Mechanism of Injury
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Questions and Answers

What is a common feature of a fracture?

  • Abnormal motion (correct)
  • Bone fusion
  • Bone elongation
  • Bone thickening
  • What is a crucial step in assessing a patient with a fracture?

  • Only assess the affected limb
  • Reexamine all extremities (correct)
  • Visually examine the patient's chest
  • Document only open injuries
  • What is the primary goal of immobilization in fracture management?

  • To promote bone growth
  • To restore bone function
  • To reduce pain
  • To include the joint above and below the fracture (correct)
  • What is a common cause of death in abdominal trauma?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of maxillofacial trauma?

    <p>It can cause airway obstruction and death</p> Signup and view all the answers

    Why is the incidence of maxillofacial trauma high despite safety laws?

    <p>The face is unprotected during rapid deceleration</p> Signup and view all the answers

    What should the nurse inspect for in maxillofacial trauma?

    <p>Symmetry of the face</p> Signup and view all the answers

    What is a critical aspect of managing maxillofacial trauma?

    <p>Establishing a patent airway</p> Signup and view all the answers

    What is the purpose of reviewing the injury history in fracture management?

    <p>To identify associated injuries</p> Signup and view all the answers

    What is a common type of fracture?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Mechanism of Injury

    • The mechanism of injury refers to the way damage to skin, muscles, organs, and bones occurs
    • Types of mechanisms of injury include blunt injury and penetrating injury

    Blunt Injury

    • Caused by a combination of forces, including acceleration, deceleration, shearing, and crushing
    • Examples of blunt injury include MVCs, falls, assaults, and contact sports

    Penetrating Injury

    • Caused by stab wounds and gunshot wounds, resulting in tissue damage by laceration and tearing

    Thoracic Trauma

    • Can range from simple to life-threatening, including simple abrasions, contusions, and insults to the thoracic viscera
    • Initial assessment and treatment of patients with thoracic trauma consists of primary and secondary surveys

    Primary Survey

    • First priority is evaluation and stabilization of airways, breathing, and circulation (ABC)

    Secondary Survey

    • Identification and management of eight potentially lethal injuries:
      • Simple pneumothorax
      • Hemothorax
      • Flail chest
      • Pulmonary contusion
      • Blunt cardiac injury
      • Traumatic aortic disruption
      • Traumatic diaphragmatic injury
      • Blunt esophageal rupture

    Simple Pneumothorax

    • Occurs when air enters between the visceral and parietal pleural spaces, often due to lung laceration with air leak

    Hemothorax

    • Blood accumulation in the pleural cavity, usually less than 1500ml, caused by injury to lung parenchyma, intercostal vessels, or chest wall vessels

    Flail Chest and Pulmonary Contusion

    • Flail chest: segment of the chest wall does not have bony continuity with the rest of the cage, requiring fracture of 2 or more adjacent ribs in 2 or more locations
    • Pulmonary contusion: bruising of the lung parenchyma, often caused by blunt trauma

    Blunt Cardiac Injury

    • Caused by direct sternal impact or rapid thoracic deceleration, resulting in myocardial muscle contusion, cardiac chamber rupture, coronary artery dissection, and/or thrombosis

    Traumatic Aortic Disruption

    • Common cause of sudden death after a vehicle collision or fall from a great height

    Traumatic Diaphragmatic Injury

    • More common on the left side, caused by blunt trauma, producing large radial tears that lead to herniation, while penetrating trauma produces small perforations

    Blunt Esophageal Rupture

    • Most commonly results from penetrating injury, producing a linear tear in the lower esophagus, allowing leakage into the mediastinum and resulting in mediastinitis and empyema

    Abdominal Trauma

    • Can be caused by both blunt and penetrating injuries, leading to hemorrhage, shock, and sepsis
    • Signs and symptoms may include acute abdomen, increased serum amylase levels, epigastric pain radiating to the back, nausea, and vomiting

    Musculoskeletal Injuries

    • Common in trauma, with delayed recognition and treatment leading to life-threatening hemorrhage or limb loss

    Primary Survey and Resuscitation

    • Airway (with cervical spine control)
    • Breathing
    • Circulation (with control of hemorrhage)
    • Disability (neurological condition)
    • Exposure (removing patient's clothes)

    Hemorrhage Control

    • Direct pressure
    • Splinting
    • Fluid resuscitation

    Assessment and Management of Bleeding

    • Assess body and extremities for external and internal bleeding
    • Check pulse, blood pressure, and skin temperature; pale, weak pulse indicates arterial injury
    • Pressure dressing and manual pressure on proximal artery
    • Manual tourniquet or pneumatic tourniquet

    Adjuncts: Fracture Immobilization

    • Method:
      • Traction → anatomical position
      • Splint
      • Check for dislocation
    • Goals:
      • Hemorrhage control
      • Pain relief
      • Prevent further soft-tissue injury

    Secondary Survey

    • History
    • Physical examination

    Physical Examination

    • Look:
      • Color of extremities
      • Perfusion
      • Wounds
      • Deformity
    • Feel:
      • Tenderness
      • Neurologic deficits
      • Pulses

    Circulatory Evaluation

    • Palpate distal pulses
    • Assess capillary refill
    • Doppler
    • Coolness and pallor

    Limb-Threatening Injuries

    • Open fractures and open joint injuries:
      • Result from communication between the external environment and the bone or joint
      • Risk of infection and delayed healing process

    Compartment Syndrome

    • Not specified

    Vascular Injuries

    • Affect arteries and veins of the limbs
    • Associated with blunt, crushing, twisting, or penetrating trauma
    • May appear viable due to collateral arteries or veins, but can cause cold, pale, and weak pulses

    Other Extremity Injuries

    • Contusion and laceration:
      • Lacerations require debridement and closure
      • Contusions recognized by pain, localized swelling, and tenderness
    • Fractures:
      • Defined as a break in the continuity of the bone cortex
      • May include abnormal motion, soft tissue injury, bone crepitus, and pain
      • Can be open or closed
      • Immobilization must include the joint above and below the fracture
      • Assess neurologic and vascular status of the extremity after splinting

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    Description

    This quiz covers the concept of mechanism of injury, including types of injuries such as blunt and penetrating injuries, and the forces that cause them. It is prepared by Mohammed Eid Alanazi.

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