Trauma Exam

Trauma

A physical injury or wound caused by external force or violence; sudden, unexpected, dramatic, forceful or violent event

Trauma Center

A regional hospital capable of providing care for critically injured patients; surgical team is on-site on a 24-hour basis

Level 1 Trauma Center

Most comprehensive, multidisciplinary emergency medical care available, all staff available 24/7; university based, research facility or large medical center

Level 2 Trauma Center

Initiates resuscitation and stabilization for all patients, specialists may not be on available on site; not a research or teaching facility

Level 3 Trauma Center

ED staff immediately available to provide initial evaluation, medical/Surgical inpatient services available to patients who can be maintained without specialized care; transfer to higher level facility after stabilization

Level 4 Trauma Center

Small, located in rural areas; provides initial care and stabilization while arranging transfer to high level facility

Pediatric Trauma Centers

Level 1 and 2; highest level of care for pediatric patients with complex injuries

Contusion

A “bruise” type injury without a fracture or a break in the skin

Abrasion

Scraping away of skin or mucous membrane

Laceration

A cut or open wound in the flesh

Sprain

Forced wrenching or twisting of a joint resulting in partial rupture or tearing of supporting ligaments

Compound (open) Fracture

Broken bone breaks through the tissue

Closed (simple) Fracture

A fracture that causes little or no damage to surrounding tissue

Ecchymosis

Oozing of blood from a vessel into a tissue

Crepitus

“Grating” feeling/sound when limb is moved

What does a “halo” sign possibly mean?

Leakage of CSF

Tecnhique change for fiberglass cast or air splint

No change

Technique change for plaster cast

2x mAs

Trauma Alert

High level trauma; neurologic alterations, cardiac arrest, penetrating injuries, airway compromise, major burns, open fractures or amputations

Trauma Response

Low level trauma; Obvious injury at risk for hemorrhage, fall 2x the pt. height, motor vehicle run over, impact of >20mph, fatality in same vehicle, ejection from vehicle

Tier 3 Trauma

Low level mechanism trauma/ high risk of injury; focus on reducing diagnosis/high risk of injury

OR Hot Level

Physiologically unstable with immediate need for OR within minutes (ex. GSW, internal bleeding)

OR Warm Level

Physiologically transient response, requires other evals/ consultation (ex. compound fracture)

OR Cold Level

Physiologically stable, unlikely to require emergent OR

Anatomic Apposition

Alignment of fracture ends make end to end contact

Lack of Apposition

The ends of fracture fragments are aligned but do not make contact

Bayonet Apposition

Fracture fragments overlap, and the shafts make contact

Angulation

An angular deformity between the axes of the major fracture fragments and describes the position of the distal fragment with respect to the proximal one (abnormal bend/curve)

Subluxation

Incomplete or partial dislocation (most commonly within the vertebral column)

Epiphyseal Fracture

Growth plate fractures that occur in growing children and adolescents

Torus/ Buckle Fracture

Incomplete fractures of the shaft of a long bone that is characterized by bulging of the cortex (compaction)