was pulled under the vehicle

Car vs Bicycle

Evaluate like you would for a car vs pedestrian collision → inspect helmet for damage

Assume that the patient has an injury to the spinal cord until proven otherwise